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Jean-Claude image, image, image, (American Dental Hygienists Association,…

- - - - Advocate for cultural sensitive area
      - Understands unique beliefs
      - Ensure cultural background is respected
      - Cultural differences related to: communication, family relationships, spiritusal beliefs, habits, eating
  - - - Non maleficence
        
        Prevent malnutrition and dehydration
      - Autonomy vs Beneficence
        
        Respect choices, but still ensure he gets adequate nutrition and care
  - - - Right to refuse food vs need for adequate nutrition
    - - Aknowledge personal and cultural food choices
  - - - Promote dental care
        
        Check if food pocketing is due to dental pain, dentures, oral infection
  - - - Ensure evaluation of cognitive impairment, mental status, dehydration and malnutrition as cause of the dementia
  - - - Asses if is a swallowing disorder the cause of weight loss
      - Asses if dementia is the reason of the speech change
  - - - Social worker more inclined in respecting JC autonomy while the nurse practitioner is concerned about the difficulty eating and wants to intervene more
      - Dental hygienist is advocationg for his oral health
    - - Western medicine may interpret his behaviour as dementia, while there is a cultural explanation. Psyquiatrist might insist in a mental problem while the nurse and social worker advocate for a cultural or a language barrier
      - Dietitian wants to ensure the patients is well nourished without thinking the reason the patient is not eating might be cultural
    - - There might be differences of opinions in how to intervene the family dynamics
      - Nurse wants to promote patient's best interest
- - - - Having services to SNF
    - - Michigan Medicare Assistant Program Counselor to select right "Medigap"
        
        Social Support
        
        Life Satisfaction
      - Utilize local University Dental/Vision/Hearing clinics
  - - - Culturally competent health care providers
  - - - Social Workers
        
        Emotional support
  - - - Medical Interpreter
        
        Self-efficacy
  - - - Belonging
- - - - Work with PCP for prescribing antibiotics and pain medication
    - - Chewing efficiency test (Dewel et al., 2017)
      - Examine hard and soft tissue, number of teeth, implants, crowns, bridges, fillings, root caries (Dewel et al., 2017)
      - Tooth pain
    - - Oral Health Assessment Tool (OHAT) (Yi Mohammadi et al., 2015)
      - Geriatric Oral Health Assessment Index (GOHAI) scores to measure oral health (Yi Mohammadi et al., 2015)
  - - - Order medications for oral pain and potentially an infection
      - Alter contraindicated medications
    - - Order feeding diet based on results