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HealthInfo Canterbury

Mouth care for someone who is dying

This page is about caring for someone who is dying. If you are caring for someone who is ill, but not dying, see Carer's guide to mouth care.

Often people who are dying need someone to keep their mouth clean, because they cannot do it themselves. It's important to do this, because it reduces the risk of infections in their mouth.

A healthy mouth has an intact lining and is clean, moist, and pain-free. An unhealthy mouth can be very sore, dry, or infected. It can have a huge impact on the quality of life of someone who is terminally ill or has a progressive disorder. For example, it can make it difficult for them to eat or drink, or to communicate with others.

Who can provide mouth care?

Anyone, including family, whānau, and caregivers, can perform this mouth care.

If you are caring for someone at the end of their life, providing mouth care can be a very important part of making sure they are comfortable. It can also help to keep you involved in their care.

How do I provide mouth care?

When you are providing mouth care for someone who is dying, do so every two hours – or more often if necessary. It's most important to check for redness, swelling, sores, white patches, bleeding, pain, or dryness. Tell their nurse or doctor if there are any changes.

When you are using a swab, make sure you don't poke it too far back on the person's tongue, as this may make them gag.

Cleaning the person's mouth

Before you start make sure the person is sitting up, or lying on their side – this protects their airway.

Make sure you have:

What to do:

Clean each area of the mouth with a new swab until it comes out looking clean. Areas to clean are:

Dry mouth

Having a dry mouth can be very uncomfortable. If the person you are caring for is too unwell to keep their mouth moist, you can use swabs (over-sized cotton buds) dipped in water, or whatever fluid they like, to moisten their mouth and lips every one to two hours.

The type of fluid you use is not as important as the act of moistening their mouth. Use fluids that are familiar to the person you are caring for. For example, you can use:

If the person is drowsy or unconscious, familiar fluids and the touch of a family member can lessen the shock of having something placed in their mouth. If the person usually drinks a lot of alcohol, swabbing their mouth with alcohol might keep them more settled. Avoid iced water, as this can be a shock, especially if someone has sensitive teeth.

Take particular care if their mouth is painful or has ulcers. Consider using choline salicylate gel (Bonjela), which you can buy from a supermarket or pharmacy. Make sure you keep their lips moist with petroleum jelly (Vaseline) or lip salves.

Sore mouth

If your loved one's tongue becomes sore, red, or covered with a fuzzy coating they may have oral thrush (candida). Tell their doctor, as this is easy to treat with antifungal drops. Regularly cleaning and moistening their mouth can help to prevent this.

On the next page: Mouth care when you are sick

Written by HealthInfo clinical advisers. Endorsed by Canterbury DHB and community palliative care specialists. Updated May 2017.

Sources

Page reference: 357774

Review key: HIPAL-17434