Wyche C J, Kerschbaum W E
Department of Oral Medicine/Oral Pathology/Oral Surgery, University of Michigan, School of Dentistry, Ann Arbor.
J Dent Hyg. 1994 Jan-Feb;68(1):35-41.
Very little research has been conducted about the state of oral healthcare for the terminally ill in Michigan hospice programs. The purpose of this study was to assess the oral healthcare services currently being provided by caregivers in Michigan hospice programs and to determine the needs for oral healthcare in-service training for nurses, home health aides, and volunteers who may provide basic oral care.
In October 1991, a four-page questionnaire was mailed to the patient care coordinators of the 90 hospice programs listed in the 1990/1991 Michigan Hospice Organization Directory. Frequency data were compiled for each question.
Coordinators from 50 programs responded for a 56% response rate. Results showed that 100% of nurses and aides and 88% of volunteers were providing oral healthcare for clients. Some services, such as oral cleansing and denture care, were more likely to be provided by aides or volunteers. Referrals to dental professionals, and palliative measures for relief of pain or other oral symptoms, were more likely to be provided by nurses. Sixty percent of patient care coordinators reported that the amount of oral healthcare in-service information being received by caregivers was less than sufficient. Only 6% of hospice programs reported using a dentist or dental hygienist as in-service presenters. Eighty-seven percent of hospice programs surveyed had no written oral healthcare protocol. Eighty percent of patient care coordinators stated that clients or their families express concerns about oral health needs at least occasionally. Eighty-three percent stated that hospice staff assess client oral conditions at least occasionally and 92% agree that oral care is important to clients.
Although a wide range of oral healthcare services are being provided for terminally ill clients in Michigan hospice programs by nurses, aides, and volunteers, the majority of providers may not receive adequate information to provide complete and effective services. Based on these results, it is recommended that the dental hygienist take a leadership role in providing oral health information to hospice caregivers.
