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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
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
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
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
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
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
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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Oral care in long term care oral care for all

  • 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. 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. 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. 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. 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. 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. 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