Oral Health Care for Older Adults with Serious Illness: When and How?

Abstract

Older adults with serious illness are particularly vulnerable to oral disease due to worsened overall health, progressive functional loss and polypharmacy. Meanwhile, inability to communicate oral health needs, increased functional disability and psychological distress also hamper timely oral health care and lead to prolonged suffering and compromised quality of life. While many seriously-ill older adults with poor oral health receive no oral health care prior to death, unnecessary treatment is also common. In response to these issues, a new oral health care model is proposed to better address the oral health needs of older adults with serious illness. This model aims to promote comfort, maintain oral function and improve quality of life. End-of-life oral health trajectories and stage-appropriate oral health care strategies are also introduced to guide the care of these vulnerable individuals.

Strategies for Oral Health Management in Patients with Acute Confusional State

“…The strategy of oral health management to these patients is (1) Making collaboration between physicians, dentists and related healthcare providers; (2) Applying the principles of palliative care; (3) Treat the patients based on their stage of illness and (4) Personalized Oral Health Care. 7,12 Chen et al in 2015 propose "a stage-appropriate oral healthcare plan" and shows on The patients categorized as pre-active dying stage and recommended to maintain the oral hygiene, with the help from nurse in inpatient ward or the caregivers. The main purposes of the treatment, based on her stage of illness, are improving comfort, manage oral pain, and control infection.…”

“…The main purposes of the treatment, based on her stage of illness, are improving comfort, manage oral pain, and control infection. 7 The treatment is taken on the bedside because of the patient's limitation of movement. The principal of palliative care must be applied on both patients to maintain their general health and prevent the systemic condition getting worsen.…”

“…The evidence-based dentistry on the decision on the timing and the type of palliative care are still limited. 4,7 The management of oral health problems on those patients must be distinguished depends on the stage of illness with the intention of increasing comfort and pain reduction. 7 The patients sometimes do not receive an appropriate oral health treatment for some reasons.…”

“…4,7 The management of oral health problems on those patients must be distinguished depends on the stage of illness with the intention of increasing comfort and pain reduction. 7 The patients sometimes do not receive an appropriate oral health treatment for some reasons. One of the reason is the lack of ability to communicate their oral health problems to the nurse or caregivers.…”

“…The plan promotes bedside oral health care and symptoms management as well as improves the collaborative work between physicians, nurses and dentists. 7 …”