Oral care in long term care oral care for all

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May 26th 2010

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Oral care in long term care oral care for all

  1. 1. ORAL CARE IN LONG-TERM CARE ORAL CARE FOR ALL Laura Carney Speech-Language Pathologist Saskatoon Health Region, Long-Term Care Healthiest People~Healthiest Communities~Exceptional Service © 2010, Saskatoon Health Region
  2. 2. POPULATION THOSE LIVING IN LTC IN SHR AGEING DEMENTIA POST STROKE, PARKINSON’S DX OTHER NEUROLOGICAL DX RESPIRATORY/CARDIAC DX Healthiest People~Healthiest Communities~Exceptional Service © 2010, Saskatoon Health Region
  3. 3. TWO PRIMARY GROUPS THOSE WITH ORALPHARYNGEAL DYSPHAGIA THOSE WITH NO DX OF DYSPHAGIA BUT WHO HAVE BEEN DX WITH ASPIRATION PNEUMONIA Healthiest People~Healthiest Communities~Exceptional Service © 2010, Saskatoon Health Region
  4. 4. GROUP ONE: DYSPHAGIA HIGH # OF MEDICAL CONDITIONS WHICH PREDISPOSE PERSON TO DYSPHAGIA MEDICATIONS MAY INCREASE RISK OF DYSPHAGIA CONTROVERSY: USE OF THICKENED FLUIDS (LOGEMANN ET AL, 2008) STAFF TIME VARIES FOR INTERVENTION ORAL CARE: POCKETING OF FOOD Healthiest People~Healthiest Communities~Exceptional Service © 2010, Saskatoon Health Region
  5. 5. GROUP TWO ASPIRATION PNEUMONIA NOT INITIALLY REFERRED FOR SWALLOWING ASSESSMENT; SEEN POST-DISCHARGE AND NOW DX AS DYSPHAGIC SUSPECT IS SALIVA LANGMORE ET AL (1998): DYSPHAGIA NOT A PRIME RISK FOR AP UNLESS OTHER RISK FACTORS ON BOARD Healthiest People~Healthiest Communities~Exceptional Service © 2010, Saskatoon Health Region
  6. 6. GROUP TWO: ASPIRATION PNEUMONIA FACTORS INCLUDED: DEPENDENT FOR FEEDING DEPENDENT FOR ORAL CARE NUMBER OF DECAYED TEETH TUBE FEEDING MULTI MEDICAL DIAGNOSES NUMBER OF MEDICATIONS SMOKING Healthiest People~Healthiest Communities~Exceptional Service © 2010, Saskatoon Health Region
  7. 7. ORAL CARE IN LTC EDUCATION: ORAL CARE AND CHEST HEALTH NURSING CARE AIDES OWNERSHIP OF RESPONSIBILITY EXPECTATION THAT CARE WILL BE GIVEN Healthiest People~Healthiest Communities~Exceptional Service © 2010, Saskatoon Health Region

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