An evaluation of an oral health training programme for carers of the elderly in residential homes

Objective The objectives of this study were: to evaluate carers' knowledge of oral health; to provide a high quality, consistent, oral health training programme for carers in residential homes; to evaluate the quality;of this programme by examining both carers' changes in knowledge and any changes in carers' behaviour as reported by residents and to assess any changes in the oral health of the elderly residents after one year. Design A cross-sectional, multi-centre study using a carer training programme, evaluated by both a questionnaire conducted with carers and residents and oral examination of residents. Setting In August 1996, 20 (20%) of the residential/nursing homes, in West Hertfordshire were chosen at random and all managers contacted and offered an oral examination for all their residents. Ten (10%) of the homes were also offered an oral health training programme for their carers. Eighteen homes accepted the oral examination for all consenting residents and 7 of the 10 homes offered accepted the carer training. Subjects Thirty-nine carers from 7 of the residential homes attended an oral health training course and 213 elderly residents in the 18 homes were examined both at baseline and after 12 months. Results Carers' baseline knowledge about oral health was poor; the oral health training programme was enjoyed and their knowledge gain after one week was high. However, the elderly residents perceived no change in the oral care given by carers either after one week or after one year and there was no measurable improvement in the oral health of residents after carer training, except for an increase in filled coronal surfaces. Few of the carers originally trained were still working in the same residential homes after one year. Conclusion Although the carer training programme was well received, no changes in oral health practice resulted. Barriers to practice of oral care by carers remained and training, even when including practical skills, evaluation by peers and a high knowledge gain, failed to reduce these barriers.