The Homebound/ Institutionalized Older Adult

Many older adults with mild to severe functional limitations can continue to live at home with the cooperation and support of family, friends, and programs such as home health, and hospice. These homebound individuals often require a dentist to make house calls or they must be brought to a hospital-based dental facility via an ambulance or other transportation system. Mobile dental units and laws that, in some states, permit the dental hygienist to provide care to the homebound or the residents of long-term care facilities offer more options for these individuals.68 In a series of studies of long-term care facilities cited in Oral Health in America: A Report of the Surgeon General, 45 to 65% of institutionalized older adult residents surveyed were completely edentulous.44 Many of the residents with or without teeth required immediate care. The literature is replete with evidence that suggests oral care in long-term care facilities is poor at best. In a 1994 Home Health and Hospice survey, only 1% of patients reported receiving oral care.21 Older adult recipients of long-term care are receiving minimal assistance with their oral care despite their needs and limitations.69

It is important to keep in mind that as greater numbers of chronically ill, dentate older adults from the baby boomer generation enter long-term care facilities, the need for oral health care services will increase and become more of a public health issue.70