Oral Hygiene Care for Residents in Iowa Intermediate Care Facilities

Objective: This study aimed to investigate the oral hygiene care (OHC) activities and attitudes of care providers in Intermediate Care Facilities for the Mentally Retarded (ICF/MR) in the state of Iowa. Methods: Questionnaires were distributed to care providers employed at a convenience sample of 3 ICF/MRs. Results: ICF/MR residents ranged from young to old adults. The response rate was 70.0%. 85% of care providers were female, 87% were white, mean age was 32.8 years (SD 14.1 yrs; range 17-69yrs), 58% had some college or higher education, 84% were full-time employees, 50% worked the day shift and mean time employed at their ICF/MR was 55.5 months. 97.8% rated OHC as important or higher for residents and 98.6% for their own OHC. 22.7% disliked OHC occasionally or more frequently. 35.6% rated lack of time and 33.1% rated lack of staff as occasionally or more frequently preventing them from assisting residents with OHC. 8.3% were never or seldom able to complete OHC. 21.2% never or seldom wore gloves during OHC. 64.9% stated that residents' behaviors resulted in inadequate OHC occasionally or more frequently. 16% of residents required no assistance with OHC, 35% required some assistance, and 49% required complete assistance. Most common OHC difficulties were residents: biting toothbrush (72.5%), refusing OHC (68.8%), not opening (60.9%), and not rinsing (59.4%). Care providers reported spending 3.0 minutes brushing resident's teeth and 3.0 minutes dentures. Logistic regression (p<0.05, Backward Stepwise) profiled those who did not wear gloves to also be those who never/seldom finished their cares, who had insufficient time for their cares, who had behavioral problems with residents, and had residents who did not open their mouth. Conclusion: Care providers experienced significant behavioral and physical difficulties while providing OHC, but still found OHC important. Training programs for care providers are needed to address these difficulties.