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Randomised clinical trial: Efficacy of strategies to provide oral hygiene activities to nursing home residents with dementia who resist mouth care
Author(s) -
Jablonski Rita A.,
Kolanowski Ann M.,
Azuero Andres,
Winstead Vicki,
JonesTownsend Corteza,
Geisinger Maria L.
Publication year - 2018
Publication title -
gerodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 54
eISSN - 1741-2358
pISSN - 0734-0664
DOI - 10.1111/ger.12357
Subject(s) - medicine , oral hygiene , dementia , hygiene , odds ratio , intervention (counseling) , randomized controlled trial , nursing homes , long term care , nursing , family medicine , dentistry , disease , pathology
Objectives The purpose of this study was to test the efficacy of MOUT h (Managing Oral Hygiene Using Threat Reduction), a nonpharmacologic, relationship‐based intervention vs. control on 2 primary outcomes for nursing home ( NH ) residents with dementia who resisted mouth care: (i) reduction in the occurrence and intensity of care‐resistant behaviours ( CRB s) and (ii) improvement in oral health. Two secondary outcomes were also examined: (i) the duration of mouth care and (ii) the completion of oral hygiene activities. Background Persons with dementia who exhibit CRB s are at risk for inadequate mouth care and subsequent systemic illnesses. Materials and methods The study used a randomised repeated measures design. Recruitment occurred in 9 nursing homes that varied in size, ownership, reimbursement patterns and location. One hundred and one nursing home residents with dementia were randomised at the individual level to experimental (n = 55) or control groups (n = 46). One hundred participants provided data for the analyses. Results Compared to the control group, persons in the experimental group had twice the odds of allowing mouth care and completing oral hygiene activities; they also allowed longer duration of mouth care ( d = 0.56), but showed only small reductions in the intensity of CRB s ( d = 0.16) and small differential improvements in oral health ( d = 0.18). Conclusion The data suggest that this intervention facilitates mouth care among persons with dementia. The management of refusal behaviour may be a clinically more realistic approach than reducing or eradicating refusals.