Care‐resistant behaviour during oral examination in Dutch nursing home residents with dementia

• Published in: Gerodontology 2023-09, Vol.40 (3), p.299-307
• Main Authors: Willems, Malou S., Hollaar, Vanessa R. Y., Maarel‐Wierink, Claar D., Putten, Gert‐Jan, Satink, Ton
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; care‐resistant behaviour; Cross-Sectional Studies; dementia; Dementia - complications; Diagnosis, Oral; Humans; nursing home; Nursing Homes; oral examination; Oral Hygiene
• ISSN: 0734-0664; 1741-2358
• DOI: 10.1111/ger.12654

Objective To assess the occurrence and associations of verbal and non‐verbal care‐resistant behaviour (CRB) during oral examination by a dental hygienist in nursing home residents with dementia. Background CRB is a barrier to providing professional oral care and daily oral hygiene care. Understanding the predictors of CRB might help care professionals in learning to anticipate this behaviour. Methods In this multicentre cross‐sectional study signs of verbal and non‐verbal CRB were reported during the oral examination. Data collection occurred in the psychogeriatrics wards of 14 different nursing homes in the Netherlands (N = 367). Results A total of 367 residents were included. CRB was evident in 82 residents (22.3%), of whom 45 (55%) showed verbal and 37 (45%) non‐verbal CRB. Associated with CRB were age >85 years, duration of residential stay longer than 2 years, and having Korsakov dementia. Other factors associated with CRB were duration of residential stay (categories “>2 and ≤4 years” or “>4 years”) and having a natural dentition (P = .043‐.005, OR = 1.20‐1.33, 95% CI = 1.00‐8.48). Significant associations for verbal and non‐verbal CRB were age between 76 and 85 years, vascular dementia and Korsakov dementia (P = .031‐.006, OR = .020‐1.49, 95% CI = 0.43‐2.15). Conclusion The occurrence of CRB was 22.3% and was associated with older age and longer duration of residential stay, Vascular and Korsakov dementia and natural dentition.