Author:
Borreani Elena,Wright Desmond,Scambler Sasha,Gallagher Jennifer E
Abstract
Abstract
Background
Older people are increasingly retaining their natural teeth but at higher risk of oral disease with resultant impact on their quality of life. Socially deprived people are more at risk of oral disease and yet less likely to take up care. Health organisations in England and Wales are exploring new ways to commission and provide dental care services in general and for vulnerable groups in particular. This study was undertaken to investigate barriers to dental care perceived by older people in socially deprived inner city area where uptake of care was low and identify methods for minimising barriers in older people in support of oral health.
Methods
A qualitative dual-methodological approach, utilising both focus groups and individual interviews, was used in this research. Participants, older people and carers of older people, were recruited using purposive sampling through day centres and community groups in the inner city boroughs of Lambeth, Southwark and Lewisham in South London. A topic guide was utilised to guide qualitative data collection. Informants' views were recorded on tape and in field notes. The data were transcribed and analysed using Framework Methodology.
Results
Thirty-nine older people and/or their carers participated in focus groups. Active barriers to dental care in older people fell into five main categories: cost, fear, availability, accessibility and characteristics of the dentist. Lack of perception of a need for dental care was a common 'passive barrier' amongst denture wearers in particular. The cost of dental treatment, fear of care and perceived availability of dental services emerged to influence significantly dental attendance. Minimising barriers involves three levels of action to be taken: individual actions (such as persistence in finding available care following identification of need), system changes (including reducing costs, improving information, ensuring appropriate timing and location of care, and good patient management) and societal issues (such as reducing isolation and loneliness). Older people appeared to place greater significance on system and societal change than personal action.
Conclusion
Older people living within the community in an inner city area where NHS dental care is available face barriers to dental care. Improving access to care involves actions at individual, societal and system level. The latter includes appropriate management of older people by clinicians, policy change to address NHS charges; consideration of when, where and how dental care is provided; and clear information for older people and their carers on available local dental services, dental charges and care pathways.
Publisher
Springer Science and Business Media LLC
Reference50 articles.
1. World Health Organisation: Oral heath in ageing societies: integration of oral health and general health. 2006, Geneva: World Health Organisation
2. Kelly MSJ, Nuttall N, Bradnock G, Morris J, Nunn J, Pine C, Pitts N, Treasure E, White D: Adult dental health survey: oral health in the UK 1998. The Stationery Office. 2000, London
3. Steele J, Sheiham A, Marcenes W, Walls A: National Diet and Nutrition Survey; adults aged 65 and over. 1998
4. Steele JG, Treasure E, Pitts NB, Morris J, Bradnock G: Total tooth loss in the United Kingdom in 1998 and implications for the future. British Dental Journal. 2000, 189 (11): 598-603. 10.1038/sj.bdj.4800840a.
5. British Dental Association: Oral Healthcare for older people: 2020 vision. 2003, London: British Dental Association
Cited by
85 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献