MDS Alert

How to make uncooperative residents relaxed and compliant.

Performing oral health assessments can seem daunting, and for your less cooperative residents these assessments can seem downright impossible. So how do you get your difficult residents to comply with an oral health assessment?

Although not always easy, the oral assessment shouldn’t take more than a few minutes, according to an instructional session by Gregory Folse, DDS, a dental consultant with the Louisiana Department of Health. And the assessment “provides crucial information to you as you investigate if the resident’s needs are being met.”

According to a recent presentation by Paul Glassman, DDS, MA, MBA with the University of the Pacific School of Dentistry in San Francisco, here are a few techniques and tips that can help you to encourage cooperation with mouth examinations, particularly among your residents with cognitive impairment:

·         Relax: You want to get the resident to relax enough for you to lift his lips and look inside his mouth, Glassman said. And if you’re relaxed, the resident is more likely to relax as well.“One way to be as successful looking in the mouth as possible is to let the patient lead,” he noted. “This means provide them with information on what you will be doing before you do it, then ask them to allow you to move forward.”

·         Project nonverbal confidence: Smile and use light touch to encourage the resident to cooperate, Glassman advised. Establish and keep eye contact with the resident. “Try to place yourself at eye level with the individual if possible.”

·         Choose your words carefully: Try to use phrases that sound helpful instead of like giving orders. “Giving orders takes away a person’s feeling of control,” Glassman noted. Also, speak in a calm and friendly but firm voice, and use the resident’s name frequently.

·         Keep it simple: Give one instruction at a time, and avoid multi-step instructions all at once. 

·         Give choices: “Offer choices whenever possible, but make sure that the choices all lead to completing the mouth assessment,” Glassman said.