Challenges and Recommendations for Oral Healthcare of Older Adults in a Long-Term Care Facility
Faculty of Dentistry, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur
How they used Delve
Dental researchers at Universiti Kebangsaan Malaysia used Delve to independently open-code focus group transcripts from 16 caregivers in a public long-term care facility, choosing it for how it supported two researchers coding separately and then comparing codes in a thematic analysis of the barriers to older residents' oral care.
“Open coding was performed independently by two researchers to label meaningful units relevant to the research questions by using Delve Qualitative Data Analysis software [22,23]. Delve was selected for its intuitive design and features, which facilitated independent coding by multiple researchers and iterative comparison of codes. As the aim of this study was to perform a thematic analysis rather than advanced query-based analysis, Delve provided sufficient functionality for data management and coding.”
- Field
- Geriatric dentistry and oral health; caregiver-reported barriers to oral care for older residents of a Malaysian public long-term care facility
- Data
- Focus group discussions with 16 caregivers at a Malaysian public long-term care facility, run by a trained moderator with a note-taker (neither affiliated with the caregivers' workplace), alongside a quantitative strand assessing 115 residents aged 60 and over with questionnaires, an Oral Frailty Five-item Checklist and clinical examinations
- Approach
- Convergent mixed-methods design. The qualitative strand was an inductive thematic analysis: open coding performed independently by two researchers in Delve, differences in interpretation resolved through iterative team discussions and a return to the raw data until consensus, initial codes reviewed by the wider research team, then codes sorted into recurring themes and refined by the team. The authors state explicitly that no formal intercoder reliability statistic was applied, resting rigor instead on independent coding, peer debriefing and consensus-building.
- Data types
- Focus groups
Abstract
Background/Objectives: As the aging population is growing globally, oral health has become integral to ensuring healthy aging and quality of life. This study assessed the oral health status of older adults in a Malaysian long-term care facility and explored caregiver-reported challenges in providing oral care. Methods: A convergent mixed-methods design was applied, involving 115 residents aged ≥60 years and 16 caregivers in a public facility. The residents’ oral health was assessed using interviewer-assisted questionnaires (demography, dependency level, Oral Frailty Five-item Checklist), clinical examinations (dental caries status, number of remaining teeth, oral and denture hygiene), and the Decayed, Missing, and Filled Teeth (DMFT) index. Focus group discussions with caregivers were conducted, transcribed, and thematically analyzed. Quantitative data were descriptively analyzed using SPSS version 29.0. Results: Over one-third of the residents (39%) were moderately to highly dependent on caregivers. All had experienced dental caries, with most having fewer than 20 teeth (92.9%) and requiring dentures (81.7%). Overall, both oral and denture hygiene were poor. Assessment of oral frailty indicated that the majority of residents (94.8%) were at risk of impaired oral function. A thematic analysis identified four key themes influencing oral health: (1) health and oral health conditions of residents; (2) variety in oral care practices; (3) older adults’ attitudes and behaviors; and (4) system factors. These themes were mapped in a conceptual framework demonstrating multilevel influences on oral care. Conclusions: Despite the single-center design, these findings provide actionable insights for improving geriatric oral health policies in Malaysia. Practical recommendations include integrating oral health into aged-care standards, expanding mobile dental services, and establishing oral care champions within facilities. Addressing these challenges is critical to improving quality of life and aligning long-term care practices with the WHO’s healthy aging priorities.
Citation
Haslina Rani, Amalina Alya Azizan, Nurul Izzah Abdul Walad, Shahir Akram Hassan, Tuti Ningseh Mohd‐Dom, Daphne Shu Huey Yeoh, Joyce Wuen Cheer Tay, Muhammad Syafiq Asyraf Rosli, Nur Saadah Mohamad Aun, Aznida Firzah Abdul Aziz, Kaung Myat Thwin, In Meei Tew (2025). Challenges and Recommendations for Oral Healthcare of Older Adults in a Long-Term Care Facility. Healthcare. https://doi.org/10.3390/healthcare13202642