Provision of involuntary oral care for individuals with dementia showing care-resistant behavior
Provision of involuntary oral care for individuals with dementia showing care-resistant behavior
This dissertation by Maud Jonker investigates involuntary oral care for older individuals with dementia who show care-resistant behavior, with special attention to the Dutch Care and Coercion Act, which came into effect in January 2020. Through a literature review, a questionnaire study, and two semi-structured interview studies, the dissertation explores care providers’ attitudes, as well as the barriers and facilitators to providing involuntary oral care and experiences concerning to the Care and Coercion Act.
Chapter 2 shows that care providers often recognize oral health problems in older individuals with dementia who show care-resistant behavior as serious harm (73.1%–93.5%), yet they remain reluctant to provide involuntary oral care (31.1%–63.4%).
Chapter 3 maps the barriers and facilitators for providing involuntary oral care found in the literature, highlighting the very limited number of studies on this topic. Therefore, Chapter 4 further explores these barriers and facilitators.
Chapter 5 discusses care providers’ experiences regarding the Care and Coercion Act. This study concludes that the law raises awareness of the phenomenon of involuntary oral care, but that many care providers still experience uncertainty about the legal concepts and the practical application of the Care and Coercion Act. Some care providers also indicated that this law might lead to quicker discontinuance of oral care provision.
Finally, Chapter 6 discusses the main findings of this dissertation in a broader context, along with its strengths, limitations, and recommendations for future research and practice.