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Praxis /Tipps

Praxis /Tipps

Zahnbehandlung vor Ort / im Bett wie in Sonnweid auch in Wien möglich? Kennt jemand eine aufsuchende Zahnärztin?

Gepostet am 21. März 2022 um 0:30

Als ich als gerontologischer Besuchsdienst beigezogen wurde war mit die Bewohnerin als „schwer psychisch krank“ von der Stationsleitung der Betreuungsstation vorgestellt worden in ihrer Demenz.

Was mich stutzig machte daran, dass die Dame ein normales erfolgreiches Erwerbsarbeit soeben geführte hatte. Eben alleinstehend geblieben war und als Erwachsenenvertreter einen Aber hat. Mit der Folge dass es in Folge demenziwller Beeinträchtigung massiv mit ihr in die soziale Isolation ging weil sie niemanden hatte der auf ihrer Seite war so meinen Hypothese. Von Anfang an war mit der Dame zuerst wegen Schwerhörigkeit sehr erschwert aber doch ein konstruktiver einfacher Dialog zu führen.

Ich stellte als erstes fest dass zwei gänzlich falsche Brillen (nämlich Weitsichtige) bei der Dame am Tisch liegen (auf Basis alter Fotos konnte ich sehr starke Kurzsichtigkeit Kursichtigenbrillen verkleinern die Augen, bei Weitsichtigkeit ist es umgekehrt) also gab es nur eine passende Brille die ebenfalls am Zusammenbrechen at bereits. Zwei andere waren bereits zerstört. Ein auf meine Initiative beigezogener Mobiloptiker bestätigte 20 Dioptrien ca. plus grauem Star wenigstens auf einem Auge. Wer Brillenträger mag sich vorstellen wie hilflos jemand mit diesem Visus ist ohne Brille oder mit einer falschen Brille. Nebenbei gibt es auch hier die von mir leider oft beobachtete Praxis Menschen die sich da selbst nicht mehr helfen können im Dunkel oder bei sehr schwächer Beleuchtung zu lassen was dem Sehen auch nicht hilft

Zusätzlich leidet die Bewohnerin unter sehr starker Schwerhörigkeit. Ich habe günstige Hörverstärker im Internet bestellt mit denen eine verbale Verständigung wieder möglich ist – mit Mühe aber doch – ohne die Hörverstärker nicht

Was sich aber rückblickend betrachtet wohl als Hauptproblem bzgl des psychischen Befindens der Dame darstellt ist dauernder starker Zahnschmerz: sie hat einige Zahnstümpfe wo die Wurzeln/ Nerven womöglich sehr schlecht geschützt sind. Sehr große Empfindlichkeit gegen Heißgetränk konnte ich beobachten.

Vorab: die Aggressionen die oft sehr schlechte Laune der bewohnerIn sind in den letzten Wochen fast verschwunden. Wahrscheinlich desshalb weil nun Neuralgien als Dauermedikation nicht nur als Bedarfsmedikation gegeben wird. – denn wir sollte eine Bedarfsmedikation bei einer Bewohnerin funktionieren die vom Betreuungspersonal für psychisch krank erklärt wird und wo auch aufgrund ders sehr starken Hörbehinderung kaum mehr Dialog stattfindet?

Ich habe eingebracht Zahncremen auch Zahnschnekzreparaturgel welche für Kinder sind und daher von der dementen Bewohnerin leichter akzeptiert werden also die üblichen für Erwachsene die sie wegen des Geschmacks verweigert

Die Zahnärztin vor Ort ist nicht gewillt mit einer Patientin die nicht mehr einsichtsfähig bzgl der vorliegen Kausalität Schmerzen Notwendigkeit einer Zahnbehandlung zu arbeiten. Das heißt eine Kurzvisite im Zimmer gab es – aus meiner Sicht ein Desaster. NmE war die Zahnärztin ganz und gar nicht in der lGse die verschiedenen Einschränkungen sinnvoll zu berücksichtigen in der Dialoggeststaltung.

Eine kausale Therapie der Zahnschmerzen wäre die beste Lösung die Therapie mit Novalgin erhöht die Lebensqualität der Klientin aber stark.

Meine Arbeit als „Demenzspezialbesuchsdienst“ besteht nun darin ihr Zuzuhören und Dialog zu führen. Brille falls verloren suchen und aufsetzen. Hörhilfen einsetzen wenn sie das zulässt. Ihr einige kleine Freuden zu ermöglichen. Kaffee und Croissant. Mandarine. Echten Orangensaft. Je nach Stimmung mehr Dialog. Ein Stofftier anbieten zum Streicheln. Eventuell Rücken bissi massieren oder Schulter streichen. Aber auch Brille putzen. WC Gang ermöglichen. Sonst nutzt sie oft Lehnstuhl oder auch Einlage in schwachen Momenten.

Tut mir leid für diesen Bericht. Er stammt aus der Wirklichkeit. Die Zusammenarbeit zwischen mir dem Vertreter und den Betreuuenden ist bei aller vielleicht gegenseitig vorhandenen Kritik von Offenheit Respekt und Wertschätzung getragen. Mal mehr Mal weniger. Wir sind alle nur Menschen. Und eine Bewohnerin mit Demenz und einer starken Persönlichkeit 24/7 zu betreuen ist echt harte Arbeit

 

 

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