Exploring barriers to oral healthcare at private residential aged care facilities in Selangor, Malaysia: a pilot study

Abstract

Introduction: Elderly people experience a high level of oral diseases, and such conditions were found to be more prevalent among those living in residential aged care facilities (RACFs). Objectives: This study explored the barriers to providing oral health (OH) care for residents living in private residential aged care facilities (RACF) in Malaysia, from the perspective of the supervisors. Methodology: This was a qualitative study, that involved face-to-face interviews with supervisors in seven private RACFs in Selangor, Malaysia. Interviews were conducted using a semi-structured open-ended questionnaire, audio-recorded for analysis, transcribed verbatim, and subjected to thematic analysis. Results: All seven supervisors agreed on a lack of any structured protocol available to residents or workers to promote OH care for residents. They reported that RACF staff received no formal training in providing OH care for residents, and noted various barriers to the provision of routine OH care, categorised into three main themes: (1) residents’ factors (e.g. physical limitations, limited family involvement, uncooperative behaviour), (2) caregivers’ factors (e.g. lack of knowledge on the part of caregivers, incompetent caregivers and insufficient comprehensive management in RACFs) and (3) environmental factors (e.g. less involvement from government, difficulty in accessing dental clinics, refusal of dentists to manage patients with complex medical conditions, and poor public awareness). Conclusions: The study concluded with the need for the establishment of an OH training program for RACF staff and a protocol for daily and professional OH care for the residents of private RACFs in Malaysia.