Evaluation of the Integrated Management Program for Acute Malnutrition in the Douentza Health District, Mopti Region, Mali

Introduction: Malnutrition is a major public health problem in Mali, despite the efforts of the government, its technical and financial partners. The aim of this study was to evaluate the integrated management program for acute malnutrition (IMPAM). Methodology: This was a descriptive cross-sectional study that took place from January to December 2020 in the Douentza health district. The study included anyone with at least one malnourished child aged 6 to 59 months in their care who agreed to take part in the study, community health center staff who had given their consent, and the URENI manager at the Douentza reference health center. Data collected via questionnaires were entered into Excel and then analyzed using Epi-Info version 7 software. Results: A total of 138 acutely malnourished children aged 6 - 59 months, including 71 girls (51.45%), 138 accompanying mothers and 11 health workers, were included in our case study. Among the malnourished, 54.34% were in the 12 - 23 months age group and 69.57% had the severe form. 93% of the mothers interviewed were satisfied with the care provided, and all the health staff interviewed stated that community conflicts had an impact on IMPAM’s activities. Cure rates were 81% in Moderate Outpatient Nutritional Recovery and Education Unit (URENAM), 84% in Severe Ambulatory Nutritional Recovery and Education Unit (URENAS) and 92% in Recovery and Intensive Nutritional Education Unit (URENI). Drop-out rates were 19% in URENAM, 16% in URENAS and 0% in URENI. The death rate was 8% in URENI and 0% in URENAM and URENAS. Conclusion: This study confirms the high prevalence of malnutrition in the district (10.54%). It also reveals that factors such as inter-community conflict and insecurity have seriously affected the IMPAM program.

Attitude of nursing students towards Internet-based nursing services for the aged

Objective To investigate the attitude,willingness,and motivation of third-year undergraduate nursing students from a university of Chinese medicine toward Internet-based nursing services for the aged(IBNSA),providing a reference for its development and related nursing education.Methods This study was conducted from March to April 2019.Using a self-designed questionnaire,this cross-sectional study comprised 508 third-year undergraduate nursing students from a university of Chinese medicine.The questionnaire was divided into two parts.The first part contained the general information of nursing students.The second part investigated nursing students’attitudes,willingness,and motivation towards IBNSA(a total of seven questions).Results Of the 508 nursing students,314(61.81%)expressed support for the IBNSA,44(8.66%)expressed disapproval.Regarding career choice,279(54.92%)were willing to choose IBNSA,51(10.04%)were unwilling.The top three motivations for choosing IBNSA as a nursing student career were increased income,high autonomy and flexibility,and good job prospects.On the contrary,the top three reasons not to choose this option were safety concerns,lack of time and energy,and unwillingness to undertake elderly care.Experience with community activities or a part-time job,experience with elderly care,willing to choose the nursing profession,willing to engage in nursing care after graduation,and willing to engage in nursing for elderly patients after graduation were significantly associated with the motivation of nursing students to participate in IBNSA(P<0.05).Conclusion The majority of nursing students have a positive attitude towards IBNSA and are willing to choose it as their future career.Nurses’and patients’safety guarantees and salary distribution were critical factors influencing their choice.Nursing schools should pay attention to the concerns of nursing students,constantly improve the management system of IBNSA,strengthen safety education,and provide professional knowledge and skills to improve the quality of personnel training.

The Experiences of the Elderly and Caregivers in Respect of Caring for the Elderly in Windhoek and Rehoboth Namibia: An Exploratory and Descriptive Study

In many instances, care for the elderly, especially in long-term care institutions, is provided under minimal supervision by caregivers who are lay people. This can lead to poor quality care or neglect of the elderly. The research question was: “How competent are lay caregivers for the elderly in old age homes, who often lack the opportunity for training to improve their knowledge and skills, in delivering care to the elderly? The aims of the study were to explore and describe the experiences of both the caregivers and the elderly in respect of caring for the elderly in old age homes. The objectives of the study were to explore and describe the experiences of the caregivers and the elderly with respect to caring for the elderly and in respect of nursing care they received. A qualitative, explorative, descriptive, contextual and phenomenology design was used to perform this study. In the situational analysis, the experiences and needs of the caregivers were described. Themes in terms of interpersonal relationships that could be positive or negative regarding the elderly were identified. These included lack of regular in-service training sessions for caregivers. Likewise, sub-themes like communication, support and caring for elderly people were revealed. Inadequate knowledge of caregivers in caring procedures, a shortage of staff, equipment and absence of policies which should support and guide the work of caregivers impacts negatively on the care of the elderly. From the experiences of the elderly and caregivers, the competencies under scrutiny emerged and were measured qualitatively by the perceptions of the elderly, in respect of the caring they were exposed to.

Quality indicators for the care of older adults with disabilities in longterm care facilities based on Maslow’s hierarchy of needs

Purpose:This study aimed to develop quality indicators for the care of older adults with disabilities in long-term care facilities(LTCFs)based on Maslow’s hierarchy of needs.Methods:The draft of the quality indicators was drawn up based on a literature review and research group discussion.The quality indicators were finalized by two rounds of expert consultation(involving 15 experts)using the Delphi method.The Analytic Hierarchy Process was applied to calculate the indicators’weight.Results:The response rates of the two rounds of consultation were 100%and 93%,and the expert authority coefficients were 0.86 and 0.87.After two rounds of consultation,the expert opinion coordination coefficients of the first-,second-and third-level indicators were 0.42,0.25,and 0.96,respectively(P<0.05),and the variation coefficient was0.25.The final quality indicators for the care of older adults with disabilities in LTCFs included 7 first-level,19 second-level,and 107 third-level indicators.Conclusion:The quality indicators for the care of older adults with disabilities in LTCFs are reliable,scientific,comprehensive,and practical and specify the content of person-centered care needs.This can provide a reference for evaluating and improving care quality in LTCFs.

Survey on hospice care attitude of family members of advanced cancer patients at different ages

BACKGROUND Hospice care plays an important role in improving the quality of life of advanced cancer patients,but controversy remains over whether age affects the attitudes of family members toward hospice care.AIM To investigate the attitudes of family members of advanced cancer patients of different ages toward hospice care.METHODS The study participants were 175 family members of patients with advanced cancer from January 2020 and October 2022.The participants were divided into youth(<40 years,n=65),middle-aged(40–60 years,n=59),and elderly(>60 years,n=51)groups.Researchers investigated and compared the degree of awareness regarding hospice care,attitudes,and whether the family members of patients would choose hospice care.RESULTS Among the family members of 175 patients,approximately 28%(49/175)were aware of hospice care.Awareness of hospice care,the proportion of hospice care acceptance and adaptation attitudes,and the proportion of those who chose hospice care in the youth group were higher in the middle-aged and elderly groups(P<0.05).No statistically significant difference was found in these three indicators between the middle-aged and elderly groups(P>0.05).Hospice care was chosen mainly to relieve pain and reduce unnecessary treatment,whereas the reasons for not choosing hospice care were mainly distrust and ethical concerns.CONCLUSION The family members of patients with advanced cancer had relatively low awareness of hospice care,while youth had a higher awareness of hospice care,acceptance,and adaptation attitudes,and were more willing to choose hospice care.

Preconception Care Health Education for Female Workers of Reproductive Age in Japan Evaluation up to 6 Months after the Program

Objectives: The aim of this study was to implement a health education program for education of preconception care (PCC) for female workers of reproductive age through a seminar and to evaluate the program based on PCC knowledge and awareness and behaviors before the seminar and at 3 and 6 months after the seminar. Methods: A small group health education seminar was implemented using leaflets for 84 female workers of reproductive age, age 20 to 35 years old, and an intervention by group discussion and feedback was provided. Of these participants, 60 (71%) who provided valid survey responses were included in the analysis. The primary outcome indicators were PCC knowledge, PCC awareness and behaviors, and a food frequency questionnaire, and the secondary outcome indicators were self-efficacy and the health awareness and stress management subscales of the Health-Promotion Lifestyle Profile scale. The survey was conducted three times, before the seminar and at 3 and 6 months after the seminar, and the results were compared. Results: The percentage of individuals with PCC knowledge was significantly increased at 3 months after the seminar as compared with before the seminar, and it remained at this level even at 6 months after the seminar. The percentage of individuals with PCC awareness and behaviors was significantly increased for the items actively eat foods containing folic acid, prevent sexually transmitted diseases, and conduct self-examinations for breast cancer at 3 months after the seminar and for the items eat well-balanced meals, make the mind active, prevent sexually transmitted diseases, and conduct self-examinations for breast cancer at 6 months after the seminar. Furthermore, the score for the health awareness subscale of the Health-Promotion Lifestyle Profile scale was significantly increased at 6 months after the seminar. Conclusion: The health education program established PCC knowledge at 6 months after the seminar and improved some PCC awareness and behaviors. Therefore, it was suggested that the program would be effective for education of PCC for female workers of reproductive age.

Evidence of Care of the Aged in Ghanaian Communities—A Scoping Review

Sub-Saharan Africa population is increasing in age with little acknowledgement on the consequences of the issues of ageing. Aim: To explore and describe evidence in published literature on care given to the aged at home and how they prepare for their ageing. Method: The study applied the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) framework for systematic literature reviews using the population, intervention, comparison and outcome (PICO) method to track the eligibility of research questions. This method was the most appropriate for use in exploring the current position in available literature for that of Ghana. The research was performed using five electronic databases from January to July 2017 taking into consideration the set inclusion and exclusion criteria. Only studies written in English were considered and a total of 18 articles met the study criteria. Reviewers extracted primary studies comprising quantitative, qualitative and critical reviews. Result: The literature review showed shortcomings in care for the aged at home. From the search, six core themes were generated: neglect of aged care;aged care for the younger generation;aged living arrangements;government neglect;preparedness;and care of the aged in Ghana. Conclusion: This review offered significant insight into care for the aged in their homes. The inclusive nature of the rigorous approach used provided a good understanding of underlying issues on the needs of the aged. Challenges for future are broadened in scope for more research and effective awareness for interventional projects, services on care given to the aged.

Method to Evaluate the Location of Aged Care Facilitiesin Urban Areas Focusing on the Equity in Terms ofUsers’Accessibility

The present study developed and tested a method to evaluate the location of aged care facilities from the viewpoint of whether they are equitably located for users,using the improved Median Share Ratio(MSR).By evaluating the current location of aged care facilities,it is possible to extract the districts which are short of facilities.The evaluation method was applied to Chofu and Kiyose Cities in Tokyo Metropolis,Japan,and the evaluation result of weighting and that of not weighting by elderly population were compared and discussed.Consequently,adopting the evaluation method with weighting by elderly population,it is possible to adequately examine the districts where new aged care facilities should be constructed.From this evidence,it is significant to evaluate the location of aged care facilities,using the improved MSR with weighting by elderly population in the study.

The Research of Social Organizations Participating in the Urban Community Aged Care＇ s Problems--Base on the City of Shanghai in China

With the deepening of China＇s aging population, the conmmnity aged care gradually become endowment new options. Social organization for its own characteristics, play an important role in participating in community aged care. But the extent to which the current social organizations to participate in the community aged care is still very low, the reason is mainly affected by the community aged care access mechanism. Article in the Shanghai community, for example, starhng fiom the present situation of the current social organizations to participate in the community aged care, analysis of the problems arising fi-om the social organizations in the community aged care, probe into its reasons in access mechanism, put forward the corresponding countermeasures and Suggestions, encourage social organizations play an effective role in the community aged care.

The Construction of the Aged Carers under the Internationa Comparative Perspective

Objective： To explore how to learn from foreign experience to promote the construction of nursing staff in China.Methods：Based on the social background and the problems faced by nursing staffin China, we selected Germany and Japan as the social environment and problems of nursing staffin China. Germany, Japan and Japan to find out how to solve the dilemma of nursing service personnel to meet the pension needs of Germany and Japan to compare whether the strategy adopted by the current development of nursing staff in China, and finally combined with the analysis of China＇s aging care workers How to draw lessons from international experience to promote the construction of nursing staff in China.Conclusion： In drawing on the experience of foreign nursing service personnel, we must first analyze the reasons for such measures, whether our country has the conditions to implement such measures is not able to solve The experience of other countries must be suitable for our country, we must combine the social environment in which our country in contrast, selectivity and targeted research.

The patients’ opinion on the use of information technologies at the Seskine Outpatient Clinic and “Centro poliklinika” Outpatient Clinic of the city of Vilnius according to the age of patients

Objectives: The objective of this study is to assess patients’ opinion of the information technologies (IT) electronic registration systems at the “Centro poliklinika” and Seskine outpatient clinics in Vilnius City. Material and Methods: The survey was conducted in May-June, 2012. In the course of the primary survey, one questionnaire was handed out to one in tenth of the newly arrived patients. Total number of 650 questionnaires was distributed. 563 respondents participated in the survey (feedback rate—86.6%). Statistical analysis of data was performed by means of personal computer using SPSS software package. Results: 54.7% of respondents state that they make use of the possibility of online registration with the family doctor. 85.05% of respondents indicate that a doctor, when making the next appointment or referring to the medical specialist, registers a patient on site by means of computer. Upon arrival of a respondent to the reception desk of the medical establishment, 90.3% of respondents are registered by means of computer. 72.4% of respondents say that they have a choice to telephone and inquire about the time of visit if they have forgotten the visit time or lost the appointment sheet. Majority of respondents using the online registration option belong to the age group between 21 and 40 years—35.3%. Conclusions: Answers by the respondents and the breakdown between “Centro poliklinika” and Seskine outpatient clinics are very similar and no essential differences have been determined.

Selection criteria for preoperative endoscopic retrograde cholangiopancreatography before laparoscopic cholecystectomy and endoscopic treatment of bile duct stones:Results of a retrospective,single center study between 1996-2002

AIM: The optimal treatment for bile duct stones (in terms of cost, complications and accuracy) is unclear. The aim of our study was to determine the predictive factors for preoperative endoscopic retrograde cholangiopancreatography (ERCP).METHODS: Patients undergoing preoperative ERCP (≤90 d before laparoscopic cholecystectomy) were evaluated in this retrospective study from the 1^st of January 1996 to the 31^st of December 2002. The indications for ERCP were elevated serum bilirubin, elevated liver function tests (LFT), dilated bile duct (≥8 mm) and/or stone at US examination, coexisting acute pancreatitis and/or acute pancreatitis or jaundice in patient's history. Suspected prognostic factors and the combination of factors were compared to the result of ERCRRESULTS: Two hundred and six preoperative ERCPs were performed during the observed period. The rate of successful cannulation for ERC was (97.1%). Bile duct stones were detected in 81 patients (39.3%), and successfully removed in 79 (97.5%). The number of prognostic factors correlated with the presence of bile duct stones. The positive predictive value for one prognostic factor was 1.2%, for two 43%,for three 72.5%, for four or more 91.4%.CONCLUSION: Based on our data preoperative ERCP is highly recommended in patients with three or more positive factors (high risk patients). In contrast, ERCP is not indicated in patients with zero or one factor (low risk patients).Preoperative ERCP should be offered to patients with two positive factors (moderate risk patients), however the practice should also be based on the local conditions (e.g.skill of the endoscopist, other diagnostic tools).

A family nurse-led intervention for reducing health services’utilization in individuals with chronic diseases:The ADVICE pilot study

Objectives:Intensive health services'utilization is common in older individuals affected by chronic diseases.This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services'use(readmissions and/or emergency service access)among older people affected by chronic conditions.Methods:This is a non-randomized before-after pilot study.A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months.Standard home care was provided during the first four months'period(months 1-4),followed by the educational intervention until the end of the study(months 5-8).The intervention,based on the teach-back method,consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment,potential complications,medication adherence,and health behaviours.Rates of health services'use were collected immediately before(T0),and after the interventions(T1).Differences in utilization rates were examined by the McNemar's test.Potential factors associated with the risk of health services'use were explored with a Cox proportional hazard regression model.Results:The sample(n=78)was predominantly female(n=50,64.1%),and had a mean age of 76.2(SD=4.8)years.Diabetes mellitus was the most frequent disease(n=27,34.6%).McNemar's test indicated a significant reduction in health services'use at T1(McNemar χ^(2)==28.03,P<0.001).Cox regressions indicated that time and patient education,as well as their interaction,were the only variables positively associated with the probability of health services'use.Conclusion:A teach-back intervention led by a family nurse practitioner has the potential to reduce health services'use in older patients with chronic diseases.

Practice Environment, Work Characteristics and Levels of Burnout as Predictors of Nurse Reported Job Outcomes, Quality of Care and Patient Adverse Events: A Study across Residential Aged Care Services

To understand how to create a stabile workforce achieving excellent quality of care and patient safety, associations between practice environments and nurse and patient outcomes have been widely studied in acute and psychiatric care hospitals. Knowing residential aged care services are challenged to tackle complex patients’ needs within certain working conditions, to what extent do nurses perceive their practice environment in geriatric care? In a cross-sectional survey, a sample of 709 registered nurses, licensed practical nurses and nurse aides employed in 25 residential aged care services completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality and patient adverse events. Associations between variables across residential aged care services were examined using multilevel modelling techniques. Associations were identified between practice environment factors, work characteristics, burnout dimensions, and reported outcome variables across residential aged care services. Multiple multilevel models showed independent variables (nursing management at the unit level, workload, decision latitude, social capital, emotional exhaustion and depersonalization) as important predictors of nurse reported outcome (job satisfaction, turnover intensions), quality of care (at the unit, the last shift, and in the service within the last year) and patient adverse events (patient and family complaints, patient falls, pulmonary and urinary tract infections, and medications errors). Results suggested the importance of nurse practice environment factors, nurse work characteristics and perception of burnout on nurse and patient outcomes across their nurse practice environment. Challenging the complex care of a vulnerable and frail population executives, physicians, nursing leaders as well as nurses in their nurse practice environment shared responsibility to create working conditions achieving excellent quality and patient safety.

Factors Affecting the Utilization of Antenatal Care among Married Women of Reproductive Age in Merca, Lower Shebelle, Somalia

Worldwide more than thousands of women and new born are at the danger of die from pregnancy and child delivery complications. Antenatal care (ANC)/ pregnancy care is the health care where expecting mothers and new born receive medical care or medical attention. The aim of this study is to examine factors affecting the utilization of antenatal care among married women of reproductive age in Merca, lower Shebelle, Somalia. Methodology: This is a descriptive cross-sectional and qualitative study design that was carried out from June to August 2022 and this study was carried out in Merca, district lower Shabelle, Somalia. Data were collected from 325 married women of reproductive age who have at least one child and more than living in Merca district. Result: Our study found that the magnitude of antenatal care uptake was 31.1% during the examined period. Very low utilization of antenatal care in Somali women is worrying in the face of high vulnerability of maternal complications. In terms of age diverse and utilization of antenatal care, women in younger age group 15 - 30 were more to utilize antenatal care services than with women in older age group 31 years above (p-value < 0.007). Our study also identified that there is association between level of education and level of utilization among women about antenatal care services (p-value < 0.001). In terms of level of awareness about antenatal care services, it is significantly associated with the level of utilization antenatal care (p-value < 0.001). Our study identified that the number of complaining complications related previous pregnancy that have no awareness about antenatal care services was higher than number of utilized antennal care awareness about antenatal care (p-value < 0.001). Based on these results, it is recommended to improve women’s awareness about antenatal care services by using health education program.

Nutrient stimulation of mesenteric blood flow-implications for older critically ill patients

Nutrient ingestion induces a substantial increase in mesenteric blood flow. In older persons(aged ≥ 65 years), particularly those with chronic medical conditions, the cardiovascular compensatory response may be inadequate to maintain systemic blood pressure during mesenteric blood pooling, leading to postprandial hypotension. In older ambulatory persons, postprandial hypotension is an important pathophysiological condition associated with an increased propensity for syncope, falls, coronary vascular events, stroke and death. In older critically ill patients, the administration of enteral nutrition acutely increases mesenteric blood flow, but whether this pathophysiological response is protective, or precipitates mesenteric ischaemia, is unknown. There are an increasing number of older patients surviving admission to intensive care units, who are likely to be at increased risk of postprandial hypotension, both during, and after, their stay in hospital. In this review, we describe the prevalence, impact and mechanisms of postprandial hypotension in older people and provide an overview of the impact of postprandial hypotension on feeding prescriptions in older critically ill patients. Finally, we provide evidence that postprandial hypotension is likely to be an unrecognised problem in older survivors of critical illness and discuss potential options for management.

Emergency department use among patients from residential aged care facilities under a Hospital in the Nursing Home scheme in public hospitals in Queensland Australia

BACKGROUND: Hospital emergency department(ED) use by patients from residential aged care facilities(RACFs) is not always appropriate, and this calls for interventions to avoid some unnecessary uses. This study aims to compare patterns of ED use by RACF patients with and without a Hospital in the Nursing Home(Hi NH) program.METHODS: RACF patients presenting to EDs of a hospital with and a hospital without this program during pre- and post-intervention periods were included. Data on patient demographics and ED presentation characteristics were obtained from the Emergency Department Information System database, and were analysed by descriptive and comparative statistics.RESULTS: In both hospitals, most RACF residents presenting to EDs were aged between 75–94 years, female, triaged at scale 3 to 5, and transferred on weekdays and during working hours. Almost half of them were subsequently admitted to hospitals. In accordance with the ICD-10-AM diagnostic coding system, diagnoses that consistently ranked among the top three reasons for visiting the two hospitals before and after intervention included Chapter XIX: injury and poisoning and Chapter X: respiratory diseases. Associated with the intervention, significant decreases in the numbers of presentations per 1 000 RACF beds were identified among patients diagnosed with Chapter XI: digestive diseases [rate ratio(95%CI): 0.09(0.04, 0.22); P<0.0001] and Chapter XXI: factors influencing health status and contact with health services [rate ratio(95%CI): 0.22(0.07, 0.66); P=0.007].CONCLUSION: The Hi NH program may reduce the incidence of RACF residents visiting EDs for diagnoses of Chapter XI and Chapter XXI.

Health care exploration work for the military empty nest old cadres

In recent years, the retired veteran cadres have grown older and older, and their numbers have also increased year by year. In this case, how to maintain the physical and mental health of empty nest veteran cadre, and further improve the quality of their life has been a realistic problem many primary health care doctors have to face and solve.

Examining older patient preferences for quality of care in postacute transition care and day rehabilitation programs

Background: Quality in health care has traditionally been determined based on clinical or health outcomes. However, these factors may not be the only aspects of health care that are important to patients. Within rehabilitation factors related to the process of care, the way in which rehabilitation services are delivered, may also be important to patients when defining quality of care. Objective: The purpose of this study was to examine and compare the preferences of older people receiving post-acute outpatient rehabilitation or residential intermediate (transition) care for alternative configurations of rehabilitation programs. Methods: A discrete choice experiment (DCE) was designed to elicit the preferences of older people for the design and delivery of post-acute rehabilitation programs. The participants were older adults (≥65 years) receiving post-acute outpatient rehabilitation or residential intermediate (transition) care in South Australia. Each participant was presented with a series of choice questions involving two hypothetical programs, the characteristics of which varied in every choice. Participants were then asked to select their preferred program. Results: Despite marked differences in case-mix and dependency levels, the preferences of the two groups were very similar, focusing on relationships and communication with health care professionals. Both groups demonstrated very strong preferences for the use of an electronic medical record and for receiving information about their treatment and progress via a meeting with a specialist physician and nurse. The outpatient rehabilitation group also exhibited a strong preference for a shared decision making model in relation to their future care needs. Conclusions: The findings highlight the commonality of preferences of older patients receiving post-acute services for the optimal configuration of rehabilitation services. Issues prioritised were service integration and access to senior medical and nursing staff. The study demonstrates the practicality and validity of DCEs to determine older people’s preferences in defining quality of care.

Professional Domiciliary Oral Care for Elderly in Nursing Homes—A Randomized Controlled Pilot Trial

Domiciliary dental care (DDC) makes regular dental visits possible for people with different functional limitations who otherwise would not be able to access a dental clinic. DDC also facilitates cooperation with nursing staff. To our knowledge, the effect of DDC on oral health among elderly people in nursing homes has not been studied. As part of a project to establish recommendations for DDC, the aim of this randomized, controlled, single-blind, pilot trial with three parallel arms was to study the effect of professionally conducted oral care intervention, in domiciliary setting, on gingival bleeding on probing, dental plaque and oral mucosa. For three months, the participants were given either A) monthly professional DDC with oral care intervention, B) monthly individual oral care instructions, or C) oral care as usual. A total of 102 (n = 107) individuals completed the study. After three months, gingival bleeding on probing was significantly reduced among more participants in groups A and B compared with group C (p < 0.0004). Dental plaque scores changed significantly over three months for group B compared with group C (p < 0.04). Mucosal-plaque scores were significantly reduced in group A compared with both group B and C (p < 0.0001). All other intergroup differences were statistically non-significant. Compared with care as usual, professional DDC has the most favourable effect on gingival bleeding, whereas individual oral care instructions result in the highest reduction of dental plaque. Both professional oral care interventions and individual oral-hygiene instructions should be included in a domiciliary oralcare programme.