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2014
February
A
Assessment of oral and dental cares provided in Ca
Assessment of oral and dental cares provided in Ca
Assessment of oral and dental cares provided in Canadian seniors long-term care facilities
0%
Exit Survey
1-Does your facility provide seniors long-term care?
Yes (If you answer Yes, please go to question 2)
No (If you answer No, this is the first and last question you have to answer. Thank you very much for returning the questionnaire.
2-Is your facility government-funded (or publicly funded)?
Yes
No
3-Can you indicate the number of residents?
4- Is there an on-site dental clinic within your facility?
Yes (If you answer Yes, please go to question 5)
No (If you answer No, please go question 6)
5-How many chairs are they?
6-Is mobile dental equipment used to provide exams and basic dental care at bedside?
Yes (If you answer Yes, please go to question 7)
No (If you answer No, please go question 10)
7-What dental health care professionals are visiting? How many of them?
Dentist
Hygienist
Denturist
How many dentist, hygienist and denturist?
8-How often are they visiting?
….. per week
….. per month
….. per year.
9-What services are provided?
Oral exam
Dental cleaning
Dental prosthetic services
Extraction
Dental restoration
10-Are the residents transferred to a hospital or another healthcare center for dental care?
Hospital
Private dental practice
Long-term care residence
Thank you for your time and consideration
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