A listener sent a question about dental care for a family member in the facility. Kathy will give you some pointers to help out.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460333/
https://www.alz.org/help-support/caregiving/daily-care/dental-care
SUMMARY KEYWORDS
teeth, nursing homes, brush, toothbrush, dental care, cooperative, dentist, nurse, person, electric toothbrush, talk, oral, care, mouth, sedated, aides, kathy, chew, amy, loved ones
SPEAKERS
Katherine Cocks, Ame
Katherine Cocks00:02
Hi, my name is Kathy. I've been a geriatric nurse for over 10 years. Many times when I would meet with family members of aged loved ones, they didn't always know what to do. I started this podcast knowledge for caregivers, to assist them with practical suggestions as they assist their own loved ones age with dignity and grace. I want to welcome you back to this episode. And I'm really excited because one of my listeners sent in a question. So let's hear from Amy, and then I will try to answer her question.
Ame 00:49
Hi, Kathy. I love the knowledge for Caregivers Podcast, you give so many great tips. And I have a question for you. I was wondering if you had any information about dental care for folks who are in nursing homes, my dad has been having some issues, and I'm really not sure what to do. And I thought she might be able to give give me some advice. Thanks so much.
Katherine Cocks01:11
Thank you, Ame, for that question. And as I began to do my research, that is a very common problem. It is very important to take care of people's teeth, because that affects their general health, whether they get infections, whether they get pneumonia, but also whether or not they can just chew because when people teeth hurt, then they quit eating, and especially if they have dementia, it's very, very difficult. It's even harder when they live in a facility. The first thing that I would do for someone in a facility is talk to the nurse. The reason is, is to find out the plan of care. So the nurse does an assessment and she develops a plan of care. And hopefully in that plan of care is oral care. So find out are they flossing his teeth are they brushing his teeth, and anything that you can do. One of the biggest challenges is that there are travelling doctors that go to nursing homes, but they're not traveling dentist. So if at all possible, if you have a loved one in the nursing home, is to try to get them to the dentist to get care. You may have to call around because if they have dementia, then you definitely want to check and see if they have experience with dental care for dementia. Sometimes they may have to be sedated. I do want to come back to some other things that you can do if you are the ones that are providing dental care many times when we're talking about dental care for an older person in a nursing home. The challenge is if they have memory issues. So there are some different things you can try, you can try to brush them from behind sometimes when we come from the front, they clench their teeth, we definitely don't want to force something into their mouth. But sometimes if you come from behind, they will let you brush their teeth. There's a thing called a Waterpik. And basically what it does is it washes between your teeth. That's something that can try to may not feel so invasive as scrubbing their teeth, it is definitely very messy. If they will not let you brush their teeth, you can try using some Q tips or some gauze wrapped around a tongue depressor and see if they will let you just do that to rub their teeth and declaimed them. Some people have recommended using a toothbrush with a long handle. Many of our toothbrushes are very small and it may be difficult for the person to use. Also, there's a thing called anti plaque mouthwash. If they're having a lot of trouble brushing their teeth, or they're resistant to that you can have them wash out with the mouthwash and that will help do some of the effects of brushing the teeth. Definitely talk again to the staff and see if they're eating a lot of high sugar foods, things that will stick to their teeth and that will cause periodontal disease and cavities. If they are having some snacks or they eat, you know, pudding or something like that, it's a good idea to encourage the staff to have them drink water. Apples, believe it or not is something that you can chew that will kind of clean your teeth. It just works like you know it's crunchy and stuff like that. So it'll kind of clean your teeth. The only problem is many times people who are older if they have teeth problem, they're not able to chew an apple. The other thing is you want to make sure that we don't force them to open their mouths, if at all possible. Now you can do some mouth props. You can also have some things that help keep their mouth open. As long as they are cooperative. You know, we don't want to be forcing something and we can break their teeth but if they're cooperative, but they just have trouble keeping their mouth open If you can do some of these mouth blocks that put them in there, they leave their mouth open. And then you can brush really quick for that. Sometimes just maybe laying them on their back can also help. There are some different types of toothbrushes, some of them, you can are curved. And you can look online, they're called a call your toothbrush, C O L L I E R, and those who have a different type of curvature, and sometimes it makes it easier to clean around the tooth. Sometimes it's easier to get like a child's toothbrush, something that is smaller, and it's easier to maneuver around. And sometimes, you know, older people in the facility, they won't let you like floss their teeth, and they really need that. But you can buy these kind of toothpicks that have a little fuzz on them. And that can kind of go between their teeth. And that might be easier to do to also help them with their teeth be able to get kind of like flossing, even though it's not exactly the same way it is recommended if they do let you brush their teeth to definitely get them electric toothbrush. Now one of the things is nursing homes are probably not going to provide electric toothbrushes. So that's something you may have to buy yourself. And you may have to go there sometimes and use the electric toothbrush. Remember with electric toothbrush, it's got to stay charged, and then those little heads on top of it, they need to be replaced every now then just like your regular toothbrush. So that's another idea of something that you can try. It's also important to always explain to them what you are doing. And sometimes we just go in there we go, okay, brush your teeth, and we assume they know how to brush their teeth. But it's a complex process to brush your teeth, you got to get the toothbrush wet, you got to put the toothpaste on it, then you brush and you got to brush the different parts of your mouth. And so a person that doesn't remember how to do that might need you to be able to walk them through all the steps and they may be more cooperative, and do it if they can do it themselves. It's always important to encourage people to do their own care as much as possible to give them independence and to make them feel proud of themselves. I unfortunately have found that from my research, it's just sometimes very, very difficult for people in nursing homes to really get that adequate oral care that they need. Again, some of them, you can't transport out. Now most nursing homes do have handicap vans. So if they can at least get in a wheelchair, they can go to a dentist that way. But definitely getting them to the dentists and getting them cleanings as often as the dentist say, if they're not cooperative, then definitely talk to your dentist about how you can help them get the oral care that they need. And like I said, just drinking water after meals or after they've eaten something with sugar will help wash some of that off also. Thank you, Ame, for that question. I hope I answered it. Sometimes I know when we're giving suggestions, it's just a trial and error thing to see what might work. And I did talk to an oral hygienist and she said that it is definitely one of the areas that's often neglected in nursing homes. Therefore, it would be one of the things that I would look at either at the federal level or the state level, getting involved with legislation to make sure that oral care is part of every client's care plan when they're in a nursing home. You may ask what's the care plan, like I said, that's when the nurse writes it up. And they may say, This person needs to be taken to the bathroom every two hours, this person needs a bath on Monday and Thursday. This person needs to be helped out of bed and it takes two people or they have to use a lift or they use a wheelchair. So it's the plan that the nurses write out for the aides to carry out. And if it's in there, then the aides are expected to do those tasks. So definitely always keep in communication with your health care team, the nurses, the doctors and the dentist and oral hygienist in order to make sure to keep their mouth as healthy as possible. I did have a lady. She was very resistant to care, they were not able to take her to the dentist. So they did end up having to put her in the hospital and just pull some of the teeth because they were painful and there was no way to do it in the office. And they sedated her. That's not always ideal, but sometimes those types of things have to be done. Thank you for listening and going on this caregiving journey with me I hope you have enjoyed this podcast. If you have found it helpful, then share it. If you wish to contact me for consulting services you can reach me at www Cathy's consulting.com and Kathy's is spelled K athy s. Remember, all content is meant for informational purposes only, and not to replace the advice of healthcare professionals.