Why does mouth care help?
Swallowing, talking, drinking and eating all produce saliva which keeps our mouths clean and moist. As death nears people talk and swallow less. They may have less interest in food and drink as the normal functions slow down or stop. So less and less saliva is produced, and their mouths become unclean, dry and uncomfortable. Talking becomes harder, and it’s undignified to have cracked lips, dried saliva and debris in the mouth. Providing mouthcare for your loved one helps give them dignity and comfort and may make it easier for them to speak.
How do you care for the mouth of your loved one?
First, gather together what you’ll need:
- a towel,
- a bowl of fresh water,
- a small, soft toothbrush (maybe a child’s),
- some Oralieve or other moisturising gel,
- some lip balm.
Top tip: Avoid lip balms containing Vaseline or other products based on petroleum (sometimes labelled ‘petrolatum’). These offer quick relief but can be more drying than alternatives.
Next, make sure the person you are caring for has their head sideways on the pillow, moving it gently if needed. That allows the small amount of water you’ll use to run freely out of their mouth. When someone is dying, they spend most of their time asleep or dozing; there’s no need to make your loved one sit up or change their position in any other way, unless they can and want to.
Place the towel on the pillow ready to mop up any water. Wet the toothbrush and gently push it in and around their mouth, moving slowly across teeth, tongue and gums. No need to go in too far, no need for vigorous scrubbing. You’re aiming just to keep their mouth fresh and empty of stringy saliva. If you wish, rinse the brush and repeat.
After this, squeeze some Oralieve or other moisturising gel onto your finger or the toothbrush and gently smooth it along the inside of their gums and lips. The gel acts as a saliva substitute.
If their lips look dry, chapped or sore, smooth on a small amount of lip balm.
As you care for the mouth of your loved one, you may choose to talk to them. Even if they are unconscious, it is likely that they will be able to hear you.
When and how often do you provide mouth care?
At any time you feel it’s necessary, even when your loved one is asleep, and ideally every few hours. No need for you to wake up through the night though; the benefits of mouthcare are outweighed by the benefits to you of a good night’s rest.
Mouth care can continue even when the person you’re caring for is unconscious and unable to cough or swallow. But it’s safest at that stage not to use water, and gentleness is key.
The team at Cottage Hospice can help you decide whether your loved one is unconscious, and whether they can still swallow.
If you want more advice, do ask the Cottage Hospice team. Someone is available every minute of the night and day. Getting it right is all about common sense and not being fearful. There’s no rush.