evidence based mouth care policy - Doncaster and Bassetlaw ...

Page 16 of 21
REF: PAT/PA 17 v.1
• A reduction in the amount of intracellular fluid causes an increased risk of
dehydration leading to thickened saliva, or dry mouth.
• Cognitive motivation for learning lessens; attention span may be reduced; both of
which may reduce patients’ ability to care effectively for their mouth and teeth.
Elipoulous (1997) suggests “an understanding of common ageing changes is essential to ensure
competent gerontological nursing practices”
In addition to these physiological processes, a number of abnormal conditions, which may present
at any time but are common in the elderly patient, may occur, and these should be considered in
combination with the normal changes of ageing. The following list is not comprehensive but
provides some examples.
Other conditions:
• Cerebrovascular accident: depending on the area of the brain affected, may affect
swallowing, speech, general functional ability; cognitive ability, all of which, as already
discussed, have a bearing on the condition of the oral cavity.
• Dementia: may cause reduced functional ability; patients may also experience a reduced
appetite, and are at risk of becoming dehydrated.
• Parkinson’s disease: Reduced function and some associated dementia may occur.
• Depression: can cause loss of appetite, reduced motivation to self care and to take oral
fluids.
• Drug therapy: as a response to abnormal conditions. Xerostomia is a side effect of a
number of drugs, including anxiolytics, antidepressants, antipsychotics, (particularly
anticholinergic drugs), diuretics (due to fluid/electrolyte intolerance). Antibiotics to treat
infection may results in oral thrush. See Drugs and Treatments table, page 5.