Promoting oral health care among people living in residential aged care facilities: Perceptions of care staff

Gerodontology ◽  
2018 ◽  
Vol 35 (3) ◽  
pp. 177-184 ◽  
Author(s):  
Amy R. Villarosa ◽  
Sally Clark ◽  
Ariana C. Villarosa ◽  
Tiffany Patterson Norrie ◽  
Susan Macdonald ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Oral Health Care ◽  
Aged Care ◽  
Care Staff ◽  
Residential Aged Care ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Perceptions Of Care

Enhancing palliative care in rural Australia: the residential aged care setting

2011 ◽  
Vol 17 (1) ◽  
pp. 95 ◽  
Author(s):  
Geoffrey Mitchell ◽  
Caroline Nicholson ◽  
Keith McDonald ◽  
Anne Bucetti
Keyword(s):  
Palliative Care ◽  
End Of Life Care ◽  
Aged Care ◽  
Care Staff ◽  
Residential Aged Care ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Advance Care

The delivery of palliative care in residential aged care communities is challenging, even more so in rural areas due to workforce ageing and shortages. The objectives of the present study were to: (i) assess the needs of, and quality of palliative care delivered to residents of 16 residential aged care facilities in rural southern Australia; and (ii) identify the needs of care staff to facilitate the delivery of quality palliative care. A cross-sectional survey of all residents, assessing the degree of functional limitation, stage of palliative care, and the presence of several quality indicators was conducted. Separate focus groups of care staff and relatives of residents sought information on the quality of care delivered, perceived strengths and weaknesses of the care delivered, and education and training needs. Quality palliative care in residential aged care facilities (RACFs) is hampered by workforce shortages, with low ratios of registered nurses, limited access to general practitioners after hours, and some communication difficulties. Some staff reported low confidence in technical and psychosocial aspects of care, especially for relatives. Relatives described mostly appropriate care, while acknowledging workload constraints. Most residents whose condition was unstable, deteriorating or terminal received advance care planning, though family expectations and unwillingness to discuss end-of-life care did tend to delay planning. Unstable residents with a reasonable prognosis were more likely to be transferred to hospital than terminally ill residents. Palliative care in participating RACFs appears to be adequate. Provision of targeted education for health care providers and implementation of protocols for advance care planning and end-of life care pathways will enhance this care.

scholarly journals DOMICILIARY SERVICES IMPROVE ACCESS TO DENTAL CARE FOR FUNCTIONALLY DEPENDENT OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S492-S492
Author(s):  
Mathew A Lim ◽  
Gelsomina L Borromeo
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Oral Health ◽  
Aged Care ◽  
Residential Aged Care ◽  
Care Needs ◽  
Dental Services ◽  
Unique Challenge ◽  
Care Facilities ◽  
Aged Care Facilities

Abstract There is growing evidence demonstrating links between oral diseases and general health. The increased retention of teeth among functionally-dependent older adults presents a unique challenge in maintaining the oral health of these individuals from basic oral hygiene to accessing dental services. The results of our cross-sectional study demonstrate the important role domiciliary dental services play in reducing the barriers to accessing oral health care in this cohort. In our study, most individuals treated by domiciliary services lived in residential aged care facilities and were significantly older than those treated by hospital and community-based dental services dedicated to the specialized care of individuals with additional health care needs. A significantly higher number of those receiving domiciliary care were unable to self-consent for treatment compared to those managed in other settings. 27.4% of these patients had a diagnosis of dementia. More than half (56.9%) of patients treated by domiciliary services received some form of treatment with almost half (48.1%) of these requiring a dental extraction. Only two of these patients were not diagnosed with a chronic condition known to affect oral health (dementia, Parkinson’s disease, diabetes mellitus, arthritis, stroke, osteoporosis). 23.7% of domiciliary appointments were used for denture fabrication. The results depict the worrying level of unmet treatment need in residents of aged care facilities. However, they also demonstrate the potential for domiciliary dental services to play a role in developing partnerships between carers and oral health professionals to improve the oral health of functionally-dependent older adults.

Challenges faced by residential aged care staff in decision-making for residents with dementia

Dementia ◽  
2020 ◽  
pp. 147130122092915
Author(s):  
Nadine Cameron ◽  
Deirdre Fetherstonhaugh ◽  
Michael Bauer
Keyword(s):  
Decision Making ◽  
Aged Care ◽  
Self Determination ◽  
Care Staff ◽  
Residential Aged Care ◽  
Organisational Support ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
National Framework

Care staff in residential aged care facilities (nursing homes) in Australia are obligated, under the Australian National Framework for Action on Dementia 2015–2019, to support residents to exercise choice and make decisions. Research indicates, however, that care staff are often given little guidance regarding which residents’ decisions should be supported or how to make decisions on their behalf. This lack of guidance can result in a denial of residents’ rights and inconsistent treatment by staff, placing residents’ wellbeing at risk. Through providing an analysis of the responses of staff at RACFs in Victoria and Queensland to two case scenarios, this study seeks to provide some understanding of the difficulties staff face in supporting residents’ self-determination and their own need for greater organisational support.

Engaging dental professionals in residential aged-care facilities: staff perspectives regarding access to oral care

2016 ◽  
Vol 22 (5) ◽  
pp. 445 ◽  
Author(s):  
Lydia Hearn ◽  
Linda Slack-Smith
Keyword(s):  
Oral Health ◽  
Oral Care ◽  
Aged Care ◽  
Residential Aged Care ◽  
Structured Interviews ◽  
Geriatric Dentistry ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Dental Professionals

The limited access to oral care for older people living in residential aged care facilities (RACFs) has been noted repeatedly in the literature. The aim of this study was to explore RACF staff perspectives on how to engage dental professionals in the provision of oral care for RACF residents. Semi-structured interviews were conducted with 30 staff from six purposively selected RACFs located in high socioeconomic areas to gain understanding of the multidimensional issues that influenced the engagement of dental professionals from a carer perspective. Analysis revealed that staff perceived tensions regarding affordability, availability, accessibility and flexibility of dental professionals as significant barriers to better oral care for their residents. Participants raised a series of options for how to better engage dental professionals and reduce these barriers. Their ideas included: the engagement of RACF staff in collaborative discussions with representatives of public and private dental services, dental associations, corporate partners and academics; the use of hygienists/oral health therapists to educate and motivate RACF staff; the promotion of oral health information for troubleshooting and advice on how to deal with residents’ dental pain while waiting for support; the encouragement of onsite training for dental professionals; and the importance of gerodontology (geriatric dentistry). Findings highlighted the need to explore alternative approaches to delivering oral care that transcend the model of private clinical practice to focus instead on the needs of RACFs and take into account quality of end-of-life oral care.

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