Access and barriers to oral health care for dependent elderly people living in rest homes

AIM: To report New Zealand rest home (rest home is the New Zealand term for residential aged care facilities where dependent, institutionalised, elderly people reside.) managers' opinions on access and barriers to oral health care for rest home residents. METHODS: An exploratory study using qualitative descriptive methods. Eleven rest home managers in a region of New Zealand were interviewed about admission assessments for new residents, oral health care, availability of dental facilities, staff training in oral hygiene, residents' nutritional needs and oral hygiene aids. RESULTS: Interviews with managers indicated that rest homes have no policies for the provision of oral health care and only arrange dental check-ups or treatment when requested by residents or family. Barriers to accessing care include making appointments, availability of staff and transport particularly for bedridden patients. Staff receive basic oral hygiene training only and face resistance to oral hygiene from some residents. No homes had a dental chair at their premises. All rest homes stocked oral hygiene aids such as toothbrushes and toothpastes. Electric toothbrushes were not generally promoted with cost being a key factor. CONCLUSION: While rest home managers were aware of the importance of good oral health, there are barriers to care. Finance is a challenge as dental care is not publicly funded and many residents rely on a limited income. Recommendations include policy changes to better fund oral health, specific oral health training for rest home staff, provision of mobile dental services to rest homes and the inclusion of gerodontology in the dental school curriculum.