1. Oral Health Care of Nova Scotia Seniors Let’s Talk Policy Terry Mitchell, BSc, RDH, MEd, CGN School of Dental Hygiene, Faculty of Dentistry Dalhousie University

2. Research question What are the key components of an oral health action plan, based on continuity of care, which will improve the oral health status of seniors in Nova Scotia?

3. Project objectives Health services evaluation Promising practices scan Forum Dissemination & communication

4. Health services evaluation Focus groups Key informant interviews

5. Promising practices scan Literature search Informal discussions, key service delivery

6. Forum Data to date –Power point –Story-telling Multi-sector small working groups

7. Dissemination & communication Conferences Reports Journal articles Newsletter Etc.

8. Oral Health of Seniors Project Team  Aileen McCormick, Senior Representative  Debra Matthews, Faculty of Dentistry, Dalhousie University  Don Pamenter, Nova Scotia Dental Association  Gael Page, Northwoodcare Inc.  Gail Brown, Nova Scotia Dental Hygienists’ Association  Gerard Ferguson, Manulife Financial  Herenia Lawrence, Faculty of Dentistry, University of Toronto  James Leake, Faculty of Dentistry, University of Toronto  Joseph Murphy, Faculty of Dentistry, Dalhousie University  Murray Nixon, Nova Scotia Department of Health  Patty Williams, Department of Family Studies, MSVU  Robert MacDonald, Faculty of Dentistry, Dalhousie University  Sandra Crowell, Atlantic Health Promotion Research Centre  Scott MacLean, Practicing Dentist  Terry Mitchell, School of Dental Hygiene, Dalhousie University  Valerie White, Nova Scotia Senior Citizens' Secretariat  William MacInnis, Faculty of Dentistry, Dalhousie University  Elizabeth Tait, Project Coordinator, Oral Health of Seniors Project  Pamela Magee, Researcher, Oral Health of Seniors Project Principal investigators: Mary McNally, Faculty of Dentistry, Dalhousie University Renée Lyons, Atlantic Health Promotion Research Centre

9. Funders CHSRF NSHRF Drummond Foundation Manulife Financial Nova Scotia Dental Association Dentistry Canada Fund CIHR for Forum Funding

10. Forum Participants Seniors from community Government Researchers Service & health care businesses Associations Action plans Collaboration Steering committee Policy development Public awareness Program delivery Geriatric education of oral health care students Geriatric education for non-oral health care providers Research

12. Policy implications Oral health must be explicitly recognized as an essential component of overall health and quality of life. –Increase awareness of decision-makers, public –Integrated health systems: coordinate private & public services

13. Policy implications Infrastructure at either the provincial or federal government levels must be established for oral health care for seniors –Leadership position in Health Canada, Provincial Departments of Health –Prevention, promotion of oral health care integrated with public, primary healthcare programs

14. Infrastructure (continued) Review relevant legislation impacting oral health Oral health programs Guidelines for private & public continuing care facilities - oral health standards & service provision Oral health exam component to “single-point” entry protocols

15. Policy implications Increase accessibility of oral health care services especially for rural dwelling, homebound, and long term care residents –Mechanisms for service delivery, transportation –LTC facilities for on-site care delivery –Standardized oral health resource kit for non- dental care providers –Oral health care labour force issues

16. Policy implications Investigate alternate methods of compensation for oral health professionals. –Impact of poor oral health on healthcare and other social systems –Quantify financial support required (public & primary health care for seniors) –Develop and evaluate dental service fee guides specific to geriatric dental care

17. Policy implications Foster research initiatives to establish data pertaining to oral health and oral health practises –National consensus for oral health assessments for seniors –Assess oral health status of seniors

18. Research (continued) –Collaborative research teams Develop & evaluate oral health promotion and oral disease prevention strategies Develop and evaluate dental practice guidelines specifically for seniors’ needs Determine the feasibility & mechanisms for integrating oral health interventions and practices into existing primary health care strategies Assess the impact of the aging population on the dental workforce Develop & test service delivery models

19. Policy implications Education for care providers and those who educate care providers must acknowledge the need for specific geriatric education –Accreditation standards: dental, dental hygiene, health related professions –Non-traditional delivery models educational components –Geriatric dentistry - specialty recognition

20. Education (continued) –Geriatric education for health care workers Nursing Continuing care assistance Pharmacy Medicine –Caregivers who provide personal care

21. Current status Report submitted Seniors oral health collaboration COHR Dissemination