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Table 5 Theme C and supporting quotations

From: The impact of frailty on oral care behavior of older people: a qualitative study

Theme C: Structural barriers: I’d like to, but I can’t

Subtheme: Disorientation: I don’t know how it works here

C1

Since I live here, I don't always get the right care. Because I don't know how it works when I need care here, if I should go back to see my old dentist or if they [staff] arrange someone. I wouldn't know. (woman, 86, recently institutionalized, slightly frail).

C2

I wouldn't mind seeing a dentist, but I don't know anyone here. I don't know who would be good. […] Everything is so distressing here. (woman, 79, moderately frail).

C3

I would have to look up where to go to. I am not at home anymore. And I don't have all the addresses anymore. So to find all that out, that is an enormous....But I should do it. I should look up where my own dentist is. And then i should go. It has been too long ago since I went there. (woman, 93, severely frail).

C4

I have to brush regularly. And, you should write this down, that does not happen here. They forget to help remind me. You have to do it yourself […] and then I lie on my bed and I think, oh my God, I did not brush my teeth. And I cannot walk by myself, I need someone to bring me to the bathroom […] They don’t help me enough. I am forgetful now, and they don’t remind me.[…] I have looked after my teeth my whole life, and now they let it get in a mess. (woman, 93, severely frail).

C5

It is a bit difficult with my hands […] and to reach the wash basin. […] [interviewer: why haven’t you asked the nurses to help you?]. I didn’t think about it, didn’t know I could do that. (man, 65, spastic, wheel chaired, severely frail).

Subtheme: Inconveniencing social support: getting (the right) help is hard.

C6

I do want to have it fixed. […] but I cannot burden my daughter to take me to the dentist as well. She has had enough on her plate. [interviewer: and have you considered asking your other children?] Well I have asked it enough. I cannot go on insisting. “Mum, stop nagging,” they say to me. (woman, 83, severely frail).

C7

I would only go now if I would have pain. And then I would ask my daughter to bring me to the dentist. […] I would only go if she can make it, because she’s busy herself. (woman, 97, severely frail).

C8

I still live independently and I have to bother people with my requests so often, and I have to ask so many people to do something for me, and I don’t like that. (woman 80, slightly frail).

C9

The whole inside hurts because of my lower dentures. And I thought, I should go the dentist, but well, I don’t have a husband no longer, and that means I would have to go there myself. […] So I haven’t gone yet. (woman, 87, slightly frail).

C10

I think that a nurse does not like to brush my teeth. A nurse is not really paid to do it, has not been trained to do it […] that makes it hard to accept help, the thought that people do not like to help you brush, it makes you feel so dependent. (woman, 80, slightly frail).