Week of May 4 - May 10, 2008

There are many ways to care for people who are struggling with the "4 A's of Alzheimer's" – anxiety, aggression, agitation and apathy – but one of the most interesting and non-invasive is through the use of essential oils, known as aromatherapy.

Good Science

Two studies examined the efficacy of aromatherapy in decreasing agitated behavior in older adults with severe Alzheimer’s. In the first study, a two percent lavender oil aroma mist was streamed into a ward for a two-hour period every other day for a total of ten treatments. On alternate days, water was used for the sake of comparison. The majority of residents, a full 60%, showed a modest improvement in agitated behavior while 33% showed no change, indicating that it noticeably helped most patients with virtually no adverse effects.

The second study explored the effect of direct application of Melissa essential oil, also known as lemon balm. Its effect on the agitated behavior of those with severe dementia was compared to that of sunflower oil (as a placebo). The oils were combined with a base lotion and applied to the participants' faces and arms twice a day over a four-week period. The results revealed a 30% reduction in agitation in 60% of the Melissa essential oil group compared with 14% of the placebo group. Significant improvements were seen also in physical nonaggressive agitation, verbal nonaggressive agitation, and physical aggression.

All-Natural

Many medications find their roots in the natural essences of plants whose essential oils are extremely powerful when used judiciously by those trained in the art of aromatherapy.

The advantage of this form of treatment, aside from the fact that it can be extraordinarily pleasant, is that aromatherapy is non-invasive and may be used in a number of modalities. 

Tactile & Olfactory Systems

Essential oils may be mixed into lotions and gently smoothed onto dry or irritated skin. They may also be combined into special formulations for a therapeutic massage. In both methods, the oils are absorbed into the body through the skin, which is the largest organ of the body, while the Alzheimer's sufferer is soothed with the gentle touch of a loved one, a physical therapist or licensed massage therapist.

In many places abroad, essential oils are often diffused through air conditioning systems to perk up or relax the atmosphere in offices and hospital departments as well.

When diffused through the air, essential oils are absorbed into the body through the olfactory system – the sense of smell – although one might not always be aware of it.

Cautions and Carrier Oils

All essential oils used for aromatherapy must be 100% pure, therapeutic grade and used only by qualified, experienced professionals, because they can be dangerous in the hands of those who are unfamiliar with their properties.

With very few exceptions, only a few drops of an essential oil are required for aromatherapy massage oil.  The remainder of the oil is actually comprised of "base oils" or "carrier oil" – a vegetable, nut or seed oil, which itself also has therapeutic value. A very tiny amount of essential oil can cover quite a large area when combined with carrier oil.

Those most often used are cold-pressed and can be combined. Some are more concentrated than others; those include carrot, hazelnut, borage seed, evening primrose, jojoba, sesame and wheat germ oils.

Oils that are more commonly used in larger quantities – also often in combinations to create fragrant base oils -- are sunflower seed, sweet almond, apricot kernel, avocado, olive, soy, grape seed, corn, peanut and safflower oils.

Lavender for Anxiety, Aggression and Agitation

One of the most common essential oils used to reduce anxiety is that produced from the Lavender plant (Lavendula officinalis), specifically from the flowers. French lavender is the oldest known variety and the most highly valued among aromatherapists.

Dr. Jean Valnet, known as the "father of essential oil therapy," lists the principal known constituents of the essential oil ethers in lavender as linalyl and geranyl (35 to 55% of linalyl acetate), geraniol, linalool, cineol, d-borneol, limonene, l-pinene, caryophyllene, butyric and valeric esters and coumarin.

It is one of the most powerful, versatile oils in existence and has been used as first aid for conditions as severe as burns (this is not meant to be used instead of treatment by a physician!) and as a mild after-bath massage for a young toddler. 

Lavender has many properties that are helpful to Alzheimer's sufferers; it is used by aromatherapists as an analgesic, an antiseptic, a calmative and a hypotensive, reducing blood pressure.

As such, it is often used to help remedy at least three of the four "A's" of Alzheimer's – anxiety, aggression and agitation.

As with all essential oils, lavender should never be used except under the supervision of a qualified professional.

Rose for Apathy

Who can resist the fragrance of a rose? Aromatherapists agree that essential oil of rose, specifically Rosa damascena, is one of the most powerful aromatherapy treatments for apathy. It is also one of the most expensive oils due to the complexity of the production process, generally steam-distilling in Morocco, Bulgaria or Turkey.

Rose oil has been used since Biblical times due to its anti-inflammatory and antiseptic properties as well as its fragrance and restorative powers.

In fact, rose oil is considered so powerful that only one drop is needed to bring an entire saucerful of base oil to life, together with a couple of drops of lavender oil (pp.318-319, Natural Healing for Women, Susan Curtis & Romy Fraser).

Aromatherapy is Art

There are many other fragrant combinations used by aromatherapists to enhance the lives of people with Alzheimer's disease, as well as their work-work caregivers.

Try a relaxing bath with a few drops of a special mixture, a late afternoon massage to ease away the scary sundowners or perhaps a brief morning "pick-me-up" hand massage to start the day. 

It might also be useful to ask an aromatherapist to make up a set of spray bottles to use in various rooms in the house – one for evening, in your loved one's bedroom, for soothing him or her to sleep, and another during the day to keep things cheery in the kitchen or living room.  Maybe even one for you!

Aromatherapy is an art form and as such, the options are endless. Who can argue with plant life, flowers, fragrance and touch?

Tips for Beginners

The best all-around essential oil to have in the house is lavender oil, because it can be used for almost anything.

For a quick massage oil:

Add 3 drops of 100% pure essential oil of lavender to 2 Tablespoons of cold-press virgin olive oil (if you cannot find this, or it's just too expensive, soy oil really will do) to create a quick, soothing massage oil.

For a special, uplifting treat:

Add 1 drop of rose oil to the above massage oil.

To create a happy atmosphere in the home:

There are many small essential oil diffusers that can be purchased today in almost any store. Lavender creates a calm atmosphere, rose restores the "heart" – but mandarin brings "cheeriness" into the room. Lemon oil energizes.  Just fill the top of the diffuser with water and add a couple of drops of essential oil, and then light the tea candle underneath.

MORE INFORMATION:

SOURCE:

Geriatrics & Aging. Nonpharmacological Management of Agitated Behaviours Associated with Dementia, 2005;8(4):26-30.

ARTICLE BY:

Ann Julian, Alzheimer's Weekly

COPYRIGHT:

Copyright © 2008. Alzheimer's Weekly LLC.
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