The Gary and Mary West Senior Dental Center: An Integrated Model of Dental, Health, and Wellness Care for Older Adults

Field: Health Professions (Health Sciences)

Despite significant advances in dentistry to prevent many oral healthcare issues, dental disease remains one of the most serious and widespread chronic health problems in America. The problem is even more severe among lowincome or impoverished older adults, who often lack access to high-quality, affordable care. The reason: oral health has remained a low priority public health issue-one that has been isolated from general health monitoring and largely overlooked by our nation's medical system. The Gary and Mary West Senior Dental Center (Senior Dental Center), located in the Gary and Mary West Senior Wellness Center (Senior Wellness Center) in downtown San Diego, California, was created to address this significant, critical unmet need.A Decade-and Counting- of Caring for Older AdultsGary and Mary West founded the Gary and Mary West Foundation (www.gmwf.org) in 2006 to help older adults age successfully, with dignity, quality of life, independence, and access to high-quality healthcare and support services. In 2009, they created the West Health Institute, a nonprofit applied medical research organization in San Diego, California, and in 2012 launched the nonpartisan West Health Policy Center in Washington, D.C. Through a combination of applied research, policy, and community initia- tives, as well as outcomes-based funding, these organizations comprise West Health and they are committed to creating and advancing sustainable, high-quality healthcare delivery models to improve care, at a lower cost, for older adults and their families.In 2010, the Wests provided a $3 million contribution through their Foundation to Serving Seniors, a nonprofit organization with more than forty-five years of serving low-income older adults, to open the Gary and Mary West Senior Wellness Center in downtown San Diego. The gift marked the largest donation in Serving Seniors' history and allowed the nonprofit to implement state-ofthe-art, cutting-edge programs and services designed to help older adults thrive.Today, it is a popular community hub that provides meals to as many as 900 low-income older adults daily. These older adults also have access to health, psychological, nutritional, social, and community supportive services 365 days a year, from more than thirty nonprofit organizations-all under one roof. The Foundation continues to provide support to the Senior Wellness Center in service of low-income older adults in San Diego, championing outcomes data collection that can validate the Center's positive impact, and to share findings and practices with other communities throughout the country, serving as a national model for the next generation of senior services.The majority of the older adults who visit the Senior Wellness Center are economically vulnerable, with 95 percent living at, or below, the federal poverty level, and nearly 30 percent are housinginsecure-almost 20 percent are homeless. They come from a diverse set of racial and ethnic backgrounds with English, Mandarin, and Spanish being the most common languages spoken.In 2014, the Gary and Mary West Foundation and Serving Seniors surveyed more than 300 older adults and discovered that dental care was their greatest unmet need. Forty-three percent of participants reported having pain in one or more teeth; 35 percent reported difficulty chewing; 22 percent reported issues with bad breath and dry mouth; and 21 percent reported bleeding gums. Fifty-eight percent of respondents stated they had not seen a dentist in more than a year (some hadn't been seen for more than five or ten years), which exceeds the guidelines recommended by the American Dental Association of visits every six months. According to the survey, the top three barriers to receiving regular dental care were high cost, limited access to participating dentists in the Denti-Cal program due to the low reimbursement rates, and lack of transportation.As regular volunteers who often serve meals at the Senior Wellness Center, the Wests were not surprised by the survey results. …