GOOD DENTAL HEALTH FOR YOUR LOVED ONE

Wendy Williams, BS RDHAP

 
 
It takes more effort for the elderly and disabled to keep teeth and gums healthy.  Dry mouth and decreased saliva flow brought on by age, illness, and some medications can increase decay and gum infections.  A general guideline is to have your loved one try to eat a well-balanced, low-sugar diet, and drink lots of water.  Recent studies now correlate gum infections to other medical conditions like heart disease and pneumonia.  With this finding, good oral health becomes even more important for the elderly and disabled.
 
Guidelines for Elderly or Disabled Caregiver
 
Brushing and flossing after meals and before bed is crucial.  For those who find it difficult to handle dental tools, there are a number of ways to adapt:

• Enlarge a toothbrush handle by wrapping it with tape or inserting it into a rubber ball or a bicycle grip handle.
  
• Elongate the handle by taping some sort of sticks (a couple of tongue depressors, ice cream sticks, or small plastic or wooden rulers) to it.
  
• Consult with your dentist or hygienist about investing in an electric toothbrush.
  
• Consider a floss holder or aid.
  

                                
If you are responsible for someone else’s oral hygiene, remember:

• Visit a dental professional regularly.  It is recommended that an elderly person who relies on others to clean his/her teeth visit a dentist twice as often as normal.  That means up to 4 times a year—and some home health aides suggest five or six times a year.  As a caregiver, you may potentially miss spots that a professional can more thoroughly address.
  
• Stand behind your loved one to brush.  It’s easier to comfortably prop your loved one on the couch while you stand behind him/her and gently tilt his/her head back on some pillows.
  
• Combine a ¼ teaspoon each of salt and baking soda with warm water, swish, and then spit for cleansing between meals or between brushings to decrease acids that cause decay.
  
• Products may be recommended (Act, Gel-kam, Biotene, Xylitol, Listerine and Peridex)
  
• Use gauze or a washcloth to clean someone’s gums (whether or not they wear dentures).  Always remove partials and dentures and cleanse them daily.
  
• Protect your hands.  If a bite reflex exists, there are soft props that can be gently inserted into the mouth.  Ask your dentist or dental hygienist for more information.
  
• Communicate clearly.  If a person suffers dementia, visiting the dentist can be upsetting, so a caregiver needs to clearly communicate the purpose of the appointment and schedule it for a time of the day when your loved one might be most alert.
  
• Ask for a house call.  If your care recipient requires extra assistance, some dentists or specially trained Hygienists (RDHAP) make house calls.  Share any special needs you may have when you make the appointment.  (To find an RDHAP in your area visit www.CDHA.org)
  

 
             
                                            Special Access Dental
Wendy Williams, BS RDHAP
Mobile Dental Hygiene for the Elderly and Disabled
www.specialaccessdental.com    714-394-0294

State fines nursing home for patient's death

Health officials say 76-year-old woman's dental hygiene was neglected at Petaluma facility

By PAUL PAYNE
THE PRESS DEMOCRAT

A Petaluma nursing home was fined $100,000 after state investigators concluded poor health care at the facility led to the death of a 76-year-old patient, officials said Thursday.

Pleasant Care Convalescent of Petaluma is accused of neglecting the dental hygiene of a patient with Alzheimer's disease who developed an infection and died March 12, said Norma Arceo, a spokeswoman for the California Department of Public Health.

The patient, who was not identified, did not receive an examination in her 19 months at the Hayes Lane facility because nursing home officials thought she wore full dentures, Arceo said.

"It's very, very serious," said Anna Ramirez, chief of the department's field operations branch. "This person should not have died."

It was at least the fourth death since 2003 that state investigators have attributed to negligent care at nursing homes owned by Pleasant Care Corp. California's second-largest nursing home chain, according to newspaper reports.

The firm, which is in bankruptcy, was fined $80,000 in June after an investigation found that poor care led to the death in 2005 of a 54-year-old resident in Norwalk, the Los Angeles Times reported.

A patient at Pleasant Care's Ukiah facility died in 2003 after a nurse was unable to provide needed aid because certain equipment wasn't kept in working order, according to the state Justice Department. A year later, a resident at its Novato facility suffered a bed sore that went untreated so long that it ultimately killed the person.

Last year, Pleasant Care agreed to pay more than $1.3 million to settle a lawsuit brought by the Justice Department alleging the chain, which had 30 facilities, provided negligent care to scores of residents.

Other provisions of the settlement included mandatory training, improved nurse-to-patient ratios and protections for whistle-blowers.

Company officials Thursday declined to comment on the Petaluma case, but Dahlia Jimenez, a vice president for finance, said the facility was auctioned earlier this week.

A new owner was not named.

The penalty for the death in Petaluma was the most severe allowed under state law, Arceo said.

It stemmed from the March 4 admission of the patient, at the family's request, to an acute care hospital to treat high fever and neck swelling, Arceo said.

Doctors traced the source of the problem to the patient's mouth, Arceo said.

Decaying teeth and food debris had spread infection, putting the patient at "risk for sudden death," one physician said in an investigative report.

She died from complications in the hospital eight days later, Arceo said.

Although her condition required total assistance with personal hygiene, there was no indication that the nursing home arranged for a dental exam since her admission in August 2005, Arceo said.

An employee told investigators he performed oral care with a green swab sponge, investigation documents said.

Another worker said she saw dentures in a cup and assumed a dentist's visit was unneeded, the documents said.

You can reach Staff Writer Paul Payne at 762-7297 or paul.payne@pressdemocrat.com.

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