topic Re: Oral Health Care In Nursing Homes Is Appalling in Wellness

Oral Health Care In Nursing Homes Is Appalling

jubilant — Mon, 29 Aug 2016 11:40:20 GMT

When we first put my Dad in a nursing home 3 yrs. ago, we thought they would see to it that his teeth got brushed. When he became more feeble and couldn't handle his toothbrush we thought surely someone would brush his teeth. Well...."nope".....they don't. His teeth started looking awful and he was complaining of sore teeth. It was a build up of food in between his teeth. Yuck!

We ended up buying dental insurance (medicare and medicaid doesn't provide it). It is rather expensive. No matter how much we plead..... his teeth never get brushed or flossed so we brush him and floss every time we are there. My sister is best at it so she usually does it....but mom and I have done it, too.

The reason I bring this up now is my Dad is recovering from Sepsis. Although it didn't come from his teeth, one of the first things the NP looked at (for infection) was in the mouth. That right there told us something! Thankfully, we had a dentist look at Dad just a few weeks ago and fill 2 superficial cavities so she could rule out anything there.

We see so many of these elderly people who no one is looking out for . Can you imagine what their teeth must look like after a couple of years? I shudder to think. My DIL works in a dentist office and she says this is very common. How sad.....especially when you read how poor dental health contributes to a lot of health problems in the elderly.

I just needed to vent about this because it is a crying shame about these forgotten elderly people. According to some articles I read today, it has been found their health is significantly improved by good oral hygiene.

Re: Oral Health Care In Nursing Homes Is Appalling

Financialgrl — Mon, 29 Aug 2016 12:13:29 GMT

I agree and what bothers me most - I've had 3 friends do their due diligence in finding a good assisted living/memory care facility. They visit a few times a week and things seem fine for awhile. Two of these friends had the facility their parent was in end up being sold and you walk in one day and don't recognize any of the staff. It's like they fire anyone who it appears is a long time employee (we figure it's bc those make more $) and replace staff with what we figure are those making much less and what was once a not too bad place - really begins to show shoddy care and see loved ones falling thru the crack.

Another issue - for two of my friends - their parent went into assisted living with a few memory issues but nothing too bad yet. These places are not cheap and yet when the patient's memory really starts faltering it's like it's a huge surprise and like staff has never experienced this before and they complain to family. I feel for you bc the love of my life has been in assisted living (diagnosed with moderate Alzheimers) and his daughter has similar issues as you. She's looking for another place - not the best of situations bc the one things these patients need is stability and familiar surroundings. She hired an aide to help a few hours a day with issues like yours but that's added $.

Re: Oral Health Care In Nursing Homes Is Appalling

jubilant — Mon, 29 Aug 2016 16:37:56 GMT

@Financialgrl

My Dad's home was great at first but it recently changed hands and it seems to me there is a shortage of help. I hear that is the case in the majority of nursing homes. When they changed hands they went from doctor owned to big health care company. That's when they started losing workers. They cut the benefits of workers and the workers can get better pay elsewhere. Many of them are young women with children to support so they need the benefits. The nursing home told us they wanted that extra money "to go to the residents".....well, imo, it doesn't!

Cutting the workers benefits is not the way to get the more "quality" help and I think there lies the problem! When you do that it doesn't help the residents....at least from what I am observing.

Re: Oral Health Care In Nursing Homes Is Appalling

Financialgrl — Mon, 29 Aug 2016 12:56:49 GMT

Yep, my BF's daughter is looking for another facility but it appears they all eventually sell out to the big corporations.

Re: Oral Health Care In Nursing Homes Is Appalling

twinkies — Mon, 29 Aug 2016 13:10:16 GMT

I feel bad that this happened to your Dad . The nurse in charge is responsible for checking and seeing that proper baths and mouthcare is carried out everyday especially if the elder needs help with activities of daily living , There is no reason why oral care is not done in the am and before bed . I you keep complainig and go to the nurse then someone will do it because they won't want to hear it anymore. Then thank them as often as[ possible to insure them that you appreciate itt ,

cathy from ma

Re: Oral Health Care In Nursing Homes Is Appalling

gardenman — Mon, 29 Aug 2016 13:18:53 GMT

@Financialgrl wrote:
Yep, my BF's daughter is looking for another facility but it appears they all eventually sell out to the big corporations.

I'm afraid so. Those companies owning multiple facilities can buy supplies in larger quantities and pay less per item making them more money. They can float stafff from facility to facility. They spend less and make more and the more facilities they buy, the more money they make.

Care in even good facilities can vary wildly. My mother had diarrhea in her last week in a rehab assignment after a stroke two years ago and when she was discharged I found out why. They had her getting four doses of laxative a day. Two doses of Miralax and two doses of another laxative each and every day will give anyone and everyone diarrhea.

Most of those places are just warehouses for people to go to until they die. My brother died in a rehab facility this past December when they refused to transfer him to a hospital when he started to decline. They felt they could treat him adequately there and they would lose money if they transferred him to a hospital. By the time they finally did transfer him, it was too late.

There's a lot of money moving around between hospitals and rehab facilities these days. Hospitals keep you for as short a period as absolutely necessary then transfer you to a rehab facility (ostensibly to save money as rehab facilities are lower cost per day than hospitals) but then you get trapped there for weeks/months offsetting any cost savings.

I keep getting the feeling there's a giant conspiracy going on to milk as much cash from consumers/insurers as possible with the quality of care being the least of anyone's worry.

Re: Oral Health Care In Nursing Homes Is Appalling

SeaMaiden — Mon, 29 Aug 2016 14:58:28 GMT

That is just so sad and so wrong. For the money $$$$ people shell out to be in these facilities.... they should be getting stellar care.

Re: Oral Health Care In Nursing Homes Is Appalling

Tinkrbl44 — Mon, 29 Aug 2016 15:00:50 GMT

@jubilant wrote:
When we first put my Dad in a nursing home 3 yrs. ago, we thought they would see to it that his teeth got brushed. When he became more feeble and couldn't handle his toothbrush we thought surely someone would brush his teeth. Well...."nope".....they don't. His teeth started looking awful and he was complaining of sore teeth. It was a build up of food in between his teeth. Yuck!
We ended up buying dental insurance (medicare and medicaid doesn't provide it). It is rather expensive. No matter how much we plead..... his teeth never get brushed or flossed so we brush him and floss every time we are there. My sister is best at it so she usually does it....but mom and I have done it, too.
The reason I bring this up now is my Dad is recovering from Sepsis. Although it didn't come from his teeth, one of the first things the NP looked at (for infection) was in the mouth. That right there told us something! Thankfully, we had a dentist look at Dad just a few weeks ago and fill 2 superficial cavities so she could rule out anything there.
We see so many of these elderly people who no one is looking out for . Can you imagine what their teeth must look like after a couple of years? I shudder to think. My DIL works in a dentist office and she says this is very common. How sad.....especially when you read how poor dental health contributes to a lot of health problems in the elderly.
I just needed to vent about this because it is a crying shame about these forgotten elderly people. According to some articles I read today, it has been found their health is significantly improved by good oral hygiene.

@jubilant

I read your post and still can't figure out who you spoke to about this problem. A nurse? The Administrator of the nursing home? Your state's Dept of Consumer Affairs? Who?

Re: Oral Health Care In Nursing Homes Is Appalling

bonnielu — Mon, 29 Aug 2016 15:16:12 GMT

I would rather jump off my roof than go to a nursing home. I want to stay here, in my home to the end. I have seen horrible things and really don't want to be part of it.

Re: Oral Health Care In Nursing Homes Is Appalling

drizzellla — Mon, 29 Aug 2016 16:54:44 GMT

@gardenman wrote:
@Financialgrl wrote:
Yep, my BF's daughter is looking for another facility but it appears they all eventually sell out to the big corporations.
I'm afraid so. Those companies owning multiple facilities can buy supplies in larger quantities and pay less per item making them more money. They can float stafff from facility to facility. They spend less and make more and the more facilities they buy, the more money they make.

Care in even good facilities can vary wildly. My mother had diarrhea in her last week in a rehab assignment after a stroke two years ago and when she was discharged I found out why. They had her getting four doses of laxative a day. Two doses of Miralax and two doses of another laxative each and every day will give anyone and everyone diarrhea.

Most of those places are just warehouses for people to go to until they die. My brother died in a rehab facility this past December when they refused to transfer him to a hospital when he started to decline. They felt they could treat him adequately there and they would lose money if they transferred him to a hospital. By the time they finally did transfer him, it was too late.

There's a lot of money moving around between hospitals and rehab facilities these days. Hospitals keep you for as short a period as absolutely necessary then transfer you to a rehab facility (ostensibly to save money as rehab facilities are lower cost per day than hospitals) but then you get trapped there for weeks/months offsetting any cost savings.

I keep getting the feeling there's a giant conspiracy going on to milk as much cash from consumers/insurers as possible with the quality of care being the least of anyone's worry.

Sadly - I couldn't agree more. Both my parents were in one of the best facilities in the Philadelphia area. But there were things I missed along the way. I would try and visit them everyday to make sure they were well cared for. But still I had to fight for my Mom to be given water so she could brush her teeth etc. Or find my Dad sitting in soaking wet pants, Or no one helping anyone to eat. I used to sit and feed the entire table or else no one would have eaten anything.

So sad - especially the people who have no one. I sometimes feel I didn't do enough. But at least I tried just about everyday to help my parents.

Re: Oral Health Care In Nursing Homes Is Appalling

jubilant — Mon, 29 Aug 2016 17:05:09 GMT

@Tinkrbl44 wrote:
@jubilant wrote:
When we first put my Dad in a nursing home 3 yrs. ago, we thought they would see to it that his teeth got brushed. When he became more feeble and couldn't handle his toothbrush we thought surely someone would brush his teeth. Well...."nope".....they don't. His teeth started looking awful and he was complaining of sore teeth. It was a build up of food in between his teeth. Yuck!
We ended up buying dental insurance (medicare and medicaid doesn't provide it). It is rather expensive. No matter how much we plead..... his teeth never get brushed or flossed so we brush him and floss every time we are there. My sister is best at it so she usually does it....but mom and I have done it, too.
The reason I bring this up now is my Dad is recovering from Sepsis. Although it didn't come from his teeth, one of the first things the NP looked at (for infection) was in the mouth. That right there told us something! Thankfully, we had a dentist look at Dad just a few weeks ago and fill 2 superficial cavities so she could rule out anything there.
We see so many of these elderly people who no one is looking out for . Can you imagine what their teeth must look like after a couple of years? I shudder to think. My DIL works in a dentist office and she says this is very common. How sad.....especially when you read how poor dental health contributes to a lot of health problems in the elderly.
I just needed to vent about this because it is a crying shame about these forgotten elderly people. According to some articles I read today, it has been found their health is significantly improved by good oral hygiene.

@jubilant

I read your post and still can't figure out who you spoke to about this problem. A nurse? The Administrator of the nursing home? Your state's Dept of Consumer Affairs? Who?

*********** We have repeatedly asked the nurses, the aids, and have mentioned it in our meetings that we have with the staff (about once every month or two). Included in those meetings are Dads head nurse, kitchen, rehab people, activities director, and social worker. We get a promise that they will attend to it and that lasts for about 2 or 3 days. They tell us they are not short handed but the aids tell us different and we can see that they are. We were told by a nurse a couple of weeks ago that a lot of the new people they have hired call in sick or just quit for a better paying job at another nursing home. I do know that their Medicare rating has gone down a point or two since changing hands. My mother and I went to an excellent home with a much higher rating and the price of it (for longterm care) was almost the same but they were not able to take him. In many of the better places there is a 6 month waiting (or more) waiting list....plus Dad is on Medicaid now and some homes will not take Medicaid.

Re: Oral Health Care In Nursing Homes Is Appalling

jubilant — Mon, 29 Aug 2016 17:09:55 GMT

@jubilant wrote:
@Tinkrbl44 wrote:
@jubilant wrote:
When we first put my Dad in a nursing home 3 yrs. ago, we thought they would see to it that his teeth got brushed. When he became more feeble and couldn't handle his toothbrush we thought surely someone would brush his teeth. Well...."nope".....they don't. His teeth started looking awful and he was complaining of sore teeth. It was a build up of food in between his teeth. Yuck!
We ended up buying dental insurance (medicare and medicaid doesn't provide it). It is rather expensive. No matter how much we plead..... his teeth never get brushed or flossed so we brush him and floss every time we are there. My sister is best at it so she usually does it....but mom and I have done it, too.
The reason I bring this up now is my Dad is recovering from Sepsis. Although it didn't come from his teeth, one of the first things the NP looked at (for infection) was in the mouth. That right there told us something! Thankfully, we had a dentist look at Dad just a few weeks ago and fill 2 superficial cavities so she could rule out anything there.
We see so many of these elderly people who no one is looking out for . Can you imagine what their teeth must look like after a couple of years? I shudder to think. My DIL works in a dentist office and she says this is very common. How sad.....especially when you read how poor dental health contributes to a lot of health problems in the elderly.
I just needed to vent about this because it is a crying shame about these forgotten elderly people. According to some articles I read today, it has been found their health is significantly improved by good oral hygiene.

@jubilant

I read your post and still can't figure out who you spoke to about this problem. A nurse? The Administrator of the nursing home? Your state's Dept of Consumer Affairs? Who?
*********** We have repeatedly asked the nurses, the aids, and have mentioned it in our meetings that we have with the staff (about once every month or two). Included in those meetings are Dads head nurse, kitchen, rehab people, activities director, and social worker. We get a promise that they will attend to it and that lasts for about 2 or 3 days. They tell us they are not short handed but the aids tell us different and we can see that they are. We were told by a nurse a couple of weeks ago that a lot of the new people they have hired call in sick or just quit for a better paying job at another nursing home. I do know that their Medicare rating has gone down a point or two since changing hands. My mother and I went to an excellent home with a much higher rating and the price of it (for longterm care) was almost the same but they were not able to take him. In many of the better places there is a 6 month waiting (or more) waiting list....plus Dad is on Medicaid now and some homes will not take Medicaid. That narrows our choices.

Re: Oral Health Care In Nursing Homes Is Appalling

jubilant — Mon, 29 Aug 2016 17:11:14 GMT

Sorry , I edited the other post and double posted somehow.

Re: Oral Health Care In Nursing Homes Is Appalling

jlkz — Mon, 29 Aug 2016 18:00:01 GMT

At the end, my mom was moved from a memory care facility to a nursing home. The first one with an available bed almost killed her twice: she was wheelchair- bound and no motor skills at the end. She was also on a feeding tube. The staff kept leaving her glass of water on the bed stand.

Result: she was taken by ambulance twice for severe dehydration. Upon her release from the hospital, the staff wanted to know when she would return. I turned to the administrative staff at the family meeting and asked: Why, do you want to finish the job of killing her???

Too, I presented them with the filthy clothes I found in her bureau.

Too, she developed bedsores because the home delayed getting her the proper bed for her condition.

I notified the department of aging about the abuse from the above conditions and more: they found no problems.

The next nursing home was in Philly: it was much better but you still needed to be on top of things.

Re: Oral Health Care In Nursing Homes Is Appalling

jlkz — Mon, 29 Aug 2016 18:03:11 GMT

@drizzellla

For dental cleaning, it might be easier to use a rechargeable WaterPik and basin to clean your dad's teeth. It would be faster than flossing and brushing.

Since I have been using the WaterPik alone, my hygienist visits have been great. Very little bleeding and the "pockets" have shrunk.

HTH

Re: Oral Health Care In Nursing Homes Is Appalling

151949 — Mon, 29 Aug 2016 19:08:54 GMT

I certainly agree that as much as humanly possible patients in nursing homes should have their teeth cleaned morning and night but I can tell you that quite often patients with dementia will not allow the aides to get in their mouth to do this chore. And let's face facts - the aides have a limited amount of time they can spend trying to cajole a patient into allowing them to do this. Until you have walked in someone else's shoes you really do not know.

Re: Oral Health Care In Nursing Homes Is Appalling

jubilant — Mon, 29 Aug 2016 23:11:55 GMT

@151949 wrote:
I certainly agree that as much as humanly possible patients in nursing homes should have their teeth cleaned morning and night but I can tell you that quite often patients with dementia will not allow the aides to get in their mouth to do this chore. And let's face facts - the aides have a limited amount of time they can spend trying to cajole a patient into allowing them to do this. Until you have walked in someone else's shoes you really do not know.

*********** Yes, I have seen some dementia patients flatly refuse oral care. In my dads case....he likes it! He also likes being shaved every couple of days. My sister does it one day a week so they only have to do it one day. We can see that some of these aids are overworked and we try to help with shaving, feeding him when he is weak, etc. Because we are there quite often and we do relieve them of a lot of their work......you would think this request for oral care would be honored.

They act like this is the "least" of their problems and who knows.....maybe it is. I'm not an expert on Nursing Homes. According to recent studies, however, on this oral hygiene.... it is not the "least" problem and needs to be addressed. I can also see that..... because we do so much for Dad..... they might feel that the person in the next room needs them more. I get that.... and we often feel torn about it. I just would like to see them hire dental hygienists for that purpose only....but there again...MONEY.

Re: Oral Health Care In Nursing Homes Is Appalling

jubilant — Mon, 29 Aug 2016 23:14:32 GMT

@jlkz wrote:
@drizzellla

For dental cleaning, it might be easier to use a rechargeable WaterPik and basin to clean your dad's teeth. It would be faster than flossing and brushing.

Since I have been using the WaterPik alone, my hygienist visits have been great. Very little bleeding and the "pockets" have shrunk.

HTH

*********** Yes, we are going to look into this this week. Thanks for your input and the reminder!

Re: Oral Health Care In Nursing Homes Is Appalling

hoosieroriginal — Tue, 30 Aug 2016 00:11:43 GMT

I just visited a friend in a nursing home - it is so sad - her mind is still so sharp! I almost wish it weren't so she wouldn't need to see everything around her. She shares a room with another woman - the room is soooo tiny you can hardly move around. She has recently been told she won't be able to go home - ever. Breaks my heart - I want to win the lottery so I can find a decent place for her to spend the rest of her days! I actually went out and bought lottery tickets today - hope me luck! She deserves so much better!

I totally get what she's saying. My BF's daughter has mu...

Financialgrl — Wed, 31 Aug 2016 14:10:57 GMT

@Tinkrbl44 wrote:
@jubilant wrote:
When we first put my Dad in a nursing home 3 yrs. ago, we thought they would see to it that his teeth got brushed. When he became more feeble and couldn't handle his toothbrush we thought surely someone would brush his teeth. Well...."nope".....they don't. His teeth started looking awful and he was complaining of sore teeth. It was a build up of food in between his teeth. Yuck!
We ended up buying dental insurance (medicare and medicaid doesn't provide it). It is rather expensive. No matter how much we plead..... his teeth never get brushed or flossed so we brush him and floss every time we are there. My sister is best at it so she usually does it....but mom and I have done it, too.
The reason I bring this up now is my Dad is recovering from Sepsis. Although it didn't come from his teeth, one of the first things the NP looked at (for infection) was in the mouth. That right there told us something! Thankfully, we had a dentist look at Dad just a few weeks ago and fill 2 superficial cavities so she could rule out anything there.
We see so many of these elderly people who no one is looking out for . Can you imagine what their teeth must look like after a couple of years? I shudder to think. My DIL works in a dentist office and she says this is very common. How sad.....especially when you read how poor dental health contributes to a lot of health problems in the elderly.
I just needed to vent about this because it is a crying shame about these forgotten elderly people. According to some articles I read today, it has been found their health is significantly improved by good oral hygiene.

@jubilant

I read your post and still can't figure out who you spoke to about this problem. A nurse? The Administrator of the nursing home? Your state's Dept of Consumer Affairs? Who?

I totally get what she's saying. My BF's daughter has mutliple meetings with the director, head nurse, etc Things change for all of a minute and then it goes on as usual. Oh and here's something I personally witnessed myself.

Friend fell and broke his leg and an arm. We (another friend and I) looked into facilities that had great reviews but our friend chose a place that was convenient for his kids to visit (two kids who never do anything for him as it is). This facility accepted Medicaid patients and all the reviews are one star where ppl say it won't let them put zero stars. I arrived about 1:30 for about an hour and he rang the buzzer twice and no one came. He had ordered lunch at noon when they asked what he wanted and when I left at 2:30 they were just bringing it in. It looked horrible and he said it was cold. The next time I visited, there was a sign on the door indicating that the facility was prsently being inspected. I saw young CNAs sitting using their phones, standing around talking in the hallways and my thought was - - - if this is how they act when they are being monitored and inspected, God help us what they do (or don't do) once no one was around. My friend stayed there 3 days and checked himself out and had in-home PT where they came to his home 3 times a week.