Oral health care is an integral part of healthcare and well-being. Rarely talked about, it is also a component of palliative care. This is not surprising as oral care tends to be forgotten about in spite of research showing its relevance to general health. As we say, “Oral wellness, Whole health”.
This is also not surprising as palliative care deals with end of life issues which causes us to focus on more profound things –regardless whether we are the patient, a family member or a caregiver.
The World Health Organization defines palliative care as:
…an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. Palliative care:
- provides relief from pain and other distressing symptoms;
- affirms life and regards dying as a normal process;
- intends neither to hasten or postpone death;
- integrates the psychological and spiritual aspects of patient care;
- offers a support system to help patients live as actively as possible until death;
- offers a support system to help the family cope during the patients illness and in their own bereavement;
- uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated;
- will enhance quality of life, and may also positively influence the course of illness; is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.
Good mouth care in our final days and weeks is about quality of life. Up to the last moment, we want to be able to communicate with those around us, socialise, feel comfortable, and enjoy whatever food and drink may suit us. This is about our dignity and self-esteem, whether it is in a hospice, hospital or in our own homes.
The aim is to have comfort by ensuring oral cleaning- with toothbrush, toothette, or gauze. Saliva substitutes where there is a dry mouth caused by treatments, medications or age. Making sure dentures fit as well as possible to prevent ulcers and that they are cleaned regularly on a daily basis. Sharp, broken, loose teeth should be attended to by a dentist, as should active oral infections.
These links offer rationales and some detailed care instructions.
If you have a loved one in palliation, these minimal interventions should offer a modicum of comfort without being too demanding at difficult time making it as normal and comfortable as possible.