Abstract
Purpose: Periodontal disease and caries remain the most prevalent preventable chronic diseases for seniors. Seniors transitioning into long term care facilities (LTCFs) often present with oral health challenges linked to systemic diseases, plaque control, psychomotor skills and oral health literacy. Many retain a discernible level of physical and cognitive ability, establishing considerable autonomy. This study examines the effect of autonomy on residents' ability to perform oral hygiene.
Methods: Descriptive data were developed utilizing mixed methodology on a convenience sample of 12 residents and 7 care staff of a LTCF. One-on-one interviews consisted of questions about demographics, and exploration of the influence of ageism, respect and time constraints on resident autonomy in oral care practices.
Results: Data suggests shortcomings, such as failure of the staff to ensure oral hygiene oversight and failure of the resident to ask for assistance. Autonomy, while laudable, was used by residents to resist staff assistance, partially motivated by residents' lack of confidence in care staff oral hygiene literacy and skills. In turn, by honoring resident's independence, the staff enabled excessive autonomy to occur creating an environment of iatro-compliance.
Conclusion: While it is beneficial to encourage autonomy, oversight and education must remain an integral component of oral hygiene care in this population. Improved oral hygiene skills can be fostered in LTCFs by utilizing the current oral health care workforce. Registered dental hygienists (RDHs), under indirect supervision of a dentist, can fulfill the role of an oral health care director (OHCD) in LTCFs. A director's presence in a facility can decrease staff caused iatro-compliance and increase oral hygiene skills and literacy of the residents, while enhancing their autonomy through education and support.
- Autonomy
- Oral Hygiene
- Long Care
- Term Care Facilities
- Health Promotion
- Disease Prevention
- Oral Health Care Director
Footnotes
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Melanie V. Taverna, MSDH, RDH, is an assistant professor/clinical faculty at the Department of Periodontics, Division of Dental Hygiene. Carol Nguyen, MS, RDH, is an assistant professor at the, Department of Periodontics, Division of Dental Hygiene. Rebecca Wright, MS, RDH, is an assistant professor/clinical faculty at the Department of Periodontics, Dental Hygiene Division. James W. Tysinger, PhD, is a distinguished teaching professor with tenure in the Department of Family and Community Medicine, and serves as Vice Chair for Professional Development. Helen M. Sorenson, MA, RT, is an associate professor in the Department of Respiratory Care. All are at the School of Health Professions at The University of Texas Health Science Center at San Antonio.
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This study supports the NDHRA priority area, Health Promotion/Disease Prevention: Investigate how environmental factors (culture, socioeconomic status-SES, education) influence oral health behavior.
- Copyright © 2014 The American Dental Hygienists’ Association