Elder care facilities: Bermuda Triangles for your loved one’s teeth

teeth-relief

This piece originally was published Aug. 23, 2015, for Caregiver Relief. After I was trespassed from seeing my dad for reporting an intruder at his memory care facility in June 2015, his dentures went missing the next day (they were lost most every day and I would conduct my own “shakedown” of his apartment, often finding them under the bed). I have this in writing from an employee of the memory care facility. So, my dad had no teeth there for 108 days. My brother claims the facility’s director told him Five Star Senior Living does not have insurance for such matters, and therefore they refused to replace his teeth. When dad and I were reunited thanks to the great work of the state of Illinois, dad proclaimed, “There’s my friend!” when I walked into the new nursing home. The second thing he did was point to his mouth and say, “Teeth, teeth.” I did manage to get dad to a dentist and have impressions made for new teeth (nothing short of a miracle for someone who has Pick’s) but he was dead two weeks later. I watched him try to gum food in the nursing home where he died for about a week, and when they switched him to a puree diet he quit eating altogether and died. This piece is reprinted here with permission from Caregiver Relief. Special thanks to Diane Carbo.

By David Heitz

We learn at a young age about sock-eating dryers, one of the greatest mysteries of life.

But there’s another Bermuda Triangle out there that caregivers for loved ones with dementia eventually come to know: Nursing homes and assisted living facilities.

Things disappear daily at these places, and while many are quick to blame the employees for theft, that usually is not the case.

With confused residents wandering from room to room, anything is possible. We have to do our parts to make it easier to track down missing items, and I’ll get to that in a minute.

But I’m not going to be an apologist for these places when dentures get lost over, and over, and over again. This, unfortunately, has been the case with my dad.

Dad’s brand new set of uppers were permanently lost six months after he went into a memory care facility in July 2013. They had been lost about half a dozen times prior to that too, but I always found them, sometimes spending an hour or longer in his room conducting my own personal shakedown.

To avoid conflict with my bottom-line, bottom-dollar brother, I ended up bringing dad’s old set of false teeth to the facility more than a year ago, and dad began using those. But that was a bad idea. Dad got new teeth for a reason – the old ones didn’t fit correctly.

Long story short, about a week after dad’s facility trespassed me (you can read all about that here) a CNA tipped me off that the teeth had gone missing again. Time and again, the many workers who kept me in the loop while I was locked out explained that dad’s teeth appeared to be gone for good. And with me gone, there was no around to do a shakedown and look for them.

Finding this wholly inacceptable, I complained to the local elder ombudsman as well as the state about the missing teeth (among other things) back in June. I’ve yet to receive a response from either.

Cutting to the chase, when I was reunited with dad last week after 108 days, he still did not have any teeth. My brother (the POA) and I are unable to have civil communications, but the last text I got from him was that he was “fighting” with the memory care facility about dad’s missing teeth, dad’s missing hearing aids, and two weeks rent ($2,050) they don’t want to refund for the second half of the month of August. He said the director of the facility said not to lose hope, the hearing aids sill may be found.

Hope isn’t going to have anything to do with it

Hope isn’t going to have anything to with it.

Dad’s original set of teeth that were lost the first time should have been on the inventory list upon admission. My brother can, today, call the dentist and have replacement teeth made.

It’s not OK to put dad’s old set, possibly seven years old or older, back into his mouth. And the facility will need to cut a check for dad’s replacement set immediately, as they have insurance for that very purpose. They’re not going to offer you this information readily when this happens to your loved one, but it is fact.

My dad has John Deere insurance and ample funds for a replacement set. So in theory, the new set should be ordered today, and without delay. When I met the social worker the other day at dad’s new facility, one of the first questions she asked was, “Where are his teeth?” It gave me immediate peace of mind to see they are on top of such things and will be monitoring his care like a hawk.

But dad’s teeth problems don’t end there. When he was found in a pool of blood on the lower level of the memory care facility on April 15 of this year, and landed in the emergency room, he suffered a chipped tooth. My dad winces and complains about his mouth incessantly, and has done so since that day. To think he has continued to suffer since April 15 to me is incomprehensible and 100 percent without excuse. In the five days we have been reunited, some of the few words he has spoken have been “I need the dentist,” “my mouth hurts” and “I need a wrench for my mouth.”

It makes me so incredibly upset. Again, dad has John Deere dental insurance and ample funds. He should be able to have a dentist look at his teeth even if we need to pay a dentist to come to the new nursing home. I have no idea whether that is even possible, however.

Most elderly in facilities broke and without dental coverage

But the reality of the situation for most people in nursing homes is this: They don’t have either dental insurance or ample funds. So what are these people to do?

It’s a huge problem. The millions of Americans on Medicare don’t have dental coverage. There are programs in place here and there, and you can click right here to go to the U.S. Department of Health and Human Services Administration on Aging website’s dental page. It lists multiple resources on how to get your loved one dental care.

Good dental care is more than a luxury. To quote from the site, “According to the Centers for Disease Control and Prevention, one-fourth of persons age 65 and older have no remaining teeth. Nearly one-third of older adults have untreated tooth decay. Severe gum disease is associated with chronic disease and severe health conditions including diabetes, heart disease, stroke and respiratory disease.”

I can tell you right now that my dad is embarrassed that he has no teeth, especially as he is trying to make friends in the new nursing home. “Whether caring for natural teeth or dentures, daily oral hygiene can mean older adults will be free of oral pain, can maintain a well-balanced diet, and will enjoy interpersonal relationships and a positive self-image,” the AOA site states.

The poor guy has been sitting in the dining room by himself, which is why I’ve gone up there and had at least one meal with him every day. When I’m not there, an employee has been sitting with him. When old ladies wheel past, my dad lifts his hand and feebly says, “Hi.” Can you imagine what this is like for him? It’s got to be like the first day of high school freshman year in the lunchroom. Not having his teeth is a blow to this little Casanova.

What you can do to help, and when all else fails…

One member of one of my online caregiver support groups offered this very good advice for avoiding the nightmare of lost teeth:

I recommend making sure dentures and hearing aids have names on them. Best place for hearing aids at night are locked in the nursing cart in a labelled container. Dentures should have a labeled container as well.

If your facility does not have a set protocol for managing these items – ask them to create one so that everyone follows the same steps.

Make sure when you bring items in that they are added to your loved one’s personal belongings list. Make sure their name is on everything, even if you are doing the laundry. If you are doing the laundry make sure there is a neat visible sign saying so, either laminated or in plastic. Keep the belonging list updated. Take photos of clothing – it especially helps when trying to locate items.

If dentures repeatedly get lost, and you don’t have the resources to replace them, and the facility is pushing back…raise hell. Period.

“Find out who the local ombudsman reports to and file a written complaint as well as file a written grievance with the state,” suggested one caregiver in my support group. “They need to be aware of this kinds of negligence. Be sure to give a copy of your written complaints to the facility as neglect of patients can cause them to lose their license.”

Adds another member, “Keep repeating your complaints with written copies to everyone. Find out if other families at the same facility also have complaints also and form a group. Bring all the complaints to the administrator. If you continue to get no response, take your evidence to the local news media.”

I don’t mean to incite. But this journey has been an unbelievable nightmare. Negligence in elder care is everywhere you look (and yes, so is quality care, and I have written about that and will continue to do so when I see it). My stories would not be going clickety-click-click if there wasn’t a whole world out there experiencing the same problems as myself. Advocating for a loved one does not make you a troublemaker. Don’t let anyone tell you different.

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