Views of homecare staff and carers on oral needs and dental care for people living with dementia: A qualitative study

Objective People living with dementia are at risk of mouth and dental problems. Many receive help with this aspect of personal care from family carers or homecare workers. We explored the views of homecare providers and carers on how this aspect of personal care is addressed and implemented. Materials and methods In this qualitative study we conducted semi‐structured interviews with carers (all family members), homecare workers and managers providing support to people living with dementia in their own homes. Interview questions focused on daily care practices, exploring barriers and facilitators to oral care. Interviews were recorded online or over the telephone, transcribed, and thematically analysed. Results Carers (n = 8), homecare workers (n = 9) and homecare managers (n = 15) were recruited from across England in 2021–2022. Across interviews, two main themes were identified: (i) Missed opportunities to address oral care, which is not always seen as a priority despite the importance and potential risk of neglect. (ii) Challenges in delivering oral care, including factors related to the person living with dementia (such as cognitive and physical decline) and factors related to the care infrastructure and policies such as training, perception of roles, allocated time, and consistency of care. Discussion More emphasis could be given to the training and skills of homecare providers to identify and prevent dental problems and to assist carers. Several strategies and tools (oral care checklists, greater detail around oral care in care assessments and care plans) could be used to enhance this aspect of personal care for people living with dementia. Key points Mouth and teeth care is important for people living with dementia in their own homes because they are at higher risk of dental problems than the general population. However, this aspect of personal care can be overlooked and information may not be shared or recorded. Mouth and teeth care and the risks of poor oral hygiene in dementia could be more consistently addressed and more integrated in assessment and care planning. There are barriers to addressing oral care. The practitioners could utilise available resources or checklists as reminders to have these assessments in place. Oral health care guidelines and skills training in homecare may be timely.