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The OHS Journey - Oral Health of Seniors Annual General Meeting

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The OHS Journey - Oral Health of Seniors Annual General Meeting

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

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