Xerostomia in terminally ill and dying patients: best practice

Clinical skills
First published in this online journal
Declaration of interests: 
Lisa Sheehy, Jasper Shaw
Author profile (accurate when this article was originally published): 
Lisa Sheehy, at the time of writing, was Senior Staff Nurse, Trinity Hospice, London, and was undertaking the MSc in Palliative Care, Department of Palliative Care, Policy and Rehabilitation, King’s College London, and Jasper Shaw is Senior Staff Nurse, Trinity Hospice, London. Email: lisasheehy83@gmail.com

Xerostomia (dry mouth) has a negative impact on health and quality of life. It can increase the risk of oral candidiasis, tooth cavities and infections and cause difficulties with swallowing and communicating. Maintenance of oral hygiene should be an integral aspect of nursing care. Oral hygiene is important within all patient populations, including patients with terminal disease and those at the end of life. However, healthcare professionals have been found not to consider xerostomia a serious symptom and are not rigorous when it comes to oral care provision and assisting patients to clean their mouth. There is minimal evidence regarding how best to manage xerostomia as part of palliative and end-of-life care. This article provides an overview of the causes and consequences of xerostomia, discusses the aims of oral care provision and the means by which nurses may assess oral health and provide oral health care, with specific emphasis on oral hygiene in terminally ill and dying patients. It also highlights some of the barriers to successful oral care provision.

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