Good mouth care can bring comfort and dignity to someone nearing the end of their life. It can support the person to feel cared for and valued alongside reducing discomfort or distress. Close family and friends can be trained to provide mouth care for their loved ones. This can help them to feel involved in the care of their loved one and that they are making a positive difference.
Poor mouth care may lead to dryness, soreness, or discomfort. The person may feel self-conscious about having an unclean or unpleasant-smelling mouth, which can be distressing for both them and their loved ones.
To help support families and staff caring for patients at end of life the community nursing teams at Humber Teaching NHS Foundation Trust wanted to help transform mouth care by introducing a seven-day mouth care kit.
The quality improvement project was led by Debi Adams, Professional Lead for Palliative & End of Life Care to improve the quality and standards of the products being used.
"Marie Curie and the Royal College of Nursing developed evidence-based guidelines to show how important mouth care is for keeping dignity and comfort at the end of life," said Debi.
"I used those guidelines to shape a quality improvement project aimed at giving staff and families everything they need to provide good mouth care, whether at home or in a clinical setting."
"After looking into the products already available, we found a seven-day kit that includes mouth cleanser, moisturising gel, and low-foam toothpaste, all packaged in a handy bag. It felt like a really thoughtful addition for staff to have in their kit bags, something they could use with patients or give to families to help care for their loved ones."
After the initial research and planning stage, Debi reached out to Health Stars to fund 100 mouth care packs to trial within the Scarborough, Whitby, Ryedale and Pocklington Community Nursing Service and Wards.
"Providing compassionate end-of-life care goes beyond offering the right equipment," said Debi. "While introducing mouth care kits was a significant milestone, we recognised the need for additional support to empower patients and families. To address this, we developed a practical leaflet on mouth care at the end of life, paired with a comprehensive training program for staff.
The rollout was carefully planned, ensuring all resources — from the kits to training materials — were finalised before implementation. Key champions in each community nursing hub and ward were trained as local experts using a ‘train the trainer’ model, ensuring consistent guidance and support across all teams. This holistic approach has enabled us to deliver high-quality, compassionate care to those at the end of life."
The project has made a real by the support staff within the community nursing service and wards. Staff were asked to provide feedback included:
“I'm so happy there are new products and information leaflets that can aid patients at End of Life to have good oral hygiene that easy and gentle on them, and that many carers and patients families will find easy to use.”
“I feel the leaflet is very informative for relatives and gives peace of mind in a very sad and unpleasant situation.”
“A way of discussing more sensitive subjects of not actively encouraging fluid intake at the end of life. Patient's relatives who I’ve provided the leaflet to reported to find it very useful.”
“Excellent simple and practical guide for patients and carers.”
The mouth care packs are now standard practice within Humber Teaching NHS Foundation Trust Community Services.
The introduction of mouth care packs for end-of-life care has enhanced the quality of care while strengthening the connection between nursing teams and the people they support. By providing practical tools, thoughtful training, and supportive resources, the initiative has helped staff feel more confident and equipped to support patients and their families at a deeply sensitive time.
