Transforming Elder Care with Clinical Aromatherapy

Aromatic solutions to common challenges in elders and long-term care:

• Behavior management in dementia
• Memory enhancement
• Pain relief
• Constipation relief
• Sleep regulation
• Appetite stimulation
• Mood enhancement
• Infection control (ie. reduced transmission and prevention of viral illnesses)
• Wound care, incuding MRSA
• Palliative care
• Stress reduction/enhanced well-being of residents and staff
• M® technique (a relaxing, simple, easy to learn method of touch done with or without essential oils; (rjbuckle.com )
• And more…

Contact us to learn more about the profiles of some of our happy clients including:

• A 100-year-old woman newly placed in a nursing home with inconsolable anxiety
• A 75-year-old female who began to use a custom essential oil blend when rest home staff noticed increased irritability and anxiety as her cognition declined (and she was later transitioned to long-term care after an ankle fracture and remains free of antipsychotics or benzodiazepines)
• A 46-year-old man with severe and extreme behavioral symptoms due to Prader Willi Syndrome who was in a long term care facility for 6 months and was managed without the use of antipsychotics
• An 86-year-old woman in an assisted living setting who was becoming confrontational, controlling, and verbally aggressive during activities
• An 83-year-old cognitively-intact female with ALS, coping with rapid deterioration of swallow and speech and inevitable death

Our unique array of skillsets allows us to synthesize advanced principles of aromatherapy with knowledge of geriatric psychiatry.

Behavioral Management with Clinical Aromatherapy

Holistic Aromatics specializes in behavioral management for people with dementia using pure, therapeutic grade essential oils forumulated specifically for clinical use. Aromatherapy can be used first line or in adjunct to conventional psychotropic therapies, often allowing lower medication dosages. We develop therapeutic aromatherapy programs across the United States for long term care, assisted living and rest home facilities, as well as for individual persons with dementia. Our ongoing use of essential oils in the dementia population for the past several years has demonstrated many positive effects. We design and implement individualized programs, based upon the unique goals and needs of your residents, facility and staff

Demographics of Dementia

Dementia is a general term for “the loss of memory and other intellectual abilities serious enough to interfere with daily living”. (Alzheimers’ Association; alz.org ) Alzheimers disease accounts for at least 50% of dementia cases, affecting over 5 million Americans. There are other causes of dementia, including vascular, mixed (Alzheimers and vascular together), Dementia with Lewy Body, Parkinson’s Disease, and fronto-temperal dementia. Dementia is the third most expensive disease in the USA, after heart disease and cancer, and the Alzheimer’s association estimates the average lifetime cost per patient to be $174,000. The direct costs in the US exceed $250 billion annually, however the indirect costs, which include things like lost productivity and the burden for caregivers, are much higher. Dementia accounts for over half of the residents in long-term care facilities.

Behavioral Symptoms and Dementia

More than 50% of people with dementia have difficult behavioral or psychiatric symptoms, commonly called agitation. Agitation is a major problem for elders with dementia, and often affects their quality of life, and ability to receive care, both in the community and in facilities. Agitation has been defined as inappropriate verbal, vocal or motor activity (Cohen-Mansfield & Billig, 1986), and is a result of the changes occuring in the brain of the person with dementia, environmental factors or triggers or illness. Agitated behavior is actualy a group of symptoms, and includes: abusive or aggressive towards self or others, putting on too many layers of clothing, pacing, wandering, spitting, cursing, repetitive speech, constant or unwarranted requests for attention or help, grabbing onto people, hoarding, screaming, biting, verbal or physical sexual advances, performing repetitious mannerisms and general restlessness. These symptoms cause distress for the resident and are problematic for caregivers. The first-line pharmacologic approach to treating behavioral symptoms is the use of neuroleptics: aripiprazole (Abilify), risperidone (Risperdol), olanzepine (Zyprexa), or quetiapine (Seroquel) and benzodiazepines : lorazepam (Ativan), alpraxolam (Xanax). These drugs are often poorly tolerated, have limited eficacy and can be costly. Additionally, people with dementia are often vulnerable to medications, resulting in many undesirable side effects, including increased confusion, changes in the individuals’ ability to function, falls, bladder dysfunction and decreased appetite.

Holistic Aromatics Clinical Trials

Stay tuned! Whyte-English, D. & Remington, R. The effects of aromatherapy and music on dementia agitation. – In progress, June, 2008.

This is a randomized, controlled study being done in 2 long term care facilities and 1 in-patient gero-psychiatry unit. Subjects are randomized to receive aromatherapy, music, both aromatherapy and music or no intervention from the research team. We are measuring occurrences of agitation using a Modified Cohen-Mansflied Agitation Inventory. Results are expected in fall, 2008.

Relevant Aromatherapy research and clinical trials (partial list)

Lee, S.Y. (2005); “The effect of lavender aromatherapy on cognitive function, emotion and aggressive behavivor of elderly with dementia.” (Korea) quasiexperimental study; hand massage with lavender showed significant differences in emotion and aggressive behavior in demented elderly.

Elliot, et.al (2007). “The essential oils from Melissa officinalis L. and Lavandula angustifolia as potential treatment for agitation in people with severe dementia.” International Journal of Essential Oil Therapeutics, 1, 143-152. Demonstrated by radioligand binding that these essential oils are able to interact with a number of key neurotransmitters implicated in mediating the symptoms of agitation.

Holmes, C. et al (2002); “Lavender oil as a treatment for agitated behavior in severe dementia: a placebo controlled study.” International Journal of Geriatric Psychiatry , 17(4), 305-8. 9 of 15 severely demented patients on a geropsychiatric ward showed a decrease in agitation agitation using lavender inhalation

Kim, .J. et al (2005); “The effects of aroamtherapy on pain, depression, and life satisfaction of arthritis patients.” (Korea). Lavender, marjoram, eucalyptus, rosemary and peppermint reduced pain and depression scores in control group

Kim, Ma et al (2005); “Effects of aromatherapy massage for the relief of constipation in the elderly.” (Korea). Abdominal massage with rosemary, lemon and peppermint improved constipation in elders

Kennedy DO, et al (2003); “Modulation of mood and cognitive performance following acute administration of single doses of Melissa officinalis with human CNS nicotinic and muscarinic receptor-binding properties.” Neuropsychopharmacology , 28, 1871-1881. Melissa leaf enhanced memory performance and increased calmness compared to controls, increased acetylcholine activity

Ballard, CG, et al (2003); “Aromatherapy as a safe and effective treatment for the management of agitation in severe dementia: the results of a double-blind, placebo-controlled trial with Melissa.” Journal of Clinical Psychiatry , 63(7), 55-8. Melissa improved agitation and quality of life indices in demented elders in long term care

Lin, PW et al (2007). “Efficacy of aromatherapy (lanvandula angustifolia) as an intervention for agitated behaviors in Chinese older persons with dementia: a cross-over randomized trial.” International Journal of Geriatric Psychiatry , 22(5), 405-10. Positive clinical response as measured by Cohen-Mansfield Agitation Inventory to lavender inhalations (p<0.001)

Our Qualifications

• 30 years of nursing experience in a variety of clinical settings, most recently in long-term care
• 20 years as an advanced practice nurse
• Certified Clinical Aromatherapy Practitioner (CCAP) and M^® Technique practitioner, through RJ Buckle Associates (rjbuckle.com )
• Ongoing education in clinical aromatherapy, including frequent educational conference calls, conferences and workshops
• Active and involved in professional aromatherapy organizations
  • Regional representaitve for the Alliance of International Aromatherapists (alliance-aromatherapists.org )
• Board-Certified Family Nurse Practitioner
• Former board certified critical care clinical nurse specialist
• Varied experience in long term care including:
  • Primary care provider
  • Provider of geriatric psychiatry consultation services with New England Geriatrics (nehcm.com )
  • Former Certified nursing assistant

  Contact us for more information.