Vulnerable Elderly Survey
About half of the respondents indicated vulnerable elderly patients make up 5% or less of their total patient population (49% of dentists; 43% of hygienists).
The majority of the dentists only saw patients who were able to come to their dental office. Only 20% of the dentists and 6% of the hygienists indicated that they provided services to patients in nursing homes or long term care facilities.
70% of dentists and 59% of hygienists reported that those on Medicaid comprised 5% or less of the vulnerable elderly for whom they provided care.
The PA 161 program is managed through the Michigan Department of Community Health and allows dental hygienists to practice under a collaborative agreement with dentists to serve unassigned and underserved populations. Of the respondents only 8% of dentists and 31% of hygienists knew about Public Act 161. The majority of both groups indicated that they would like to learn more about this program (67% of dentists; 85% of hygienists).
The largest barriers to dental care for the vulnerable elderly, as perceived by the respondents, is the inability to pay for services (90% of dentists; 93% of hygienists), and the lack of providers that accept Medicaid (75% dentists; 99% hygienists).
When asked to indicate interest in different activities to enhance oral health care of vulnerable elderly in their communities, the majority of dentists (84%) indicated accepting referrals to their private practice. The hygienists were most interested in education for nursing homes or assisted living, working with these facilities to provide on-site care, and collaborating with dental professionals in these facilities.
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Most vulnerable elderly are not receiving regular dental care. Given the current size of the elderly population, the anticipated increase in the sized of the elderly population, as well as in the increase in the number of teeth retained by this population, more providers are needed to provide care to the vulnerable elderly.
The current trend is for the elderly to stay in their homes. Models of dental care are needed for persons who are unable to leave their home, nursing facility, or assisted living facility.
Most vulnerable elderly on Medicaid are unable to obtain care. Models of dental care are needed for persons on Medicaid which would provide adequate compensation to dental providers.
The PA 161 program is a working model to provide oral health care to the vulnerable elderly. Education and program facilitation for dental providers is needed to expand oral health care services to the vulnerable elderly.
The information collected in this survey has been used to develop a directory of oral healthcare providers of the vulnerable elderly population in the state of Michigan. The Vulnerable Elderly Directory is located at: www.michigan.gov/oralhealth. This directory will need to be regularly updated.