Abstract
Introduction
The population of older persons is growing worldwide. Caring for older patients in their homes is
becoming the preferred model of health care delivery. However, the model results in increased need
for coordinated and integrated forms of care provision as older adults have often complex health
problems. Although oral diseases are the most common of the chronic diseases for older adults,
oral health care has been neglected in health care services. This is mostly, due to knowledge gaps,
disintegrated and fragmented healthcare services and blurred responsibility between different
levels of care. It is urgent to include oral health in the integrated care perspective for older adults
receiving home care services to avoid unnecessary health deterioration, increased care dependency
and utilization of health care services. Therefore, the aim of CORAL is to provide a generic
scientific-based integrated care model for connecting home health care and oral health services.
Methods
CORAL is constructed in 3 stages by following the UK Medical Research Council’s framework for
complex intervention:1) Acquisition of knowledge about oral- health and health care service
delivery for older adults in home care services; 2) Development of an inter-professional and inter-
service collaboration model for connecting the oral health service with the home care service based
on the acquired knowledge and a co-creation approach; 3) Evaluation of the implementation
process and effectiveness on cost and service utilisation.
Results and discussions
To provide an integrated care model for connecting home health care and oral health services, it is
important to acquire knowledge regarding the oral health status of older adults living at home and
regarding home care nurses’ experience with promoting oral health in older adults. Thus, we have
conducted a scoping review on the oral health status and oral health-related quality of life among
older adults receiving home care services and a scoping review on the oral health care-related
beliefs among home care professionals and their attitudes toward promoting oral health in older
adults receiving home care services. The reviews have given us an international insight and the
knowledge acquired from these studies will be used in developing the model by a co-creation
process.
Conclusions
CORAL will provide the answers to some of the demographic, structural, organisational, economical
and societal challenges. The outcome will contribute to the connection of home care services and
Henni: CORAL – Connecting ORAL health-and home care service for patients receiving home care in Norway
oral health services for older adults. It will facilitate knowledge-based and sustainable services and
politics. This will reduce costs, increase patient safety and improve quality and efficiency of care.
Lessons learned
COVID-19 has made it challenging to carry out research activities involving patients and healthcare
professionals. We have learned that we must adapt and use alternative methods when necessary.
Limitations
The CORAL model will be strongly based on Norwegian conditions, which means that other
countries wishing to implement the model may have to make country specific or regional
adaptations.
Suggestions for future research
Our aim for further research is to apply for more funding to implement the CORAL model nationwide
in Norway as a continuation of the CORAL-project