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CALD workers discuss gaps in oral care

Culturally and linguistically diverse personal care workers’ own experiences with dental care may influence the care they provide residents, and regular training is required, a new study finds.  

There have been longstanding calls for residential aged care to improve its approach to dental health, as residents often have higher needs and poorer oral health outcomes than seniors living in the community.

A new study by researchers at the University of Western Australia has examined how CALD personal care workers understood oral care and their experiences in delivering it to residents. Despite the proportion of CALD workers in residential aged care, the researchers noted this was one of the first studies to focus on oral health within this group.

Some 15 care workers from African background were interviewed, 75 per cent of whom had worked in residential aged care in Australia for over three years; 80 per cent had some form of tertiary qualification.

While all participants considered dental care as important for wellbeing and quality of life, most had never personally accessed dental services in Australia or their native country. When they had, it was generally in response to dental emergencies or pain.

“Few participants mentioned the need for preventative oral care such as routine scaling and polishing and dental check-ups as reasons for visiting dental practitioners,” the study reported.

The study suggested these experiences influenced the delivery of oral care to residents. Further, some participants mentioned there was insufficient training and understanding among CALD workers about how to provide oral care, noting it was given less priority in training compared to other areas such as manual handling or first aid. Some participants reported receiving initial education about oral health in their professional training, but said there was often not sufficient development to maintain their knowledge in practice.

One participant said:

“Most of the carers do not have knowledge of dental treatment. Many of them don’t even brush the residents’ teeth. When they (residents) don’t have any teeth in their mouth they (carers) don’t even know that the gum is part of the oral care.”

Where participants had accessed dental health care for themselves or had some dental training, they were more likely to carry out regular oral care for residents, the study found.

Participants also noted that other workplace demands competed with providing oral health care, including high workload, time restrictions, and residents’ physical and behavioural difficulties. Others said that management did not make dental care a priority.

A significant number of the workers thought residents’ were not receiving adequate dental care and noted a lack of dental professional visiting the facility or on staff.

“Other health care professionals such as nurses, GPs, unlike the dental professionals, visit the residents, I never seen a dentist coming to the aged care facilities,” said one participant.

The study recommended regular training that incorporated workers’ attitudes, experiences, and expectations on how to achieve the best oral health for residents.

However, the research also indicated that improved training for personal care workers alone may not improve the quality of oral care in facilities, given the limited influence such workers may have on organisational practice. It suggested there needed to be better education for all stakeholders in the sector.

The study recognised that findings were limited to a specific CALD group and metropolitan area, and indicated research be extended to look at other CALD backgrounds.

The study was published in the journal Gerodontology.

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7 Responses to CALD workers discuss gaps in oral care

  1. Ljubica Petrov January 22, 2016 at 3:10 pm #

    I am sure that quality of aged care services provision is less dependent on the ethnicity of aged care workers than it is on training, professional development and comprehensive workplace orientation programs.

  2. Amanda Luttrell January 25, 2016 at 3:32 pm #

    I agree. If the centre makes it a priority and provides relevant training the background of carers is not really relevant.

  3. Cristina Hurley January 27, 2016 at 9:29 am #

    The key issue in this debate is “that management did not make dental care a priority”. If dental care is included in the daily care plan then ideally, the practice of daily oral health would be on the facility radar.
    There is of course a link between oral health and other burdens of disease, such as cardiovascular health. It is definitely time to manage much more closely this issue, and whether a facility has CALD care officers or not, it is up to management to ensure that all staff have their continuing professional development needs attended to. Staff who are from CALD backgrounds require good support mechanisms for the betterment of care to our elderly and also for their own workplace harmony and wellbeing.

  4. Juie Fraser January 27, 2016 at 2:22 pm #

    Regardless of ethnicity if care workers deliver services based on how they think care should be provided (their views and upbringing) will miss the “person centred approach”. As mentioned above dental care will need to be in the daily care plan. This comes back to ensuring care staff receive adequate training on self awareness, self reflection, person centred approach and understanding chronic diseases.

  5. Kylie Wise January 27, 2016 at 6:58 pm #

    Care staff with poor English skills don’t possess the nuances and subtleties of language required to effectively manage challenging behaviours. Do you really expect unsupervised and overworked staff to grasp the importance of providing diligent hygiene to a resistive or dependent resident …

    Sure, education and supervision are the keys to improvement, but if providers reckon they can’t even afford registered nurses it’s unlikely they’ll spring for toothbrush training.

  6. Ljubica Petrov February 5, 2016 at 2:11 pm #

    Is it possible for the author to fully reference the research that is referred to in this article?

  7. Darragh O'Keeffe February 5, 2016 at 2:58 pm #

    Hi Ljubica

    The paper was:

    Culturally and linguistically diverse (CALD) carers’ perceptions of oral care in residential aged care settings in Perth, Western Australia

    Bola Adebayo, Angela Durey and Linda M. Slack-Smith
    Centre for Research Excellence in Primary Oral Health Care (UWA), School of Dentistry, The University of Western Australia

    As mentioned in the story, it was published in the journal Gerodontology.

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