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Palliative Care and the Mouth; Oral Problems in Palliative Care

Palliative Care and the Mouth; Oral Problems in Palliative Care. Emma Riley Macmillan Oral Health Practitioner. Palliative care. ‘…the active holistic care of patients with advanced, progressive illness. Management of pain and other symptoms and provision of psychological, social and

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Palliative Care and the Mouth; Oral Problems in Palliative Care

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  1. Palliative Care and the Mouth; Oral Problems in Palliative Care Emma Riley Macmillan Oral Health Practitioner

  2. Palliative care ‘…the active holistic care of patients with advanced, progressive illness. Management of pain and other symptoms and provision of psychological, social and spiritual support is paramount. The goal of palliative care is achievement of the best quality of life for patients and their families. Many aspects of palliative care are also applicable earlier in the course of the illness in conjunction with other treatments

  3. Palliative Care does not mean end of life When a patient is end of life they can be placed on the LCP

  4. Mouth care maintains: • Self-esteem • Comfort • Person’s ability to communicate • Socialise • Enjoy food and drinks

  5. ORAL HYGIENE CARE A clean and infection clear mouth is a BASIC NEED. Heals(1993)states that a patients oral status is a good indication of the care received

  6. Assessment • Identify patients at risk of oral problems and plan mouthcare: radiotherapy/chemotherapy, Enteral fed, dysphagia, immunocompromised, oxygen and terminally ill. • Drug history: Antichloinergics(e.g. hyoscine) – increase dry mouth. Bisphosponates-risk of osteonecrosis of the jaw, especially if oral/dental health is poor.

  7. Assessment Examine thoroughly with a torch and a tongue depressor. Remove dentures, avoid painful lips by lubricating. Assess for dryness, coating, ulceration or tooth decay. Assess for pain. Document findings accurately and assess often

  8. Helping the symptoms • Acknowledge that there is a problem, don’t just see it as “par for the course” • Maintain good oral hygiene. • Try one of the various products available. • Reassess to see if there has been any improvement.

  9. Toothbrushes

  10. Toothpastes

  11. Swabs

  12. EDENTULOUS PATIENTS • GENTLY RETRACT CHEEKS AND WITH GENTLE STROKES BRUSH INSIDE SURFACES • USING GAUZE HOLD THE TONGUE AND GENTLY BRUSH REAR TO FRONT • GENTLY BRUSH PALATE • ASPIRATE IF AIRWAY IS AT RISK

  13. DENTURES • BRUSH WITH WATER • PAYING ATTENTION TO THE CLASPS • RINSE WELL • SALIVA SUBSTITUTE MAY BE USED BEFORE REPLACING DENTURE IN THE MOUTH

  14. And finally Quality of Life

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