My mother is on hospice care in a memory unit. She is bedridden, but can sit in a wheelchair. Any advice?

Thanks everyone. I talked to the hospice nurse today and she is bringing swabs to clean my mother’s teeth and mouth. This was just something we hadn’t dealt with until now.

Ask hospice what you should do!

I would just let it go. When my mom is in memory care and on hospice, I will not be doing dental care any longer. As long as she is not suffering, there is no reason to do this. And if she is in pain, perhaps hospice will be able to manage her pain.

The only time I chose to further agitate and traumatize my mother w dementia about her teeth was if one was bad and needed to be pulled. I called in the traveling mobile dentist at that point to the tune of $1000+. The dentist worked on mom in her suite, while seated in her recliner. Yes, the angst from mom was real but there was no other choice at that time.

Staff should help mom rinse her mouth and swab a bit daily I suppose, but at this stage of the game, just keep her comfortable is your only goal.

Best of luck.

Speak to hospice about this. Often bad breath comes not from the teeth but the condition of the gums; there is little to do about that at this late stage with an elder in hospice. It may also come from any illness that is affecting the gut at all.

Again, hospice knows this patient, and with your input should be able to help with questions.

Hospice should provide mouth swabs. Some are plain most are imbedded with a mouthwash type product so when you moisten it it will have mint or other "aroma, flavor and be like a mouthwash"
If Hospice is not providing them ask or have the nurse ask. It might be possible that they are provided but they are not being used or they are being used on someone else.

Here is an example of dental swabs. They already have toothpaste in them. Use then throw out.

https://www.walmart.com/ip/100-pcs-Oral-Care-Swabs-Tooth-Cleaning-Mouth-Toothette-Oral-Sponge-Swabs-Unflavored/1746284693?wmlspartner=wlpa&selectedSellerId=101247967&&adid=222222222271746284693_147609983928_18500527357&wl0=&wl1=g&wl2=t&wl3=625876230454&wl4=aud-1651068664746:pla-1808164932162&wl5=9003829&wl6=&wl7=&wl8=&wl9=pla&wl10=678405860&wl11=online&wl12=1746284693&veh=sem&gclid=Cj0KCQjwla-hBhD7ARIsAM9tQKvBqhb7e55mKmVNHee-yUBaS-uvam-udb_LHmisI_CWxChB-0XEyoIaAi2qEALw_wcB&gclsrc=aw.ds

Ohhh I like the swabbing idea.

My mom’s little MC has a dentist come in on occasion. It is optional and not cheap but in this case has been worth the expense. This dentist does cleanings only, nothing fancy, and in the months between mom’s dental care does deteriorate. But this method keeps things reasonable.

I haven’t the foggiest idea how this dentist works on dementia seniors either! Even the experienced care staff finds dental care with these residents to be an area of battle. I joke that the dentist must be a wizard lol

If she got a check-up, would she then be able to cooperate with any dental treatments? Would she tolerate a novocaine shot? Or drilling? It's hard to come to the conclusion that her oral care won't be like it was in the past. I agree with using sponges and mouthwash, if at all possible. Sometimes there are no "good" solutions, only least bad options.

Routine dental care is definitely the last box on staff's checklist of duties and is very often overlooked in facilities, I had an RN try to tell me that my mom's bleeding gums were normal. I would look into getting the little sponges on a stick for oral care, they would be gentler than a toothbrush and can be dipped in medicated mouthwash to gently clean around her mouth (colgate peroxyl doesn't need a prescription). But unless you are there to do the swabbing it will take an order on her med chart to ensure it gets done, that's where a prescription mouthwash may be preferable. And make sure the order says to dip and swab, the staff at mom's facility had her trying to swish and spit and she simply wasn't capable of that 🙄

Why would you put her through a procedure that will have no real upside to it?
Chances are she would have to be sedated to do anything. That will probably cause a faster decline.
If anything has to be done like pulling a tooth or even a filling who will care for her mouth while it heals.
There are choices that "we" as caregivers make that in a "normal" situation there would be no question but when dealing with someone that has dementia or is close to end of life it makes no sense. I called these choices Benefit VS Burden. If the benefit would outweigh any negative aspect then I would go forward. In most cases I elected to not follow through with treatment.
If moms mouth is infected antibiotics can be prescribed.
If moms gums are sore there are topical products that can be put on to numb the discomfort.
Using a swab to brush the gums and teeth is standard practice if a toothbrush can not be used.
I would make sure that the staff at the facility is not following through on clearing the area between the gums and cheek as POCKETING is very common with dementia. I used to have my Husband take a bit of food then I would rub his cheek and have him take a sip of whatever he was drinking. Even as I had to thicken his fluids and puree his food I would still make sure that his mouth was clear. This also might prevent aspiration later of bits of food remain.