How improving oral care has meant more kisses for care home resident, Mr A, living with Advanced Parkinson’s – A case study

As part of Parkinson’s Awareness week we wanted to share with you how, by using our empathy for a gentleman living with advanced Parkinson’s, and our knowledge of the condition, we were able to gain a good understanding of his needs and advise on and recommend specialist oral care product solutions for him.

This has proved to be life changing for Mr A and has led to a more loving and fulfilling relationship with his wife. J

‘All I want is to be able to feel that my mouth is fresh and clean every day’

This is what Mr A told me when I first met him and asked him how I could help improve his oral care.

I was genuinely moved by his simple wish, and it made me realise that this was something that I completely took for granted – I would never dream of leaving the house without feeling that my teeth are squeaky clean and my breath sweet.

And it also made me absolutely determined to do everything within my power to help make Mr A’s wishes happen.

Background to oral care case study

We were asked to conduct a trial with Mr A living in a care home in Leicester with Advanced Parkinson’s Disease. I had met one of his nurses at a workshop where I had been giving a presentation ‘How to brush up on oral care in care homes’ and the nurse had approached me afterwards for help as they were at a loss as to how to improve this gentleman’s oral care.

Mr A had no swallow reflex was on a peg feed and was nil by mouth. His mouth care was described as very poor by staff, as he wasn’t able to open his mouth very well. Therefore access to his mouth to deliver effective oral care was limited. Added to this the staff were frightened of the possibility of Mr A swallowing or aspirating on the oral care products which were in use.

Mr A had severe halitosis and a substantial build up of debris on his tongue as a result of intermittent cleaning results. He had his own teeth and didn’t have any particular issues with these at the time of the trial.

The oral care regime that was in place when I first met Mr A:

Mr A’s oral care plan stated brushing twice a day with a normal toothbrush (large head) and standard toothpaste. This was only happening intermittently due to the staff’s lack of confidence in the products provided and the risk of aspiration. Also, despite Mr A’s halitosis, staff would not use a mouthwash for additional fear of aspiration.

What we recommended and why:

We know that a toothbrush used properly is the only tool that will successfully remove bacterial plaque from the teeth and mouth.

For tooth brushing – we advised on using our Tepe Special Care Compact Toothbrush as it is very gentle with a small head which is less invasive and more effective at reaching all parts of the mouth. This soft toothbrush was perfect for Mr A as it is recommended for people with swelling and difficulty opening their mouths and its sturdy, ergonomically designed handle provides a comfortable and secure grip. It can also easily be angled for better access to all areas of the mouth.

Toothpaste – As Mr A was at risk of aspiration we recommended our Oralieve Mild Mint SLS free Non Foaming Toothpaste. Sodium Lauryl Sulphate (SLS) is the ingredient added to many toothpastes that makes them foam. This can have a drying effect on the oral tissues and therefore should be avoided in people who already have a dry mouth. Similarly, for those patients at risk of aspirating, an SLS free toothpaste could also be beneficial so as to reduce this risk as far as possible.

Providing dry mouth care – As Mr A had a significant build up of dried secretions in his mouth and particularly on his tongue, we recommended the use of Oralieve Moisturising Dry Mouth Gel to be massaged into all areas of the mouth (cheeks, palate, tongue) coupled with the Moutheze oral cleanser. Dry mouth moisturising products provide long lasting relief for a severe dry mouth and can be used to soften dried secretions so that they can be removed more readily. Dry mouth gel can be mixed with a couple of drops of water to make it more palatable to patients.

Mouth Cleansing – We recommended Moutheze oral cleansers for Mr A to help clean the soft tissues of his mouth and remove food debris and tenacious dried saliva. Moutheze provide gentle mouth cleansing without the choke or aspirating hazard of sponge swabs or the awkwardness of toothbrushes.

What happened clinically?

The introduction of the soft headed toothbrush with angled head and the SLS free non foaming toothpaste, resulted in the staff being able to deliver regular mouth care. They could now do this with confidence that the risk of aspiration was minimal and being able to access all areas of Mr A’s mouth for cleaning, easily and thoroughly.

The use of dry mouth gel and the Moutheze enabled the staff over a period of time to work on reducing the build up and to restore Mr A’s tongue to a pink and healthy state. The nurses commented that the dry mouth gel had proved really successful for lubricating Mr A’s dry lips and mouth and his mouth area was cleaner with less coating.

The carers found that Mr A’s breath was much fresher and he was communicating more as his mouth was not so dry.

What happened socially?

I went to visit Mr A a month later and hardly recognised the person that stood before me, to the man I first met. He was smiling, confident and was socialising much more as a result of using our products, and he told me that his mouth felt much fresher and cleaner and that it didn’t feel so dry.

Mr A’s wife visited him every day and she found that his breath seemed much fresher especially when talking and he no longer had any signs of the bad breath he had been experiencing in the past. As a couple they were now able to be much more physically close than previously and were enjoying kissing again as a result of his improved oral hygiene.

Mr A and I exchanged a high five and I was absolutely delighted that we had been able to help give back to Mr A his fresh feeling mouth, his confidence and more kisses with his wife.

#parkinsons #comfortincarecarehomes #healthandwellbeingincarehomes #oralhealth #empathy #hcsuk #dignityincare #improvinglivesfor30years



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“We’ve built a strong working relationship with Hcsuk over many years, having used them to source, install and service our medical training equipment. We have always found the team very professional, helpful, and well-organised. We’d like to give a particular shout out to Phil, the technician / engineer who has been the consistent friendly face visiting our business to inspect and test our mobility hoists every 6 months. Thank you for all your support and advice.”

P. B. (Care Manager), Blue Bird Care Ltd

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We would just like to pass on our thanks for all of your help with our orders and would be pleased if you would also pass on our thanks to the manufacturers for being so accommodating in meeting our requirements. We have found everyone very helpful.

Lincs Partnership NHS Foundation Trust

Since I set up the account for Hcsuk over 18 months ago I have found them to be an excellent advocate of our products. They have been willing to learn about the technical and servicing elements to our hoists and the sales staff have really taken on board and proactively promoted our range where possible. I feel that as a company Hcsuk have got the desire and right people in place for growing in this competitive industry. They seem to push themselves to go that little bit further and offer that little bit more to stand out from the rest. May our relationship continue going from strength to strength.

Joerns Healthcare

As a care home manager I have used Hcsuk for my supplies for the last 20 years in two homes. I have always found them to be helpful and reliable. Their products are of the highest standards, they are able to source anything. The delivery service is prompt and regular so I do not have to keep large amounts of stock. They supply extra services such as servicing and repairs which are done efficiently, and training in COSHH. The reps are pleasant and helpful bringing new products to my attention but are never ”pushy”. Aftercare is good, any problems soon sorted. I would recommend them highly and would not think of using anyone else.

Littleover Nursing Home

HPC have supplied Hcsuk (Health Care Services Ltd) for well over a decade now and we would consider them to be a high quality and professional business run in an organised and progressive manor. We do not rank our customers or have a preferred customer status but if we were to introduce such a scheme I can confirm that Hcsuk would easily make such a grade.

HPC Healthline

As a manufacturer we look for key values in a distributor some of these include honesty, reliability, commitment and reputation. Hcsuk carry all of these and many more. With a twenty plus year working relationship we now place Jo and the team at the top of our distributor list. I have no hesitation in recommending Hcsuk to any prospective manufacturer or customer and wish Jo and the team all the best for the future.

Cleenol Group Ltd

It is brilliant that we are able to ring Health Care Services and that you will go the extra mile to get us the stock we need as soon as possible.

Rykneld View Nursing Home

Just to say a huge thankyou to you and your fantastic team, and I mean that from the Heart. I have never before experienced such a person centred company.

Hampton Grange Nursing Home

What I like about working with Health Care Services is the relationship we have built up and the personal service. The homes report that you always deliver on time, the quality is consistently good and the prices competitive. Your team members are always willing to go that extra mile for us and if ever we have an issue there is always someone there to save the day.

Eastgate Care

Thanks to Jo for going over and above to get us our items in time for our special event at Buddleia House – it was very much appreciated. A massive thankyou for your continued assistance as a supplier to ourselves.

Buddleia House

We have always received excellent services from everyone at HCS at our 2 care homes, especially Lee, Jo and Phil. Always professional with a quick response time. Nothing ever seems too much trouble. Recently I had to use them personally for equipment to enable my mothers discharge from hospital. I had a response within the hour for prices and delivery came straight from the manufacturer to speed up delivery. Phil arrived at the same time to put the equipment together for us! I can’t thank them enough for putting our minds at ease and for the continued support from a personal and professional perspective. I’d recommend them to anyone requiring care equipment and its nice to support local businesses. Especially when they do such a good job!!

Orla House

I contacted HCSUK trying to find a hoist that could be operated unaided by the client. I had become very disheartened, no-one was really helpful until I spoke to Donna at HCSUK.

Donna was incredibly understanding, her professionalism raised my spirits again. Everything Donna said she would do she did, including arranging for me to speak to Andrew the salesman who like Donna was incredibly helpful, happy to bring two machines to demonstrate.

I can’t recommend them highly enough. They are good people.

Penelope C

I spoke to Lee Atterbury 2 weeks ago, when I was despairing about the prospect of finding any equipment to help my husband in the bathroom. I had tried all the popular brands, but none were right for his needs.

When I spoke to Lee he understood what I was saying and set about trying to find what we need. He was so patient and understanding and gave me the confidence to explore outside the box.

I spoke to Lee today and was able to tell him that we, hopefully, have found the solution. I am sorry that it was not a product you sell, though you may in the future, but will certainly look first to HCS for other products.

Thank you so much to Lee for first class customer service.

Christine G, Sheffield

VAT Relief Information

Conditions for VAT relief for disabled people

Some of the products which can be purchased from the Hcsuk website are available for an eligible person to purchase without paying VAT on them. HM Revenue and Customs sets out the conditions when equipment for disabled people might be free of VAT and how to claim exemption from paying VAT on these products.

Products a can only be exempt from VAT when all the following conditions are met:

  1. The customer is eligible to purchase supplies at the zero rate
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  3. The goods and services are eligible to be supplied at the zero rate

A more detailed explanation of each of these conditions is given below, but you should visit the HM Revenue and Customs Website to fully understand the conditions

The product must be being purchased for someone who is chronically ill or disabled.

A person is ‘chronically sick or disabled’ if he/she is a person:

It does not include a frail elderly person who is otherwise able-bodied or any person who is only temporarily disabled or incapacitated, such as with a broken limb.

‘personal or domestic’ use means that the supply must be made available specifically for the use of an eligible individual.

You don’t have to physically buy the goods in person. If your parent, guardian or wife or husband buys the goods and services for you, then you won’t be charged VAT.

What counts as personal or domestic use?

Personal or domestic use means that the goods or services are supplied for your own private use, rather than for business purposes. Also, the goods or services must be just for your own use – not for use by anyone else, or chronically sick or disabled people in general. However, if you and your partner are both chronically sick or disabled and you buy goods or services for both of you to use, then you won’t have to pay VAT.

Products which are offered for sale on this website which qualify for VAT relief to be claimed for an eligible person.

The products which can be bought without paying VAT are:

Only the products on our site carrying the VAT exemption price (the smaller price marked ex VAT) are eligible to be purchased this way and you must tick the box on the basket page indicating that you wish to claim VAT exemption on the items in your basket that are eligible for VAT relief.

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Please note that all orders submitted with a VAT relief claim form completed are checked before the order is processed.

It is necessary to complete a separate claim form each time a qualifying product is purchased from Hcsuk.


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