In this study, we examined the pneumonia depression effect of the facilities residents by encouraging the problem solving skills for oral health care offacilitiesʼ staff member, and by implementing an oral health care management method to improve daily practices. The subjects are residents of an intensive-care old peopleʼs home located in Kyotango, Kyoto, Japan, and a twice-yearly inspection was done 7 times from 2010 to 2013. Our oral health care management had two activities. One is oral hygiene and the other is training of the ingesting/swallowing-function. On the management of oral hygiene, we proposed the oral health care methods to the staff according to individual subject condition using the oral hygiene classification developed by Takei et al. This followed the screening process implemented with mouth wetness and the number of Candida for the high risk pneumonia subjects. On the management of trainings of the ingesting/swallowing-function, we proposed the addition of indirect functional training to the direct functional training for lunch after the screening process implemented with the result of food testing for needy subjects. We supported once in one or two months for the initial year and provided the test results every half year for three years. Also, the data on hospitalization for pneumonia was obtained from the community hospital used by all subjects. In this research, oral health care management was done to improve the quality of daily oral health care for all the residents of the facilities. Also, the incidence of pneumonia was evaluated including the factor of dynamic change of subjects for three years. The results showed that, the pneumonia depression effect was not clear, but candida counts and ammonia concentration decreased, and swallow-function improvements are recognized. Also, comparing the percentages of subjects hospitalized once or more in a year, before three years and after three years of the management, the number has declined. We will continue to consider further management methods to keep this pneumonia depression effect.
View full abstract