Dr. Steve Arthur, the recently retired Director of the Office of Oral Health for the State of Vermont, recalls a visit to his 92 year old mother in an out-of-state assisted-living facility and being very concerned at what he found missing in her care there.
“It’s true that I’m probably more alert to oral health care needs than most, but I noticed how little, if any, attention was given to my mother’s dental hygiene needs,” he said. “My mother has dementia which makes it difficult for anyone to provide oral health, but I believe her dental care was already being overlooked. It wasn’t a priority for the staff there and her oral health care needs were being neglected.”
The community Dental Health Care Team at The Manor: Dr. Steve Arthur, Director of the Office of Oral Health for the State of Vermont (retired);Kevin Kelley, CEO of CHSLV; Sandy Beynnon, Dental Hygienist with CHSLV; Krys Laychak, Director of Nursing at The Manor; Lynn Smith, Administrator at The Manor; and Linda Greaves, Public Health Dental Hygienist for the Vermont Department of Health. Photo Credit: Erika Mitchell
For these reasons, when he was contacted by The Manor in Morrisville, VT, about an oral health project for their nursing home patients, he quickly referred Linda Greaves, the Public Health Dental Hygienist for the Department of Health’s Morrisville office. Greaves, with her own passion for working with geriatrics, and an understanding of complications for providing oral and dental care when a person is wheelchair bound, suffering from dementia or Alzheimer’s disease or, simply unable to tolerate a visit to a clinic, enthusiastically joined the Manor Oral Health Team.
As the region’s public health hygienist, Greaves is familiar with the needs of a rural and underserved community, “Being able to provide dental care to nursing home residents who cannot access care in a dental office is a win-win situation. For some, that means direct bedside care.”
The Manor’s investment in a portable dental unit, an autoclave, which sterilizes equipment and supplies by subjecting them to high pressure saturated steam, and a Broda reclining chair, made this possible. It’s really a wonderful service,” she enthused, “And, it’s rare for anyone in a nursing home to receive this level of dental care on site, if at all.”
While seniors and vulnerable adults living in nursing homes are not denied care altogether, oral health has mostly remained the responsibility of the resident and their family.
According to Lynn Smith, Executive Director and Nursing Home Administrator for The Manor, “Most nursing homes have a contractual agreement with an outside dental provider for as-needed visits. For The Manor, we envisioned a full service, comprehensive dental care system with regular weekly services for our residents.”
Enthusiasm for the project from Dr. Arthur and Ms. Greaves along with The Manor’s considerable investment in time, attention and resources led Administrator Smith to form a vigorous community health care collaboration with other key organizations. Partners include Kevin Kelley, CEO, and Clinical Supervisor Sandy Beynnon of Community Health Services of Lamoille Valley (CHSLV), as well as the Morrisville District Office Health Department, and Mary Atherton, RN, Program Administrator for the LNA Program at the Green Mountain Technical Career Center (GMTCC).
All became fully committed to the mission.
According to Kelley, “We recognized early on that there was a need for dental health care in this kind of setting and wanted to help answer the questions about who would provide the services, training and staff education.” What’s more, he says, “My Family Practice physicians are on board and understand how important oral health care is to the overall health of the patient and resident.”
For Beynnon it was an opportunity to reach out to a multitude of people in Lamoille County who might benefit from better oral health care. “We place an emphasis on the entire family of our clients. Once a loved one sees how their elder is being cared for; it sometimes prompts them to consider their own dental care needs. The ripple effect is very positive.”
A resident receives dental carein the new dental suite at The Manor. Photo Credit: Laurie Shapleigh
Linda Greaves working alongside Ms. Smith and Ms. Laychak said of their efforts, “The Manor made this their priority. Lynn Smith was undaunted. She made this happen and we were happy to partner with her and her staff.”
Along with Smith, The Manor’s Director of Nursing, Krystina Laychak, considered how the lack of in house dental hygiene might affect the quality of overall health for the Manor’s residents. Laychak shared that good oral hygiene matters beyond the provision of care to the mouth.
“Good oral hygiene,” she explained, “has been shown to reduce incidents of pneumonia, improve swallowing, enhance cough sensitivity and improve saliva production.” Further, Laychak said, “Salivary disorders, or “dry mouth”, can be caused by any number of more than 500 medications and contributes to tooth decay, mouth sores and oral infections.”
Smith underscored Laychak’s explanation, “Every aspect of our residents’ health is important. Oral health is part of that care and we were determined to provide it.”
Smith and Laychak have rounded out their community connections by providing oral health education for the Licensed Nursing Assistants of The Manor, many of whom trained at the GMTCC in Hyde Park, VT. “The instructors are incorporating a more comprehensive oral health care training in their curriculum,” said Laychak. “For residents of The Manor, this is a very positive outcome.”
As for Dr. Arthur, it’s a nice way to ease out of his career in public service and into retirement knowing that, as more Vermonters age, the quality of their oral health care will not be compromised. Not, at least, if they reside at The Manor.
“We’re going to see many more elders with teeth,” he states, not facetiously, “And while we may not know the past oral health practices of our elderly residents, we do know that we can provide them quality care as they age. The Manor has taken the lead in showing us how.”
For Smith, it was simply, “the right thing to do. So, we did it.”
For more information about The Manor and its oral health care program, contact Administrator, Lynn Smith at 802.888.8752.
Source: The Manor, July 16, 2014