please provide any reference for online searches Case Study 1…

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Case Study 1

Peter Dawson, an Aboriginal elder, is a new resident at Beachwood Aged Care. Although he is frail, he is a well- mannered and a cooperative gentleman who is talkative, he enjoys playing cards and invites you often for a round of card games. He has settled in well to  his new surroundings and has made his room pleasant and homelike with photos of his grandchildren and tributes to his favourite football team. Peter is forgetful at times however he manages his activities of daily living with supervision from care staff and occasional prompting and redirection to complete tasks. Peter has a good appetite generally and loves sweet foods and often buys chocolates and lollies from the mobile trolley shop each week. He also enjoys his coffee with three teaspoons of sugar with a sweet biscuit regularly throughout the day. 

Upon admission, The RN performed an oral health assessment with Peter and assessed his natural teeth and an upper partial denture and concluded his oral health ‘healthy’ therefore a referral to a dentist was not needed. Based on this, the RN wrote up an oral health care plan for Peter as self-managing’.

Several months have now passed and Peter’s behaviour has suddenly and uncharacteristically changed, he has become confused and uncooperative with staff. He has declined also with his personal hygiene, he has stopped  cleaning his teeth and won’t let you help him and often yells at you to ‘get away’ when you try, and he won’t open his mouth for you to inspect his teeth, gums and partial denture. Review from his GP resulted in being prescribed antibiotics and treated for a possible urinary tract infection with minimal effect.

It is often very busy in the morning with the personal care of your allocated  residents so when Peter behaves like this, it is just easier to not worry about his oral hygiene care. This seems to be happening often and you realise that other care staff have also been doing  the same and leaving his oral health care as Peter is uncooperative and time consuming. You notice his breath has become offensive and it is very unpleasant to be around him, and you notice also he has also

been having difficulty eating his food.

You have been able to get Peter to open his mouth one afternoon and you take out his partial upper denture, it is thick with built up plaque  and matter and you notice one of the wires is broken and has been digging into his gums and you can see the part of the mouth housing the wire is red and swollen.

You begin Peter’s oral hygiene which had not been managed appropriately for some time, you begin brushing his teeth and notice his gums are bleeding and Peter appears uncomfortable as you attend to his needs. You report your findings to the RN on duty and a dental appointment and GP referral is made.

Questions to answer

1: what are the immediate issues with this scenario for Peter’s oral healthcare and how should they be managed?

2: How may dental pain cause a client’s behaviour to suddenly change? how can dental oral mismanagement cause complex physical health issues?

Case Study 2: