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The Same Broken Record

by Kathleen Heren, Rhode Island State Long Term Care Ombudsman

Kathleen Heren

The recent telephone calls to the Ombudsman reveal another serious issue—the need for oral surgeons. If an elder has dental coverage and funds, finding an oral surgeon is not a problem. If you are poor or on Medicaid, it’s totally different. The majority of oral surgeons want nothing to do with elders receiving state-funded care. The one oral surgeon that could always be counted on to assist an elder on Medicaid in need of dental surgery has been suspended from practice due to a vaccine disagreement with the Department of Health. I am not here to discuss the right or wrong of the suspension. I will, however, say it’s like canceling your homeowner's policy the day before a hurricane.

"If an elder has dental coverage and funds, finding an oral surgeon is not a problem. If you are poor or on Medicaid, it's totally different." ---Kathleen Heren

I know there are clinics in the community that will see a long-term care resident for dental issues, but they may not include oral surgery. Have you ever experienced a toothache or have you ever had your face blow up from an infected tooth? I am certain you didn’t wait 3 weeks to see a dentist. I am also confident you had the transportation to go to the appointment. This again is not the fate of long-term care residents.

Rhode Island needs oral surgeons for the elderly

Usually, they are told two or three weeks before they can be seen in the clinic. Now the facility has to arrange transportation. Again, I don’t want to hear we have Medicaid transportation available. Try getting an emergency ride. “Good luck” with that.


If the resident has dementia, who will accompany him/her? The homes are so short-staffed they can just about do the basic care for their shift. If a family member is not available, the clinic is not going to see the elder unaccompanied.


This is not a new issue because of COVID; COVID has only heightened the problems. The general assembly can increase dentists’ payments when they return in January, but that still does not solve the need for an oral surgeon. Nutrition is such a fundamental right in life. How do you eat when your mouth is full of broken teeth? Most residents who wear dentures received them over 20 years ago. Do you think they still fit? The device, no matter how much dental adhesive is used, is still going to move around when chewing.

"...if a resident [of a long-term care facility] cannot express pain due to dementia but can only cry out in pain, they may end up with an anti-psychotic medicine because of behavioral actions." ---Kathleen Heren

The next option is puree food. That, of course, is the same as baby food. Has anyone ever looked at a puree tray? Really mouth-watering. Now, if a resident cannot express pain due to dementia but can only cry out in pain, they may end up with an anti-psychotic medicine because of behavioral actions. It should comfort everyone to know the prisoners at the A.C.I. receive total dental care. That is not to say they shouldn’t receive it, but elders should also receive the same services. And why, with all our wonderful universities, don't we have a dental school in Rhode Island?

Pureed food - unappetizing

In closing, the so-called legislators we have in Washington are opposing Medicare's coverage of dental services. Why? Please, no more cups of water to try to control a four-alarm blaze. When you are sitting with your family over the holidays eating your dinner, remember the elders who can’t chew their food so their turkey looks like baby food.


My staff and I wish you all happy holidays. If you have any questions, please feel free to contact our office numbers: 401-785-3340, or fax 401-785-3391.


Please get vaccinated.

 

Ms. Heren provides a monthly guest blog to Connelly Law Offices, Ltd. in which she discusses issues and topics that come across her desk as the Rhode Island State Long Term Care Ombudsman. The opinions expressed in our guest blogs are those of the author(s) only. They do not purport to reflect the opinions or views of Connelly Law Offices, Ltd, or its employees.

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