Over the years I've heard Lavender is very calming, soothing and can provide restful sleep. I'm wondering if using Lavender around an AZ patient would provide some form of relaxation? Does anyone know ?
Hi Bar-bra: It certainly won't hurt unless there is an allergic reaction to it. It's known to help insomnia, anxiety, depression, mood distrubances, restlessness, etc. You can use it in several forms: teas, dried flowers, infusions, lavender oils. Some people are allergic and may have a reaction, so be careful. There is a good website : lavendercentral.com.
Most of what I found on Google itself seemed to be a resounding YES, aromatherapy can help ... all written by aromatherapists. So I turned to Google Scholar for a more scholarly opinion.
I found roughly four million papers that turned out to be literature surveys, the vast majority of which cited precisely two clinical studies as providing some evidence that aromatherapy might be useful (see below).
The remainder of the reviews said that the jury is still out. Some clinical studies have claimed that efficacy was shown, others that it was not. Most of these were either very small and did not have appropriate controls OR the aromatherapy involved massage with an essential oil, usually lavender, and the massage may have been the component that was helpful, rather than the lavender. (Or, possibly, that cutaneous application of the lavender is needed, rather than just breathing its vapors.)
One paper that really struck me as having something relevant to say pointed out that many AD patients develop problems with the sense of smell. (In fact, I do know that some researchers believe that we can develop a method for very early diagnosis based on the person's sense of smell.) This tends to lead one to believe that aromatherapy may be of limited utility in AD patients, although it might be useful in patients with other dementia syndromes.
On the other hand, the aromatherapy might be soothing to the caregiver, and the ADLO might pick up on that and be calmed by it. :-)
The two clinical studies which were frequently (very) cited as evidence that aromatherapy may be useful were:
Ballard CG, O'Brien JT, Reichelt K, Perry EK. 2002. 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 63(7):553-8. (NOTE that this may be considered a massage therapy.) 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). CONCLUSION: 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.
Holmes C, Hopkins V, Hensford C, MacLaughlin V, Wilkinson D, Rosenvinge H. 2002. Lavender oil as a treatment for agitated behaviour in severe dementia: a placebo controlled study. Int J Geriatr Psychiatry 17(4):305-8.Links OBJECTIVE: To determine whether aromatherapy with lavender oil is effective in the treatment of agitated behaviour in patients with severe dementia. DESIGN: A placebo controlled trial with blinded observer rater. SETTING: A long-stay psychogeriatric ward. PATIENTS: 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). INTERVENTION: 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. ASSESSMENTS: For each subject 10 total PAS scores were obtained. Five during treatment and five during placebo periods. RESULTS: 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)). CONCLUSIONS: Lavender oil administered in an aroma stream shows modest efficacy in the treatment of agitated behaviour in patients with severe dementia.
There was another study, which was not cited by any review I saw, but which supports the use of lavender inhalation aromatherapy:
Lin PW, Chan WC, Ng BF, Lam LC. 2007. Efficacy of aromatherapy (Lavandula angustifolia) as an intervention for agitated behaviours in Chinese older persons with dementia: a cross-over randomized trial. Int J Geriatr Psychiatry 22(5):405-10. This study investigates the effectiveness of lavandula angustifolia (lavender) in treating agitated behaviours of demented people in Hong Kong. It was a cross-over randomized trial. Seventy Chinese older adults with dementia were recruited; half were randomly assigned to the active group (lavender inhalation) for three weeks and then switched to control group (sunflower inhalation) for another three weeks; the other half did the opposite. Clinical response was evaluated using the Chinese versions of Cohen-Mansfield Agitation Inventory (CCMAI) and Neuropsychiatric Inventory (CNPI). ...CONCLUSION: In summary, lavender is effective as an adjunctive therapy in alleviating agitated behaviours in Chinese patients with dementia.
I also found an abstract of a presentation at a 2007 symposium which found that aromatherapy was effective in 9 of 12 patients when the essential oil was applied in a two inch circle on the inside of the wrist, which facilitated absorption as well inhalation. The remaining three subjects had no change.
Another short abstract noted that in their clinical study, aromatherapy was beneficial in the short-term, but its efficacy tended to decrease over time.
One book on alternative medicines, which was lukewarm at best about using aromatherapy (with or without massage) for treating Alzheimer's, had the following warnings about aromatherapy in general:
Contraindications: Pregnancy, contagoius disease, epilepsy, local venous thrombosis, varicose veins, broken skin, recent surgery. Precautions/warnings: Essential oils should not be taken orally or used undiluted on the skin. Some oils cause photosensitive reactions and some have carcinogenic potential. Allergic reactions are possible with all oils. Adverse effects: Allergic reactions, nausea, headache Interactions: Many essential oils are believed to have the potential to either enhance or reduce the effects of prescribed mediations including antibiotics, tranquillizers, antihistamines, anticonvulsants, barbiturates, morphine, quinidine.
My daughter is a nursing home consultant and has gone to many seminars about dementia. One of her facilities participated in a study using a combination of frankincense and grapefruit applied to cloth patches pinned to residents' clothing. Families noticed much improvement which disappeared when the patches were discontinued. If anyone really wants the info I can bug my daughter for it. This is so weird-I recently installed weather bug on my computer and it just started chirping-scared me to death-thought my computer was about to blow up. We are in for strong wind, hail and possible tornadoes. This is sunny Florida.
Imohr I did use it on Bill while he was in the hospital after a knee replacement. I truly believe it was the only thing that kept him from being a direct admit to a psych ward. Did it change anything-who knows. He eventually wound up in a psych hospital and from there to a series of dementia facilities. Would I try it again-absolutely. Nothing to lose, I'm even trying the coconut oil. The frankincense is very expensive-so be prepared. I got it in a very good non-chain health food store. Good luck to us all! Nora
My daughter has her degree in psychology and education and works with children who are mainstreamed in the public system. They call her department "psycho-ed". These are the children that have severe psychological problems due to damage from birth parents, abuse (physical or psychological) and are usually on meds. She tells me that she has used aromatherapy with the children and has had some good results. Also, I have worked with her school with pet therapy. I do know that works, first hand. It's worth a try.
You are all such fountains of information ..... THANK YOU !
Sunshyne .... THANK YOU for your very indepth research and sharing of information. I did know there was a great deal of information on the 'net about aromatherapy including the use of Lavender but what I was really wanting to know was whether or not anyone had actually used Lavender as a calming agent, in other words had anyone had any actual hands on, personal experience, while care giving
<quote> Another short abstract noted that in their clinical study, aromatherapy was beneficial in the short-term, but its efficacy tended to decrease over time. <unquote> ..... Sunshyne, I strongly suspect this may well be the case. Just as some medications loose their effectiveness over time.
MMarshall ...... yes, I agree pet therapy definitely does work ..... I can personally attest to that. When my husband was first diagnosed we had two toy poodles - he was very attached to them and they to him - I could see the benefits as we began this journey.
Then we lost our one male (of natural causes) on Easter Sunday of 2006 - husband was devastated. Then December 30, 2006 we lost the little girl - sadly she died as a result of that poison dog food - kidney failure. Again husband was devastated. Selfishly, I couldn't bring myself to get another pet right away as I was also devastated and needed time to heal. This past September I bought a 4# Yorkshire Terrier who has brought so much joy to my husband. Not only does she love to sit on his lap and soak up the attention but also, every night, she sits and patiently waits while I ready my husband for bed and then she jumps up and down until I put her up on the bed where she immediately runs up onto my husband's chest, flops herself down and gives him *Rosie Kisses* (her name is Rosie:) My husband loves it and laughs right out loud ...... I think it is so good for him to close his eyes at night laughing ...... what a great way to end the day!
bluedaze, yes, I would love more info on your frankincense and grapefruit therapy. It sounds too weird ... so it probably works. <grin>
One of the other nontraditional treatments that I have a bit more faith in than aromatherapy (given that our spouses' sense of smell is likely to be damaged) is music therapy -- listening to classical music or to music that was popular when your ADLO was young, sing-alongs, playing instruments. There are studies that show this helps, and a ton of anecdotal evidence.
Sunshyne I will forward the info on frankincense and grapefruit when I get it from my daughter. She is on the road every week so be patient. I truly believe in aroma therapy and have thus far been able to remain drug free. Don't know why-but I prefer to control my emotions in non pharmaceutical ways. That holds true for my because I'm weird. In no way do I feel mood altering drugs are a no-no for others. Tranquilizers and mood elevators definitely have their place, and being a caregiver is the place.
I love lavender. Have a couple of very nice plants of it in the yard. However, DH has practically no sense of smell at all. He can't even smell Nocke's box when it needs cleaning. I personally don't have any trouble with my olfactory nerves. I've heard AD patients have a deficient sense of smell and he certainly does.