224128 Improving daily oral care for older adults with dementia in the nursing home

Sunday, November 7, 2010

Kavita P. Ahluwalia, DDS, MPH , Community Health, Columbia University College of Dental Medicine, New York, NY
Noreen Myers-Wright, RDH , Department of Behavioral Sciences, Columia University College of Dental Medicine, New York, NY
Nelson Peralta, MD , Research, Isabella Geriatric Center, New York, NY
Gregory Bunza, DDS, MS, MPA, Assistant Prof of Clinical DentalMedicine , Restorative Dentistry, Columbia University College of Dental Medicine, New York, NY
David Emanuel, MD, VP and Chief Medical Officer , Department of Medicine, Isabella Geriatric Center, New York, NY
Background: Most oral diseases can be managed by combining professional and good daily care, but the provision of daily oral care in older adults with dementia is complicated by patient behavior and aggression. Recent data indicate that oral care needs of institutionalized older adults with dementia are high and oral health related quality of life (OHQoL) is poor. While healthcare professionals agree that oral health is vital to the health and wellness of institutionalized elderly, local, state and federal mandates concerning the provision of daily oral care are not well defined and open to interpretation. Specific Aim: A quasi-experimental study designed to assess the feasibility of training nurses and CNAs to provide daily oral care in institutionalized older adults with dementia is being conducted in NYC. Nursing staff in the intervention group (n = 275) will receive training regarding daily oral care for patients with dementia; the control group (n=268) will receive service as usual. Changes in pre- and post-intervention knowledge,opinions and practices of nursing staff;within-and between-group differences in subjects' oral health (dental caries, periodontal disease, prosthesis fit/function/cleanliness), and OHQoL will be measured at baseline and post- intervention.Preliminary data: indicate that daily oral care needs in this population are high and nursing staff are not optimally trained or provided with appropriate daily care aides. Significance:This study documents daily oral care needs in institutionalized older adults with dementia,and provides a roadmap for a sustainable intervention to improve daily oral healthcare and OHQoL.

Learning Areas:
Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Chronic disease management and prevention
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
1)Discuss the importance of daily oral care for institutionalized older adults with dementia. 2)Explain the importance of training nursing staff to provide daily oral care for institutionalized older dementia patients. 3)Describe components necessary for a standardized oral health care program for institutionalized older dementia patients.

Keywords: Dementia, Oral Health Needs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am co-principal investigator on a grant funded to address the issue of daily oral care in people with dementia.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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