Saskatchewan Oral Health Professions (SOHP)

Seniors Oral Health and Long Term Care Strategy

How can we ensure that all seniors and residents of long term care homes have access

to oral health care as a standard of care?

Together we can make a difference

Update…since October 2012

Meetings: March 22, 2013

Laura Carney, SLP – Rural LTC

Plan - Early 2012 to present

Review Documents/Programs from around the world and decide on direction – “Made in Saskatchewan” model

Develop and Revise Strategy and RecommendationsRevised based on feedback received at May 2012 OHC meeting

Apply for Funding – Received from SK Oral Health Professions Group

Documents to be developed – in process

Permission/Agreement with Australia established

Public Health Observatory – Research Unit asked to provide data on Aspiration Pneumonia, Cardio Pulmonary Disease and Diabetes to assess potential savings to government health spending

Pilot the training resource/Portfolio Training and Consultation with Long Term Care Homes

Strategy and Recommendations to government

Vision

Oral health is an integral part of the overall health of residents in long term

care homes and seniors in the community.

Recommendations

1. That the Saskatchewan Government, Ministry of Health endorses the Saskatchewan Seniors Oral Health and Long Term Care Strategy developed by the Saskatchewan Oral Health Professions collaboratively with Long Term Care.

Recommendations

2. That legislated Oral Health Care Policies/Standards for Long Term Care and Personal Care Homes are established based on best practice to strive for optimal oral and overall health for the people of Saskatchewan. Policies should ensure that every senior and long term care resident has the right and access to oral health care services:

2.1 An individualized oral health care plan2.2 Basic oral hygiene supplies2.3 Daily oral hygiene 2.3 Professional dental services 2.4 Oral health record included within the resident’s health record 2.5 Dental recommendations/orders are followed

Note: As per Section 23 of the current Personal Care Home Regulation, each resident receive a dental examination, as necessary.

Recommendations

3. That an Oral Health Coordinator (OHC)(s), who is a licensed oral health professional, should be employed in each health region to facilitate the delivery of initial oral assessments, dental examinations and treatment, daily oral hygiene for residents and oral health education. The Oral Health Coordinator will work collaboratively with the long term care, multi-disciplinary team to improve the oral and overall health of residents.

Recommendations

4. That upon entry into a Long Term Care (LTC) home, an initial oral assessment must be completed by a licensed oral health professional, through the general/medical consent provided by the long term care home.

4.1 Oral assessments should be routinely performed every 6 months thereafter, by an oral health professional or a health care professional trained in oral health.

4.2 Non-oral health professionals performing oral health assessments or care will receive appropriate training developed by this project.

4.3 All training will be provided by oral health professionals.

Recommendations5. That initial oral assessments may trigger a referral to a dentist for

a full dental examination to include:5.1 Personal client record, including consent for dental examination5.2 Review of medical and dental history5.3 Complete examination of the oral cavity, to include:5.3.1 Assessment of hard and soft tissues5.3.2 Assessment of oral hygiene care5.3.3 Oral cancer screening5.3.4 Denture Assessment5.4 Treatment plan/progress notes5.5 Estimate/Consent for financial responsibility5.6 Consent for treatment

Recommendations6. Treatment needs based on the dental examination, may be

provided by dentists, denturists, dental hygienists, dental therapists and/or dental assistants. Residents may access dental services through their personal oral health professional or through dental services as available through the long term care home.

7. That the Saskatchewan government establish a safety net program for more equitable access to oral health services for low income residents (similar to Ministry of Health Supplementary Health/Family Health Benefits or Alberta’s Dental Assistance for Seniors Program through which low income seniors are eligible for up to $5000 every 5 years for those aged 65 and older).

8. That the Saskatchewan Seniors Oral Health and Long Term Care Strategy is incorporated into post-secondary educational health training programs, orientation, and continuing professional development (i.e. for physicians, nurses, care aides, etc).

Recommendations

9. That the standard for new long term care homes includes provision for a treatment room suitable for a variety of health professionals including access to portable dental equipment to facilitate dental treatment.

10. That the implementation of a Saskatchewan electronic health record includes an oral health component.

11. That surveillance, evaluation and continuous quality improvement be performed on an ongoing basis to demonstrate improved health and oral health status outcomes.

Next Steps

Documents to be finalized/completed

Vidya Shanmugam

Public Health Observatory – Research Unit asked to provide data on Aspiration Pneumonia, Cardio Pulmonary Disease and Diabetes to assess potential savings to government health spending

Pilot the training resource/Portfolio Training and Consultation with Long Term Care Homes

Strategy and Recommendations to government