Professional Documents
Culture Documents
Health
Part 1
March 19, 2018
Michele Andrus, Leslie Coleman, Marisa Martin,
Haleigh Turley
NEEDS ASSESSMENT
A. General Data
1. Description of Site
6:00- Wake up
7:30- Breakfast
9:00- Let's Walk or Sit and Fit
10:30- Various games depending on the day
11:30- Lunch
1:00- 3:00 Various activities and games; nap optional
5:00- Dinner
5:30- Social hour or movie/popcorn
In the future, the activities coordinator could implement our oral health
program into their set daily routine. The staff will be able to use the skills
learned during this time to implement oral cancer screenings and teach
proper denture care to the residents. These plans will promote a better
quality of life for the residents and an above average standard of care at
Pelican Bay.
Pelican Bay is a private pay facility. They do not provide any type
of preventive oral hygiene aids to their residence. Pelican Bay will provide
transportation to dental offices if needed. They also offer fluoridated water
provided by the city. The family is the sole provider of preventative care
for the residents. (1) The previous oral health program was directed
toward the residents, contributing limited benefits due to lack of
compliance. (1) There was also a mental health barrier because most of
the residents could not recall what was taught at the oral health sessions.
Due to lack of compliance from the staff, we were unable to assess the
knowledge and awareness of dental health that the staff is using daily. A
pre-test will be given at the first education session to gather initial
information and assure compliance from the staff.
1. Dental Caries
Prevalence
1. 93% of seniors 65 and older have had dental caries on permanent
teeth.
1. White seniors, higher income families, and individuals with higher
education portray more decay.
Unmet Needs
1. 18% of seniors 65 and older have untreated decay.
2. Black seniors, Hispanic seniors, lower income individuals, and less
educated individuals have more untreated decay.
Age
65 to 74 years 17.07
75 years or more 19.52
Sex
Male 20.42
Female 16.43
Race and Ethnicity
White, non-Hispanic 15.92
Black, non-Hispanic 36.78
Mexican American 41.19
Poverty Status (Income
compared to Federal Poverty
Level)
Less than 100% 33.22
100% to 199% 23.82
Greater than 200% 14.22
Education
Less than High School 26.16
High School 17.68
More than High School 14.30
Smoking History
Current Smoker 27.28
Former Smoker 18.74
Never Smoked 16.58
Overall 18.18
(10)
Severity
1. Seniors 65+ have an average of 9.24 decayed or missing
permanent teeth as well as 43.02 decayed and missing permanent
surfaces.
2. Hispanic subgroups and those with lower incomes present with
more severe decay on permanent teeth.
3. Black/Hispanic subgroups and those with lower incomes have more
untreated decay on permanent teeth.
Characteristi Decayed Missing Filled Total decayed,
c permanen permanent permanent missing, or
t teeth teeth (MT) teeth (FT) filled
(DT) permanent
teeth (DMFT)
Age
65 to 74 0.39 8.32 8.96 17.68
years
75 years or 0.47 9.41 8.42 18.30
more
Sex
Male 0.53 8.67 8.37 17.57
Female 0.35 8.96 8.99 18.30
Race and
Ethnicity
White, non- 0.36 8.30 9.57 18.23
Hispanic
Black, non- 1.04 12.61 3.25 16.90
Hispanic
Mexican 1.10 9.74 4.26 15.11
American
Poverty
Status
(Income
compared to
Federal
Poverty
Level)
Less than 1.01 12.19 4.10 17.30
100%
100% to 0.58 10.79 6.84 18.21
199%
Greater than 0.29 7.61 10.24 18.15
200%
Education
Less than 0.77 11.99 4.92 17.68
High School
High School 0.38 9.58 8.39 18.35
More than 0.28 6.71 10.91 17.90
High School
Smoking
History
Current 0.82 12.45 5.68 18.95
Smoker
Former 0.42 9.58 8.41 18.40
Smoker
Never 0.39 7.76 9.31 17.46
Smoked
Overall 0.43 8.81 8.71 17.96
(10)
2.Periodontal Disease
1. 10.20-11.03% of seniors age 65 and over have periodontal
disease. Of this group, 10.58% are categorized as having
moderate to severe periodontal disease.
2. Older seniors, Black/Hispanic seniors, current smokers, those from
a lower income, and less educated individuals are more likely to
have periodontal disease. This group is also more likely to have
moderate/severe periodontal disease.
Sex
Male 12.97 20.61
Female 8.56 14.40
Poverty Status
(Income compared
to Federal Poverty
Level)
Less than 100% 17.49 31.96
100% to 199% 11.59 18.75
Greater than 200% 8.62 13.91
Education
Less than High 16.56 28.24
School
High School 8.30 15.51
More than High 8.90 12.38
School
Smoking History
Current Smoker 13.80 32.01
Former Smoker 9.20 19.25
Never Smoked 11.12 14.08
3.Oral Hygiene
Perceived Condition of Teeth and Mouth
1. 24% of Seniors 65+ report the condition of their teeth/mouth as very
good or excellent.
2. 16% of all Seniors 65+ report the condition of their teeth/mouth as
poor.
3. Black/Hispanic Seniors, those with lower incomes, and individuals
with less education report the condition of their teeth/mouth as
poor.
1. Seniors with higher incomes and higher education have a greater
likelihood of reporting the condition of their teeth/mouth as very
good or excellent.
(10)
4.Oral Cancer
(10)
6. Additional Information
Tooth Loss
Number of Teeth Remaining
1. Seniors over age 65 have an average of 18.90 remaining teeth.
2. Black seniors, current smokers, and those with lower incomes and
less education have fewer remaining teeth.
Sex
Male 19.03
Female 18.77
Education
Less than High School 15.86
High School 18.10
More than High School 20.96
Smoking History
Current Smoker 15.39
Former Smoker 18.16
Never Smoked 19.91
Overall 18.90
(10)
Sex
Male 24.42
Female 29.30
Education
Less than High School 43.32
High School 28.28
More than High School 13.65
Smoking History
Current Smoker 49.69
Former Smoker 28.69
Never Smoked 21.72
Overall 27.27
(10)
Goal: The primary goal for this program is to increase the staff's
knowledge of oral health care by 20% to prevent and control oral diseases
in the care facility.
The 65+ population has the highest amount of oral cancer cases
compared to all other population groups. (10) Healthcare
personnel, specifically at long-term care facilities for 65+, have little
knowledge on how to perform an oral cancer screening. (12) Oral
cancer screenings can be easily done by looking in one's mouth
with some form of light source. (11) If done correctly, oral cancer
screening can help detect cancerous lesions at the earliest stages
and increase chances of survival. (11)
Program Design
A. Activities
1. Session One (February 6th, 2018)
a. Life Enrichment Director and LVN for Assisted Living Side
Present oral health care program to caregivers to improve oral health of
residents
Discuss the need to teach caregivers to clean and care for dentures and
do oral cancer screenings Discuss the best time to work with caregivers
Pre-test
Give flyer with oral health program times and dates
This session will take 30 minutes and we will need the Life Enrichment
Director and the Resident Care Director.
2. Session Two (March 27th, 2018)
a. Caregivers
Presentation of general oral health conditions and how to implement oral
cancer screening.
i. Use brochures on Oral Cancer screening to explain the procedure
for an oral cancer screening and to provide examples of irregular
tissue.
ii. Demonstrate how to evaluate a patient's oral cavity using a light
source (pen light, or loupes), tongue depressor and gauze.
This session will take an hour and we will need the caregivers to attend.
3. Session Three (April 3rd, 2018)
a. Caregivers
Presentation of proper denture cleaning and why it is important for healthy
oral tissues. Relation of improper denture cleaning and candidiasis
infection.
i. Demonstrate how to clean a denture with a denture brush, while
explaining the procedure and reasoning for overnight soaking.
ii. Define candidiasis and use flip book to show pictures that provide a
visual aid of oral tissues and tissues affected by candidiasis.
iii. Acknowledge the staff's concern about the high incidence of
dentures that are thrown away in the trash or lost by residents by
giving donated cases with chains.
This session will take an hour and we will need the caregivers to attend.
4. Session Four (April 10th, 2018)
a. Caregivers
Assessment of the oral health program. Caregivers will give a
demonstration and relay what they have learned to other providers in the
Pelican Bay facility.
i. Evaluate the caregivers' ability to implement the program.
ii. Post-test
iii. Have caregivers demonstrate how to clean dentures and evaluate
their ability to recall the reasoning for the soaking technique and
leaving dentures out overnight.
iv. Have caregivers identify pictures of normal and abnormal tissue
using visual aids from a flip book.
v. Address the staff's concern about residents losing dentures and
evaluate how donated cases are helping.
This session will take an hour and we will need the caregivers to attend.
C. Resources
The following are the resources required to implement the Oral Health
Program
1. Personnel
a. Life Enrichment Director and Resident Care Director (first and last
sessions only)
b. Caregivers (Sessions 2-4)
c. As many of the staff as possible (session 4)
2. Visual Aids
a. Flipbook with pictures of different pre-cancerous lesions (Made by
Clinicians)
b. Flipbook with pictures of common denture lesions (Made by
clinicians)
c. Typodont with toothbrush (Provided by clinicians)
d. Denture model (Provided by LIT)
e. Brochures; The Oral Cancer Exam, Older Adults and Oral Health,
Daily oral care guide for caregivers, Dry Mouth
3. Supplies
a. Denture Cleaner, Denture toothbrush, Polident tabs, gauze, tongue
depressors, mouth mirrors (donated by LIT)
b. Gloves, masks, loupes (supplied by clinician)
4. Evaluation Material
a. Pre-test
b. Post-test: same as pre-test
c. Administrator Evaluation
5. Supplements
a. Cases for dentures/partials (donated by Dr. Williams D.D.S)
b. Chains for cases (donated by clinicians)
c. Outline of the program plan (supplied by clinicians)
d. Incentive T-Shirts (donated by clinicians)
e. Incentive Whitening Stripes (donated by clinicians)
f. Flyer to put near time clock for staff to be aware of program dates
and time (created by clinicians)
g. List of dental providers for low cost in the area (made by clinicians)
D. Budget
The estimated cost of the oral health program is as follows:
Denture brushes (donated by LIT Dental Hygiene for use)
Denture cleaner (donated by LIT Dental Hygiene for use)
Polident tablets (donated by LIT Dental Hygiene for use)
Partial cases (donated by Dr. Williams D.D.S for use)
Chains for partial cases (donated by clinicians)
Oral Cancer screening brochures (supplied by NIH)
Gloves (supplied by clinician)
Mask (supplied by clinician)
Gauze (donated by LIT Dental Hygiene for use)
Tongue Depressors (donated by LIT Dental Hygiene for use)
Loupes (supplied by clinician)
T-Shirts (donated by clinicians)
Whitening Strips (donated by clinicians)
E. Timetable
There will be a total of four sessions between February and April. The
schedule is as follows:
Session 1: February 6, 2018
Session 2: March 27, 2018
Session 3: April 3, 2018
Session 4: April 10, 2018
Evaluation
A. Formative
1. Weekly review of oral cancer screening, have caregivers
demonstrate
2. Weekly review of denture care, caregivers demonstrate
3. Weekly meeting with Resident Care Director and/or Memory Care
Director to evaluate the program
4. Weekly review of all general health care knowledge to help the
knowledge to be remembered
B. Summative
1. A pre-test and post–test will be given to the caregivers and then
compared to assess the growth in their oral healthcare knowledge.
2. An ending questionnaire will be given to the Life Enrichment
Director, Resident Care Director, and the Memory Care Director to
assess the effectiveness and what accomplishments came from the
oral health program.
3. A written instruction manual will be provided by the clinicians to
Pelican Bay to have as a reference to train future caregivers and
employees.
4. An annual check with the administrators will bring in long term data
on the successful utilization of the oral cancer screenings and care
of dentures for the residents
References
1. Cindy Dorsey and Tameka Wycoff, LVN. Personal Interview
February 7, 2018. 409-860-1672
2. http://www.pelicanbayassistedliving.org/ Retrieved February
13, 2018
3. https://www.bbb.org/southeast-texas/business-
reviews/assisted-living-facilities/pelican-bay-assisted-living-
community-in-beaumont-tx-90055035
4. https://www.beaumontenterprise.com/news/article/New-senior-
living-center-opens-in-Beaumont-4187673.php
5. Investapedia.com/terms/a/adl
6. Gnjato, S. (2016). Impact of Dentures on Oral Health-Related
Quality of Life. Medicinski Pregled / Medical Review, 69(7/8),
203-211. doi:10.2298/MPNS1608203G
7. Kaur Shergill, D. (2017). A Question to Denture Wearers- Does
it Improve the Quality of Life? International Journal of
Community Health & Medical Research, 3(1), 55-58.
doi:10.21276/ijchmr.2017.3.1.12
8. Rinker, J. (2015). Denture Care and Nursing Home Residents.
Rdh, 35(6), 26-30. http://www.rdhmag.com/articles/print/volume-
35/issue-6/features/denture-care-and-nursing-home-residents.html
Retrieved March 8, 2018.
9. World Health Organization (WHO)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247544/
10. https://www.nidcr.nih.gov/research/data-statistics
11. Gomes, M. S., Bonan, P. F., Ferreira, V. N., de Lucena Pereira, L.,
Correia, R. C., da Silva Teixeira, H. B., & ... Bonan, P. (2017).
Development of a mobile application for oral cancer screening.
Technology & Health Care, 25(2), 187-195. doi:10.3233/THC-
161259
12. Baumann, E., Koller, M., Wiltfang, J., Wenz, H., Möller, B., &
Hertrampf, K. (2016). Challenges of early detection of oral cancer:
Raising awareness as a first step to successful campaigning.
Health Education Research, 31(2), 136-145.
doi:10.1093/her/cyv099
Appendix+
1. Pretest/posttest
2. List of low cost dental care providers in the area
3. Brochures from NIH:
1. The Oral Cancer Exam
2. Older Adults and Oral Health
1. Daily oral care guide for caregivers
2. Dry Mouth
1. Assisted Living & Memory Care Rates 2018
2. Pelican Bay Assisted Living Community February 2018 Newsletter
3. Program evaluation