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Abstract

Directors of care and aromatherapy care planners from 28 residential aged care facilities were surveyed about their practices and perceptions of aromatherapy in their facility. A total of 1032 (59%) residents in these facilities received aromatherapy, with 47% receiving daily treatments. The treatments were applied by assistants in nursing in most facilities, with activities officers and registered nurses also applying the treatments. The one essential oil used by all facilities was lavender (Lavandula angustifolia) followed by most facilities using tea tree (Melaleuca alternifolia), geranium (Pelargonium graveolens), eucalyptus (Eucalyptus globulus) and bergamot (Citrus bergamia). Commercial blends were used by 15/28 facilities. The choice of individual essential oils and blends suggests that aromatherapy is considered effective for both behavioural/psychological symptoms and physical ailments like arthritic pain. Nearly all facilities used foot baths and hand, foot, limb and neck-and-shoulders massage. The average monthly cost of materials per person was AUD 4.50. Directors of care also perceived that aromatherapy moderately reduces the amount of pharmaceuticals used. The main types of pharmaceuticals perceived to be reduced by aromatherapy were sedatives and analgesics. Considering all these findings, it appears as though aromatherapy is being used extensively in aged care facilities to manage symptoms of dementia and age-related physical discomfort. It is clear from this survey however, that further research is required to determine a 'best practice' for aromatherapy in dementia and aged care.

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... Resultatet visade att 26 av 32 personer i personalen upplevde att patienterna fick ett välbefinnande av beröringen och personalen upplevde att relationen till patienten förstärktes genom beröringen (Doherty, 2004). En studie av Joy Bowles et al., (2005) syftade till att beskriva och identifiera effekten av aromaterapi samt utförandet av aromaterapi på demenssjuka personer. Vårdare använde beröring på patienten för att applicera aromaoljan. ...
... Beröringen gav däremot ingen effekt på fysiskt aggressivt beteende (Hicks-Moore & Robinson, 2008;Hawranik et al., 2008). medmänsklig relation skapades (Skovdahl et al., 2007;Holliday Welsh et al., 2009;Edvardsson et al., 2002;Joy Bowles et al., 2005;Joy Bowles et al., 2002;Doherty, 2004). ...
... Flera studier visade att relationen mellan vårdare och patient förstärktes av beröringen och relationen blev mer mellanmänsklig. (Skovdahl et al., 2007;Welsh et al., 2009;Edvardsson et al., 2002;Joy Bowles et al., 2005;Joy Bowles et al., 2002;Doherty, 2004). Vårdpersonalen i en studie upplevde att beröring var lätt att lära sig. ...
... Since 2003, there has been increasing use of essential oils by members of the public, and a surge of interest in adjunctive and complementary therapies in palliative care management. Although some information from the survey was published during my doctorate (Bowles et al., 2005), I felt the details around essential oil use which weren't originally reported could be useful to practitioners working in aged care today. ...
... The statistical package used was SPSS for Windows v11.01 (Statistical Package for Social Sciences, LEAD Technologies, Inc). The summaries and correlations are reported in Bowles et al. (2005). ...
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To determine whether aromatherapy with lavender oil is effective in the treatment of agitated behaviour in patients with severe dementia. A placebo controlled trial with blinded observer rater. A long-stay psychogeriatric ward. Fifteen patients meeting ICD-10 diagnostic criteria for severe dementia and suffering from agitated behaviour defined as a minimum score of three points on the Pittsburgh Agitation Scale (PAS). A 2% lavender oil aromatherapy stream was administered on the ward for a two hour period alternated with placebo (water) every other day for a total of ten treatment sessions. For each subject 10 total PAS scores were obtained. Five during treatment and five during placebo periods. Nine patients (60%) showed an improvement, five (33%) showed no change and one patient (7%) showed a worsening of agitated behaviour during aromatherapy compared with placebo. A comparison of the group median PAS scores during aromatherapy showed a significant improvement in agitated behaviour during aromatherapy compared with placebo (median PAS scores 3 c.f. 4; Wilcoxon Signed-Ranks test p = 0.016 (one-tailed)). Lavender oil administered in an aroma stream shows modest efficacy in the treatment of agitated behaviour in patients with severe dementia.
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Article
Behavioral and psychological symptoms in dementia are frequent and are a major management problem, especially for patients with severe cognitive impairment. Preliminary reports have indicated positive effects of aromatherapy using select essential oils, but there are no adequately powered placebo-controlled trials. We conducted a placebo-controlled trial to determine the value of aromatherapy with essential oil of Melissa officinalis (lemon balm) for agitation in people with severe dementia. Seventy-two people residing in National Health Service (U.K.) care facilities who had clinically significant agitation in the context of severe dementia were randomly assigned to aromatherapy with Melissa essential oil (N = 36) or placebo (sunflower oil) (N = 36). The active treatment or placebo oil was combined with a base lotion and applied to patients' faces and arms twice a day by caregiving staff. Changes in clinically significant agitation (Cohen-Mansfield Agitation Inventory [CMAI]) and quality of life indices (percentage of time spent socially withdrawn and percentage of time engaged in constructive activities, measured with Dementia Care Mapping) were compared between the 2 groups over a 4-week period of treatment. Seventy-one patients completed the trial. No significant side effects were observed. Sixty percent (21/35) of the active treatment group and 14% (5/36) of the placebo-treated group experienced a 30% reduction of CMAI score, with an overall improvement in agitation (mean reduction in CMAI score) of 35% in patients receiving Melissa balm essential oil and 11% in those treated with placebo (Mann-Whitney U test; Z = 4.1, p < .0001). Quality of life indices also improved significantly more in people receiving essential balm oil (Mann-Whitney U test; percentage of time spent socially withdrawn: Z = 2.6, p = .005; percentage of time engaged in constructive activities: Z = 3.5, p = .001). The finding that aromatherapy with essential balm oil is a safe and effective treatment for clinically significant agitation in people with severe dementia, with additional benefits for key quality of life parameters, indicates the need for further controlled trials.
The dementia epidemic: economic impact and positive solutions for Australia. Canberra: Access Eco-nomics 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
  • O Access-Economics Ballard Cg
  • Brien
Access-Economics. The dementia epidemic: economic impact and positive solutions for Australia. Canberra: Access Eco-nomics; 2003. Ballard CG, O'Brien JT et al. 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. J Clin Psychiatry 2002;63(7): 553–8.
Dementia: aromatherapy's effectiveness in disorders associated with dementia
  • S Mitchell
Mitchell S. Dementia: aromatherapy's effectiveness in disorders associated with dementia. Int J Aromather 1993;5(2): 20-23.
The dementia epidemic: economic impact and positive solutions for Australia. Canberra: Access Economics
  • Access-Economics
Access-Economics. The dementia epidemic: economic impact and positive solutions for Australia. Canberra: Access Economics; 2003.