Assessment/management of the mouth at the end of life

Abstract

A dry and sore mouth tends to be viewed as a minor symptom in comparison to complex symptoms, such as pain and nausea, when experienced by patients with terminal disease. However, a clean and pain-free mouth has a big impact on patients’ physical, sociological and psychological functioning. Dry mouth (xerostomia) is a common symptom of many palliative care medications, most specifically opioids. However, it has been found that nurses working in palliative and end-of-life care do not carry out regular oral care assessments and lack knowledge of treatment protocols. In view of the morbidity caused by mouth problems in patients with advanced disease it is essential that nurses include oral health when carrying out assessments of palliative care patients. This article describes the assessment and management of a man with rectal carcinoma and liver metastases whose oral symptoms were causing him pain, embarrassment and social isolation. It also provides details of oral assessment and treatment guides as developed by St Christopher’s Hospice, London. Conflicts of interest: none