Most horror stories about poor nursing home care include tales of grotesque “bed sores,” broken bones gone undiagnosed, and similar cases of obvious caregiving lapses. But the best way to measure the quality of long-term care facilities may not be to see how many of these “big” mistakes are made. Instead, it might be more appropriate to look into resident’s mouths.
As a New York Times article discussed last week, there is a chronic problem of poor (and virtually non-existent) dental care provided at far too many nursing homes. A facility’s attention to dental care may be a key indicator of their overall commitment to proper support.
For one thing, many seniors do not have dental insurance. Medicare usually does not cover basic dental care. Medicaid might, but many have reported problems finding local dentists who accept Medicaid coverage. Without private insurance, many seniors simply go without regular cleanings and preventative care. Following a medical setback, dementia, or other challenge, many of these seniors land in nursing homes already in poor dental health.
And the problem only gets worse from there.
That is because, as several recent investigations have uncovered, large segments of the nursing home population do not receive the basic aid they need to keep up oral health. Many residents who need help brushing their teeth on a daily basis do not receive it, leading to serious problems.
It is important to note that this lax caregiving is not just an oversight, it is a breach of federal nursing home standards. As the NYT story points out, the Omnibus Budget Reconciliation Act of 1987, which include nursing home caregiving standards, specifically explains that residents must receive help brushing their teeth if needed.
Those standards are frequently not followed. For example, in 2006 researchers took a look at a sample of nursing homes in upstate New York. They found that a paltry 16% of residents receive any sort of oral care at all! Those residents who did have help with brushing their teeth only had them brushed for a total of 16 seconds a day–far below the recommended limit. In other words, not only was the care poor, it was almost non-existent.
Even worse, more research is emerging which shows the consequences of poor dental care. One research effort from 2010 published in the Journal of the American Dental Association found that inadequate dental care can dramatically increase risk of nursing home residents developing pneumonia. They argued that as many as one in ten nursing home deaths may be prevented with improvement in such care.
The takeaway: Be cognizant of oral care at nursing homes, and take steps now to ensure you and your loved one will have access to necessary dental services in your golden years.