Older Person Symposium Flashcards
(44 cards)
What are the challenges of treating the older population?
Increasing number of people with long term conditions
Increasing age with concurrent increase in co-morbidities
Polypharmacy
Dementia
Impaired ability to cooperate
What are the effects of Lichen Planus?
Discomfort in eating
Difficulty in performing OH
Risk of malignancy
Systemic disease and polypharmacy may contraindicate therapies
What is aspiration pneumonia?
Food, liquid or teeth are breathed into the airway or lungs, causing pneumonia
Most common cause of death in patients with dysphagia associated with neurological impairment
Describe tx planning in the early stages of dementia?
Planning for future
Identify and attempt to retain key teeth
Focus on high quality restorations
Are complex restorative tx able to be cared for in the long term?
Establish a preventative regime
Give examples of key teeth?
Occluding pairs of teeth
Anterior teeth
Describe tx planning during the mid-stage of dementia?
Maintenance and prevention
Consider medical status and its implications on care
Access becomes more challenging
What is ART?
Atraumatic Restorative Technique
Describe tx planning during late stage dementia?
Focus on comfort
Moist, clean and healthy mouth free of pain and infection
Non-invasive
Emergency management - limited options
What do we need to control, to control oral biofilm based disease?
OH and removal of biofilm
Sugar
Level and quality of care
Teeth
Fluoride
Operation intervention when required
What are techniques for communicating with older people?
Approach from the front
Break it down into steps - short words, simple sentences
Non-verbal - smile, gentle touch
Get the environment right - quiet
Distraction
What is dementia?
An acquired progressive loss of cognitive function, intellectual and social abilities
May see amnesia, inability to concentrate, disorientation and intellectual impairment
What does dementia affect?
Memory
Thinking
Orientation
Judgement
Learning capacity
What are the different types of dementia?
Alzheimer’s
Vascular dementia
Dementia with Lewy Bodies
Frontotemporal
Give examples of rarer forms of dementia?
Parkinson’s disease
Multiple sclerosis
What are the risk factors of dementia?
Age
Gender - woman more likely
Genetic background
Medical history
Lifestyle
What are the early stage symptoms of dementia?
Loss of STM
Confusion
Poor judgement
Anxiety
Communication problems
What are the middle stage symptoms of dementia?
More support required
Aggression and anger
Increasingly forgetful
May behave inappropriately
May experience hallucinations
What are the late stage symptoms of dementia?
Inability to recognise familiar objects, surroundings and people
Increasing physical frailty
Difficulty eating and swallowing
Incontinence
Gradual loss of speech
What is the treatment for dementia?
No pharmacological, surgical or behavioural care
Counselling can delay residential care by up to a year
Aspirin and reducing cardiac risks
NSAIDs may slow progression
What can make a healthcare environment dementia friendly?
Reception desk visible from the entrance
Avoid non-essential signs
Signage should be eye level with simple, clear use of text and colour
Good levels of natural light to minimise artificial light
What conditions do we need to manage in older patients?
Dry mouth
Ulceration
Infection and pain
What is a haemangioma?
Malformation of blood vessels creating a pool of blood under the mucosa
What is a fibroepithelial polyp?
Caused by trauma
Tissue doesn’t heal properly so more tissue is produced in response
What is black hairy tongue?
Variation of normal anatomy
Overgrowth of normal surface of tongue
