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Oral health research in seniors receiving homecare services: Barriers to access

Dionne T. Otey, MPH1, Tanya Darlington, DDS1, Kavita P. Ahluwalia, DDS, MPH1, and Mildred Ramirez, MA, PhD2. (1) School of Dental and Oral Surgery, Columbia University, Division of Community Health, 630 West 168 St, New York, NY 10032, 212.304.7182, dto3@columbia.edu, (2) Research Division, Hebrew Home for the Aged, 5901 Palisade Avenue, Riverdale, NY 10471

Primarily due to fluoridation, Americans are maintaining an intact dentition into old age, resulting in an increased risk for dental diseases and their sequelae. Although oral diseases can have a profound negative impact on general health and quality of life, especially in seniors with medical and functional co-morbidities, the provision of oral health services is often neglected in seniors. As part of a project designed to assess the effect of improved oral health related training for caregivers (nurses and home health aides) of seniors receiving homecare services, baseline and post-intervention oral health data were collected by conducting oral examinations in subjects’ homes. Although 175 examinations have been conducted, there were significant barriers associated with accessing subjects. Segmentation of services between agencies providing homecare workers and those providing administrative oversight may result in difficulties accessing accurate subject lists and data such as address and time in program. The high turnover of home health aides, who most often are the first line of communication with subjects, can result in difficulties establishing trust for repeat visits. Subjects’ cognitive and functional impairments can pose a significant barrier, e.g. subjects may have difficulty responding to phone contacts or may be unable to open apartment doors. In addition, seniors’ lack of oral health related knowledge and perceived need for oral care pose a barrier to access. Although these factors highlight the difficulties associated with accessing seniors for research purposes, preliminary data suggest that similar barriers exist in the delivery of oral health services in this population.

Learning Objectives:

Keywords: Oral Health Needs, Home Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Current Issues in Health and Health Care for Older Adults

The 132nd Annual Meeting (November 6-10, 2004) of APHA