By Jayne Connery FRSA FRSPH, Director/Founder of CCFTV
For many older people living in care, dentures are far more than a personal possession. They are essential to eating, communicating, maintaining dignity and preserving a sense of normality. Yet when an older person moves between a care home and hospital, oral care can become an overlooked part of the handover process, with dentures among the personal items that can be lost, misplaced or left behind.
Care Campaign for the Vulnerable (CCFTV) has repeatedly highlighted the importance of looking at the whole care journey, particularly when people move between services. A transfer from a care home to hospital, or from hospital back into a care home, is a vulnerable point in that journey. Clinical information must be transferred, medication must be reconciled and care needs must be communicated, but personal belongings and everyday essentials also need to be accounted for.
For a person living with dementia, the loss of dentures can be particularly distressing. They may be unable to explain what is missing, where they last had them or why they are suddenly struggling to eat. Instead, the change may present itself through refusal of food, increased agitation, withdrawal or difficulty communicating. What can initially appear to be a change in behaviour may actually have a very simple explanation: something essential to that person’s daily life has disappeared.
This is why oral health should be recognised as part of the wider safety and wellbeing conversation within social care.
When a resident is admitted to hospital, there should be clear communication about whether they wear dentures, whether they require assistance with them and how they are normally cared for. Their dentures should be appropriately identified, stored and recorded as part of their personal belongings. Equally, when that person is discharged back to their care home, there should be a clear process for confirming that their essential belongings have returned with them.
The same principle applies in reverse. When someone is transferred from a care home to hospital, staff should ensure that relevant information about their oral care accompanies them. A person with dementia may be unable to tell a hospital nurse that they normally wear dentures or that they need assistance to remove and clean them. Good continuity of care means that this information should not depend on the person’s ability to communicate it themselves.
The problem becomes particularly difficult for families when dentures go missing and responsibility becomes unclear. A family may be told that the resident left the care home with their dentures, while the hospital has no record of receiving them. The hospital may believe the dentures remained with the care home, while the care home believes they were transferred with the patient. The family can then find themselves trying to establish where something as fundamental as a set of dentures disappeared.
This should not become a blame exercise – only a learning exercise. Good care depends upon clear documentation and accountability. If an item is handed over, that should be recorded. If it is received, that should be checked. If it cannot be located, the issue should be identified promptly, investigated and communicated to the family.
The financial cost of replacing dentures is also only one part of the problem. For an older person who has worn their dentures for many years, they can be familiar, comfortable and highly personal. Replacement may take time, and during that period the individual may struggle to eat normally or communicate effectively. For someone who is already frail, reduced food intake can have wider consequences for their health and wellbeing.
There is also the issue of dignity. An older person should not have to sit at a dining table unable to eat comfortably because their dentures have disappeared during a hospital admission. Nor should a person living with dementia be left distressed because an item that has been part of their daily routine for years has been lost.
Oral health must therefore be viewed as part of person-centred care rather than an additional task that sits separately from everything else.
The same principle applies to glasses, hearing aids and other essential personal items. These belongings can determine how well an individual can communicate, understand what is happening around them and participate in everyday life. When they are missing, the person’s ability to engage with their care can be significantly affected.
For CCFTV, this is ultimately about continuity, transparency and dignity. Safety does not begin and end at the care-home door. A person’s safety and wellbeing must be protected throughout their journey between services.
That means hospitals and care homes working together, rather than treating discharge as the point at which responsibility simply changes hands. It means accurate records, effective handovers and staff understanding the importance of seemingly small personal items. It also means families being informed when something has gone wrong rather than having to discover the problem themselves.
There is an important cultural point here too. Good care does not mean that nothing ever goes wrong. Mistakes and losses can happen in any organisation and what matters is how they are responded to. Openness, honesty, timely investigation and learning are essential to maintaining trust between families and care providers.
A missing set of dentures may sound like a small issue when viewed within the enormous pressures facing health and social care. For the person who relies upon them, it is anything but small. It can affect whether they eat, whether they communicate, socialise and how they feel about themselves.
It can also affect a person’s dignity and wellbeing and in a person living with dementia, it can affect behaviour and emotional stability – that is why oral care deserves to be part of every safe transfer of care. Every transition should protect not only the person’s clinical needs, but also their dignity, identity, belongings and ability to live as independently as possible.
At Care Campaign for the Vulnerable, our message is oral care is care, and dentures are not simply possessions. They are part of a person’s ability to eat, communicate and maintain their dignity. Protecting them should be considered part of protecting the person.
