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Many frail older adults can be seen at a dental office, provided for ease of being seated and standing again, reception furniture that they are mobile and the office is accessible and senior-should be: friendly. More severe functionally dependent elderly persons
• Not low to the floor
benefit from receiving on-site, mobile care.
• Firm
• With arms The Senior-Friendly Dental Office
To reduce risk of falls, flooring should be: While most dental offices are suitable for children and adults,
some modifications are needed in order to accommodate the
• Consistent throughout the office
frail elderly adult. Elderly patients almost always have one or
• No deep pile carpeting
more chronic medical conditions, so it is especially important
• No throw rugs or clutter on the floor (watch hoses and cords)
to review the medical history each time the patient visits the
• No slippery areas/surfaces
office. Information should also be collected about types of lighting to reduce age-related vision medical conditions and medications, as well as recording
contact information for the patient’s physician. According to
• Adequate lighting without glare
Dr. Linda Niessen, Clinical Professor at Baylor College of
• Consistent level of lighting throughout the office
Dentistry:46 “In dentistry we are surgeons. We see disease:
• Avoid small print
we cut it out. We will always be surgeons. But a practice that
• Use contrasting paper and ink colors for written materials
is treating an older population will increasingly take on more to adjust to age-related hearing loss: oral health medicine components. It will be increasingly important for us to gather a complete medical history on the
• Stand closer to the patient
patient and know if they have heart problems that may require
• Enhance visual and additory clues
systemic antibiotics or if the person has had a hip replacement,
• Remove mask
or stroke. It’s important to know that the ulcers in the patient’s
• Maintain face-to-face, eye level, eye contact
mouth may be a result of their arthritis medication. The
• Touch appropriately
medical management of the patient will increase.”
• Drop pitch, speak distinctly
Erickson has developed the following list of essentials for
• May increase volume but do not yell
the “senior-friendly office” .
• Minimize background noise
recommendations refer to the physical office setup, and others
• Use quiet locations for interaction
suggest about ways of interacting with seniors to show respect
• Turn off any music
and to facilitate communication.
• Turn off dental equipment whenever possible
Other communication enhancements:
• Use titles and surnames unless asked specifically to use first name
• Provide written instructions to reinforce verbal
• Communicate with caregivers as appropriate
• Do not communicate with caregivers at the expense of speaking with the patient treatment is often complex, it is recommended that a written treatment plan be reviewed and signed by patients or their representatives.
Dr. Kenneth Shay, Director for Geriatrics and Extended Care for the Department of Veterans Affairs explains that when treating elderly patients, dentists encounter “clinical challenges that are not necessarily unique to the elderly but are encountered with unique frequency and often with unique presentations. In addition, dental care can be complicated by medical, functional, behavioral and situational factors that are associated with aging. It means treating those same familiar On-site Delivery Systems. Functionally dependent older adults are often best served by bringing dental services to them, rather than transporting them to the dental office. The provision of on-site care has many unique aspects besides mobile dental equipment. According to Helgeson and Smith, mobile and on-site dental care delivery systems are not simply traditional private dental practices located in nursing homes. They are interdisciplinary team efforts designed to systematically address the oral health needs of nursing home residents. The provision of dental care involves not only dental staff, but also nursing staff, primary care physicians, patient representatives, and third-party payers who each have important roles to play. In addition, on-site delivery systems must assist in establishing preventive programs, provide education for nursing staff, and participate actively in the medical-dental management of medically compromised patients. The traditional fee-for-service funding model for dental care has provided excellent access to care for patients and population groups who are able to pay for needed care. Unfortunately, the connection between ability to pay and the availability of dental care creates financial barriers for nursing home residents.