Healthy Lifesmiles
Development of an Oral Health Promotion training
programme for nurses and carers of older people in
Co. Meath
Mary O’Farrell, Carmel Parnell, HSE Dublin North East
Background
Increasing aging dentate population
Numbers aged 65+
Thousands
500
450
468
414
436
400
350
300
250
age 65 and over
200
150
100
50
0
1996
2002
2006
www.cso.ie
Numbers aged 65+ and 80+
Thousands
500
450
468
414
436
400
350
300
250
age 65 and over
200
age 80 and over
150
100
50
90
101
113
0
1996
2002
2006
www.cso.ie
Age 80+ as a proportion of age 65+
Thousands
500
450
468
436
414
400
350
300
250
age 65 and over
200
age 80 and over
150
100
50
90
22%
101
23%
113
24%
0
1996
2002
2006
www.cso.ie
% dentate aged 65+
70
59
60
52
50
40
30
% dentate age 65
28
20
10
0
1979
1989/90
2000/02
Whelton et al., 2007
Background
Oral health of older
people in residential care
is poor
Training of carers essential
North East Healthy Aging
(2002) recognised need
for oral health care for
older people in residential
care
Background
St Joseph’s Hospital,
Trim, Co. Meath
Residential and Day
Care Unit
Pilot oral health needs
assessment, 2004
Pilot study
254 older people examined
o 104 residents, 150 Day Care users
Poorer oral health status among residents
o Fewer teeth but more decay
o No dentures
High need for denture treatment for both groups
Pilot study
Questionnaire to staff (n=54: 66% response rate)
o Most were involved in oral health care
o 1 in 5 had received training in oral health care
o 98% interested in receiving training in oral health
care for older people
o Low staff turnover
Development of Programme
2007: Pilot oral health
programme developed
in partnership with:
o HSE Meath Dental
Services
o HSE Meath Oral Health
Promoter
o HSE Management
o St Joseph’s Director of
Nursing, senior nursing
and health promotion
staff
Aim
Improve the skills of hospital staff in providing oral
health care for residents
Objectives
Develop Model of Good Practice
o Establish ethos and standards for oral health
Develop structured training programme for nurses
and carers
o OHP resource pack
o OH aids
Provide denture marking
Evaluate training programme
Model of Good Practice
“These Oral Health Standards are
driven by a respect for the rights of
older people and the principle that
older people in residential care
settings should be able to lead full
lives that reflect, as far as possible,
the lives they led prior to admission
into what will be their home - the
residential care setting.
Consequently, the standards
promote a person-centred ethos and
culture that should govern the
provision of residential care for older
people.”
Summary of Standards
1.
2.
3.
4.
5.
6.
7.
8.
Oral health assessment on admission
Denture labelling with the owner’s consent
Suitable facilities for on-site dental treatment
Arrangements for emergency and routine dental care
for residents
Suitable environment in which residents are able to
maintain their oral health
Structured Training for Nursing and Care staff in oral
health care for residents
Introduction of a healthy eating policy
Regular ongoing oral care from nursing, care and public
dental service staff for residents with dementia
Training Programme
Interactive workshops
90 nurses and carers
Healthy Lifesmiles
Resource pack for staff
o
o
o
o
o
Information pack
Tutor’s guide
12 Information cards
Guide to oral hygiene aids
CD
Oral Health packs
Evaluation
Pre and post training questionnaires to workshop
participants
o Highlighted low awareness of oral health care
prior to training
Staff very positive about training programme
Evaluation
“We are very tuned in now to what food we
are giving the patients and tuned in to why
patients may be having problems. We are
bringing them regularly to the dentist and
we are carrying out all the oral
assessments”
Evaluation
Appreciation of oral health in context of general
health
“…the dietician visits the wards every week,
so I don’t see it any different that the dentist
should visit the ward, and that would help
the transition from education for us”
“ So, it (poor oral health) really does impact
on them. And the pork chop is gone, and the
dinner is gone to custard, you know.”
Ways forward
New oral health policy for older people
Dissemination
Ongoing evaluation
Acknowledgements
The Team:
Mary Carr
Dorothy Halpin
Rosarii Mc Cafferty
Mairin Mc Inerney
Liz O’Reilly
Rita O’Toole
Declan Quinn
Staff and clients of St Joseph’s hospital, Trim