Caregivers' Experiences With Involuntary Oral Care for Individuals With Dementia Within the Dutch Care and Coercion Act

Background: Individuals with dementia frequently show care-resistant behaviour toward the provision of oral care. Providing oral care despite care-resistant behaviour is legally considered to be involuntary oral care. In the Netherlands, the provision of involuntary oral care to incapacitated individuals with dementia is regulated by the Care and Coercion Act (CCA) since 2020.

Objective: This study aimed to assess how care providers experienced the CCA in the context of involuntary oral care for individuals with dementia.

Methods: 32 one-on-one semi-structured interviews were conducted with different care providers involved in oral care for incapacitated individuals with dementia.

Results: Through the interviews, multiple experiences concerning the CCA were identified. These experiences were related to: (1) awareness of involuntary care, (2) implementation of the law, (3) definitions, (4) circumvention of the law and (5) responsibility for involuntary care.

Conclusion: The CCA creates awareness about involuntary oral care among care providers. However, many care providers view the legal definitions differently, causing variation in the interpretations and applications of the legislation. Also, several care providers feel that the law could result in quicker discontinuation of oral care provision. Care organisations and policymakers should provide clarity concerning the legal definitions and provide training on legislation and the provision of oral health care in cases of care-resistant behaviour.