Randomised clinical trial: Efficacy of strategies to provide oral hygiene activities to nursing home residents with dementia who resist mouth care

Authors:
Publisher website
Google Scholar
Abstract
Objectives: The purpose of this study was to test the efficacy ofMOUTh (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 (CRBs) 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 exhibitCRBs 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 ofCRBs (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.
Funding Information
  • National Institute of Nursing Research (R01NR012737)
  • National Institutes of Health

This publication has 53 references indexed in Scilit: