Care with a Smile: For a Smile in Care Homes

individual

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INTERPERSONAL : SCIENCES

humanistic --------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

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group

Self-esteem, self-image anxiety, worry, depression Able to express needs communication Ability to ask, remind, argue - self-advocate Challenging behaviours, agitation, aggression Irritability, poor sleep reduced attention and concentration Observation of staff - pain? Loss of dentures, memory

Changes in gums, gum disease, weight loss cleaning teeth, false dentures, fit, marking dentures, care plans Access to toothbrush, toothpaste, mouth wash, Oral hygiene Sugar – sweets (one of few pleasures?) Risk of thrush and other infections (cardiac?) Mobility of the resident Appearance and sense of well-being Pain of toothache, analgesia – tiredness Avoiding eating and drinking properly Access to dental surgery Changes with speech Equipment challenges of remote care, technology changes Mobile clinics

Responding to expressed distress - whether explicit or implicit (listening - caring) Confidence. Isolation Avoiding other people. Having friends and family to advocate for dental care Impatience with others, argumentative, shouting Family expectations

Guidelines Commissioning of dental care in the residential / nursing home sectors Local authorities, Health, CQC Asessment - Evaluation Referral process Staff  awareness and knowledge The nursing home make the referral? The family must make the referral? Payment National standards Domiciliary visits paid in advance. Dental service packs packs circulated to residential and nursing homes across a Region. Global access to Dental care?