She has mid stage dementia. Her gums have always been very sensitive and she’s balking on brushing her teeth, even with help. Her breath is pretty strong and I’m concerned about the condition her teeth may be in. What do we do about getting her checked since she never leaves the memory unit and is on hospice care?
Chances are she would have to be sedated to do anything. That will probably cause a faster decline.
If anything has to be done like pulling a tooth or even a filling who will care for her mouth while it heals.
There are choices that "we" as caregivers make that in a "normal" situation there would be no question but when dealing with someone that has dementia or is close to end of life it makes no sense. I called these choices Benefit VS Burden. If the benefit would outweigh any negative aspect then I would go forward. In most cases I elected to not follow through with treatment.
If moms mouth is infected antibiotics can be prescribed.
If moms gums are sore there are topical products that can be put on to numb the discomfort.
Using a swab to brush the gums and teeth is standard practice if a toothbrush can not be used.
I would make sure that the staff at the facility is not following through on clearing the area between the gums and cheek as POCKETING is very common with dementia. I used to have my Husband take a bit of food then I would rub his cheek and have him take a sip of whatever he was drinking. Even as I had to thicken his fluids and puree his food I would still make sure that his mouth was clear. This also might prevent aspiration later of bits of food remain.
My mom’s little MC has a dentist come in on occasion. It is optional and not cheap but in this case has been worth the expense. This dentist does cleanings only, nothing fancy, and in the months between mom’s dental care does deteriorate. But this method keeps things reasonable.
I haven’t the foggiest idea how this dentist works on dementia seniors either! Even the experienced care staff finds dental care with these residents to be an area of battle. I joke that the dentist must be a wizard lol
https://www.walmart.com/ip/100-pcs-Oral-Care-Swabs-Tooth-Cleaning-Mouth-Toothette-Oral-Sponge-Swabs-Unflavored/1746284693?wmlspartner=wlpa&selectedSellerId=101247967&&adid=222222222271746284693_147609983928_18500527357&wl0=&wl1=g&wl2=t&wl3=625876230454&wl4=aud-1651068664746:pla-1808164932162&wl5=9003829&wl6=&wl7=&wl8=&wl9=pla&wl10=678405860&wl11=online&wl12=1746284693&veh=sem&gclid=Cj0KCQjwla-hBhD7ARIsAM9tQKvBqhb7e55mKmVNHee-yUBaS-uvam-udb_LHmisI_CWxChB-0XEyoIaAi2qEALw_wcB&gclsrc=aw.ds
Again, hospice knows this patient, and with your input should be able to help with questions.
Staff should help mom rinse her mouth and swab a bit daily I suppose, but at this stage of the game, just keep her comfortable is your only goal.
Best of luck.
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