Chapter 58 Flashcards
What are some barriers for receiving dental care?
- few dental clinics in nursing homes
- cost
- fear
- no transportation
- limited mobility
- patients attitude to their health
- patients pain
- medicare does not cover dental servives
These patients can sometimes be limited to one or two activites a day. They are usually dependent on caregivers.
Residence bound patients
What are residental facilities?
nursing homes
rehab centers
assisted living
There are US federal regulations on dental services requiring these facilities to receive medicare or medicaid funding
true
What are community based settings?
- senior centers
- work/activity centers for disabled
- medical practices
- homeless shelters
- churches
- elementary schools
- head start and day care
What are common oral problems for residence bound patience?
- perio
- lack of daily oral care
- need for routine check up
- difficulty biting or chewing
- weight loss
- toothache/ pain
- loose teeth
- fractured teeth
- lost filling or crowns
- caries
- ill fitting denture
Does oral health affect systemic health?
yessss!
What can lead to compromised nutrition?
oral pain or discomfort
What can compromise ability of daily oral care?
physical limitations
True or False: Oral health and cleanliness can affect pts self-esteem, quality of life, and ability to communicate
true
Hygienist providing care in a homebound patient can…?
- traige for pt who need to see dentist
- assist in preventing further complications
- educate to prevent caries
- encourage daily care
- palliative care
- contribute to pts general well being and quality of life
Preparation for home visit tx:
- understanding pt
- instruments and equipment
- appointment time
How to prepare for understanding the patient before a home visit?
- know before you go
- review HH and call before you go
- consider any pt problems
- determine precautions for this pts care and safety
- arrange with dentist if premed is required
- if local anethesia is needed
- arrange if there are extra items needed during DH care
When should a home visit appointment be?
contact the pt to see what time is convenient and the apt should be around a time the pt is awake
Instruments/ Equipment for a home visit?
- Routine DH care can be provided by manual instruments
- if ultrasonic is needed, they can be transported
- May need covered plastic tubs and boxes for clean or contaminated materials
How do you approach a home bound visit patient?
- communication
- personal factors
- suggestions for general procedures
How should you communicate with a home bound patient?
Clinician needs to be empathetic and understanding. Gentle approach is best. Clinician should communicate with pt but discuss tx with caregiver
Treatment location:
- Some patients may be able to sit in a chair or wheelchair
- Kitchen or bathroom may be the most advantageous bc of access to water and counterspace
How should you treat a patient in a bed?
Adjust pts head for best height. Use pillows to support or stabalize the patients head
How should you treat a pt in a wheelchair?
Headrest can be attached. Some wheelchairs can tilt back. A pillow may help also
What does the critically ill require?
maintenance of oral cleanliness bc of helplessness of pt
Role of a hygienist:
- Evaluate pt needs
- plan and conduct oral health program for nurses
- include hands on demonstrations
- motivate caregiver for daily care
Role of the hygienist for terminally ill pt:
- provide comfort
- educate pt and caregiver on oral care
- emphasis on symptom relief and clean oral cavity
- terminal illness is no excuse for neglect
- focus on short term palliative care
Oral lesions in terminally ill pt?
- candidiasis
- xerostomia
- changes in mucosa
- denture problems
