Oral disease burden of dentate older adults living in long-term care facilities: FINORAL study

Abstract Background A growing number of older adults have natural teeth and are at high risk of oral diseases, which are induced by oral bacterial accumulation and proceed unnoticed and quietly. Our aim was (1) to examine the association of oral disease burden (ODB) with health and functioning among dentate long-term care residents, and (2) to find easily detectable signs for nurses to identify residents’ poor oral health. Methods In this cross-sectional observational study dentists examined 209 residents’ oral status, and nurses assessed residents for their functioning and nutrition in long-term care facilities in Helsinki, Finland. ODB was defined by asymptotic dental score (ADS). Six clinical signs of residents’ poor oral health were considered as potentially easy for nurses to detect: lesions on lips, teeth with increased mobility, lesions on oral mucosa, eating soft or pureed food, unclear speech, and needing assistance in eating. The association of these was tested with high ODB as outcome. Results Participants were grouped according to their ADS scores: low (n = 39), moderate (n = 96) and high ODB (n = 74). ODB was linearly associated with coronary artery disease and poor cognitive and physical functioning: needing assistance in eating, poor ability to make contact, and unclear speech but not with other diseases including dementia or demographic characteristics. Furthermore, ODB was linearly associated with eating soft or pureed food. Of the six selected, easily detectable signs, having at least two positive signs gave 89% sensitivity to detecting high ODB. Conclusion Poor oral health was common and ODB accumulated among residents with poor functioning. Nurses may use a few easily detectable signs to screen residents’ oral health when considering a resident’s need for consultation with an oral health professional.

Download Full-text

Oral health assessment of older adults living in long-term care facilities by non-dental professionals: a systematic review protocol of instruments

BMJ Open ◽

10.1136/bmjopen-2021-050289 ◽

2021 ◽

Vol 11 (8) ◽

pp. e050289

Author(s):

Lorrany Gabriela Rodrigues ◽

Mario Vianna Vettore ◽

Isadora Lemos Figueiredo ◽

Aline Araújo Sampaio ◽

Raquel Conceição Ferreira

Keyword(s):

Systematic Review ◽

Older Adults ◽

Oral Health ◽

Long Term Care ◽

Health Assessment ◽

Measurement Properties ◽

Term Care ◽

Care Facilities ◽

Dental Professionals

IntroductionRegular oral health assessment among older adults living in long-term care facilities (LTCF) can improve their oral health. Different instruments have been developed and used to evaluate the oral health of institutionalised older people by non-dental professionals. These instruments must demonstrate adequate measurement properties. This systematic review aims to examine the studies describing the instruments employed to assess the oral health of older adults living in LTCF by non-dental professionals. The study will also evaluate the measurement properties of such instruments using the checklist proposed by the Consensus-based Standards to select health Measurement Instruments (COSMIN).Methods and analysisStudies describing the development of instruments for assessing oral health of institutionalised older adults by non-dental professionals will be included. Studies assessing at least one measurement property (validity, reliability or responsiveness) will be also considered. Electronic searches will be conducted on MEDLINE (PubMed, Ovid), Embase, Web of Science, Scopus and LILACS databases. Two independent reviewers will select the studies and will extract data concerning the characteristics of the research and the instrument. The measurement properties will be evaluated using the COSMIN checklist. The Grading of Recommendations, Assessment, Development and Evaluation approach will be used to grade the quality (or certainty) of evidence and strength of recommendations.Ethics and disseminationNo ethical approval is required. The results will be submitted for publication to a peer-review journal and presented at relevant conferences.PROSPERO registration numberCRD42020191479.

Download Full-text

Uitbraak COVID-19 in de verpleeghuiszorg

Tijdschrift voor Gerontologie en Geriatrie ◽

10.36613/tgg.1875-6832/2020.03.01 ◽

2020 ◽

Keyword(s):

Older Adults ◽

Nursing Home ◽

Nursing Homes ◽

Long Term Care ◽

Informal Caregivers ◽

Rapid Review ◽

Daily Routine ◽

Term Care ◽

Care Facilities

Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study. Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems. The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.

Download Full-text

Older Adults Diagnosed With Schizophrenia in Long-term Care Facilities: Life Course Theory for Holistic Nursing Research and Practice

Journal of Holistic Nursing ◽

10.1177/08980101211025372 ◽

2021 ◽

pp. 089801012110253

Author(s):

Verónica G. Walker ◽

Elizabeth K. Walker

Keyword(s):

Older Adults ◽

Life Course ◽

Health Beliefs ◽

Long Term Care ◽

Life Course Theory ◽

Nursing Research ◽

Term Care ◽

Holistic Nursing ◽

Care Facilities

Older adults diagnosed with schizophrenia (OADWS) often enter long-term care facilities with unique challenges related to trauma and stress experienced throughout their life course. Health care workers often report that when they work with this population, they feel unprepared due to limited training. In this article, life course theory is presented as a lens for holistic nursing research and as a way for nurses to adapt interventions already used with cognitively impaired older adults (e.g., those diagnosed with Alzheimer's disease) for OADWS in long-term care. It is hoped that these ideas will facilitate discussion of ways to inform training for holistic long-term care of OADWS. Holistic principles of nursing addressed with life course theory as a lens include the following: (a) accounting for strengths and challenges; (b) honoring experiences, values, and health beliefs; (c) viewing interrelationships with the environment; and (d) nurturing of peace, wholeness, and healing.

Download Full-text