Abstract
Aim/ObjectivesTo present the findings of the challenges relating to access to dental care for older people in care homes from the Fluoride Interventions in Care Homes (FInCH) Trial.MethodsThematic analysis of 11 interviews / focus groups with care home managers and care staff were carried out against a framework informed by the literature drawing on lived experiences.ResultsThe challenges identified mapped to Penchanksy and Thomas’s (1981) five dimensions of access but also highlighted themes specifically relevant to the care home population. These include a lack of suitable services for routine and urgent domiciliary and clinic care, complex referral processes, operational challenges in the need for appropriate care chaperones, expectations of information for dental charge exemption and capacity / consent processes within the home.DiscussionThere is a malalignment of dental services offered to meet the needs of care home residents which has resulted in a reactive dental care system that is not fit for purpose and an entire generation of older people living in care with dental neglect.ConclusionUrgent action is needed to commission not only the appropriate quantities of both routine and urgent dental care, but ensure it is delivered by clinicians who are appropriately skilled to meet the high levels of dental needs in an increasingly medically and behaviourally complex care home population. In line with eye tests and prescribing at the very least, free routine dental examinations should be offered to all care home residents, creating the opportunity for advice and prevention, and enabling care home residents to function and be free of pain.Trial RegistrationThe FinCH Trial registration EudraCT number 2017-002248-34.
Highlights
It is well known that the United Kingdom (UK) population is ageing, and this section of the population is growing at a faster rate than any other age group
We have a complex social care landscape, with a mixed economy which is straining under the pressure of an ageing population with increasing care needs
AIM The purpose of this paper is to report on some of the qualitative findings from the NIHR funded Fluoride Interventions in Care Homes (FInCH) Trial, in relation to the challenges and issues of access to dental care for older people in care homes, from the perspectives of care home managers and care staff
Summary
It is well known that the UK population is ageing, and this section of the population is growing at a faster rate than any other age group. In 1999, around one in six people were aged 65 years and over (15.8%) This increased to one in every five people in 2019 (18.5%) and is projected to reach around one in every four people (23.9%) by 2039.1 This growth represents an additional 7.5 million people aged 65 years and over in the United Kingdom (UK) in 50 years’ time. The COVID 19 pandemic[3] has shone a light on care homes in England[4] and across the UK but the problem of a neglected and severely underfunded social care system has been long standing. We have a complex social care landscape, with a mixed economy which is straining under the pressure of an ageing population with increasing care needs
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