"Eight Items and Four Notes" for Seniors Watching Teeth
Eight
items: obstacle, period, referral, cognition, simplicity, vision, hearing,
medication.
Four
notes: physical, psychological, social family, who should be responsible.
Let's
talk about "eight items"
1.
Obstacles: Accessibility to the dental clinic, barrier-free access to the
clinic, or low-level obstacles and safety require special design
considerations.
2.
Period: Appointment consultation in the morning or afternoon period, you need
to consider the situation of the elderly. For example, some elders have stiff
movements in the morning due to illness.
3.
Referral: establish the habit of regular referrals and reminders. For example,
the clinic's prior reminder, the elderly self-recorded in the calendar, or
family and caregiver reminders.
4.
Cognition: Physicians need to pay attention to the cognitive status of elders
when communicating; for example, when we explain the condition, try to approach
from the front of the eyes, and use non-verbal communication, such as smiles
and eye contact, is very important.
5.
Simple: Patients with cognitive limitations are prone to information overload,
so instructions and instructions should be simple and sentences should be
short, such as "open mouth".
6.
Vision: Because the vision of the elderly is relatively aging, it should be
noted that the visual materials given to the patient need to be adjusted
appropriately. For example, the instructions for post-operative precautions
should be designed for the elderly and easy to read.
7.
Hearing: Because the hearing of older people is relatively aging, we should
speak clearly, loudly, and slightly slower.
For
elders who can read lips, we can face the patient below the line of sight and
the mask should be removed so that the elder can read our speech. You can use
written, graphic, animated, or video instructions to help explain dental
information.
If
you have a hearing aid, you can minimize background noise and avoid sudden
noise when speaking. It is recommended that the patient adjust or turn off the
hearing aid during treatment.
Before
speaking, you need to give elders a message or light contact to attract
attention to your speech and reduce the use of proper nouns. When using
different equipment, it is also necessary to let the elderly know.
8.
Medication: Response to the use and interaction of multiple drugs: The elderly
may use some drugs more or less. Physicians, family members, and caregivers
must bear in mind that these drugs reflect the disease of the elderly Problems
and adjustments to the dentist’s medical decisions and treatment.
Four
notes
Note
1: Physiological changes
No
matter how advanced human technology and medicine are, aging is a fact that
cannot be changed. Changes in the body are relatively easy to find, and degradation
or disease is a subject we must face sooner or later. The aging of these
physical functions will also make it difficult for the elderly to maintain
their oral cavity.
Hearing
loss, presbyopia, cataracts, joints, skeletal muscles, lungs, cardiovascular,
digestive system, nervous system, metabolic system, etc., or related diseases,
or already a disease condition, will often make self-oral cleaning more
difficult.
For
the elderly with limited mobility, we now think that simply walking to the
toilet to brush their teeth is a barrier for them. Moreover, the skills of
toothbrushes, interdental brushes, and flossing, which require the coordination
of fine movements, hand-eye coordination, and proprioception, are not easy to
achieve.
Older
people often complain of dry mouth and less saliva. Part of this is the
deterioration of the saliva line that produces saliva. Of course, dry mouth may
also be because the elderly usually use many kinds of drugs, and their
interaction. Or dry mouth may be caused by psychological factors. The advantage
of saliva is that it can help you eat and talk. It removes food from teeth and
reduces the impact of oral acid on tooth decay; saliva also carries minerals
that keep teeth strong.
The
general principle is to reduce the barriers for the elderly to maintain oral
hygiene and health care on weekdays.
1.
The design of the moving line in the home and the design of the toilet. How to
make dental cleaning tools suitable for the elderly to grasp and use, and even
some compensation techniques (you can ask a functional therapist).
2.
Elderly with physical inconvenience may require caregivers to assist with oral
cleaning. The caregiver's oral cleaning skills and mentality also need to be
learned and adjusted.
3.
The timing of teeth cleaning is also a part of our attention, and some elders
or caregivers need to be reminded. Like using an electronic calendar, when time
is up, it automatically pops up to remind you to clean your teeth.
4.
To combat dry mouth, you can take small sips of water from time to time. You
can also chew sugar-free gum, but avoid alcohol and smoking. In addition,
saliva substitutes may also help.
Note
2: Psychological changes
Psychological
changes, because they are intangible and invisible, are often ignored by family
members or caregivers, such as delirium, depression, and dementia. Especially
cognitive impairment and dementia are common.
The
change in cognition makes it easy for the elderly to take care of their oral
cavity, which also makes dental intervention difficult.
1.
Self-cognition and understanding of oral diseases, as well as accepting the
doctor's advice or following the doctor's orders after treatment, are all major
challenges.
2.
Learning new techniques, or adapting to new things, becomes relatively difficult;
for example, the use and adaptation of new movable dentures and fixed dentures
are also a challenge for some elders. However, some scholars have expressed
skepticism.
3.
I forgot to brush my teeth and when I had brushed my teeth; or after receiving
a tooth extraction, I was unable to follow the instructions to take drugs or
hemostasis principles.
4.
Even some of the pain that can't find the reason, some parts may affect the
physical feelings due to psychological factors. Or, a certain part is really a
physical disease, which leads to psychological effects.
Therefore,
serious psychological and cognitive problems must be consulted by
psychiatrists, psychologists, and psychopsychologists.
We
cannot label the elderly because it is difficult for them to communicate; we
also don’t have any ability or power to say that they are mentally problematic,
because this requires a rigorous mental and psychological expert assessment
before they can be diagnosed.
Note
3: Social family
In
addition to eating and talking, the function of teeth is another part of the
appearance, which will affect the psychological level of the elderly. For
example: seniors who have long missing teeth, the face looks relatively
unenergized, or the factor of missing teeth is unclear, and the elderly may
feel less beautiful, don’t want to talk, or don’t want to go out Socialization
indirectly affects the mental health of the elderly.
On
the other hand, social welfare, social insurance, and social care systems do
play a considerable role in the dental intervention of the elderly. For
example, some seniors of the ethnic group, even if they are physically
self-sufficient, need to rely on the support of the family at the economic
level; often because of economic factors, some seniors are worried about receiving
dental treatment plans.
Note
4: Who should be responsible?
The
focus of the field of long-term care, or social welfare and social insurance on
senior dentistry, can be considered as assistance. The main body, mind, and
soul roles are the family members and caregivers of the elderly.
Occasionally,
after seeing family members or caregivers bring the elders to the clinic, they
will drop a sentence. The doctor will decide if you want, or the doctor will
leave it to you.
In
this case, our doctors can really help. After all, the body is its own, and the
patient himself is responsible for his or her mouth; if the patient is
incapable, the family or caregiver must pay a large part of the responsibility.
What
we hope is that the doctors, family members or caregivers, and the elders
jointly formulate a treatment plan and do their best.
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