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Project Objectives

Objective 1 – To document internal and external factors related to the provision of oral care and oral disease prevention for older adults in four rural continuing care settings.

Objective 2 – To work with care providers and other stakeholders in each of the 4 settings to design a set of actions to integrate oral care into organizational policy and practices.

Objective 3 – To implement an oral care action strategy in each facility and to explore experiences of the health care team and relevant stakeholders.

Objective 4 – To evaluate the process, outcomes and changes associated with the action plan, and to recommend revisions to organizational policies and practices based on evaluation findings.

Principal Investigator:

Dr. Mary McNally

Term of Project:

July 2008 – December 2011

Project Location:

The Eastern Shore of NS:
Middle Musquodoboit NS, Musquodoboit Harbour NS, Sheet Harbour NS and Halifax NS

For more information please contact:

Karen McNeil,
Project Coordinator
(902) 494-3094
karen.mcneil@dal.ca

Funded by:

Partners:

• The Eastern Shore Tri-Facilities of Capital Health
  - Duncan MacMillan Nursing Home
  - The Birches Continuing Care Centre
  - Braeside Nursing Home
  - Eastern Shore Memorial Hospital
• The Nova Scotia Community College,
• Continuing Care Branch - Nova Scotia Department of Health,
• Nova Scotia Department of Seniors
• Nova Scotia Group of IX Seniors
• The Health Association of Nova Scotia

What's New - Project Updates

Dec 16, 2009

An "Oral Care Action Planning Workshop" was held on October 30th, 2009. The purpose of this workshop was to present the initial findings from the NSHRF funded "Oral Care in Continuing Care Settings: Collaborating to Improve Policies & Practices" project and to develop a set of actions for the next phase of the project.

The day was greatly enriched by the diverse group of participants and representatives who attended. It was especially informative to have care-providers from the Capital District Health Authority Tri-Facilities in attendance to share their knowledge about key areas of interest and need. Dr. Chris Wyatt also provided a wealth of knowledge related to geriatric oral health care and delivery of oral care services when he shared his experiences with the UBC ELDERS program.

PHOTO GALLERY
October 30, 2009

Oral Care Action Planning Workshop

View the gallery »

Why are we doing this research?

To date, research focusing on the introduction of daily mouth care programs for dependent older adults in long-term care has met with limited success. Many studies demonstrate that there is need for greater awareness about the importance of oral health, more education for those providing oral care, and organizational structures that provide policy and administrative support to ensure that daily mouth care is an integral part of overall personal care.

Why is this research important?

Although health care systems are concerned with a broad range of factors and services that affect the health of Canadians, oral health care has historically been absent from health care discussions. Canadians are living longer than previous generations and are also aging with a greater percentage of natural teeth. This results in new patterns of disease and greater challenges for providing care to dependent older adults.

Approximately one-third of Canadians over the age of 80 live in some form of long-term care residence. Mouth care is an integral part of daily personal care. However, it is also known that mouth care is often inadequate for those who depend on others to carry out tasks of daily living. Oral health has been given low priority in long- term care. Oral health and oral hygiene status amongst dependent older adults is poor. This places them at risk for oral diseases and dysfunction, and greatly impacts quality of life.

Why is oral health status in long term care a concern?

1. Residents enter long term care with poor oral health
   Failing oral health may be an indicator of increasing frailty. Often, oral health will decline dramatically when seniors living at home become less able to attend to their own personal care needs.
2. The prevalence of dementia is increasing
   Residents with dementia are often resistant to receiving oral care. Also, as communication skills decrease residents are less able to communicate when they have oral pain or discomfort.
3. There is a limited amount of time for mouth care
   Given the repulsion factor associated with providing oral care and the fact that oral health problems are often hidden from plain view, an 'out-of-sight, out-of-mind' attitude often bumps oral care to the bottom of the priority.

A Collaborative Effort

A key feature of this research is the attention that is being placed on ensuring that the research is relevant to end-users. Early in the research, the community partners identified relevant desired outputs from the research that would support the incorporation of a formalized and sustainable process for integrating oral care into their continuing care settings.

These outputs included: training and education; orientation on mouth care for frontline staff; development of an "oral health care" toolkit for residents; and evidence based recommendations for policy within the organization.

These products are being developed as part of the research process. Engagement of specific stakeholders and end-users throughout all phases of the project ensures that know-ledge generation, synthesis and exchange is an embedded and continuous process.

Team List

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