263963 Oral home care for adults with developmental disabilities: A survey of paid and family caregivers about roles and responsibilities

Monday, October 29, 2012 : 1:29 PM - 1:47 PM

Paula M. Minihan, PhD, MPH , Dept. of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
John P. Morgan, DDS , Dept. of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA
Konstantina Yantsides , Dept. of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
Carrie Nobles, MPH , Dept. of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
Angel Park, MS, MPH , Div. of Advanced and Graduate Education, Tufts University School of Dental Medicine, Boston, MA
Matthew Finkelman, PhD , Div. of Advanced and Graduate Education, Tufts University School of Dental Medicine, Boston, MA
Paul Stark, ScD , Div. of Advanced and Graduate Education, Tufts University School of Dental Medicine, Boston, MA
Aviva Must, PhD , Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
Policies and programs to address oral health disparities among adults with developmental disabilities (DD) require empirical information about daily home care in addition to dental services. Paid and family caregivers who accompany adults with DD to dental clinic appointments in a specialized statewide system are eligible to complete computer-assisted personal interview surveys. 404 caregivers supported by the state DD agency (85%) and 74 family caregivers (15%) have completed surveys to date.

The adults they assisted were diverse: 57% were male; 43% > age 50; 71% lived in state-supported community residences, 10% with their families, 9% independently and 8% in state-operated facilities. Ninety-five percent had intellectual, 54% communication, and 42% physical disabilities. Thirty-two percent were unable to let caregivers know about dental problems. Of the 95% with any natural teeth, 55% needed ‘hands-on-hands' or complete help with oral home care; 32% needed supervision/reminders.

Caregivers reported that toothbrushes (99%), toothpaste (99%) disposable gloves (91%) and floss (62%) were ‘always/often available'. More caregivers felt ‘very confident' to assist with toothbrushing (84%) and mouth rinsing (72%) than flossing (47%). Most (85%) had training in universal precautions. Of those providing direct assistance, 79% used disposable gloves, 10% face masks, and 7% safety glasses ‘always/often.' More caregivers rated patient-specific instructions (verbal, 76%; written, 75%) as ‘very useful' than other potential resources. These preliminary findings suggest that caregivers have varying levels of knowledge, confidence and skills about oral home care. Identifying methods to enhance oral home care would benefit caregivers and the persons with DD they support.

Learning Areas:
Chronic disease management and prevention

Learning Objectives:
Describe four levels of assistance that adults with developmental disabilities may require from a caregiver to ensure oral home care occurs as recommended. List at least six supplies that are essential to perform recommended oral home care routines. Identify at least four special aids that are available to help adults with developmental disabilities and their caregivers optimize oral home care.

Keywords: Disability, Oral Health Needs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a co-investigator on this NIDCR-funded research. Specifically, I was a member of the team that developed the proposal. Once funded, I led activities related to Aim 2, the caregiver survey. These included developing the CAPI survey instrument; pilot-testing and revising it; obtaining the requisite IRB approvals; implementing the survey in the field; training and supervising field staff; and participating in data analysis and interpretation.
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.