As your parent or grandparent ages and becomes less mobile and therefore less capable of visiting doctors’ offices and therapy appointments, it does not mean the quality and consistency of healthcare they receive is diminished or compromised. Advances in technology related to medical technology and equipment, provider education, and patient software over the past few decades have facilitated motivated providers driven by compassion to expand their services beyond their traditional offices.
While we emphasize the importance of “meeting the patient where they are” when educating patients on symptoms and disease and creating treatment plans to restore and maintain their health. One of the most important core values that separate good providers from the best providers is the ability to empathize; good care means that a provider applies his or her experience and knowledge to deliver optimal results for a patient within the standards of care established by the industry; compassionate care indicates delivery of that same care but with an awareness of the individual patients needs and desires related to their health and their overall quality of life.
For our patients who are less mobile or completely immobile and are restricted to their homes, for our patients in hospitals, nursing facilities, or assisted living communities, and for our patients who have special needs or other constraints that would limit them from visiting an office, the best care is that which can be delivered exactly where they are.
Now while this work is vitally important and may sound noble and very rewarding, it is also really, really hard. Being in a foreign environment and moving a lot of heavy equipment all while managing the care of the sickest of sick patients who are oftentimes in a cognitive state (ie. dementia, Alzheimers, depression, etc) that does not allow them to show gratitude or patience for the care they are receiving can be a challenge. Add on top of this the complexity of navigating health and dental, private and state insurances to cover these critical procedures. This type of healthcare practice is a very different model than what we are prepared for in school and what we can learn from any mentor or professional community or continuing education. But the handful of us that are taking care of these patients figure it out because the need is so vast, and if we weren’t to do it, there doesn’t seem to be anyone else who will.
So with this philosophy of care in mind and the understanding of the challenges that have to do with this service, here are things you can review to identify the right practitioner for your loved one.
(1) Education
Part of healthcare service is empowering the patient and his caregiving team (ie the patient himself and his family members and/or nurses) with the information and understanding needed to maintain the oral health restored by the provider. The physician, dentist, hygienist, therapist, etc. cannot be with the patient everyday to deliver care. Our interactions and opportunities to deliver care are limited to a few appointments, a few times per year, to interact. So it is critically important that we support our patients by providing the education necessary to continue their health.
Things to look for?
Does the doctor have and use written materials, videos, and other resources to educate patients and their families on disease, health, and maintenance of health?
Does the doctor provide training to staff members and family on ongoing care that can be provided?
Does the doctor team offer

Pictured Above: Onsite's Dr. Rodriguez with nursing facility nursing staff after an inservice training on oral hygiene
(2) Communication
Depending on where the patient is on their health journey, taking care of a geriatric patient can be comparable to caring for a child insomuch as elderly patients are not always able to identify or communicate their issues nor are they able to maintain their own care. So communication between the primary caregiver/ patient advocate and the provider team is critically important. A family member should be feel as if they truly understand what their loved one’s diagnosis is, the cause of any disease they are experiencing, and arguably the most important, the reason why we are recommending certain therapies and protocols to restore and maintain their health. If you do not feel this way, then ask questions. Ask for help.
Things to look for?
Access to information related to health, disease, diagnosis, therapy, and ongoing home care
Scheduling appointments so that family can be present during the treatment, or having communication before and after an appointment to relay any and all info related to that visit
Phone, email, text… doctors and their teams can be available to you as you need to best support your elderly loved ones. It seems simple, but in our current healthcare system, many patients ave grown accustomed to a compromised quality of care. But to remind you, you are entitled to have your questions, your phone calls answer/ returned, and your requests met all in order to optimize the quality of life of the patient.
(3) Diagnosing & Treating Planning
Getting a diagnosis, understanding the cause of that diagnosis, and creating and delivering a custom plan to restore and/or maintain health is one of the main objectives of cares. But when it comes to an elderly patient, this can be more complex for a few reasons, most notably, that the diagnoses and diseases can be more complex or severe, and secondarily, there are oftentimes more people involved in the care and therefore more people that need to understand and potentially make decisions. In order to optimize this situation, information related to a patients care needs to be share with all necessary parties, answers related to the cause and any recommended therapy as well as alternatives need to be understood.

Things to look for?
A diagnosis with an explanation of what that is and what causes it
Alternative treatment options. Every patient is not built the same. Having flexibility to create a custom plan based on an individual’s needs can facilitate better health over the longer term
An ongoing, longterm health plan to maintain the restored health established after the doctor’s treatment.
(4) References
It’s ok to ask for references!! We encourage it. A provider who is proud of what the service their team has provided will have no problem pointing you to a variety of past patients and their caregivers who can detail their experience under our care. It may seem silly or awkward, but asking for and having access to this kind of information can help put a family at ease knowing that their parent or grandparent is receiving outstanding care.
Things to look for?
Ask for references from other patient families, nurses, or others who have collaborated with this team to hear different perspectives on this experience.
Ask to be present during the initial evaluation to discuss in person what is going on and how we can achieve an optimized clinical outcome.
Pictured Right: Onsite's Dr. Rosellini talking with patient after dental care appointment
If you have questions or would like more information on elderly dental care, feel free to contact our team at 214-368-0901. We would be honored to be your loved one’s dental provider or to help you on your journey to find the right partner.