Expert Guest Blog Post by Jane Peterson RHD BSc, Co Founder of Knowledge Oral Healthcare
We live amongst an aging population1 and as life expectancy increases so does the number of dentate people entering care homes. It is estimated today that less than 6% of the population aged 65 and above are edentulous (have no teeth) compared to 37% in 19682. Inevitably with an aging population, complex medical, cognitive and physical conditions can develop and as these people become less able to care for their own mouth they become more dependent on others to carry out effective mouth care. With this increased level of dependency comes a greater risk of developing poor oral health so it is essential we raise awareness of the importance of daily mouth care.
Oral care is a fundamental aspect to a person’s quality of life. Oral diseases and conditions can be both painful and distressing. They can have an impact on a person’s ability to eat and speak and are increasingly linked to a number of other health problems, many of which can be life threatening such as heart disease and aspiration pneumonia.
Professor Leng, deputy chief executive of NICE (National Institute for Health and Care Excellence) declared ‘oral health is too often neglected’ and ‘oral health should be a priority in care homes’3.
In July 2016 the NICE Guidelines (NG48)4; ‘Oral Health for Adults in Care Homes’, were published which includes recommendations on;
NICE offers ‘A quick guide for care home managers’6 which includes an Oral Assessment Tool and information on what to expect from the CQC. This is a great starting point for all care homes to begin making the improvements needed for oral health in the elderly and to ensure you are fully ‘CQC ready’.
The publication of the NICE Quality Standards (QS151)5 in June 2017 sets out 3 quality statements;
NICE offers recommendations to care homes on ‘what works’ and the Quality Standard (QS151) is the rule book to which care homes should refer. Quality standards are designed to drive and measure improvement in quality and can be used to review services. The CQC inspection framework is aligned to NICE quality standards and the introduction of QS151 has recently been incorporated to assess and continually monitor the performance of care homes and identify areas in need of improvement.
Providing good oral care for residents can be challenging; time constraints, increased workloads, uncooperative residents and carers lacking knowledge and skills can result in inadequate oral care. In order to safeguard the health and wellbeing of vulnerable elderly people, good daily oral care is crucial. In palliative and end-of-life care it becomes particularly important to ensure the person’s mouth is clean and comfortable. In the words of Professor Leng; “This is about maintaining basic human dignity in those who may need help in looking after themselves”.
There is currently no mandatory oral care training requirement for care homes, which has led carers to be unsure of how to manage simple oral conditions such as bleeding gums, let alone more complex cases. Evidence suggests that nurses have little knowledge of the link between poor oral health, dysphagia and pneumonia, so further mouth care training is recommended.
As a team of registered dental care professionals Knowledge Oral Health Care Ltd offers bespoke training sessions to individual care homes. All training is aligned to the NICE guidelines and quality standards so you can be confident that your care home receives the training required to satisfy the quality standard measures.
AnOral Health eLearning course has also been developed by Skills for Health, developed for all staff working with patients and residents. The course highlights the importance of oral health including how plaque causes dental disease, why teeth should be brushed, how to care for dentures and the link between oral health and general health.
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