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I'm generally happy with this aid, not about the pushback. Need to figure out best way to deal with it that won't result in the loss of the aid

As background Mom is stage 6 and IMHO on the cusp of stage 7. We did a dentist appointment and the dentist instructed the aid to brush my mom's teeth and told us we now need to have visits every 3 months. My assumption is my mom is no longer capable of properly brushing her own teeth. Aid says my mom can do it and if we take away the responsibility it will speed up her decline. I go with the medical advice.
My current idea is to sign up for pallative care and have a professional nurse as interiediary so I'm not the villain.
Is mom using (or not using) an electric toothbrush or a regular one?
If a regular one switching to an electric might be much easier.
(by the way if the dentist did not mention this switch to a toothpaste that does not contain fluoride. Fluoride can upset the stomach if swallowed and with dementia often the spitting out of all the toothpaste is difficult and the inclination is to swallow what is in the mouth,.)
You need to tell the caregiver that this is necessary and if she does not comply you will find another caregiver that will help with ALL ADL's.
Her telling you that taking away the responsibility of brushing teeth is like her telling you that she will no longer help mom in the bathroom because that is taking away responsibility. Or she will no longer help her dress....
The dentist is your intermediary here...the dentist TOLD her that that she needed to do oral care and she is refusing.
I have to ask is the caregiver using a swab to sweep your mom's mouth after eating to remove pocket food from between the cheek and gums? If not this is something that she needs to do as well. Leaving food in the mouth can be dangerous as it can be aspirated later it is also not good to leave food in the mouth for extended periods of time.
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firsttimer1 1 hour ago
she uses electric. so that's not the issue.
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I was a homecare CNA for 25 years before going into the business of it and will say that the 'aide' spends more time with your mother than probably anyone else. So if your mother still has some small levels of independence in what she can do, the caregiver would know what they are. She may need assistance with brushing her teeth. Like the caregiver may have to get everything set up and literally walk your mother through every step. If the caregiver is through an agency, she may not be allowed to brush teeth. The same way as the caregivers are not allowed to administer medications. They can remind the person. They can bring them their medication bottle or box. They can't fill the medication box. Check with whatever agency you use and ask what their policy is on teeth brushing.

The caregiver is right about taking away responsibilities and the person declining fast. Any level of independence must be continued. I had a care client years ago who was homebound from dementia. She was still able to get food into her mouth on her own. She made a mess and it was disgusting to watch, but messes can be and were cleaned up. If there was a visitor around her mealtimes I told them ahead of time what to expect. Some would get upset and insist that I spoon feed her and I refused. This was the last independence she had and I wasn't going to take it away from her. Of course, I would spoon feed her if the meal was something she couldn't pick up with her hands like soup. Any independence is worth preserving.

Instead of getting on the caregiver and adding another task to what is already a very hard job, why don't you pay your mother a visit, set up everything she needs to brush her teeth, and see if she can do it for you. If she is unable to remember how to brush her teeth, then you and the caregiver need to have a talk. If her caregiver is a trained CNA, you will not need the dentist to show her how to brush teeth because she is already trained for that.
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firsttimer1 2 hours ago
There's definitely truth in what you say. I noticed a further decline after I took away mom's checkbook, but I had little choice. Similar while I get the idea that it keeps some pathways functioning tis also true that an infection in the mouth is a big deal and i don't want her losing teeth or worse. The dentist clearly saw that what's going on now isn't working
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It’s part of the aide’s job to do this. What’s not part of the aide’s job is determine what mom is and isn't capable of doing. Not sure if the aide is refusing out of overstepping or laziness, but no matter, it should be done by the aide. Nothing will “speed up” the decline. Sadly, it goes forward no matter what we do. Perhaps have the dentist write a note of instruction to the aide
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BurntCaregiver 2 hours ago
No, Daughter1930. It is not always the aide's job to brush teeth. Different agencies have different rules about things like brushing teeth.

People always assume that it's laziness with an aide when they don't do something. Always a lazy aide. Never a lazy nurse or a lazy family (and mind I've seen my share and everyone else's over the years of these two groups), it's always a lazy aide. Care clients and their families expect a lot from an aide. Far more than the other care staff on a case who make two, three, four times and more what that aide gets paid.

When someone is waited on hand and foot and treated like an infant, it will speed up their decline. Yes, it will. I have seen it happen.
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I'm hoping the reluctance is due to not feeling comfortable with the process and that a professional nurse might help with instructions and guidance
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