Decision-making concerning involuntary oral care in older individuals with dementia

Abstract

Many older individuals with dementia show care-resistant behavior for oral care. Providing care despite resistance is considered to be involuntary care. The Dutch law, 'Wet zorg en dwang' (care and coercion), states that care must be ceased in the presence of resistance, unless there is (a risk of) serious harm. This study was conducted to gain insight into the attitudes of healthcare providers with regard to involuntary oral care in older individuals with dementia. An online questionnaire consisting of general questions, case specific questions and knowledge questions about the Dutch law was filled out by 392 care providers. In all cases, a discrepancy was seen between the assessment of oral health problems as potentially harmful and the willingness to provide involuntary oral care. Hence, many healthcare providers are aware of the subsequent potential health risks related to not providing care, but are still reluctant to provide involuntary oral care. A large part of the healthcare providers also has a low level of knowledge with regard to the Dutch law 'Wet zorg en Dwang'.