How Can I Improve Mouth Care For My Residents Living With Dementia?

Having helped to care for my own Mum for over 6 years, living with Vascular Dementia I experienced, first-hand, some of the challenges of delivering effective oral care to someone living with dementia. It is proven that they are more likely to resist tooth brushing and that this is often a response to fear or a previous bad experience.

Oral Hygiene Management Guide

Dementia UK have also recently published research supporting the fact that that people living with dementia have a higher rate of tooth decay and gum disease, and this can be because they find it difficult to perform normal daily activities, or are unable to express that they have a toothache.

https://www.dementiauk.org/get-support/maintaining-health-in-dementia/mouth-care-dementia/

I am sharing a blog which includes some of the strategies that helped me with my Mum, and also to answer the question that many care home customers asked me, how can I improve oral care for my residents with dementia? I hope this is helpful and will be useful to others too.

Our top 10 coping strategies to help you to improve oral care for your residents with a Dementia

One of the biggest challenges we know you face, because it is one of the most frequently asked questions we get asked regarding oral care is:

How Can I Deliver More Effective Oral Care For My Residents With A Dementia?

It is fact that your residents with a Dementia are most likely to present your care staff with the greatest challenges regarding delivering effective oral care, as they are more likely to resist tooth brushing. This is often a response to fear or a previous bad experience.

And with the number of people with a Dementia who have their own teeth expected to rise significantly, if oral care is not carried out, a vicious circle of pain and discomfort, leading to increased resistance becomes likely.

Those people who have advanced Dementia may not be able to verbally communicate pain and discomfort in their mouths, and this may manifest itself in other ways such as crying, pulling or hitting their faces, hitting out at care staff or being very passive.

To compound this, many carers have little or no experience of training in delivering good oral care and there is a lack of good quality, safe and fit for propose oral care product solutions available on the market.

The Important Thing To Remember Is That As With All Other Aspects Of Care, There Is No Standard One Size Fits All Solution.

A good oral health plan, in 3 stages, should be created for each resident which is specific to their own individual needs.

Stage 1

On admission a risk assessment should be completed to ascertain the oral health needs of your resident.

Stage 2

A care plan should be created from the findings of the risk assessment.

Stage 3

The care plan should be followed and documented at regular intervals dependant on the findings of the risk assessment, and both should be reviewed at least every 12 months.

Always Encourage Independent Brushing Where Possible

Always try to encourage your residents to brush their teeth for themselves for as long as they are able to do so, to promote their independence and dignity for as long as possible.

Sometimes, residents will forget that they need to brush their teeth, and a reminder to brush is all that is needed.

Some residents may be able to brush their teeth, when prompted, with some assistance. Try using the Chaining or the Bridging methods to help support your resident to brush their teeth themselves.

The Chaining Method – Place your hand over your resident’s hand and guide them as they brush.

The Bridging Method – Standing in front of the resident, brush your own teeth so that they can copy and follow your actions.

For Residents Who Are Non-Compliant With Tooth Brushing.

If you have residents who refuse to brush or have their teeth brushed, try to understand this behaviour as a sign of distress rather than thinking that the resident is choosing to be aggressive and uncooperative. Remember, this is often a response to fear or a previous bad experience.

We do need to respect peoples’ decision should they decline from wanting their teeth brushed, however, it is important to remember that oral hygiene is part of personal care and that brushing is not just dismissed because your resident has declined to have their teeth brushed at that time and in that place.

Think About How You Would Feel If You Weren’t Able Brush Your Teeth For 2 Weeks

If you clean your teeth twice a day with a brush and paste, then that’s the minimum attention you should give your resident.

Then Think About How You Would Feel If You Were Reliant Upon Someone Else To Brush Your Teeth For You

  • Be flexible – try prompting oral care at different times of the day and in a place where your resident feels comfortable, it doesn’t have to be in the bathroom!
  • Review the tools and products being used, are they appropriate for your resident? Look at the size of toothbrush head and strength of bristles, too big? Too hard? Small, soft headed toothbrushes are recommended, such as our Tepe Special Compact Toothbrush.
  • Use an SLS free (non-foaming) toothpaste,this has a tremendous benefit to your residents who have to have mouth care delivered by a carer as it will greatly reduce the risk and fear of aspiration and also take away any potential choking and gagging risk. It also allows carers to see if there are any problems in the mouth.
  • It is important NOT to wet the tooth brush as this will avoid unnecessary liquid in the mouth, and only use a pea size amount of paste, as, again, this will greatly reduce the risk and fear of aspiration and also take away any potential choking and gagging risk.
  • Always approach your resident to assist them with their oral care either from the side or at the front of them and always at their level. Try using the Chaining or the Bridging methods to help support your resident to brush their teeth them selves
  • Talk to your resident calmly and kindly, and tell them what you are doing throughout the care to help build their trust and confidence.
  • Consider also, carer preference, if there is a particular carer that your resident enjoys a good rapport with, there will most likely be able to achieve a more positive outcome.
  • Think about introducing a system of brushing, eg always start brushing from left to right so that you can monitor which teeth have been brushed if you have to split mouth care into short bursts.
  • Record oral care in care plans including refusal, so that it is documented that you have attempted to deliver that care, but it is your residents’ choice not to have it.
  • Remember that any changes in oral care that are currently being delivered need to be managed in small steps to allow your resident to get used to new ways. Small introductions of change will enable you to gauge how well things are working and how well your resident is responding to and is compliant with new introductions, workings and tools.

And finally, and above all, always remember that you are dealing with one of the most intimate areas of your resident’s body which is used for lots of lovely things, eating, talking and kissing.

When delivering oral care – ‘Look beyond the illness and reach out to the person who needs to feel secure, respected and cherished’.

To learn more about oral care and Dementia as well as other highly dependent and medically compromised residents, and to get QCQ ready for the new oral care quality standards for adults in care homes, read our blog here.

Oral Hygiene Management Guide


Read our trustpilot reviews
Read More

Customer Testimonials

“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

You are part of a great company, if we can help you grow by contracting you out to our sites its good for you, but it’s great for us because your service is fantastic, very efficient, everyone within Hcsuk is super helpful in answering queries and every time we’ve had an issue, Hcsuk has always been there to solve the problem almost immediately, which is fantastic.

Leicestershire County Council

Truly exceptional levels of customer service, the best I have experienced for many years. Very helpful staff made follow up calls to ask how the equipment was performing and supplied extra user instructions to supplement the manufacturers manual. I would not hesitate to order from this company again.

Savills Estate Agents

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 consistantly 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

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
  2. The goods are for the personal or domestic use of the customer
  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.

How to claim

On the my basket page of this website a link to the online declaration form is provided if the basket contains a product that qualifies for VAT relief. You must tick the box to state you wish to claim VAT relief on the eligible product and complete in full the reason by which you are ‘chronically sick or disabled’ and name and address of the claimant. If possible the person making the claim should complete this form, but a family member, carer or medical professional may complete the form on the claimants behalf. To submit the claim and receive the VAT relief, click the ‘Submit VAT Relief Claim’ button before proceeding to the checkout.

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.

 

0
Your Cart