REPORTED DENTAL ATTENDANCE AND PERCEIVED BARRIERS TO CARE IN FRAIL AND FUNCTIONALLY DEPENDENT OLDER ADULTS

Objectives This study was designed to investigate the reported dental attendance and the perceived barriers to dental care for frail and fun ctionally dependent older adults. Design A single centre study of a ho usebound group of more than 60 years of age and their personal carers. Setting The study was carried out from a general dental practice in W are, Hertfordshire, a market town 20 miles north of London. Subjects a nd methods A group of 263 housebound adults more than 60 years old wer e identified. The subjects were living in 5 residential homes, 3 shelt ered housing complexes and in private accommodation. The subjects and 115 of their personal carers were interviewed. Results 93% only attend ed a dentist when they had problems. The presence of natural teeth, re sidential status and age were all statistically significant independen t explanatory variables for the time since the previous reported denta l visit. Lack of perceived need was found to be a barrier to care for 86% of subjects. Cost and lack of suitable transport were also commonl y identified. However, the true cost implication to a patient was poor ly appreciated especially by those 34% of subjects who cited cost as a barrier. 52% of the whole group, rising with age to 75% of those more than 90 years old, expressed a preference for treatment to be carried out in their own homes. 93% of carers had found difficulty in arrangi ng dental care for their clients but the difficulties were not always the Same as the subjects' perceived barriers. Among the carers, younge r, regular dental attendees who were paid to care were more likely to see benefit in obtaining dental care for their clients. Conclusion The mechanisms by which these barriers to care may be lowered should be i nvestigated in order to meet the unmet need identified by this study.