Greetings from the Nova Scotia Senior Citizens’ Secretariat

1. Working Together to Improve the Oral Health of Seniors:Developing an Action Plan for Nova ScotiaWestin Nova Scotian Hotel Halifax, NSNovember 5-6, 2003

2. Greetings from the Nova Scotia Senior Citizens’ Secretariat Presented by: Valerie White, Executive Director

3. Seniors in Nova Scotia • 129,200 or 13.7% of the population • Oldest population in Atlantic Canada/third oldest in Canada • Fastest growing segment of the population   • By 2026, population is expected to almost double  • Slightly more live in rural communities • Majority of seniors are women • Average life expectancy: 81 for females/73 for males

4. Seniors in Nova Scotia • Average income: $31,100 • 6% living below the low-income cut-off • Half income is spent on basic living expenses • Over half live in their own homes with family members • Most do not receive external assistance with personal care • 6% living in residential and nursing home facilities

5. OHS Project Background Presented by: Elizabeth Tait, OHS Project Coordinator

6. Rationale • Oral health impacts: • Overall health • Quality of life • Retaining their natural teeth • Lack of awareness  increase in health and human cost • Lack of an integrated set of policies and practices  multiple barriers OHS Project Background

7. Project Design

8. Research Team • Atlantic Health Promotion Research Centre, Dalhousie University: Renée Lyons, Sandra Crowell, Patty Williams • Faculty of Dentistry, Dalhousie University: Mary McNally, Bill MacInnis, Joe Murphy, Terry Mitchell, Debora Matthews • Staff:Elizabeth Tait, Pamela Magee, Jennifer Kilfoil, Crystal Holly OHS Project Background

9. Research Team • Faculty of Dentistry, University of Toronto: Herenia Lawrence, Jim Leake • Manulife Financial: Gerard Ferguson • Nova Scotia Dept. of Health: Murray Nixon • Nova Scotia Dental Association: Don Pamenter • Nova Scotia Dental Hygienists Association: Gail Brown • Nova Scotia Senior Citizens’ Secretariat: Valerie White • Northwoodcare Inc.: Gael Page • Senior Representative:Aileen McCormick OHS Project Background

10. Overview of Forum Presented by: Karen Pyra, Forum Facilitator

12. Project Findings Presentation (Part I): Health Services Evaluation Presented by: Mary McNally, Principal Investigator & Members of the OHS Project Team

13. Welcome to Smileyville

14. Introduction McNally PI Played by: Mary McNally

17. Focus Group Findings Recap

18. Focus Group Findings Services: All traditional services and practices except: • Rural areas • Homebound • Long-term care facilities Health Services Evaluation

19. Focus Group Findings Challenges: • Financial • Long-term care • Attitudes, beliefs, and practices Health Services Evaluation

20. Focus Group Findings Things that Help: • Friends, family and community members • Education and awareness • Transportation • Insurance • Dental professionals Health Services Evaluation

21. Focus Group Findings Ideas: • Universal dental insurance • Mobile dental units • Dental care coordinator • Policies and standards • Awareness raising strategies Health Services Evaluation

23. Key Informant Interview Findings Recap

24. Question: How is oral health care of seniors being addressed by indirect care provider sectors in Nova Scotia? Most common reason reported was lack of awareness. All sectors noted their willingness to address the issue in the future if the evidence warrants. Key Informant Interview Findings “It’s being addressed, but not sufficiently…” Health Services Evaluation

25. Small Group Activity #1:Sharing Our Perspectives • Discuss which of the challenges reflect your own experience • List other challenges • List other ‘things that help’

26. Project Findings Presentation (Part II): Promising Practices Scan Presented by: Pamela Magee, OHS Research Coordinator

28. Scan Areas Seniors’ Oral Health Promotion Scan Seniors’ Oral Health Care Program Scan Promising Practices Scan Geriatric Dental Education Scan Seniors’ Oral Health Policy Scan Seniors’ Insurance Scan

29. Seniors’ Oral Health Care Programs Scan

30. Key Findings • Lack of research • Limited number of ‘senior-specific’ oral health care programs Promising Practices Scan

31. Key Findings • Lack of program evaluations • Need to develop indicators • Promising indicators were accessibility and sustainability Promising Practices Scan

32. Key Findings • Accessibility and sustainability practices address oral health challenges • Publicly-funded programs are narrow • Multi-sectoral partnerships needed Promising Practices Scan

33. Seniors’ Oral Health Policy Scan

34. What are oral health care policies?

35. Key Findings • Advocacy • Care and Access • Coverage Promising Practices Scan

36. Key Findings • No oral health care policies for seniors in Nova Scotia • Care and access policies lack standards and guidelines • Coverage policies are limited Promising Practices Scan

37. Seniors’ Insurance Scan

38. Key Findings • Dental plans → pre-payment for dental care • 2 basic types of plans are available to seniors Promising Practices Scan

39. Key Findings • Seniors + Ability to make out of pocket payments = Access to private dental insurance • Seniors + Publicly-funded plans = Increase in utilization rates • Publicly-funded dental plans are limited Promising Practices Scan

40. Geriatric Dental Education Scan

41. Key Findings • Dental and dental hygiene programs require geriatric dental components • Lack of universal curricula standards and procedures • Geriatric dental education should be integrated with health care programs Promising Practices Scan

42. Key Findings • Geriatric dentistry not a specialty • Seniors require unique oral health care treatment • A need for extensive clinical experience Promising Practices Scan

43. Seniors’ Oral Health Promotion Scan

44. Key Findings • Seniors’ oral health information and oral hygiene training provided upon request • Oral hygiene training for caregivers should be regular and on-going Promising Practices Scan

45. Key Findings • No universal assessment tool for dental professionals • No universal assessment tool for non-dental professionals Promising Practices Scan

46. Small Group Activity #2:Prioritizing Challenges • Create a list of six challenges that should be addressed first

47. Small Group Activity #3:Action Planning • List actions to address your assigned challenge • Determine who needs to be involved in implementing each action • Set a realistic time frame for each action

48. Planning our Next Steps Presented by: Karen Pyra, Forum Facilitator

49. Please complete your evaluation

50. Travel Claim Personal Information: include NAME and FORWARDING ADDRESS If you have receipts from air travel, taxis or meals to be reimbursed If you have mileage to be reimbursed Date Signature