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Angie Stone, RDH, BS

Innovator Series

Innovator Angie Stone is a hygienist, a certified dementia practitioner and care giver, international speaker and author of the bestselling book: Dying From Dirty Teeth. She founded The HyLife Oral Health Alliance, a team who provide oral care for elders in care communities. She shares her experience during this Pandemic.

We discuss:
- Hardest Hit and Forgotten
- Serving an at risk population
- Better than we once were

Video transcription:

Liz Lundry, RDH - Hi, everybody. And welcome to this edition of the StellaLife Innovator series. Today we're going to be hearing from Angie Stone. Angie and her team at the HyLife Oral Health Alliance have been serving the oral health needs of elders who reside in care communities for nearly a decade. This became a passion for Angie once she saw firsthand the lack of effective oral care provided for her mother-in-law when she was a resident in a nursing home. Angie is a dental hygienist. She's a certified dementia practitioner, a certified caregiver, an international speaker, as well as the author of the Amazon bestselling book, "Dying From Dirty Teeth". She's the founder and CEO of HyLife Oral Health Alliance and has an article that was featured on the cover of the May RDH magazine. So Angie has a powerful message for us today. Let's welcome Angie Stone.

Angie Stone, RDH, BS - Hey, everybody. Angie Stone here. Thank you to Liz and StellaLife for having me come on and share a little bit with you about what I do. I am the founder and CEO of the HyLife Oral Health Alliance, HOHA for short, and what we do at HOHA is we take care of the oral health needs of dependent adults wherever they live. Most of our clients live in memory care facilities or communities, and that's because 95% of the people that we serve have Alzheimer's disease. The importance of having an outside provider come in and take care of the oral health is second to none. We all know that the oral cavity is connected to the rest of the body, right? And when our mouth isn't healthy, we really struggle with keeping the rest of us healthy, the rest of the body healthy. So what we do is we focus on providing care that keeps the mouth healthy. Another aspect of our care is that there is oral bacteria that has been specifically implicated in the progression of Alzheimer's disease. And so it's vitally important with these folks, this population, to really be focused on keeping their mouths clean, and that's what we do. So the system the protocol is we go in and we brush the teeth once a week and clean between the teeth with either floss or little interdental brushes, and we also supply the clients with a source of xylitol, usually in the form of a xylitol mint or a tooth gel. And so the xylitol then helps us to control the bacteria load in between our weekly visits. There is research to show that a professional brushing someone's teeth, an elders teeth once a week is enough to lessen the incidence of aspiration pneumonia. Aspiration pneumonia is a leading killer in these care communities. And when I say care communities as a whole, I mean nursing homes, assisted living and memory cares. The aspiration pneumonia is typically what will take the elders life and the aspiration pneumonia, guess where it starts, it usually starts in their mouth because the mouths of these folks are not being tended to by the care team at an effective level. So why is that? We know that care teams are definitely overworked and they don't have enough time to spend with every resident and one of the very first things to be let go from their care is the oral health. So that's a pretty good system, and things are going along great until they weren't. And so in the middle of March, most of our communities started telling my oral care specialists, who are also hygienists, that we had no longer could get in to see our patients. We had no access to them. And that's because all these communities because of COVID-19 went on lockdown. So when we can't get to our folks, their oral health is suffering. And as I've been reading and learning about COVID, the oral cavity can be really super involved in the transmission of COVID. We're putting aerosols out, and they're saying now that even when we talk and we sing, we are expelling aerosols out of our mouths. So now imagine that you haven't had really effective oral care. Imagine that you haven't been able to brush your teeth by yourself in two months. And imagine that you had someone who really didn't understand how to control the bacteria, get all the plaque off your teeth, in two months. That is crazy to think about, right? We do not want to sit around for two months and not have our teeth cleaned. So pretty much all of us know the story of what's happened with this population, who has been the hardest hit with COVID. They've been forgotten. We can no longer provide services, and any other outside service has not been allowed in. And oftentimes the residents have been confined to their rooms. So now they're just sitting ducks and hopefully the COVID does not get into their care community, because once it does, we know that it spreads like wildfire. As of March 17, my business has been shut down, much like dental practices have, right? And what we're now going through is we're trying to figure out what our reentry looks like and what things will we need to have in place to reenter and not only not bring something to our residents, our clients, but also not pick up anything from the care communities ourselves. I have been hearing from, particularly dental hygienists for the last couple of weeks, as things are starting to open up as dental practices are going back to work and they have these same concerns. So even though I'm not in a dental practice, I am experiencing much of the same as the dental practice owners and the team members. The interesting thing is that we really don't have any good answers, and I think that is one of the most challenging things is that we simply don't know. We don't know where this is all going. We don't know enough to make recommendations that say yes, we know that if we do this, that we are going to be able to slow down this virus or stop this virus. I listened to a webinar today from the American Dental Association with two amazing speakers and that's exactly what they were telling us is that we just don't know enough. There isn't research out there showing anything much with COVID-19, because we've only been dealing with this particular virus in this pandemic for about six months, and that's all the time we've had to look at it. And so this is uncharted territory that we're in, and that can feel really scary. And so the message that I've been sharing with the dental professionals that have been reaching out with me is that we have to make choices that we can live with.  So many times I'm hearing that the team is being told they're going back to work, and if they don't want to come back to work, if they don't feel that they have the appropriate personal protective equipment, they're not safe with the aerosols, if they don't know enough about how that aerosol is going to work in the office, they're being told to return to work anyway or lose your job. And to me, that's a sad thing. That's a sad thing. What I'm not hearing a lot about, and I know it has to be happening out there, right? What I'm not hearing a ton about is teams that have been communicating well. Teams that have been working on this problem together as a unit, as a team and allowing everyone to feel heard. I think that's the biggest issue that is being worked through here that we're seeing is that people are not feeling seen and heard and when we don't feel seen and heard, we feel disrespected. And so it's very, very important as we move on through this pandemic, back into our businesses, as we're dealing or working with even our families, right through all of this, many people have varying attitudes, and maybe that's not the best word, but varying opinions. We have everything from, oh, my gosh, everybody is going to die, right? I know if I go anywhere, I'm going to die on one end of the spectrum, and then we have the other end of the spectrum where this is all made up. This is all made up. It's a conspiracy theory throughout the whole world. Okay. And I look at both sides, both extremes. And I'm like, okay, look, guys, as which is usually the case, the truth lies somewhere in the middle, right? Somewhere in the middle. And I know that as human beings, when we come together and we try to see this side of it and this side of it, and we talk to each other and we really listen to each other, right? That's where the magic is going to happen through all this and that's what I've been trying to do with my team. I want to hear their concerns. Yes, I'm the leader. Yes, in some aspects, it's up to me to decide what is best, right? But I'll tell you what, if we're not hearing the people that work with us, if we're not taking the time to hear their concerns and taking their concerns into account, we're going to have trouble. I was told by a hygienist the other day that they were going to have a team meeting, and the doctor told her, because she had been asking questions of the dentist, the dentist text her and said, "don't challenge me at the meeting". Okay, look, that's not going to go well, right? That's not going to go well. The message is going to go much better if we say, "tell me your concerns," and you legitimately listen. Does it mean that we are going to be able to address every one of our team members' concerns? No, it does not. Meeting in the middle so that everybody feels that there's been something decided that speaks to something that they're concerned about is where this magic is going to happen. And I believe that when we do that, that's how we're going to come out of this thing better than we were before we went in. And that's usually what troubles do, isn't it? Troubles come and we're like, "holy buckets, this is a hot mess." And then, as humans, with empathy bring our brains together and we figure it out. And in the end, it's typically better than it was before. So in closing, I just want to say that at HyLife, in the beginning, this felt like a huge daunting task and at some points, it still does, we're trying to figure this out. And I know that if we listen to each other and work together, and if we've had differences in the past, putting those aside for the greater good of ourselves, our teams and our patients is where we have the best opportunity out of this whole craziness. So thank you for listening to me. I hope that wherever you are in this process in your life, with this COVID pandemic, that things are looking up, and if they aren't yet, I know they will soon. Thanks again to StellaLife for the opportunity to share my thoughts on this platform. Hope you have a great rest of the day or the evening whenever you're watching. Thanks, bye bye.

Liz Lundry, RDH - Thank you, Angie, for those heartfelt words. Yes, we're all facing a lot of obstacles right now, but we might as well advance together. And while we're doing that, why not do it joyfully? We have that choice. So have a wonderful week and come back next week and we'll see you again on the StellaLife Innovators series next Friday. Thank you so much.