Providing Care for People with Disabilities Flashcards
Describe the definition of disability
- May be physical, cognitive, mental, sensory, emotional or developmental
- May be present from birth or occur during a person’s lifetime
- Complex phenomenon, reflecting an interaction between features of person’s body and features of society in which they live
Describe the spectrum of disability
- Majority of people have minor or moderate disability
- Can live at home and functionally independent
- Small proportion live in care homes (high proportion of older people)
- Proportion increases with age
Describe 3 groups whose oral health is affected by disability, according to Faulks and Hennequin 2006
- Experience disability due to impairment of oral function
- Condition which has direct or indirect repercussions on oral health
- People disabled by social or environmental context which reflects oral health
Describe the demographics of disability
- Lower mortality rates of children with complex disabilities increasing
- Increasing life expectancy
- Increase volume of older people
- Cultural shift away from acceptability of tooth loss as part of ageing
Describe the demographics of disabled population
- 1/4 adults are affected by disability
- Disability increases with age
- 2/3 of people with disability are over 65 years old
Name 2 main causes of disability in patients up to 16 years old
- Genetic
2. Congenital
Name 2 main causes of disability in patients from 16-49 years old
- Trauma
2. Neurological conditions
Name 3 main causes of disability in patients from 50-64 years old
- Musculoskeletal
- Cardio-respiratory
- Neurological
Name 3 services who provide dental care for patients with disability
- General Dental Practitioners
- Community Dental Service (specialist in Special Care Dentistry)
- Hospital Dental Service (consultant / specialist in Special Care Dentistry)
Describe the multi disciplinary team with regards to special care dentistry
- Dentist / Specialist / Nurse / Hygienist
- GMPs
- Physicians
- Anaesthetists
- Psychiatrists
- Nurses
What is a carer?
Anyone who cares unpaid, for a friend or family member, who due to illness, disability, mental health problem or addiction cannot cope without their support
Describe the roles of a carer
- Banking
- Shopping
- Feeding
- Bathing
- Dressing
- Medicine administration
Describe 4 important aspects of patient access
- To building
- To dental surgery
- Domiciliary care
- Access to mouth
Describe 4 physical factors which may impact a disabled person’s access to the building
- Transport
- Car parking
- Access to building
- Time of appointments
Describe 3 staff attitudes which may impact a disabled person’s access to the building
- Attitudes of staff have influence over practice
- Staff attitudes must be aligned with current policy and visions
- Large investment and resources and effort made to train workers
Name 3 ways a dental surgery can be made more accessible for disabled patients
- Room for wheelchair to be brought alongside dental chair
- Hoists or Banana boards for transfer to chair
- Treat patient in wheelchair using attachments or reclining devices
What is domiciliary care?
Care at home
Name 3 advantages of domiciliary care
- May feel more comfortable and less anxious
- Less demanding for patient
- Reduce DNA and cancellations
Name 3 disadvantages of domiciliary care
- Emergencies may be hard to handle at home
- Demanding on service
- Facilities may be inadequate for dental treatment
Name 4 reasons access to the mouth may be limited
- Learning disabilities may lead to challenging behaviour
- Neuromuscular conditions may result in spasticity or hypotonic
- Medical conditions e.g rheumatoid arthritis
- Acute mental problems e.g Schizophrenia
Describe dementia
- Progressive, neurodegenerative disease which affects the ability to perform daily living activities
- Variety of syndromes
- Around 700,000 in UK suffering from dementia
- 1:2 male to female
Name 5 reversible dementias
- Drugs / Alcohol
- Emotion and depression
- Metabolic factors e.g Pernicious anaemia
- Trauma of brain tumours
- Infections e.g TB / HIV
Name 5 causes of irreversible dementia
- Alzheimer’s disease
- Vascular disease / Stroke
- Huntington’s disease
- CJD
- Brain tumours
Describe Alzheimer’s disease
- Most common form of dementia
- Involves part of the brain that controls thought, memory and language
- Combination of factors is responsible
- Age is great risk factor
- More common in water
Describe the normal stage of Alzheimer’s Disease
No more than normal forgetfulness
Describe the forgetfulness stage of Alzheimer’s Disease
Subjective forgetfulness but normal physical examination
Describe the early confusion stage of Alzheimer’s Disease
Difficulty at work, in speech or when travelling in unfamiliar areas
Describe the late confusion stage of Alzheimer’s Disease
Decreases ability to travel and can’t remember current events
Describe the early dementia stage of Alzheimer’s Disease
Needs assistance in choose clothes and disorientation
Describe the middle dementia stage of Alzheimer’s Disease
Needs supervision for eating and toileting (may be incontinent)
Describe the late dementia stage of Alzheimer’s Disease
Severe speech loss, incontinent and motor stiffness
Describe dental care for a patient suffering from early stages of dementia
Reinforce dental care and educate and encourage help from carers
Describe 3 complications of patients with dementia and dental care
- Drugs may cause involuntary tongue and jaw movements
- Dry mouth
- Sugar based medication
Describe how the progression of dementia may affect patient’s dental care
- Unable to clean teeth
- Unable to understand importance of oral health care
- Unable to communicate need for dental pair
- Unable to be involved in decision making / consent
- Unable to tolerate treatment
Describe spina bifida
- Occurs as result of non-fusion of one or more posterior vertebral arches, with or without protrusion of contents of spinal canal
- Prevalence of approximately 5 in 2000 live births
- 25% have epilepsy
Name 5 dental implications of spina bifida
- Often wheelchair users
- UTIs common
- Frequently on antibiotic treatment
- Latex allergy in approximately 60%
- Antibiotic prophylaxis not required in children with shunt
