A literature review of oral health awareness among caregivers in aged care facilities

RESEARCH QUESTION The aim of this study was to review the literature that analyses the knowledge, awareness and attitudes of caregivers working in residential homes regarding oral health. ABSTRACT The population of older people is growing at an exponential rate, and the number of elderly entering aged care facilities is also increasing. The health challenges of advancing age increase the dependency of this population group on others for care needs. There is an undeniable correlation between oral health and overall well-being, and a state of adverse oral health considerably diminishes the quality of life. Oral health in elder persons, particularly those living in nursing homes, is extensively compromised and increased dependence for oral care assistance exacerbates their poor oral status. Caregivers are the primary oral care providers for the institutionalised elderly, which necessitates an understanding of their awareness and attitudes towards oral health. The aim of this study was to review the published literature pertaining to the analysis of the knowledge, awareness and attitudes of caregivers working in residential homes regarding oral health. The objectives of this study were to explore the literature on the knowledge, awareness and attitudes of caregivers employed in residential homes towards oral health and identify the key barriers in the provision of oral care to the elderly residents. An integrative literature review was conducted which revealed four major themes: caregiver barriers, elderly barriers, organisational barriers and systemic enablers as well as seven sub-themes. The review highlighted the importance of understanding oral health from a caregiver’s perspective and identifying the multi-level barriers that prevent effective oral care delivery, change of which presents substantial oral health gains for the elderly. Moreover, it was identified that generating awareness through oral health education is not sufficient in inducing positive oral health attitudes in caregivers and an integrated multidisciplinary approach coupled with better organisational support is needed in order to achieve exemplary oral health goals for the institutionalised elderly. The review concludes with recommendations for practice in nursing homes and examples of qualitative questions which could further future research