The OHS Journey - Oral Health of Seniors Annual General Meeting
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  • List of Potential Forum Participants Will be circulated throughout the day Please review and add your comments on the following questions: Do we representation from all necessary sectors? Do we have the best people to represent those sectors? How do we facilitate buy-in – spark interest?
  • In 1998, a Team was formed Focus groups were held to focus the topic Several meetings were held to design the project A literature review was completed A LOI and proposal were submitted and approved in 2001 OHS project began in April 2002
  • Here are some of the challenges
  • The team decided our project’s goal would be to… Explain continuity of care….
  • Data: An evaluation of seniors’ oral health services in Nova Scotia A scan of existing systems and analyses of lessons learned Increased awareness of the issue: By the team At the Forum Through communication and dissemination Links to other research and initiatives is ongoing and will become more intense after the forum
  • Nova Scotia is ideal to host a project on seniors oral health because…
  • WITH ASSISTANCE FROM…
  • Renamed working groups to better reflect the group’s workplan: Methodology & Analysis and Best practices becomes Research Recruitment, Forum and Communication becomes Forum planning
  • We should all be proud our the team effort that has been put forth this year. Besides being active members on the working groups the team members have contributed to the project’s success. Bill provided us with resources and contacts Valerie is helping to get up-to-date statistics and helped with communication efforts Aileen helped review the recruitment materials for seniors and provided feedback Debora helped develop the research logic framework for the Best Practices Patty has helped review the focus group findings Murray provided us with 2 opportunities to communicate our project Joe helped us work through the how to present the survey and focus group findings Gail helped with the Truro focus group Herenia reviewed documents and provided feedback Gerard provided a letter of support for our Forum proposal, help decipher an article on insurance and made recommendations for the funding section of the Best Practice Scan. We have been successful in activating an intersectoral team with representatives from the above sectors. This graphic reminded me of our team and that we all come from different buildings but together we make up the oral health care system for seniors. Therefore, we need to find ways to work together and address this issue as a team rather than individually. Like the saying says “It takes village to build a model”
  • We have to remind ourselves to sit back and appreciate the amount of work we achieved. We have been very productive and successful in our first year setting a strong foundation for the next year and years to come. Today should also be about celebrating this successes as we hear about the findings. We are working towards something great and so many people want to see us succeed. I wanted to share with you the comments I have receive from many people I have met along the way in the last year have said “Thank you” “This is long overdue” “I’m so glad you are looking into this” We have the support and it is up to us where we go with this. We have the potential to make a huge difference in many people’s life. Any questions or comments about today’s update presentation or the update that was sent to you by email? Now I’ll pass the stage over to Pam who will be presenting the rest of today’s finding presentations.
  • Pam put a huge amount of work to get the findings to the point they are today. This all happened very fast and she will be giving you a glimpse to see what is to come in some cases when the data collection is not complete. As you saw on our timeline, we expected it to take until the Forum for the results to be analyzed and written up.
  • Pam begins... Health Services Evaluation : To examine continuity of care in the delivery of oral health services for seniors in Nova Scotia. Key Components: a. Survey: To gain insights around the oral health practices, attitudes and beliefs of a purposive non-representative sample of Nova Scotia seniors, dentists, and dental hygienists. b. Focus Group Sessions: To gain insights into the types of oral health services available to seniors in Nova Scotia, gather information about what helps and what hinders seniors access to oral health care, and insights into what the select group of people feel will help enhance oral health systems for senior’ living in Nova Scotia from a purposive non-respresentative sample of Nova Scotia seniors, dentists, dental hygenists and nurses. c. Key Informant Interviews: To collect information about the extent to which oral health care of seniors is being addressed by privately financed delivery systems, organized dentistry, and government agencies (e.g. dental, economic and policy experts; health services managers; dental insurance plan mangers; nursing home managers; academic researchers; and dental educators). Best Practices Scan : An analysis to determine the best continuity of care practices in a variety of jurisdictions, Canada and elsewhere. Key Components: a. Comprehensive review of existing literature relating to the Oral Health Care of Seniors b. Scan of seniors’ dental care programs c. Scan of seniors’ oral health policy d. Scan of geriatric dental education (DDS & DH) e. Scan of seniors’ oral health promotion/prevention services Oral Health Policy Forum: This Forum will be held to review OHS project findings and develop collaborative financial, organization and policy intervention strategies; hence will help clarify sector roles and relationships while working towards the common goal of developing a model for continuity of care in Nova Scotia, and Canada.
  • Please hold your questions until after the presentation, feel free to make notes in your workbook
  • Please hold your questions until after the presentation, feel free to make notes in your workbook
  • Please hold your questions until after the presentation, feel free to make notes in your workbook
  • Ranked according to key services mentioned by most groups Bring up numbers of focus groups
  • Health Services Evaluation : To examine continuity of care in the delivery of oral health services for seniors in Nova Scotia. Key Components: a. Survey: To gain insights around the oral health practices, attitudes and beliefs of a purposive non-representative sample of Nova Scotia seniors, dentists, and dental hygienists. b. Focus Group Sessions: To gain insights into the types of oral health services available to seniors in Nova Scotia, gather information about what helps and what hinders seniors access to oral health care, and insights into what the select group of people feel will help enhance oral health systems for senior’ living in Nova Scotia from a purposive non-respresentative sample of Nova Scotia seniors, dentists, dental hygenists and nurses. c. Key Informant Interviews: To collect information about the extent to which oral health care of seniors is being addressed by privately financed delivery systems, organized dentistry, and government agencies (e.g. dental, economic and policy experts; health services managers; dental insurance plan mangers; nursing home managers; academic researchers; and dental educators). Best Practices Scan : An analysis to determine the best continuity of care practices in a variety of jurisdictions, Canada and elsewhere. Key Components: a. Comprehensive review of existing literature relating to the Oral Health Care of Seniors b. Scan of seniors’ dental care programs c. Scan of seniors’ oral health policy d. Scan of geriatric dental education (DDS & DH) e. Scan of seniors’ oral health promotion/prevention services Oral Health Policy Forum: This Forum will be held to review OHS project findings and develop collaborative financial, organization and policy intervention strategies; hence will help clarify sector roles and relationships while working towards the common goal of developing a model for continuity of care in Nova Scotia, and Canada.
  • Health Services Evaluation : To examine continuity of care in the delivery of oral health services for seniors in Nova Scotia. Key Components: a. Survey: To gain insights around the oral health practices, attitudes and beliefs of a purposive non-representative sample of Nova Scotia seniors, dentists, and dental hygienists. b. Focus Group Sessions: To gain insights into the types of oral health services available to seniors in Nova Scotia, gather information about what helps and what hinders seniors access to oral health care, and insights into what the select group of people feel will help enhance oral health systems for senior’ living in Nova Scotia from a purposive non-respresentative sample of Nova Scotia seniors, dentists, dental hygenists and nurses. c. Key Informant Interviews: To collect information about the extent to which oral health care of seniors is being addressed by privately financed delivery systems, organized dentistry, and government agencies (e.g. dental, economic and policy experts; health services managers; dental insurance plan mangers; nursing home managers; academic researchers; and dental educators). Best Practices Scan : An analysis to determine the best continuity of care practices in a variety of jurisdictions, Canada and elsewhere. Key Components: a. Comprehensive review of existing literature relating to the Oral Health Care of Seniors b. Scan of seniors’ dental care programs c. Scan of seniors’ oral health policy d. Scan of geriatric dental education (DDS & DH) e. Scan of seniors’ oral health promotion/prevention services Oral Health Policy Forum: This Forum will be held to review OHS project findings and develop collaborative financial, organization and policy intervention strategies; hence will help clarify sector roles and relationships while working towards the common goal of developing a model for continuity of care in Nova Scotia, and Canada.
  • Smileyville is a rural town in Nova Scotia very similar to many of the towns where we conducted focus groups. We conducted 13 focus groups; 7 with seniors and 6 with dentists, hygienists and nurses. More about the focus groups…Smileyville is where a representative researcher (on behalf of all the researchers who collected the data) has asked representatives from the 4 sectors to come together and provide an overview of the what was said (the findings) by the senior, dentist, dental hygienist, and nurse participants.
  • Please hold your questions until after the presentation, feel free to make notes in your workbook
  • Health Services Evaluation : To examine continuity of care in the delivery of oral health services for seniors in Nova Scotia. Key Components: a. Survey: To gain insights around the oral health practices, attitudes and beliefs of a purposive non-representative sample of Nova Scotia seniors, dentists, and dental hygienists. b. Focus Group Sessions: To gain insights into the types of oral health services available to seniors in Nova Scotia, gather information about what helps and what hinders seniors access to oral health care, and insights into what the select group of people feel will help enhance oral health systems for senior’ living in Nova Scotia from a purposive non-respresentative sample of Nova Scotia seniors, dentists, dental hygenists and nurses. c. Key Informant Interviews: To collect information about the extent to which oral health care of seniors is being addressed by privately financed delivery systems, organized dentistry, and government agencies (e.g. dental, economic and policy experts; health services managers; dental insurance plan mangers; nursing home managers; academic researchers; and dental educators). Best Practices Scan : An analysis to determine the best continuity of care practices in a variety of jurisdictions, Canada and elsewhere. Key Components: a. Comprehensive review of existing literature relating to the Oral Health Care of Seniors b. Scan of seniors’ dental care programs c. Scan of seniors’ oral health policy d. Scan of geriatric dental education (DDS & DH) e. Scan of seniors’ oral health promotion/prevention services Oral Health Policy Forum: This Forum will be held to review OHS project findings and develop collaborative financial, organization and policy intervention strategies; hence will help clarify sector roles and relationships while working towards the common goal of developing a model for continuity of care in Nova Scotia, and Canada.
  • Mobile Geriatric Dental Services (Ontario) – Dr. James Morreale
  • Number are combined with canada and us. Do not delineate between can and us schools
  • How do we use our knowledge around these gaps to help build the model for Nova Scotia? How should the team be organized to work towards model development? What processes are needed after the Forum to develop the model? Get team members to put stickies on the wall Re-organize the sticky notes into key areas and ask what is missing, add missing elements

The OHS Journey - Oral Health of Seniors Annual General Meeting Presentation Transcript

  • 1. The OHS Journey – Year 1
  • 2. Where we’ve been Team FG’s Meet Lit. Submit OHS
  • 3.
    • By 2041, the senior population will be 23% (1995 only 12%) - 80,000,000 more teeth to care for!
    • Literature indicates many barriers to care:
      • Financial, access, attitudes & beliefs, institutional, education, physiological
    • Oral health is marginalized from publicly funded health care
    • Oral health impacts overall health and quality of life
    Serving Seniors: Challenges for Oral Health
  • 4. Purpose
    • To determine the key components of a health services model , based on continuity of care, which will help improve access to oral health services for seniors .
  • 5. What’s needed?
    • A collaborative, integrated team approach
    • Data
    • Increased awareness of the issue
    • Links to other research and initiatives
  • 6. Nova Scotia: Our Project’s Playground
    • High proportion of seniors: 128,333 seniors (65+) in NS; 13.6% of total population
    • Many seniors living in rural communities, at home and with poor socio-economic conditions
    • Currently, outside of our project, there is no information on the oral health services, barriers and facilitators
    • No publicly funded dental services for seniors
  • 7. Objectives – Year 1 (Data Collection/Planning)
    • Develop a survey for seniors and DCP
    • Develop 4 focus group guides
    • Develop a research logic framework for the Best Practices
    • Identify resources and experts to consult
    • Develop a recruitment strategy and materials
    • Begin organizing the Forum
    • Develop a communication plan
    MAWG BPWG RFCWG
  • 8. Objectives – Year 2 (Analysis/Model Dev./ Dissem.)
    • Synthesize, design and prepare a final report and executive summary for the Focus Group findings and Best Practices Scan
    • Design Forum process, recruitment strategy, funding, and develop materials/presentations
    • Host Forum
    • Assist with the development of proposals for future projects/initiatives
    • Develop a oral health services model for Nova Scotia
    • Disseminate project findings
    Research Forum Planning Team
  • 9. Products/Wins
    • Intersectoral team, 20+ working group meetings
    • A comprehensive evaluation framework
    • Communication Plan - 30 opportunities
    • Facilitator training workshop
    • Recruitment process and materials
    • 2 surveys and 4 focus groups guides
    • Survey and Focus Groups findings
    • Framework for Best Practices Scan
    • Over 266 literature references
    • Detailed tracking of project progress
  • 10. It takes a village to build a model Insurance Education Dentistry societies LTC facilities Seniors Researchers Government Researchers
  • 11. Celebrating our Work
  • 12. Today’s Agenda 9:30am Welcome & Project Update (Mary & Liz) 10:00am Seniors’ Oral Health Services Evaluation: An Overview & Discussion of the Findings (Pam & Liz) 12:00pm Lunch 12:45pm Best Practices Scan: An Overview of Preliminary Findings (Pam) 2:30pm Building a Model: A Discussion to Plan Year 2 (Renée) 3:15pm Closing Remarks (Mary) Please take a few minutes to complete the evaluation – thank you!
  • 13. Challenge Today
    • To receive an update of the OHS project’s Year 1 activities
    • To share and discuss the research results we have to date
    • Prepare recommendations and a plan for Year 2 activities including the Forum and model development
  • 14. Research Objectives
      • Goal : To determine the key components of a health services model, based on continuity of care, which will improve the oral health status of seniors?
      • Seniors’ Oral Health Services Evaluation
        • Survey, Focus Group Sessions, Key Informant Interviews
      • Best Practices Scan
        • Review of literature, program scan, policy scan, professional training scan, insurance scan, promotion & prevention scan
      • Oral Health Policy Forum
        • Review OHS project findings, develop strategies, clarify sector roles
  • 15.
    • Seniors’ Oral Health Services Evaluation
  • 16. Senior Focus Groups
    • 7 focus groups
    • Average # attending: 10
    • Range: 2-15
    Northwoodcare Inc. - Halifax Canso Dartmouth Margaree Forks Saulnierville Bridgetown Bear River First Nations
  • 17. Dentists, Dental Hygienists and Nurses Focus Groups
    • 6 concurrent focus group sessions (18 in total)
    • Average # attending:
      • DDS & DH = 7
      • Nurses = 4
    • Range:
      • DDS & DH = 6-9
      • Nurses = 2-5
    Sydney Kentville Yarmouth Halifax Truro Antigonish
  • 18.
    • Survey Findings
  • 19. Profile of the Senior Participants
    • 67 senior participants
    • Most:
      • Female
      • Living 21+ years in their community
      • Perceived oral health and general health to be good
      • Partial or full dentures, only 73% had all their own teeth
    • All but 3 of the seniors were able to care for their own teeth and/or dentures
    • Slightly over half of the seniors visited a dentist, dental hygienist, or denturist in the last year
    • Only 68% of the seniors have private dental insurance
  • 20. Profile of Dentist and Dental Hygienist Participants
    • 41 dentists and 44 dental hygienists participants
    • Most:
      • 41+ years of age
      • 11+ years in practice
    • 19 DDS and 22 DH had some form of geriatric training - either as a component of their degree or CE courses
    • Seniors comprised less than 30% of their patient base
    • Like the seniors, most of the care providers perceived their senior patients’ oral health and general health to be good
    • All but 10% indicated that their dental offices were wheelchair accessible
    • 26 DDS and 9 DH provide dental services to seniors outside of the traditional dental office:
      • 16 DDS and 5 DH in nursing homes
      • 7 DDS in the hospital
      • 4 DDS and 2 DH serve homebound seniors
  • 21.
    • Focus Group Findings
  • 22. Profile of Nurse Participants
    • 21 nurses participated in the focus groups
    • There were both general nurses and nurse supervisors and working in homecare, long-term care and hospitals.
    • Majority indicated no existing dental care policies or procedures in work place.
    • No formal or informal geriatric dental care training either during nursing training or through their place of employment
  • 23. Question #1: What are the existing dental services for seniors? Note: Lack of services in rural areas Key Findings - Services
  • 24. Key Findings - Barriers
      • Question #2: What hinders seniors from accessing dental care (the barriers)?
      • Financial ( Rural )
      • Lack of continuity –LTCF
      • Attitudes Beliefs, & Practices (Rural/Communication)
  • 25. Key Findings - Enablers
      • Question #3: What helps seniors access dental care (the enablers)?
      • Supportive Measures
      • Transportation
      • Education/Awareness
      • Initiatives Outside N.S.
  • 26. Key Findings - Ideas
      • Question #4:What do you feel is needed to create a system of oral health care for seniors living in Nova Scotia?
    • Universal dental coverage
    • Mobile clinics/equipment
    • Policies/standards
    • Geriatric education/awareness
    • Dental Coordinator
      • Think Big and Dream Big!
  • 27.
    • The following is an example of storytelling
  • 28. An Overview of the Seniors’ Oral Health Services Evaluation Adventures in Smileyville                          
  • 29. Welcome to Smileyville
  • 30.
      • Introduction
    Gotta Research Played by: Pam Magee
  • 31. Our Representatives Shirley A. Senior Played by: Liz Tait Dr. Phil Yourtooth Played by: Steve Creaser Unida Scale Played by: Jennifer Le Ima Caregiver Played by: Crystal Holly
  • 32. Profile of the Senior Participants
    • 67 senior participants, 7 focus groups
    • Most:
      • Female
      • Living 21+ years in their community
      • Perceived oral health and general health to be good
      • Partial or full dentures, only 73% had all their own teeth
    • All but 3 of the seniors were able to care for their own teeth and/or dentures
    • Slightly over half of the seniors visited a dentist, dental hygienist, or denturist in the last year
    • Only 68% of the seniors have private dental insurance
    Shirley A. Senior (Liz Tait) will be travelling to Smileyville to speak on behalf of the senior patricipants-
  • 33. Profile of DDS and DH Participants
    • 41 DDS and 44 DH participants
    • Most: - 41+ years of age
      • - 11+ years in practice
    • 19 DDS and 22 DH - some form of geriatric training (component of degree or CE courses)
    • Seniors comprised < 30% of patient base
    • Most care providers perceived senior oral health and general health as good
    • All but 10% indicated that their dental offices were wheelchair accessible
    • 26 DDS and 9 DH provide services to seniors outside dental office:
      • 16 DDS and 5 DH in nursing homes
      • 7 DDS in the hospital
      • 4 DDS and 2 DH serve homebound
    Dr. Phil Yourtooth (Steve Creaser) and Ms.Unida Scale (Jen Le) will be travelling to Smileyville to speak on behalf of the participants of their sector
  • 34. Profile of Nurse Participants
    • 21 nurse participants in the focus groups, 6 focus groups
    • Nurse supervisors and general nurses; working in homecare, long-term care and hospitals.
    • Majority indicated no existing dental care policies or procedures
    • in work place
    • No formal or informal geriatric dental care training either during nursing training or through their place of employment
    Ms. Ima Caregiver (Crystal Holly) will be travelling to Smileyville to speak on behalf of the nurse patricipants
  • 35. The Round Table Begins…
  • 36. Question 1. What are the existing dental services for seniors?
  • 37. Key Point Recap – Question #1 Note: Lack of services in rural areas
  • 38. Question 2. What hinders seniors from accessing dental care (the barriers)?
  • 39. Key Point Recap – Question #2
      • Financial ( Rural )
      • Lack of continuity –LTCF
      • Attitudes Beliefs, & Practices (Rural/Communication)
  • 40. Question 3. What helps seniors access dental care (the enablers)?
  • 41. Key Point Recap – Question #3
      • Supportive Measures
      • Transportation
      • Education/Awareness
      • Initiatives Outside N.S.
  • 42. Question 4. What do you feel is needed to create a system of oral health care for seniors living in Nova Scotia?
  • 43. Key Point Recap – Question #4
    • Universal dental coverage
    • Mobile clinics/equipment
    • Policies/standards
    • Geriatric education/awareness
    • Dental Coordinator
  • 44. Discussion Questions
    • What key findings or issues stand out? What are the highlights?
    • Do you feel that story-telling would be a useful tool for dissemination of these findings at the Forum? Ideas for improvement?
  • 45. Recap of Focus Group Findings
    • Services: All / rural
    • Barriers: Financial, LTC facilities, attitudes, beliefs and practices
    • Enablers: Supportive measures, transportation, education / awareness
    • Think Big: Universal dental coverage, mobile units / equipment, policies / standards, geriatric education / awareness, dental coordinator
  • 46.
    • Best Practices Scan
  • 47. Literature Review Prevention & Promotion Scan Program Scan Policy Scan Professional Training Scan Insurance Scan BP Scan
  • 48. Best Practices Analysis Scan of barriers and facilitators in oral health services for seniors’. Critical analysis of experiences and lessons learned in Canada and elsewhere. Objectives: Conduct a review of the literature relating to the Oral Health Care of Seniors’.
    • Conduct a scan for programs & services at 3 levels:
    • Seniors’ dental programs
    •   Geriatric dental training programs
    •   Seniors’ oral health promotion/prevention services
    • Conduct a scan of existing policies that address seniors’ access to oral health care:
    • gov’t, insurance
    • national, international
    Progress: Comprehensive search of existing literature completed Oral Health Policy Scan –initial stages of search, on-going
    • Seniors’ oral health program scan: completed
    •   Geriatric dental training scan: completed
    •   Promotion / prevention scan on-going
    Next Steps:
  • 49. Literature Review
  • 50. Key Findings
    • 266 articles that address seniors’ oral health issues:
      • Disparities in Oral Health Care and Access
      • Seniors’ Oral Health Status
      • Oral Health and Quality of Life
      • Oral Health and Medical Status
      • Oral Health and Nutrition
      • Barriers to Accessing Oral Health Care
        • Seniors’ Barriers
        • Care Providers’ Barriers
        • System Barriers
      • Long-term Care Facilities and Oral Health
      • Oral Health Prevention/Promotion
      • Geriatric Oral Health Education/Training
      • Policy and Seniors’ Oral Health
      • Recommendations and Future Directions
    Attitudes, beliefs and practices
  • 51. Policy Scan
  • 52. What is a Policy?
    • A policy is “a broad direction or course of action that has been endorsed by a body with authority to both implement it and resource it.”
    • HEAL Policy and Initiatives Scan, 2003
  • 53. Types of Policies
    • Care/Access - Those which state the level of care one must receive, and also the level of access to which one is entitled
    • Coverage - The policies which outline the coverage of dental care and treatment to which individuals are entitled
    • Advocacy - The policies of authoritative bodies which advocate for better or changed Oral Health Policies
  • 54. Profile of Policies (total = 18) Canada: 7 3 Coverage 4 Care/Access US: 4 2 Advocacy 2 Care/Access International: 7 1 Advocacy 6 Coverage
  • 55. Canadian Policies (total = 7) Federal: 2 2 Coverage Ontario: 2 2 Care/ Access BC: 1 1 Care/ Access Yukon: 1 1 Coverage NWT/ Nunavut: 1 1 Coverage
  • 56. Policy- Canada Care/Access Provincial Health Care Insurance Plan Act Care/Access Regional Long Term Care Facility Oral and Dental Care Program (Halton) Care/Access Provincial Ontario Nursing Homes Act Coverage Provincial Extended Health Benefits for Seniors Care/Access Provincial Community Care Facility Act Coverage Federal Non Insured Health Benefits Coverage Federal Veterans Health Care Regulation Addressing Level Policy
  • 57. Policy- International Care/Access Federal US United States Medicaid and Medicare Advocacy Federal US Policy of American Public Health Association Advocacy State US North Carolina Senior Tar Heel Legislature Care/Access Federal US Medicare and Medicaid: State operations manual Coverage Federal Ireland Irish Legislation Coverage Federal Germany Social Security Coverage Federal France Securite sociale & couverture maladie universelle Coverage Federal Australia Policy of Gov't of Australia Addressing Level Location Policy
  • 58. Key Findings
    • Policies can be classified as governing care/access, coverage or advocacy
    • There are relatively few policies directly mandating the Oral Health of Seniors
    • There is also a lack of research or assessments of the few existing policies
  • 59. Program Scan
  • 60. What is a Program?
    • Division of programs (better and promising)
  • 61. Profile of Programs (total = 58) Canada: 32 US: 18 International: 8
  • 62. How did we select ‘Better Programs’
    • Based upon:
    • 1. Theoretical and best practices literature findings from:
      • health prevention/promotion literature
      • community development and capacity building literature
    • 2. Discussions with senior oral health program directors (e.g. Apple Tree, Baycrest Geriatric Dental Program and Golden Care)
  • 63. Key Indicators Sustainability Public/Private Partnerships Duration Funding OH initiatives Geriatric Education Expansion Awareness On-going evaluation Awareness Delivery Location Transportation Open to seniors Accessibility Literature and Program findings used to help determine ‘better seniors’ oral health programs’ using accessibility and sustainability as the assessment markers
  • 64. Key findings
    • Halton Dental Program (Ontario)
    • Golden Care Dental Services (Ontario)
    • Baycrest Centre for Geriatric Care (Ontario)
    • Apple Tree Dental (US)
    • Geriatric Dental Clinic, Yad Sarah (Isreal)
  • 65. Insurance Scan
  • 66. What is a Dental Insurance Plan ?
    • An agreement that guarantees the financial coverage of costs (partial or full) incurred as a result of receiving dental treatment
    • Two kinds:
      • Private
      • Public
  • 67. Private Insurance Needs Assess. Program Group Individual Company No   Atlantic Blue Cross Not willing to participate Canada Life No  No  Manulife No No  (retiree packages)  Great West Life No No No  Maritime Life N/A Sun Life N/A Imperial N/A Standard Life  No  ( none offered in NS)  Green Shield Canada N/A Liberty Evaluation Dental Packages for Seniors
  • 68. Public Insurance All seniors 65+ Comprehensive $1400 2 years max Yukon Population Coverage Plan All residents Partial coverage Germany National Dental Plan Seniors (homebound and LTC), partial for others Comprehensive Sweden National Dental Plan Seniors (homebound and LTC) and children Comprehensive Norway Public Health Dental Plan All residents Comprehensive 70% Coverage Finland Public Health Dental Plan All residents Comprehensive Denmark Public Health Dental Plan All Status First Nations & Metis Comprehensive NIHB Dental Plan All veterans 60 and older Comprehensive $600 max Veteran Affairs Dental Plan All seniors 60 and over Comprehensive $1000 max NWT Extended Benefits Dental Plan
  • 69. Key Findings
    • Private: If seniors come forward and ask for private insurance – the insurance companies will develop a dental plan
    • Public: Not good enough just to have a system in place (e.g. NFLD children’s)
    • Explore why not working: attitude and beliefs of seniors, caregivers perception of need, dental community not raising awareness about the system
  • 70. Prevention & Promotion Scan
  • 71. Prevention and Promotion Scan:
      • This scan is ongoing
      • The three components of this scan are:
        • Basic Informational Resources
        • Educational Tools
          • Workshops
          • Tool Kits
          • Other educational aids
        • Assessment tools developed
  • 72. Professional Training Scan (DDS and DH)
  • 73. DDS and DH Programs in North America DH Programs (US) Diploma = 115 Degree = 60 DH Programs (Cdn) Diploma = 20 (1 private) Degree = 4 (2 pending) DDS Programs (US) Undergraduate = 53 DDS Programs (Cdn) Undergraduate = 10
  • 74. Key Findings DDS Programs
    • Geriatric dental education is not universal in Canadian and US schools
    • Need to develop universal geriatric educational standards
    • Curriculums not changing to meet the needs of the population; no major changes over the last decade
    • Major barrier to inclusion/expansion of geriatric didactic and clinical components in curriculum, over crowded curriculum
    • Lack of faculty members with an interest in or training in geriatrics
  • 75. Geriatric Component in DDS Undergraduate Programs
  • 76. Key Lessons: Iowa University Geriatric Dental Program
    • Geriatrics:
      • multidisciplinary
      • should be integrated into clinical departments
    • Seniors require specific OH treatment
    • Senior faculty member as director of geriatric courses
    • Students should only provide care when equipped with the knowledge and skills
    • Students need to gain clinical experience working with seniors
    • Faculty need CE in geriatric dental care
  • 77. Key Findings DH Programs
    • Lack of standardized geriatric accreditation standards
    • Differences between geriatric components offered in Diploma and Degree programs
    • Lack of faculty trained in geriatric dentistry
    • Overcrowded curriculum cited as the key barrier to the growth of geriatric curriculum within programs
    • No major changes in geriatric components in curriculum over last decade
  • 78. Geriatric component in DH curriculum 40 Specific Course 113 Clinical Component 187 Geriatric Component Canada and USA N = 210 Curriculum requires:
  • 79. Average time allotted for geriatric didactic and clinical components in dental hygiene programs
  • 80. Time Allotted to Geriatric Clinical Components: Dental Hygiene Programs
  • 81. Key Findings DDS and DH Programs
    • Similar barriers identified to lack of enhancement of geriatric dentistry components in curriculum
    • Overcrowded curriculum
    • Lack of faculty trained in geriatric
    • Financial considerations
    • Lack of standardized accreditation standards
    • No major changes in geriatric components offered over last ten years
                                   
  • 82. Lack of standardized accreditation assessment tool Lack of a continuum of oral health care from one setting to another (independent living, homecare, long-term care, hospital) Lack of standardized geriatric accreditation standards Lack of seniors’ oral health delivery programs Lack of availability of services (transportation, facilities, equipment) Where are the gaps? Lack of care providers Lack of insurance coverage Lack geriatric education/awareness Lack of policies/standards Lack of communication between health sectors Lack of training for care providers
  • 83. Building a Model Education Services Policy Funding Training Research ? Public Private
  • 84. Discussion Questions
    • How can these findings be used in the development of a model?
    • What is necessary to build the model:
      • During the Forum
      • After the Forum
    • Do we need new team members to help with strategic planning and model development?
  • 85. Closing Remarks - Workplan
    • Synthesize, design and prepare a final report and executive summary for the Focus Group findings
    • Synthesize, design and prepare a final report and executive summary for the Best Practices Scan
    • Design Forum process, recruitment strategy, funding, develop materials/presentations
    • Host Forum
    • Assist with the development of proposals for future projects/initiatives
    • Develop a oral health services model for Nova Scotia
    • Disseminate project findings
    Research Best Practices Forum Planning Team