The oral cavity holds thousands of colonies of microorganisms. These organisms are largely beneficial to the body and that is why they are also called normal flora. In persons on long term care in nursing homes, poor oral hygiene is fairly common. This predisposes them to infections that may lead to various compilations including aspiration pneumonia. We will look at how oral care and aspiration pneumonia should be handled.
It has been established that the risk for aspiration among patients on long term care is markedly increased if there is a concomitant disease in the cavity. Examples of these diseases and medical conditions include periodontal diseases and dental caries. Other conditions that may worsen the situation include the existence of swallowing difficulties, inability to feed and poor motor coordination. The elderly are at a higher risk of suffering from this conditions than the general population.
It has been shown through research that close to 15% of adults have swallowing difficulties. This figure appears to increase as we advance in age due to what are believed to be changes taking place in the physiology and anatomy of the oropharynx. At the age of 80 years, it appears that almost half of the people have varying degrees of swallowing challenges. Other factors that may contribute to the problem include stroke, cerebral palsy and dementia among others.
One of the most effective interventions that can be undertaken is to take care of the posture of these patients when they are swallowing. This is done with the help of a posture and swallowing therapist. The patient and their care taker need to be taught the maneuvers that they can perform during swallowing so as to minimize the risk as much as possible.
The numerous medications that are prescribed for this group of patients may in some cases inhibit the swallowing reflex. For this reason all drugs need to be carefully considered with regard to their effect on swallowing. Other interventions that may be undertaken include dietary modification, administration of medications to reduce gastric acid secretion (proton pump inhibitors) and to minimize the secretions by giving drugs such as angiotensin converting enzymes.
Suppression of oral functions is common in patients on care. The causes behind this are the depressed consciousness and the presence of feeding tubes. A lot of saliva and mucous secretions are produced at this point to help and deal with the problem. Unfortunately, these secretions mix with solid residues in the mouth to form a sticky paste that will be seen adhering to the mucosal surfaces and teeth.
The self-cleaning mechanisms in the oral cavity are usually non-functional in these patients. This means that the paste that is formed in the mouth has to be removed mechanically. If this is not done, then there is a high risk that infections will set in. These infections can cause pneumonia when aspiration takes place. Inhalation of organisms may still occur even on the absence of overt aspiration.
Proper oral hygiene for elderly clients in long term care facilities is a vital step in the prevention of aspiration as well as other associated complications. Some of the complications that may be encountered if this is not done regularly include infective endocarditis and abscess formation. Apart from regular cleaning of the oral cavity, other risk factors of aspiration need to be reduced as much as possible.
It has been established that the risk for aspiration among patients on long term care is markedly increased if there is a concomitant disease in the cavity. Examples of these diseases and medical conditions include periodontal diseases and dental caries. Other conditions that may worsen the situation include the existence of swallowing difficulties, inability to feed and poor motor coordination. The elderly are at a higher risk of suffering from this conditions than the general population.
It has been shown through research that close to 15% of adults have swallowing difficulties. This figure appears to increase as we advance in age due to what are believed to be changes taking place in the physiology and anatomy of the oropharynx. At the age of 80 years, it appears that almost half of the people have varying degrees of swallowing challenges. Other factors that may contribute to the problem include stroke, cerebral palsy and dementia among others.
One of the most effective interventions that can be undertaken is to take care of the posture of these patients when they are swallowing. This is done with the help of a posture and swallowing therapist. The patient and their care taker need to be taught the maneuvers that they can perform during swallowing so as to minimize the risk as much as possible.
The numerous medications that are prescribed for this group of patients may in some cases inhibit the swallowing reflex. For this reason all drugs need to be carefully considered with regard to their effect on swallowing. Other interventions that may be undertaken include dietary modification, administration of medications to reduce gastric acid secretion (proton pump inhibitors) and to minimize the secretions by giving drugs such as angiotensin converting enzymes.
Suppression of oral functions is common in patients on care. The causes behind this are the depressed consciousness and the presence of feeding tubes. A lot of saliva and mucous secretions are produced at this point to help and deal with the problem. Unfortunately, these secretions mix with solid residues in the mouth to form a sticky paste that will be seen adhering to the mucosal surfaces and teeth.
The self-cleaning mechanisms in the oral cavity are usually non-functional in these patients. This means that the paste that is formed in the mouth has to be removed mechanically. If this is not done, then there is a high risk that infections will set in. These infections can cause pneumonia when aspiration takes place. Inhalation of organisms may still occur even on the absence of overt aspiration.
Proper oral hygiene for elderly clients in long term care facilities is a vital step in the prevention of aspiration as well as other associated complications. Some of the complications that may be encountered if this is not done regularly include infective endocarditis and abscess formation. Apart from regular cleaning of the oral cavity, other risk factors of aspiration need to be reduced as much as possible.
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The following article explains about the effectiveness of oral care and aspiration pneumonia prevention. To read the informative post now, check out the blog at http://www.swallowstudy.com.
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