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Dr. Jablonski-Jaudon is Associate Professor, Dr. Winstead is Program Manager, and Dr. Azuero is Associate Professor, School of Nursing, and Ms. Jones-Townsend is Clinical Trials Administrator, Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama; and Dr. Kolanowski is Professor of Nursing, College of Nursing, and Professor of Medicine, College of Medicine, Penn State University, University Park, Pennsylvania. Dr. Jablonski-Jaudon is also Clinician, Memory Disorders Clinic, The Kirklin Clinic of UAB Hospital, Birmingham, Alabama.
The authors have disclosed no potential conflicts of interest, financial or otherwise. Dr. Jablonski-Jaudon acknowledges support from the National Institute of Nursing Research (NINR) (R01NR012737). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NINR or the National Institutes of Health.
Mouth care is oral infection control ( Fulmer, Jablonski, Mertz, George, & Russell, 2012 ). Consistent oral hygiene reduces the incidence of pneumonia in dependent and cognitively impaired older adults residing in nursing homes (NHs) ( Maeda & Akagi, 2014 ; Tada & Miura, 2012 ; van der Maarel-Wierink, Vanobbergen, Bronkhorst, Schols, & de Baat, 2013 ; Van Ness, Peduzzi, & Quagliarello, 2012 ). Consistent mouth care also stimulates salivary production, improves appetite, and contributes to overall well-being ( De Visschere, Schols, van der Putten, de Baat, & Vanobbergen, 2012 ; Dyck, Bertone, Knutson, & Campbell, 2012 ). However, older adults with dementia often resist caregiving activities associated with mouth care. Care-resistant behavior (CRB) remains one of the primary reasons for the omission of mouth care ( Jablonski et al., 2009 ; Willumsen, Karlsen, Naess, & Bjorntvedt, 2012 ). As a result, NH residents with dementia who exhibit CRBs are three times more likely to have more tooth decay than those who allow mouth care ( Willumsen et al., 2012 ; Zuluaga, Ferreira, Montoya, & Willumsen, 2012 ).
The purpose of the current article is to describe a personalized practice originally conceived as a way to prevent and minimize CRB to provide mouth care to older adults with dementia. The intervention, Managing Oral Hygiene Using Threat Reduction Strategies (MOUTh), contains three components: (a) an evidence-based mouth care protocol for older adults with dentition or dentures; (b) recognition of CRBs; and (c) strategies designed to lower the perception of mouth care as...