[Dysphagia] lemon glycerine swabs (& my 2 cents)

[sorriso at adelphia.net (sorriso@adelphia.net)]

Thank you very much Ingrid.  I received it and will be putting it to good use tomorrow.

Linda
---- Ingrid Scholten <ingrid.scholten@flinders.edu.au> wrote: 
> I've just sent you the requested article via Science Digest. Hope it makes
> 
> Ingrid Scholten
> 
> -----Original Message-----
> From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
> Of sorriso@adelphia.net
> Sent: Thursday, 19 May 2005 09:25
> To: dysphagia listserv
> Subject: [Dysphagia] lemon glycerine swabs (& my 2 cents)
> 
> Does anyone have a copy of the article, "Improving Oral Healthare for the
> Frail Elderly:  A Review of Widespread Problems of Best Practices?" which
> appeared in Geriatric Nursing, July/August 2002, vol 23, number 4?  If not
> that article, anything similar that can be emailed to me?
> 
> I am re-addressing the issue of lemon glycerine swabs used for oral care at
> one of the SNFs I go to.  Nursing are using these on a patient of mine and I
> asked them to stop.  I need proof to back up this crazy notion of mine.
> (They still don't believe me that you don't need a gag reflex to swallow
> because the pt's MD even said that is so--I heard him!)  I had a fabulous
> article which specifically addressed the issues of drying mucosa, tooth
> decay, etc. (I can't recall if it actually was the one above) but I lost or
> misplaced it.  A search of the archives recommends this study.  A Google
> search of the internet found me the journal but I'm not paying for it.  
> 
> Interestingly enough, the Google search underscored today's controversy on
> the list.  Look through the citations and you'll see "use lemon glycerine
> swabs for comfort" and "never use lemon glycerine swabs."  I am firmly in
> the never use lemon glycerine swabs (for oral care for the sake of this
> post, I'm not going anywhere near the issue of DPNS right now but okay,
> since I brought it up, I'm not promoting that either) camp.  I believe that
> those who are using the swabs to provide comfort are relying on old
> information which has been proven false (and those disseminating the
> information haven't kept themselves up-to-date).  How sad that
> families/caregivers are swabbing the mouths of their loved ones, attempting
> to provide comfort and are actually causing discomfort by irritating the
> tissues and likely making them quite thirsty.
> 
> I am absolutely positive that it was on this list that I learned the truth
> about the swabs.  I don't need to have all my information sugar-coated and
> politically correct.  This is serious stuff we do every day.  If I ever have
> to stand before a judge to defend what I've done, I'm going to know that
> it's research proven and I can point to my evidence in a journal.  I'm sure
> a judge would act authoritatively and speak firmly, professionally; not
> worry about being "nice."
> 
> And, for the record, I did ask a stupid question here once and lived to tell
> the story and continue asking questions.
> 
> I don't blame Irene for being a little fed-up.  It must be incredibly
> frustrating to be in her position.  She educates us and we don't pay a dime.
> Do we respect what is being said more if we pay for it, being lectured in a
> finite amount of time when we can't ponder what is instructed before
> questioning, must they be nice?  I spend hundreds of dollars each year for
> my CEUs and it is here that I really learn.  I think we can all agree that
> we're all wonderful people with the best of intentions and we'd have a lot
> of fun over dinner and wine.  But here, I believe we can be all business (it
> certainly saves on the typing, this is the longest post I've ever had!).
> 
> I think Suzanne Morris' ideas on the subject are well worth listening to and
> it would be a wonderful way for Irene to catalog information and spare
> herself from repeating it.  The minor glitch would be directing those who
> need the information to that place.
> 
> Since I've taken so much of your time already, let me share another of my
> experiences today at work.  A registered nurse at another of my SNFs was
> telling me how well a new patient was doing, "She's swallowing well, you can
> even see her epiglottis move."  Wow.  
> 
> Happy Wednesday and welcome back Irene, I'm one very happy SLP!
> 
> Linda A. Zanchi, MA CCC-SLP
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