No More Fighting and Biting During Mouth Care: Applying the Theoretical Constructs of Threat Perception to Clinical Practice

Jablonski, Rita A.; Therrien, Barbara; Kolanowski, Ann

doi:10.1891/1541-6577.25.3.163

Cited by 32 publications

(49 citation statements)

References 63 publications

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“…Persons with dementia experience neurological changes that create heightened threat perception, that is, even innocuous caregiving activities may be perceived as an assault and initiate the flight or fight response (Jablonski, Therrien, & Kolanowski, 2011). CRB during mouth care makes conceptual sense: Persons with dementia are engaging in a fight or flight response to an “attacker” who is literally “in their face.”…”

Section: Background and Conceptual Frameworkmentioning

confidence: 99%

“…We chose to use the RTC-DAT in a pilot study that examined the feasibility of an intervention to reduce CRBs exhibited by NH residents with dementia while receiving mouth care (Jablonski, Therrien, Mahoney, et al, 2011). The pilot study employed a quasi-experimental design with participants serving as their own controls.…”

Section: Background and Conceptual Frameworkmentioning

confidence: 99%

“…Examples of the caregiver behaviors included smiling, using judicious touch, and bridging (having the elder hold a toothbrush while the mouth care provider completed mouth care). For more information about the MOUTh intervention, please see Jablonski, Therrien, Mahoney, et al (2011) and Jablonski-Jaudon et al (2016).…”

Section: Background and Conceptual Frameworkmentioning

confidence: 99%

“…The next 14 days were the intervention period, during which participants received mouth care from research staff twice daily while CRB data were collected. Procedures and results have been published elsewhere (Jablonski, Therrien, Mahoney, et al, 2011). …”

Section: Background and Conceptual Frameworkmentioning

confidence: 99%

“…Resistiveness to care is a common behavioral response observed in persons with dementia, especially when the care involves close proximity between the older adult and the caregiver (Jablonski, Kolanowski, et al, 2011; Jablonski, Therrien, & Kolanowski, 2011; Willumsen, Karlsen, Naess, & Bjørntvedt, 2012). Resistiveness to care is common during oral hygiene.…”

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confidence: 99%

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Revising the Resistiveness to Care Scale

Jablonski¹,

Winstead²,

Jones-Townsend³

et al. 2016

j nurs meas

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Background and Purpose The Resistiveness to Care Scale for Dementia of the Alzheimer's Type was developed to quantify care-resistant behavior. The purpose of this article is to explain how the instrument was modified and tested in two clinical studies that examined interventions to improve the oral hygiene of persons with dementia who resist care. Methods After pilot testing, the revised instrument (RTC-r) was used in 7 facilities (N = 83 residents). Systematic training procedures were implemented to preserve reliability. Results Clinical validity was confirmed throughout the pilot and interventional studies. Reliability was assessed using inter-rater reliability, which ranged from 0.87 (p < .001) to 1.0 (p < .001) across 2,328 mouth care observations. Conclusions The RTC-r validly and reliably measures care-resistant behavior in persons with dementia.

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Section: Background and Conceptual Frameworkmentioning

confidence: 99%

Section: Background and Conceptual Frameworkmentioning

confidence: 99%

Section: Background and Conceptual Frameworkmentioning

confidence: 99%

Section: Background and Conceptual Frameworkmentioning

confidence: 99%

mentioning

confidence: 99%

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Revising the Resistiveness to Care Scale

Jablonski¹,

Winstead²,

Jones-Townsend³

et al. 2016

j nurs meas

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Oral Health and Healthcare for People Living with Dementia and Other Cognitive Impairments

Curl

Kerr

Geddis-Regan

2022

BDJ Clinician’s Guides

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Oral hygiene and oral health in older people with dementia: a comprehensive review with focus on oral soft tissues

et al. 2017

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BackgroundThe number of older people with dementia and a natural dentition is growing. Recently, a systematic review concerning the oral health of older people with dementia with the focus on diseases of oral hard tissues was published.ObjectiveTo provide a comprehensive literature overview following a systematic approach of the level of oral hygiene and oral health status in older people with dementia with focus on oral soft tissues.MethodsA literature search was conducted in the databases PubMed, CINAHL, and the Cochrane Library. The following search terms were used: dementia and oral health or stomatognathic disease. A critical appraisal of the included studies was performed with the Newcastle-Ottawa scale (NOS) and Delphi list.ResultsThe searches yielded 549 unique articles, of which 36 were included for critical appraisal and data extraction. The included studies suggest that older people with dementia had high scores for gingival bleeding, periodontitis, plaque, and assistance for oral care. In addition, candidiasis, stomatitis, and reduced salivary flow were frequently present in older people with dementia.ConclusionsThe studies included in the current systematic review suggest that older people with dementia have high levels of plaque and many oral health problems related to oral soft tissues, such as gingival bleeding, periodontal pockets, stomatitis, mucosal lesions, and reduced salivary flow.Scientific rationale for studyWith the aging of the population, a higher prevalence of dementia and an increase in oral health problems can be expected. It is of interest to have an overview of the prevalence of oral problems in people with dementia.Principal findingsOlder people with dementia have multiple oral health problems related to oral soft tissues, such as gingival bleeding, periodontal pockets, mucosal lesions, and reduced salivary flow.Practical implicationsThe oral health and hygiene of older people with dementia is not sufficient and could be improved with oral care education of formal and informal caregivers and regular professional dental care to people with dementia.Electronic supplementary materialThe online version of this article (10.1007/s00784-017-2264-2) contains supplementary material, which is available to authorized users.

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No More Fighting and Biting During Mouth Care: Applying the Theoretical Constructs of Threat Perception to Clinical Practice

Cited by 32 publications

References 63 publications

Revising the Resistiveness to Care Scale

Revising the Resistiveness to Care Scale

Oral Health and Healthcare for People Living with Dementia and Other Cognitive Impairments

Oral hygiene and oral health in older people with dementia: a comprehensive review with focus on oral soft tissues

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