Alzheimer’s and Dementia

Alzheimers | West Coast Institute of AromatherapyLife can be challenging both for those dealing with Alzheimer’s and Dementia, as well as their caregivers.  Incorporating essential oils and essential oil blends can make quite a difference in all of their lives.

Dementia is the loss of intellectual and social abilities severe enough to interfere with daily functioning. According to the Alzheimer’s disease is the most common cause of dementia. In Alzheimer’s disease dementia occurs because of the degeneration of healthy brain tissue which causes a steady decline in memory and mental abilities. Apparently about 4 million older Americans have Alzheimer’s with the number expected to triple by the year 2050 as the population ages.

Alzheimer’s is a progressive, degenerative brain disease which causes more than simple forgetfulness. It may start with confusion and slight memory loss but eventually leads to irreversible mental impairment.

According to many of the common signs and symptoms of Alzheimer’s include:

  • Increasing and persistent forgetfulness. At its onset, Alzheimer’s disease is marked by periods of forgetfulness, especially of recent events or simple directions. But what begins as mild forgetfulness persists and worsens. People with Alzheimer’s may repeat things and forget conversations or appointments. They routinely misplace things, often putting them in illogical locations. They frequently forget names, and eventually, they may forget the names of family members and everyday objects.
  • Difficulties with abstract thinking. People with Alzheimer’s may initially have trouble balancing their checkbook, a problem that progresses to trouble recognizing and dealing with numbers.
  • Difficulty finding the right word. It may be a challenge for those with Alzheimer’s to find the right words to express thoughts or even follow conversations. Eventually, reading and writing also are affected.
  • Disorientation. People with Alzheimer’s often lose their sense of time and dates, and may find themselves lost in familiar surroundings.
  • Loss of judgment. Solving everyday problems, such as knowing what to do if food on the stove is burning, becomes increasingly difficult, eventually impossible. Alzheimer’s is characterized by greater difficulty in doing things that require planning, decision making and judgment.
  • Difficulty performing familiar tasks. Once-routine tasks that require sequential steps, such as cooking, become a struggle as the disease progresses. Eventually, people with advanced Alzheimer’s may forget how to do even the most basic things.
  • Personality changes. People with Alzheimer’s may exhibit mood swings. They may express distrust in others, show increased stubbornness and withdraw socially. Early on, this may be a response to the frustration they feel as they notice uncontrollable changes in their memory. Depression often coexists with Alzheimer’s disease. Restlessness also is a common sign. As the disease progresses, people with Alzheimer’s may become anxious or aggressive and behave inappropriately.Because Alzheimer’s symptoms usually progress slowly, diagnoses is often delayed.While Alzheimer’s might be the most common cause of dementia is not the only one. There are also vascular dementia, lewy body dementia and frontotemporal dementia. Several less common brain disorders that can lead to dementia include Huntington’s disease, Parkinson’s disease, Creutzfeldt-Jakob disease and advanced stages of AIDs. Coping with loved ones who have dementia can be extremely challenging, calling for support and caring not only for the person with dementia but also for the caregiver themselves. This is where our wonderful essential oils can be so helpful.

Whether the oils are applied topically in the form of hand massage, or diffused into the air, studies have shown that there can be a reduction in agitation in those suffering from dementia. While the studies that I found only focused on a few oils namely Lavender and Melissa, when one remembers how easily aroma triggers both emotional and memory responses in the brain, and how the aroma trigger can be quite unique to the individual, the choice of oil may be quite varied. Using calming, relaxing oils would obviously be very helpful in cases of agitation and insomnia however any aroma that brings back pleasant memories can only increase the quality of life for the individual.

I did a talk at a long term care facility one day on essential oils and their use. Most of the inhabitants weren’t really able to listen to a proper talk about the use of essential oils, so I just did individual hand massages for anyone who wanted one. I took along three hand creams and let each person choose which one they wanted me to use. It was amazing, to me at any rate, that most of them, men and women included, chose the blend with Rose Otto and Ylang Ylang, a few chose the blend with Jasmine, Orange and Sandalwood and almost no one chose the more citrus blend with Neroli, Bergamot and Orange, which actually was my favorite blend. I will never forget the look of joy and pleasure on their faces during and after the short hand massage. Definitely an example of how such a small thing could greatly enhance someone’s quality of life.

Hopefully the caregivers will also have opportunities to support themselves through their journey with the use of essential oils, whether they are applied in a soothing massage, added to a relaxing bath or just diffused at the end of the day, these precious gifts of nature can really make a difference to our emotional well-being, coping skills and quality of life.

There have been several small studies done testing the effectiveness of the use of aromatherapy and essential oils with dementia. Here are a few.

Smallwood J, Brown W, Coulter F, Irvine E, Copland C, Aromatherapy and behaviour disturbances in dementia: a randomized controlled trial, International Journal of Geriatric Psychology 16: 1010-1013, 2001 carried out a single-blind randomised trial designed with 21 inpatients (12 female, 9 male) that had been diagnosed as suffering from severe dementia and concluded that massage combined with essential oils resulted in a reduction of agitation.

Ballard C G, O’Brien J T, Reichelt K, Perry E K, 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): 553-558,2002 double-blind, placebo-controlled trial using the for the treatment of clinically significant agitation in severe dementia patients (72 patients were enrolled in the study who had clinically significant agitation and confirmed severe dementia) concluded that there was a significant improvement in agitation for the active group as opposed to the placebo group. Melissa essential oil at 10% or the placebo (sunflower oil) were combined with a base lotion (containing Prunus dulcis oil, glycerine, stearic acid, cetearyl alcohol and tocopheryl acetate) and stored in plastic containers that dispensed a metered dose of 0.16-0.17 g of lotion. These containers were given to care assistants who applied the lotion topically on the patient’s face and both arms twice daily, giving a total of six doses per day, overall providing a total of 200 mg of oil. The treatment was continued for four weeks. It was concluded that the use of aromatherapy with melissa is a safe and effective treatment for clinically significant agitation in people with severe dementia, with additional benefits for quality of life parameters.

Holmes C, Hopkins V, Hensford C, MacLaughlin V, Wilkinson D, Rosenvinge H, Lavender oil as a treatment for agitated behaviour in severe dementia: a placebo controlled study, International Journal of Geriatric Psychology, 17: 305-308, 2002, recruited 15 patients from a long term psycho-geriatric ward, all all of whom fulfilled ICD-10 diagnostic criteria for severe dementia. Four patients had probable Alzheimer’s disease, seven had probable Vascular dementia, three had probable Dementia with Lewy Bodies and one patient was fully diagnosed with Fronto-Temporal Dementia. All of the patients scored greater than three points on the Pittsburgh Agitation Scale (PAS), denoting high levels of agitation. The communal area of the ward was diffused with either 2% Lavandula angustifolia essential oil or water on alternate days using three aroma-streams, for a period of two hours between 4 pm and 6 pm. In the last hour of each session the individual behaviour of the patients was assessed using the PAS. Concomitant drug therapy was allowed during the trial but no changes in medication were made during the trial period. The majority of patients (60%) showed a significant improvement in agitated behaviour in comparison to the placebo, with a drop of between 1 and 3 points on the PAS, while 33% had no change in behaviour. None of the patients who had a diagnosis of Dementia with Lewy Bodies showed any evidence of improvement and one of them appeared to worsen. This highlighted the difficulty of treating groups of patients at the same time and as such, its widespread use could not be advocated. It was concluded that aromatherapy with lavender essential oil demonstrated modest efficacy in the treatment of agitated behaviour in patients with severe dementia, although patients with different forms of dementia may show a varying response.
Bob Harris, Essential Oil Research Database 2008. Essential Oil Resource Consultants.

Some Blends to Consider

Citrus Delight Memories Romance Gentle Rest
3 drops of Mandarin 4 drops of Jasmine 3 drops of Rose 3 drops of Rosewood
1 drop of Rom. Chamomile 3 drops of Sweet Orange 2 drops of Ylang Ylang 2 drops of Lavender
3 drops of Bergamot 2 drops of Sandalwood
2 drops of Neroli

These are lovely blends and may be appropriate for many occasions not only for Alzheimer’s and Dementia Patients.

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