Working Together to Improve the Oral Health of Seniors: Developing an Action Plan for Nova Scotia

Westin Nova Scotian Hotel Halifax, NS November 5-6, 2003

Greetings from the Nova Scotia Senior Citizens’ Secretariat

Presented by: Valerie White, Executive Director

Seniors in Nova Scotia • 129,200 or 13.7% of the population • Oldest population in Atlantic Canada/third oldest in Canada • Fastest growing segment of the population • By 2026, population is expected to almost double • Slightly more live in rural communities • Majority of seniors are women • Average life expectancy: 81 for females/73 for males

Seniors in Nova Scotia • Average income: $31,100 • 6% living below the low-income cut-off • Half income is spent on basic living expenses • Over half live in their own homes with family members • Most do not receive external assistance with personal care • 6% living in residential and nursing home facilities

OHS Project Background

Presented by: Elizabeth Tait, OHS Project Coordinator

Rationale • Oral health impacts: – Overall health – Quality of life • Retaining their natural teeth • Lack of awareness  increase in health and human cost • Lack of an integrated set of policies and practices  multiple barriers

OHS Project Background

Project Design

Research Team •

Atlantic Health Promotion Research Centre, Dalhousie University

: Renée Lyons, Sandra Crowell, Patty Williams •

Faculty of Dentistry, Dalhousie University

: Mary McNally, Bill MacInnis, Joe Murphy, Terry Mitchell, Debora Matthews •

Staff

: Elizabeth Tait, Pamela Magee, Jennifer Kilfoil, Crystal Holly

OHS Project Background

Research Team • • • • • • • •

Faculty of Dentistry, University of Toronto:

Herenia Lawrence, Jim Leake

Manulife Financial:

Gerard Ferguson

Nova Scotia Dept. of Health

: Murray Nixon

Nova Scotia Dental Association:

Don Pamenter

Nova Scotia Dental Hygienists Association:

Gail Brown

Nova Scotia Senior Citizens’ Secretariat:

Valerie White

Northwoodcare Inc.:

Gael Page

Senior Representative:

Aileen McCormick

OHS Project Background

Overview of Forum

Presented by: Karen Pyra, Forum Facilitator

Project Findings Presentation (Part I):

Health Services Evaluation

Presented by: Mary McNally, Principal Investigator & Members of the OHS Project Team

Introduction McNally PI Played by: Mary McNally

Focus Group Findings Recap

Focus Group Findings

Services:

All traditional services and practices except: – Rural areas – Homebound – Long-term care facilities

Health Services Evaluation

Focus Group Findings

Challenges:

• Financial • Long-term care • Attitudes, beliefs, and practices

Health Services Evaluation

Focus Group Findings

Things that Help:

• Friends, family and community members • Education and awareness • Transportation • Insurance • Dental professionals

Health Services Evaluation

Focus Group Findings

Ideas:

• Universal dental insurance • Mobile dental units • Dental care coordinator • Policies and standards • Awareness raising strategies

Health Services Evaluation

Key Informant Interview Findings Recap

Key Informant Interview Findings

Question: How is oral health care of seniors being addressed by indirect care provider sectors in Nova Scotia?

“It’s being addressed, but not sufficiently…” • Most common reason reported was lack of awareness.

• All sectors noted their willingness to address the issue in the future if the evidence warrants.

Health Services Evaluation

Small Group Activity #1: Sharing Our Perspectives

• Discuss which of the challenges reflect your own experience • List other challenges • List other ‘things that help’

Project Findings Presentation (Part II):

Promising Practices Scan

Presented by: Pamela Magee, OHS Research Coordinator

Scan Areas Seniors’ Oral Health Care Program Scan Promising Practices Scan Seniors’ Oral Health Policy Scan Seniors’ Insurance Scan Seniors’ Oral Health Promotion Scan Geriatric Dental Education Scan

Seniors’ Oral Health Care Programs Scan

Key Findings • Lack of research • Limited number of ‘senior specific’ oral health care programs

Promising Practices Scan

Key Findings • Lack of program evaluations • Need to develop indicators • Promising indicators were

accessibility

and

sustainability Promising Practices Scan

Key Findings •

Accessibility

and

sustainability

practices address oral health challenges • Publicly-funded programs are narrow • Multi-sectoral partnerships needed

Promising Practices Scan

Seniors’ Oral Health Policy Scan

What are oral health care policies?

Key Findings • Advocacy • Care and Access • Coverage

Promising Practices Scan

Key Findings • No oral health care policies for seniors in Nova Scotia • Care and access policies lack standards and guidelines • Coverage policies are limited

Promising Practices Scan

Seniors’ Insurance Scan

Key Findings • Dental plans → pre-payment for dental care • 2 basic types of plans are available to seniors

Promising Practices Scan

Key Findings • Seniors

+

Ability to make out of pocket payments

=

insurance Access to private dental • Seniors

+

Publicly-funded plans

=

Increase in utilization rates • Publicly-funded dental plans are limited

Promising Practices Scan

Geriatric Dental Education Scan

Key Findings • Dental and dental hygiene programs require geriatric dental components • Lack of universal curricula standards and procedures • Geriatric dental education should be integrated with health care programs

Promising Practices Scan

Key Findings • Geriatric dentistry not a specialty • Seniors require unique oral health care treatment • A need for extensive clinical experience

Promising Practices Scan

Seniors’ Oral Health Promotion Scan

Key Findings • Seniors’ oral health information and oral hygiene training provided upon request • Oral hygiene training for caregivers should be regular and on-going

Promising Practices Scan

Key Findings • No universal assessment tool for dental professionals • No universal assessment tool for non-dental professionals

Promising Practices Scan

Small Group Activity #2: Prioritizing Challenges

• Create a list of six challenges that should be addressed first

Small Group Activity #3: Action Planning

• List actions to address your assigned challenge • Determine who needs to be involved in implementing each action • Set a realistic time frame for each action

Planning our Next Steps

Presented by: Karen Pyra, Forum Facilitator

Please complete your evaluation

Personal Information:

include NAME and FORWARDING ADDRESS

If you have receipts from air travel, taxis or meals to be reimbursed

Travel Claim

If you have mileage to be reimbursed Date Signature

Closing Remarks

Presented by: Karen Pyra, Forum Facilitator & Mary McNally, Principal Investigator