RNs lead the project to assist seniors with oral health care
One of the first lessons we learn as children is the importance of good oral hygiene, but it’s a practice that often gets lost on seniors, and that has the potential to lead to serious consequences.
It’s now one of the biggest concerns facing long-term health-care providers in Ontario, and it’s what led to a new project - Oral Care Community of Practice - which aims to educate nursing home caregivers about the importance of oral health care in seniors.
Registered nurses Ibo MacDonald and Heather-Woodbeck are long-term care co-ordinators who are co-leading the project, working with nursing homes across the province to deliver the wake-up call that seniors simply can’t afford to let their oral health slide.
“Plaque is the cause of all oral health problems and also has links to systemic problems as well; aspiration, pneumonia, stroke, poor diabetic blood-sugar control, heart attacks,” says MacDonald. “If you’re not removing that plaque, that’s what leading to these long-term problems.”
She says because of mobility and dexterity issues, coupled with dementia in many cases, residents are coming into nursing homes with poor oral health already, and it’s up to the caregivers to try and prevent it from getting worse through regular cleanings. In some cases, residents will have to be referred to dental specialists.
As part of their mission to get ahead of the problem, MacDonald and Woodbeck are hosting educational webinars for nursing-home professionals and then make followup visits to the homes where they set up a team around oral care and analyze what needs to be improved.
They also educate caregivers on how to look for abnormalities, such as gingivitis, cavities and abscesses, as well as offer hands-on strategies for working with seniors on oral care.
“It’s a gentle, persuasive approach with a stop-and-go technique, and listening carefully to what the resident is saying,” says Woodbeck. “If a resident tells you to stop, you stop immediately.”
She says little changes can make a big difference, too; like approaching a resident from a 45-degree angle so they see the caregiver clearly and aren’t startled when they suddenly find a toothbrush in their mouth.
The pair is also encouraging nursing homes to look at their daily brushing schedule, seeing if maybe the timing could be changed to improve the outcome.
They say many nursing homes crush pills with something sweet, like juice or jam, after the resident has already had their teeth brushed for the evening, leading to increased risk of rotting and cavities.
Most homes also try to cram in teeth brushing during the morning breakfast rush, which they say contributes to the tension and anxiety around the practice.
“It’s ideal to do it after breakfast and right before bed,” says Woodbeck.
“If you were to organize when you do this care, it might be more successful. And it might be easier for staff to do it,” adds MacDonald.
Through their project, they also encourage nursing home caregivers to take the time and talk with residents who are reluctant to open their mouths, to see what’s contributing to their fear of getting their teeth brushed in the first place.
“If the resident doesn’t want oral health care done, try to figure out why,” said MacDonald.
Registered nurse Ibo MacDonald is co-leading the Oral Care Community of Practice project.