Abstract
Objectives: To describe the frequency of brushing teeth and cleaning of dentures, performed by caregivers, for institutionalized elderly people. Methods: A cross-sectional study in a sample of 196 caregivers of 31 health centers in Barcelona. The dependent variables were frequency of dental brushing and frequency of cleaning of dentures of the elderly by caregivers. The independent variables were characteristics of caregivers and institutions. We performed bivariate and multivariate descriptive analyses. Robust Poisson regression models were fitted to determine factors associated with the dependent variables and to assess the strength of the association. Results: 83% of caregivers were women, 79% worked on more than one shift, 42% worked only out of necessity, 92% were trained to care for elderly persons, 67% were trained in oral hygiene care for the elderly, and 73% recognized the existence of institutional protocols on oral health among residents. The variables explaining the lower frequency of brushing teeth by caregivers for the elderly, adjusted for the workload, were: no training in the care of elderly persons (PRa 1.7 CI95%: 1.6-1.8), not fully agreeing with the importance of oral health care of the elderly (PRa 2.5 CI95%: 1.5-4.1) and not knowing of the existence of oral health protocols (PRa 1.8 CI95%: 1.2-2.6). The variables that explain the lower frequency of cleaning dentures, adjusted for the workload, were lack of training in elderly care (PRa 1.7 CI95%: 1.3-1.9) and not knowing of the existence of protocols (PRa 3.7 CI95%: 1.6-8.7). Conclusion: The majority of caregivers perform activities of oral health care for the elderly at least once per day. The frequency of this care depends mainly on whether caregivers are trained to perform these activities, the importance given to oral health, the workload of caregivers and the existence of institutional protocols on oral health of institutionalized elderly persons. Key words:Institutionalized elderly, caregivers, oral hygiene, long-term care, oral health.
Highlights
The demographic transformation of society seen during the past few decades, characterized by a higher proportion of older people, is implying major changes and challenges for health systems and social policy [1]
83% of caregivers were women, 79% worked on more than one shift, 42% worked only out of necessity, 92% were trained to care for elderly persons, 67% were trained in oral hygiene care for the elderly, and 73% recognized the existence of institutional protocols on oral health among residents
The majority of caregivers perform activities of oral health care for the elderly at least once per day. The frequency of this care depends mainly on whether caregivers are trained to perform these activities, the importance given to oral health, the workload of caregivers and the existence of institutional protocols on oral health of institutionalized elderly persons
Summary
The demographic transformation of society seen during the past few decades, characterized by a higher proportion of older people, is implying major changes and challenges for health systems and social policy [1] In this context, the increased life expectancy is not always accompanied by a better quality of life [2], because aging can mean some people need help them in performing activities that once seemed simple, so the attention to the needs of dependents is one of the great challenges of social policy [3]. Based on the conceptual framework proposed by Chami et al [17] which recognizes the importance of the characteristics of caregivers and the institutional attributes among the factors that hinder the provision of oral hygiene care to institutionalized elderly dependents, the objectives of this study were to describe the specific activities of oral health care (brushing teeth and cleaning dentures) of the elderly performed by caregivers in social-health centers (SHC) with residential activity in the Barcelona Health Region in 2009
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