Caring for care homes

care homesDentists will continue to get the blame for poor oral health in care homes until the Government starts commissioning dental care, Michael Watson says.

A care home manager who has been struggling to get a dentist who will check the teeth of residents with dementia, wants Jeremy Hunt to take action and find one for her.

She has written to her local MP, Andrea Leadsom, saying: ‘I am finding this area extremely difficult to obtain a dentist that is willing to visit our care home’.

The MP has passed on her concerns to the Secretary of State.

One concern of hers is that the CQC has rated her care home as ‘requires improvement’, because she cannot find a dentist willing to visit – she is being penalised for something that is beyond her control.

She makes the case that while GPs, district nurses, chiropodists, opticians and hairdressers ‘are all visiting the home regularly to offer their services’, when it comes to dentists, she says: ‘I’m finding the lack of interest and support unprofessional due to the negative understanding of dementia in older adults.’

Now I have only read one side of the story and I am mindful of the fact that there are many reasons why it may be difficult, if not impossible, to make such visits under the UDA contract.

I can understand the manager’s frustration, but it is probably unfair to castigate local dentists as ‘unprofessional’.

Dementia-friendly dentistry

The FGDP has recently put online its publication Dementia-friendly dentistry: good practice guidelines.

This ‘enables dental professionals to understand dementia and its implications for dental practice’, so that they can ‘adapt their patient management and clinical decisions accordingly’.

Speaking of the guidelines the Alzheimer’s Society says: ‘Dentists have a crucial role to play in the community for people with dementia … we hope that dentists across the UK will put them into practice.’

They can only do this, however, if their local area team is willing and able to commission such services.

This cannot be done by throwing a few more UDAs at a practice and hope that they will transform into care home visits.

Nor can we have any confidence that a new contract, along the lines of the prototypes, will be any more effective.

‘Uncaring and unprofessional’

Public Health England has found people living in care homes were more likely to have no natural teeth and higher levels of tooth decay than elderly people living at home, according to a report on the oral health of older people in England and Wales in 2016.

Care home managers also experienced greater difficulty accessing dental care for residents than older people in their own homes did.

In addition, the second most common oral health issue raised by care home managers relates to residents resisting oral care checks.

Health Minister, Steve Brine MP, has promised that this summer Public Health England will be publishing ‘Commissioning better oral health for vulnerable older people.’

But unless the mechanism exists (which it doesn’t) to support commissioning of health and social care, then no progress will be made to ‘have positive impacts on the oral health of vulnerable older people.’

In the meantime, care home managers are left unable to provide such services for their residents and dentists will continue to be blamed for being ‘uncaring and unprofessional’.

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