Mouth care for dying patient - page 2

lucida sans unicode3sienna hello, i'm jeanette from new zealand and i've joined allnurses.com because i have some questions and also because i'm sure i'll learn some interesting things here. i... Read More

  1. by   nettie01
    Thank you all for your last entries and tips. And Hi there across the Tasman sea (Australia)
    Jeanette
  2. by   talaxandra
    Quote from nettie01
    Thank you all for your last entries and tips. And Hi there across the Tasman sea (Australia)
    Jeanette
    Hi!
  3. by   safewaygreenbox
    Quote from Bird2
    The facility I work uses a mouth/lip moisturizer. Smells like spearmint and can be safely put on the inside of the mouth. I don't remember the name but it is very inexpensive. Our local Hospice also uses the product. So, after routine oral care, apply the moisturizer and no more crusty mouths.
    This sounds good, any chance of you getting the name for us?

    Cheers
    Kay the 2nd
  4. by   Bird2
    Quote from safewaygreenbox
    This sounds good, any chance of you getting the name for us?

    Cheers
    Kay the 2nd
    I will be at work in 2 hours and will reply with the name of the product we use. I'm sure you will like it.
  5. by   Bird2
    Quote from safewaygreenbox
    This sounds good, any chance of you getting the name for us?

    Cheers
    Kay the 2nd
    There are many brands designed for the inside of the mouth and lips but we use a product from Kimberly-Clark. It is called Dental Swab/mouth moisturizer.
  6. by   Mazzi
    I worked in a dental office for 16 years before nursing so I too am very aware of mouth care. Our hospice use a pink swap dipped in mineral oil and lightly coat the mouth. This serves two purposes, helps soften hard mucus and then helps keep it clean and soft. Also niffty tip, if pt's eyes seem dry (as when in a coma and does not close the eyes) a small amount of K-Y jelly on the lashes help keep the eyes closed. Our morticians love this d/t helps with appearances at the funeral home.
  7. by   safewaygreenbox
    Quote from Bird2
    There are many brands designed for the inside of the mouth and lips but we use a product from Kimberly-Clark. It is called Dental Swab/mouth moisturizer.
    Thanks. We have nothing like a mouth moisturiser where I work. Will try and get hold of one to try it out.

    Kay the 2nd
  8. by   Jackson1951
    hi! i'm a huge fan of oral care and foot care on my patients who cannot do it for themselves. if i was that patient i would want it done for me! i take a sponge swab, dip it in water. thickened water if good too especially if your patient is aphagic. squeeze most of the water out or scrape most of the thickened water off. use a small flashlight so you can see way back to the epiglottis. hopefully your patient is not adverse to opening his/her mouth. be careful not to shine the flashlight into patient's eyes! gently swab around teeth on all three sides. use clean swab now. gently scrub tongue top and bottom. if you loosen any debris wipe it out or use a suction yankauer. i wouldn't use my finger, gloved or not just in case the patient involuntarily bites down. use another clean swab again. swab the roof of the mouth. keep repeating these steps using a clean swab each time and the dried mucous will soften up and peel right off. after you get the initial crusts off, keep up with the swabs every 2 hours. patient will not get another buildup and also will be so much more comfortable. a little vaseline on the lips is good too. by the way, check the nose too for big boogers. yes, i have picked patients' noses before. gloved finger of course and don't push it deeper into the nose.
    Quote from nettie01
    [font=lucida sans unicode]lucida sans unicode3sienna


    hello, i'm jeanette from new zealand and i've joined allnurses.com because i have some questions and also because i'm sure i'll learn some interesting things here.
    i work on a general medical ward and we sometimes have people who are dying. i've had the experience a few times of starting my shift and finding the dying patient with a mouth thickly coated with dried secretions. i think some nurses are reluctant to be too invasive but i get my gloves on, get a hot/warm flannel and try to clean everything up. i believe the most important reason is that the dried secretions can become quite a lump and then an airway risk. (i've seen a person choke on material from their own mouth). these people are usually nil by mouth and mouth-breathing - especially when they become unconscious. i find a lot of nurses use big swabs to do mouth care but i think they are too soft for removing debris, although they are good for moistening the person's mouth.
    recently i was cleaning a person's mouth and i was using tweezers to remove the layers (perhaps this is not recommended) and i unfortunately pulled on mucosa at one point and caused bleeding - this memory is still with me after several days.
    should i have just left the man's mouth alone? after all, he was unconcscious - did his coated mouth bother him? i also made the previous nurses look bad because it seemed (to the man's son, who was watching me) that they hadn't been doing their job.
    what do the experts think? (palliative care nurses and anyone who's looked after dying people).
    any tips about better methods and good solutions to use would be appreciated.
    i've been honest, hope that you're not too shocked.
    thanks for reading my note.
    jeanette
  9. by   nettie01
    Thanks a lot Jackson1951!!!
    I started this thread in 2005 so it's a surprise to see your post.
    It's all still up to date.
    thanks again
    Jeanette
  10. by   IEDave
    Yep - an oldie but a goodie!

    In my case, not only am I a brand-new CNA, but also a family member of a terminally ill patient (now, a deceased patient - mom passed away on 11/26/2008) so I felt compelled to address this one from both a professional & personal viewpoint.

    Professionally - just reviewed what the ARC (American Red Cross) teaches in the NAT textbook, and generally agree with all comments; one thing that ARC recommends is use of a soft toothbrush for toothcare. I suspect that this might be preferable to tweezers for use on stubborn mucus - a bit easier on the mucosa. And, yep - mouth care q2h is what my mom was receiving during her stay in palliative care.

    On a more personal note - I suspect that mouth care contributes greatly to pt comfort. While my mom was in a minimally conscious state (left hemisphere CVA - 2 areas of ischemia revealed via MRI) she did actively suck at the moistened swabs, so I would surmise that the liquid PO made her feel better. So, yeah - definitely keep on top of it. The patients probably appreciate it, and I can attest to the fact that the family members certainly do.

    Thanks for all you do,


    ----- Dave
  11. by   smurfynursey
    So sorry to hear about your mom.

    (hugs)

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