A course about the end of life: Kelsch coaches professionals on palliative dental care

Aug. 26, 2015
Dental hygienists are patients' total oral health care providers beginning from birth through to the end-of-life process.


Dental hygienists are patients' total oral health care providers beginning from birth through to the end-of-life process. Many hygienists are looking for career alternatives beyond the traditional private practice. Hygienists often move into opportunities for pediatric patients, but there are limited opportunities for end-of-life care.

Or, are there? Noel Brandon Kelsch, RDHAP, has developed a program titled, "Oral Comfort Care and End-of-Life Patients: Cradling People in Our Laps," that offers hygienists a look into a specialized care area that can provide both comfort for those in the end-of-life process while offering an alternative for hygiene practice. Whether a hygienist can or wants to start her/his own business (or whether incorporating aspects of the program into the traditional dental practice), Noel believes there is a huge oral health care need to be met for those facing the end of life.


Other articles by DePalma


Noel provides participants with the tools and insight into strategies for comfort care with patient protocols and treatment planning expertise. Her years as a hospice hygienist have helped her develop a comprehensive course that compassionately meets the needs of these patients.

Goals and objectives of Noel's program include:

  • Defining comfort and hospice care
  • Identifying end-of-life patient's oral care needs and palliative care protocols
  • Delineating the role of the dental professional in delivery of comfort and hospice care
  • Developing an oral treatment protocol and plan for patients facing the end of life
  • Distinguishing the need for integrated medicine and collaboration between health-care professionals

Noel provides a handout that incorporates compound and prescription medications that she has found to be beneficial for end-of-life clients, along with numerous resources for the clinician. She is an interactive speaker with lively audience participation, hands-on products, and group activities within her PowerPoint presentation. Noel also presents programs on methamphetamine use/addiction and mental health, along with her passion for educating dental professionals about various aspects of infection control.

Her journey into end-of-life care began with a close friend's journey with cancer. While assisting Melissa Spencer in maintaining her oral health as Spencer's life was deteriorating due to brain cancer, Noel developed protocols to assist other patients and caregivers in similar situations.

As she began presenting the program, Noel was concerned that dental professionals would not be interested in the program. The opposite was true. Hygienists see the value in serving patients in all levels of care. They realize the hygienist's role needs to expand into areas that are not traditional.

Noel is a graduate of Cabrillo College with an associate's degree in dental hygiene and received her RDHAP from the University of the Pacific. She also possesses a bachelor's in oral health promotion from O'Hehir University.

Noel began presenting continuing education courses after attending many infection control programs that were very dry and boring. She believed that infection control could actually be fun! "Infection Control with a Twist" gives a humorous look at infection control infused with cutting edge information. Noel has created an empowering presentation that involves audiences and inspires participants to make changes within their practice.

From the infection control program, she developed "Identifying Methamphetamine Abuse and Developing a Treatment Protocol" that takes dental professionals through the use of visuals, personal experience and handouts into the world of methamphetamine use and abuse while presenting treatment protocols for these patients.

Noel has also created programs on mental health, serving underserved populations, and AIDS/HIV. In the mental health program, Noel teams with her daughter, Marhya, who is a licensed clinical social worker, to provide a program that not only discusses the dental implications of mental health disease but the disease process and care itself.

One of her most interesting experiences while presenting CE occurred during air travel to present the methamphetamine program. During the flight she had her abuse program open on a laptop. She heard some whispering from behind her, but didn't let it affect her and kept working.

Shortly thereafter, a steward approached her and asked her to accompany him to the front of the plane. She proceeded to the galley and three people surrounded her and quietly asked her if she was doing drugs! She explained no, that she was working on a PowerPoint for a presentation she would be giving the next day. She had been working on slides that had the ingredients for making meth open, and her fellow passengers noticed it. She loved the fact that people cared enough to ask.

Noel also has a creative side where she loves to paint using watercolors. She considered many careers at a young age - a therapist, an artist, working in communications, but is amazed that as a hygienist she can do many of these, including writing her infection control column for RDH magazine. She describes herself as resourceful, accepting, and creative. She enjoys empowering people through her programs and enjoys hearing back from course participants about how her programs have affected them and their practices. Travel delays, interesting hotel adventures, finding food in unknown towns for a vegetarian and being away from the love of her life, Dave, are the hardest parts of giving CE presentations.

Smiles impact clients/patients at every level of their lives, from breathing to getting a job. Noel feels that cradling people in your lap as a dental professional can make their smile a little brighter and their health a little better. It is a life saving job. She enjoys going into the street and providing oral health care to those who do not have the ability to come to her or other hygienists. She relishes providing comfort care to those who need it. She appreciates clinical research regarding infection control. Dental hygiene provides a multi-faceted job that can and does make a difference in so many lives! Noel believes that with the majority of people losing their lives to degenerative diseases, the role of the hygienist is essential to delivering comfort care. Providing this comfort is a precious gift that can be life changing for the patient, their family, and the hygienist.

For more information about Noel or her programs, contact her at [email protected] or visit noelkelsch.com.

Thought for the month:

"Your journey never ends. Life has a way of changing things in incredible ways." - Alexander Volkov RDH

Dental Professionals and HIV-Part 1

The INeedCE course for this month is "Dental Professionals and HIV-Part 1." By using discount code AM815RDH, readers will receive a 50% discount. The regular price is $59; with the discount, the tuition is $29.50. The discount expires on Sept. 23, 2015.

Course description

With the introduction of highly active antiretroviral therapy (HAART) for HIV, AIDS is now manageable and patients are living lives relatively free of many of the oral conditions that characterized the disease prior to and during previous treatment regimens. Although the incidence of oral diseases has improved, many patients with HIV and emerging AIDS may still develop one or more oral conditions that dental professionals need to be aware of when examining the patient with AIDS.

Effective office infection control procedures to prevent spread of the disease are as important today as they were 30 years ago when AIDS was first confronted.

This educational course is divided into two parts. The first part reviews current science related to the immune events associated with the oral route of transmission of the virus, new information on the pathogenesis of the disease, concepts related to the oral cavity as a viral reservoir for HIV and oral pathology that is associated with AIDS. The second part deals with the practical clinical

considerations that need to be addressed when treating the AIDS patient.

ANN-MARIE C. DEPALMA, RDH, MEd, FADIA, FAADH, is a Fellow of the American Academy of Dental Hygiene and the Association of Dental Implant Auxiliaries, as well as a continuous member of ADHA. She presents continuing education programs for dental team members on a variety of topics. Ann-Marie is collaborating with several authors on various books for dental hygiene and can be reached at [email protected].