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Powerpoint presentation
Oral Health in the Pal iative Care Patient: Care throughout the Continuum of Il ness
Rose Anne Indelicato, MSN, ANP-BC, ACHPN, OCN, Daniel Pomerantz, MD, MPH, FACP, & Dorothy Wholihan, DNP, ANP-BC, GNP-BC, ACHPN
Sound Shore Medical Center of Westchester, New Rochel e, New York
New York University Col ege of Nursing (NYUCON), New York, New York
INTRODUCTION OUR CASE: MRS. THOMPSON
•In 2000, the Surgeon General declared dental health as the most
Pre/Post Test Results: Questions 1-5
common unmet health need. While preventative oral care has
reduced tooth loss, the elderly present with more complicated dental needs and higher levels of oral disease. Diligent oral care is
required to prevent systemic complications, promote adequate
nutrition and maximize patient comfort and dignity.
•77 year old woman with PMH of HTN, COPD, OA & Dementia
•Although Palliative Care provides a “total” care focus for patients
•Lives at home with her elderly sister
Post Test
with serious illness, oral health issues may be forgotten or ignored,
•Current Medication Regimen: HCTZ, Arthrotec, Aricept, Namenda,
either due to pressing medical problems, a patient’s inability to
participate in care, or lack of attention by healthcare professionals.
•Wears partial dentures & uses oxygen prn
•In partnership with The Oral Health Nursing Education and
Topics Highlighted Pre/Post Test Results: Questions 6-10
Practice (OHNEP) Initiative to promote inter-professional
participation in oral health for all patients, an educational program
•Specific Oral Care Issues for Mrs. Thompson related to:
was developed, illustrating the oral care needs and challenges for
•Chronic Illnesses: COPD, osteoarthritis, dementia
the elderly palliative care patient in various care settings.
•Oral Health Issues Across Various Care Settings: Post Test
•An interactive presentation: “Mrs. Thompson,” utilizing a case-
•Oral Intubation & Mechanical Ventilation
•Risk Profile & Prevention of Aspiration
based approach was created. Content was obtained through
literature searches, data from the “Smiles for Life” website and
•General Medical Floor, Long Term & Hospice Care:
Subjective Responses to Program:
•This presentation was incorporated into a four hour
interdisciplinary conference: “Palliative Care: A Focus on
Commitment to Practice Change
Forgotten Issues & Symptoms” which was held in April, 2013 in
Pre/Post Test: 10 Item True/False Questions
•Attendees plan to:
1.Complete tooth loss in the elderly has declined from 50% to 18% in the past
•In order to have the greatest impact on the most healthcare
•Invite presenters to their inpatient facilities to replicate the
professionals, this free conference was offered to healthcare
learning session for those staff who did not attend the conference.
2.Dietary changes in the elderly do not increase the risk of forming dental
facilities and schools of nursing through professional societies
•Review the current policies and procedures related to oral care at
3.The use of beta 2 agonists (such as albuterol) leads to reduction in saliva
•Continuing educational credits were offered to nursing
attendees who completed a course evaluation.
•Incorporate new tools and reference materials related to oral care
PARTICIPANTS
4.Causes for halitosis in patients at end of life include the use of oxygen and
anticholinergics for secretion management. (T)
5.Implementation of oral care interventions has not reduced the incidence of
•Review newly learned information with nursing assistants.
Attendees included healthcare professionals and volunteers from the Tri – State area
6.In patients with COPD, dental plaque does not impact the development of
•Utilize patient case to create a unit based in-service for
(New York, New Jersey & Connecticut)
professional and para-professional staff.
Attendance Profile
7.Patients with early stage dementia are unable to undergo restorative dental
ACKNOWLEDGEMENTS
8.The use of a spacer with an inhaler will help prevent the development of
Sincere thanks to Dr. Judith Haber at NYUCON and the Oral
9.The Mouth Care Assessment & Documentation tool involves evaluation of
Health Nursing Education and
the teeth, tongue, lips and mucous membranes. (T)
Practice Initiative
10.Gram + lactobacillus is often found in the oral cavity. (T)
Secretariado Japonês da Jornada Mundial da Juventude DICAS PARA APROFUNDAR A MENSAGEM DO PAPA BENTO XVI PARA A 26ª JORNADA MUNDIAL DA JUVENTUDE Em Agosto de 2011 em Madri (Espanha), terá lugar a 26ª Jornada Mundial da Juventude (JMJ). Como preparação espiritual para as Jornadas o Papa envia aos jovens uma Mensagem por ocasião do Domingo de Ramos, que foi designado “Dia Mundial da J
Dr. Jeff Moore, Au.D. Doctor of Audiology PATIENT INSTRUCTIONS FOR VNG TESTING You will be instructed to refrain from taking certain medications for 48 hours prior to your test date. Certain medications can influence the body's response to the test, thus giving a false or misleading result. You will find a short list below; however, if you have any questions or concerns about disco