Teeth not worth worrying about

Friday, 05 December 2008 11:53 | Print page:

ABC’s Lateline Program last night featured the appalling lack of dentistry within many of Australia’s aged-care facilities.

Who looks after the mouths and teeth of those who live in facilities for the frail and old? Hardly anyone, it seems? I can’t remember ever seeing a dentist, dental therapist or dental hygienist, in any of the homes that I regularly visit.

The dentist on Lateline, Dr Clive Rogers, said that it was not uncommon to find several abscesses in the mouths of the residents he sees. Ouch!! Ever had an abscess on a tooth?? He goes on to tell, and show, us the massive build up of food and plaque in the mouths of the frail older people he is checking. It is not a pretty sight.

He notes that the issue of dental care rarely seems to be raised by the aged-care accreditors and comments, “All the nursing homes I see should not be passing their accreditation. And from the survey I did, that seems to be the consensus around Australia”

We also know that some experts place the lack of dental care for frail older people as one of the causes of their, far too frequent, malnutrition.

Meal time is little pleasure if you have no teeth, broken teeth or gum disease. And then there are matters of poor self esteem, depression and other associated health problems that come with untreated dental problems.

Many of the current nursing home client group have full dentures as they grew up when dental care, more often than not, entailed the removal of the offending tooth or teeth – rather than repair and treatment. They need their plates cleaned and adjusted. Now an increasing number of older people have their own teeth. Thus, tooth cleaning after meals is essential in order to prevent decay - another job to be done in our understaffed aged-care facilities. My guess is that it often gets skipped.

Sometimes I wonder if teeth aren’t considered to be a part of your body by the various authorities.

Dentistry isn’t covered by Medicare and seems to be the aspect of health care that is just neglected.

Dr Clive Rogers says immediate action needs to be taken. Now what would be the chance of that happening?

Newer articles:

31/07/2009 - Bonds for high care?
14/06/2009 - No use complaining
19/04/2009 - Doctors speak out on staffing levels
29/03/2009 - Frail residents left underfed and at risk
18/01/2009 - Aged care needs the three R’s

Older articles:

02/12/2008 - Not-for-profits lose the plot
28/10/2008 - Who is pulling the strings?
23/09/2008 - Ministers from nowhere
04/09/2008 - Why did it take so long?
11/08/2008 - Making no apology... Again and again...

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Columnist said: “Well that is a shocker! An assessor flogging videos to the facilities! “ You sound surprised, Columnist. Happens all the time. Training, for another example. The facilities have to meet certain staff training goals to get their CAP funding. Any old accreditation auditor can knock off from the agency any day, put on their consultant hat the next, advise a facility on its training obligations (for a fee), sell it their own training program, collect the fees, and morph back into an auditor the next day. More or less. You wouldn’t want to be the facility that knocked ‘em back, would you! There’s also the question of what really is a consultant? When does a consultancy become a brokerage? I want to use some links on that, so I’m going to the Forum

Couldn't agree with you more, Di Bates. But is the complaints system failing - or just succeeding at what it was designed to do - keep aged care out of the media. I've only seen the complaints body in action once - but that was a specific prerequisite of the [old] Complaints Resolution Committee before they would agree to deal with his complaint - that he or his family did not speak to the media.

The demon we fight in the aged care industry is not the lack of oral hygiene nor the lack of genuine continence management or the failure to feed the starving, dying patients appropriately etc etc. The demon we fight is the arrogant refusal by the government and the upper level bureaucrats that these issues, reported to them over and over again, are being blatantly ignored as a result of the total failure of the government complaints mechanisms. To fix all of these problems a New Age in the provision of care of our elderly and infirm is urgently needed. We, the community, are the ones who must bring this about by vocalising through organisations such as Aged Care Crisis. These problems are quite obviously ours to find a solution to because the government is not, and until their heads are out of the sand, will not fix. Di Bates Daniel's Shield

The problem is staffing, however accreditation does not take into account or specify an optimum level of staff required. There is also the problem of experienced & quality staff, many Registered & Enrolled nurses are being replaced by inexperienced carers, many of whom have issues with english speaking, drug abuse and mental health, again there is little in accreditation to guard against unsuitable staff working in aged care apart from a "police clearance" I'm aware or many complaints to the relevant department and minister regarding staffing impacting on care. The results of complaints are spot checks though nothing is done except for "recomendations" and "assistance" to the facilities. Until some real action is taken the elderly in these facilities will continue to suffer.

Well that is a shocker! An assessor flogging videos to the facilities! By the way, I reckon that cleaning teeth and checking mouths doesn't need too much instruction. But it does require having enough staff on duty so there is time to do it.

Grateful thanks to Dr Clive Rogers. And I think you'd find sight and hearing (though slightly less critical than the mouth) are equally ignored. A few years ago, as a carer, I endured a 20-minute video on oral care. The content was ok, if very basic common sense. But the production was a hoot. It was sold to the home by its nurse consultant, who is also a long-time accreditation assessor in our state. They'd filmed it themselves, edited it themselves and copied it onto $2 VHS tapes from down at the supermarket - and were flogging it off to the aged care facilities at $70 each (and still are, I think.) Why would the members of the accreditation agency ever imagine there might be something wrong with oral health? As far as they're concerned, oral health in nursing homes is doing just great - they're making a welter out of it.

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