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Daily oral and personal hygiene is becoming difficult due to agitation and combativeness of resident with dementia. Any suggestions or tips?

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I, too, would like to hear from the community about this issue. I'd think if there is no way that the caregiver can help the person brush the care receiver's teeth, at least lots of water could rinse teeth. If raw apple can be eaten without danger, I've read that apples can help cleanse the teeth. Let's hear from the community on this, since I didn't (thankfully) have this issue to cope with. Who has ideas?
Carol
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I have tried and almost give up. Mom argued when we went to the dentist to get her teeth cleaned and would not let them do it. When I get her to wash her hands after toileting (and that is a fight) I just hand her the toothbrush. Sometimes she will brush and sometimes not. I used to try it before bed and she would never cooperate so I tried it in the morning and am getting better results. If she is obstinate I just don't do it. There is only so much one can do when the care receiver is adamant.
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Have you tried giving the patient an electric toothbrush? Might be a physical reason for not wanting to brush... arthritis in hands? Or might be painful to brush!
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You are right that there's only so much you can do. It was wise to look for better timing. Take what you can get. But when she's too stubborn about it you won't get the job done anyway and you'll both be upset.
Good luck with this battle.
Carol
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Funny this subject just came up with my dad. He has 2 really bad teeth and we went to the dentist and she said they one needs to come out the other could be a root canal and crown. But once my dad found out what it cost he refused. Problem is one is infected. $350 later and once it starts to hurt again it will be back to the dentist for more of the same and another $120 visit. I'd like to knock him out and have them all pulled but he is too proud to retain his teeth.
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It's a constant battle with age, teeth and AD. In the end, you just want to keep them out of pain. It's very hard to do quality dental hygiene.
Best Wishes,
Carol
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Remember you have to take care of bad teeth. If there is infection it can and will effect his life. I'm sure the dentist told you that. He can be put under so he will not fight the procedure. More money, but very necessary if infection is present. Don't wait on this one.
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He is on antibiotics and the tooth is feels better but I know it's a matter of time before it gets bad again. Hate to have to trick him into getting them pulled.
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Yes, the antibiotics will only be a delay tactic. Will not solve anything. Tooth will have to be pulled or repaired via root canal. Sometimes you just have to do what is right. Don't look at it as a trick.
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I am a mobile dental hygienist. I come to the facility or home and perform preventive dental care for residents. Sometimes a mild sedative must be used. There are also mobile dentists to provide dental care ie extractions, fillings, etc so the resident can stay in the comfort of their usual surroundings. Otis a challenge for daily oral care. Sometimes two caregivers must be utilized. While the resident is sitting, one from behind cradles the head while one in front holds their hands or uses blanket/plush toy. The one from behind can the brush the teeth. Sometimes a electric toothbrush is too stimulating. I am looking into a xylitol gel made by "spiffies" to give a spoonful to the resident after meals. It is fruit flavored and the xylitol prevents decay. Google mobile dental hygienists or dentists on your area for help.
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My sister loved the water pik with warm water. LOL water all over the bathroom, but she had fun.
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I also was haveing trouble getting mom to brush. She has dental implants and an upper plate. I take her to a periodontist where the hygienist specializes in older peoples teeth. They will sedate also if necessary.
If I let her clean her own teeth she would just take her plate out scratch it with her fingernails to get off the built up gunk and rinse and put back in her mouth.YUCK!
I got her an electric tooth brush when she moved in with me and she will use it if I stand right there and tell her how to turn it off and on.I have to soak her plate in a 3 minute soak because she won't go to bed without her teeth. Periodontist said to soak them overnight. When I remind her we need to brush her teeth, she usually says she already has (NOT) or "I have been brushing my teeth for 50 years without you and I don't need you to tell me what to do,". I say "OK let's go in and you can show me" She spends about 3 minutes just looking for what she needs as I let her do it herself and of course she can't even find the tooth brush or tooth pastes. I have to be in there when she does it because she has tooth paste for her implanted teeth in her mouth and a stronger paste for he dentures. Plus the soak. Finally after she figures out she doesn't even know why she is in the bathroom or where anything is she says " OK what do you what me to do?, and she will then let me help. It is a struggle and I admit some nights it is not worth the fight. The first time I took here into get her teeth cleaned after she had lived in assisted living for 2 years, and I realized no one else was going to remind her or help her with her teeth, the hygienist said her teeth and dentures were so bad they had to double clean and it cost twice as much for the cleaning as it took longer. Now after living with me and 2 cleanings later in 2 years they say her mouth and teeth look good with no problems. It is a lot like taking care of a child and they throw tantrums and are a pain in the butt too. I raised 7 great kids so now I am just raising another. The only difference is instead of progression you see regression and it is sad to lose that person that once was.
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My 100-year-old MIL had a very difficult time with this. I learned to bring her the little kidney-shaped plastic "spit bowl" that hospitals dispense, with her toothbrush and a glass of water. She would then do it watching TV, no problem. Caution with an electric toothbrush, if not agile or without finger sensitivity, you can really rip your gums with them. Finally, I've heard of dental rinse when all else fails. I have asked a number of dentists about Plan B if Plan A (brushing) is not an option. They just shrugged. Oh yea, also the old toothpaste on the finger and rub can work too.
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I worked in the medical field for 30plus years.I dealt with combative patients and residents.It was not easy ..I tried slow procedures, letting them hold the brush and then trying to brush their teeth after they got used to holding it and not throwing it.Sometimes it worked ,others not so much.My son is handicapped and he only uses an electric toothbrush,otherwise regular ones will be thrown.It is a "win some loose some" situation.You might have to resort to sedation to get any work done.My brother has the same handicap as my son and he has to sedated to have dental work done.Otherwise "brain storm" with the dental staff.I know as a caregiver every person is different and responds to different attempts.Sometimes distraction worked,talking about something else while they brushed.One lady I got thinking about a garden problem I had,byt the time she got done having her teeth brushed she forgot how bad it was.Others watched tv while they brushed.I hope this helps.I commend your efforts and reaching out to us.God bless
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It has been awhile since I've had this situation, but we used to be able to get soft swabs (like a giant q-tip) that we would dip in mouthwash to clean the teeth and tongue. If the residents are able they may handle the mouth care themselves. If not, it sounds like two people would be needed to prevent the resident from hurting the one performing the mouth care.

Don't use a product that contains glycerine because that has a drying effect. In case you weren't aware, there are also products that moisten the mouth.
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We have a Water Pik (yes, the water does get everywhere), an electric toothbrush, special toothbrushes for people with arthritis, mouthwash and sometimes I get toothpaste in a different flavor just to make things more interesting. We also have those dental flosses in little holders. All this for a compliant but forgetful parent. I think my next step would be to say "let's go brush our teeth" and then do it at the same time so that she could just copy me. I am picturing a more combative situation and am full of admiration for all the caretakers and professionals who deal with this every day.
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Oh yes the swabs..thanks for bringing that up..lemon ones can be drying but work.Just be careful the person does not clamp down with their teeth, lost a few tips that way...
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Spry make Xylitol candies and gum. Kaiser dental has them.
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Yikes I am glad my Mom has false teeth and I can take them out and not worry about a toothache, maybe I should get them! To clean my Moms mouth I take a paper cup with warm water and mouth wash in it and stir it up. I use gloves and put my finger/s in it and then put my finger up on her gums above where her teeth would go and keep dipping, then the bottom gums. I then use clean water and clean gloves to rinse it. Seems to not bother her too much as my fingers are warm and gentle and I sing thru it as to what I am doing. %this is the way we wash your mouth, wash your mouth wash your mouth, etc% you get the picture.She has severe dementia and cannot think of two things at once so when her mind is on a song, it helps. Hope this can help you out. We use to go thru hell with her fingernail cutting until I learned to just file them down weekly.Good luck
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Here's my solution. For my non-cooperative client with Dementia I did two things. Joke, and wrap her hands in warm washcloths. When she didn't want to do something, I would say "You know - the President might come to visit today." I don't know why this always got her, but it did. The warm washcloth thing worked for two of my clients with Dementia. Calmed them immediately. One fell asleep within seconds. Just super warm water on the cloths, each hand wrapped securely. Tell her, while making direct eye contact and holding her hands, that you are treating her to a little spa treatment for her hands while you care for her mouth. You may also use baking soda and coconut oil so you combat bad bacteria, encourage healthy gums and teeth, and don't have to worry about swallowing.
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In the nursing home where I worked, we had little sucker-type sponges with mouthwash infused on the sponge and the back and forth action would "brush" the teeth. See if you can get some of those. At least the patient can do it by themselves and give them a sense of accomplishment. Give it to them, show them how it works, and then walk away. It may take them some time, but just wait.
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I forgot about those, Ferris. If they just chew on the little sponges it would help. Good idea if there is no risk of choking.
Thanks, Carol
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Husband loves apples, they clean teeth somewhat. He'll use mouthwash and in very small amount it helps.
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My mom is 90 and wears dentures. I cannot for the life of me get her to remove them to be cleaned. She suffers from Alzheimer's, so her ability to reason is long gone. She insists she does not wear dentures. It's been so long, I can't remember the last time she removed her dentures for cleaning or even used a toothbrush. Her breath is horrible. When I attempt to have her clean them, she becomes extremely agitated and angry.
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This is too bad, since she may end up with mouth sores.

Dentures can become a big problem with aging people. My dad's jaw bones had deteriorated to the point that there was no support for his dentures (he had to get them when he was quite young because of a health problem). It was a struggle to keep them in so he could eat. This is the opposite of your problem, but my point is that teeth can become a huge issue with age.

My mother--in-law's teeth totally rotted away, but the only thing we could do was make sure there was no abscess. She couldn't tolerate any treatment. Even my mother, who'd had good teeth most of her life, ended up with rotted teeth as her health declined. One tooth that should have been removed would have taken oral surgery, but she couldn't take that, so a kind dentist found a way to make it comfortable and filled it with a quick substance that protected her tongue from rough spots.

It's great to have so many people chime in with their struggles and advice. What a terrific community!
Carol
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