14 | International Therapist Issue 85 | Nov/Dec 2008

Holistic | Aromatherapy

A touch of comfort

Kate Nellist looks at some of the many ways aromatherapy can bring comfort

and relief to older clients

While being older is not a ‘disease’, extra care is required when treating more mature clients, as the process of ageing brings about many physical, mental and emotional changes.

Adapting treatmentAromatherapy treatments may have to be adapted according to the health of the client. Conditions such as arthritis may benefi t from compresses rather than direct massage, and if lying down is diffi cult or uncomfortable then treatment should be adapted to suit the needs of the individual. A full body massage may be too much for some elderly clients, in which case targeting more specifi c areas,

such as their feet or hands, can prove equally benefi cial in bringing about feelings of comfort and safety.

Percentage of oilsWhen treating the elderly, only half the usual concentration of essential oils should be used, and it is important to keep the dose in line with the client’s age, weight and health (both mental and physical).

Gaining consentSeeking GP consent will be necessary if the client has a medical condition or is receiving prescribed medication. This is also important when the client has dementia, as there will be issues surrounding ‘informed consent’, which will usually involve input from the whole care team, as well as the client’s family.

Other precautionsWhen massaging an elderly client be aware that their skin can be very delicate and may require more carrier oil to prevent ‘pulling’. Also, be sure not to leave a residue of oil on their hands and feet, as this could potentially lead to a fall or accident if they slip or lose their grip. If massage is inappropriate, essential oils can be vaporised or used diluted in the bath.

Treating common ailments

There are a number of ailments that are more likely to affect this group of people.

MemoryAromas of all kinds stimulate memories and this is of great benefi t to older people. Familiar smells, such as Lavandula angustifolia (lavender true), Rosmarinus offi cinalis (rosemary), Mentha x piperita (peppermint), Rosa damascena (rose) and Citrus aurantium var. amara (sweet orange) can be particularly nostalgic.

In a care home setting, a group session using these familiar aromas can often trigger memories and induce chatter. Recalling happy times can be enjoyable for clients and enlightening for carers and family members.

Sometimes memory is affected by a deterioration of the mind in illnesses such as Alzheimer’s disease. Some essential oils for stimulating the mind and improving the memory are Rosmarinus offi cinalis (rosemary) and Mentha x piperita (peppermint). For depression, essential oils that are a tonic to the nervous system may be used, such as Boswellia carteri (frankincense), Citrus aurantium var. amara (sweet orange), Neroli bigarade (neroli), Ocimum basilicum var. album (sweet basil), Origanum majorana

Many elderly people receive little or no caring touch from others. Introducing aromatherapy with massage can improve the quality

of life for both the client and those caring for them. Touch through massage has a deep effect for the recipient, passing on feelings of warmth, comfort, security and safety. Using essential oils with massage can further enhance the benefi ts of treatment, giving deeper relaxation and assisting in

insomnia, depression, confusion and anxiety. Helen Passant introduced massage to

what was then called the ‘geriatric ward’ at Churchill Hospital, Oxford, in the 1980s. She discovered in a very short time that the patients’ skin texture improved and was more resistant to bruising and tissue damage.

Later, essential oils were introduced to the treatment, and the added benefi ts of these enabled the levels of conventional sedative medicines to be reduced.1

Considerations when treating the elderly

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International Therapist | 15Issue 85 | Nov/Dec 2008

Aromatherapy | Holistic

(sweet marjoram), Rosa damascena (rose otto) and Salvia sclarea (clary sage). A blend of these can be given by inhalation, in the bath, or by scalp, hand or foot massage.1

InsomniaAs we get older and become less active we require less sleep. Elderly people often cat nap during the day and this can make it harder to get a good and refreshing night’s sleep. When using essential oils for insomnia the dose is of paramount importance in achieving the result required. For instance, one or two drops of Lavandula angustifolia (lavender true) can be relaxing and soporifi c, whereas more can have the opposite effect. Other oils that may be benefi cial to use include Chamaemelum nobile (chamomile Roman), Origanum majorana (sweet marjoram), Cananga odorata complete (ylang ylang), and Santalum austrocaledonicum (sandalwood). One or two drops can be used on a tissue or in a vaporiser and no more than four drops in a bath blend.

Joint aches and painsThe ageing process often leads to degeneration of the joints through wear and tear or by conditions such as arthritis, rheumatism and osteoporosis.

In the main, with problems such as these, therapists look to help relieve infl ammation

These are blends I have put together based on my own knowledge and experience. Aromatherapists should always take into account the individual needs of their client when blending oils.

Massage blend general 25ml sunfl ower oil2 drops Origanum majorana (sweet marjoram) 2 drops Chamaemelum nobile (chamomile Roman) 2 drops Lavandula angustifolia (lavender true)1 drop Eucalyptus smithii (eucalyptus Smithii)

Cooling joint compress 25ml white lotion or aqueous lotion2 drops Lavandula angustifolia (lavender true)2 drops Mentha x piperita (peppermint)2 drops Eucalyptus smithii (eucalyptus Smithii)

Blend for application 90ml lotion10ml carrot oil (macerated) enriching for the skin3 drops Chamaemelum nobile (chamomile Roman)3 drops Lavandula angustifolia (lavender true) 3 drops Cymbopogon martini (palmarosa)

Massage blend warming & soothing20ml sunfl ower oil5ml mustard seed oil 2 drops Zingiber offi cinale (ginger)2 drops Piper nigrum (black pepper)1 drop Styrax benzoin (benzoin)1 drop Chamaemelum nobile (chamomile Roman)

Warming joint compress10ml sunfl ower oil2ml hypericum oil1 drop Lavandula angustifolia (lavender true)1 drop Zingiber offi cinale (ginger)1 drop Styrax benzoin (benzoin)

Blend for application 100ml lotion3 drops Origanum majorana (sweet marjoram) 3 drops Chamaemelum nobile (chamomile Roman)3 drops Lavandula angustifolia (lavender true)3 drops Eucalyptus smithii (eucalyptus Smithii)

Massage blends and compresses

and pain. Gentle massage, compresses and daily application of lotions can be most benefi cial (see panel above).

For massage, a light carrier oil with warming, pain-relieving and anti-infl ammatory essential oils is useful. Compresses can be applied using a carrier oil, followed with warm towels or wheat bags for heat.

Some clients may prefer a cool compress if their joint is hot as a result of infl ammation, but in my experience most prefer treatments that have a warming effect.

After treatment, it is useful to give the client or carer a lotion containing the relevant oils to apply to the affected area two or three times a day, if possible.

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16 | International Therapist Issue 85 | Nov/Dec 2008

Holistic | Aromatherapy

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Poor circulationDue to limited mobility and ageing, the body becomes more sluggish. Poor circulation can lead to many health problems, too many to discuss here. However, we can aid the circulation with aromatherapy massage and in doing so support all the body’s systems and organs and help to maintain and improve good health.

Aromatherapy foot baths and foot massage are very useful for treating poor circulation. For best results, it is helpful to show the carer how to massage with a lotion so that the treatment can be carried out daily. A massage blend of 90ml lotion and 10ml mustard seed oil with four drops of Piper nigrum (black pepper), four drops of Cupressus sempervirens (cypress) and four drops of Origanum majorana (marjoram) works well. Foot baths can be given by the therapist as a preliminary to the aromatherapy massage treatment. Dilute the chosen essential oils in a dessertspoonful of salt before adding them to the water and then soak the feet for 10 minutes.

DigestionOlder people often suffer a loss or lack of appetite. We expect that people who are less active require fewer calories, but sometimes they need to be encouraged to eat. A blend of Citrus aurantium sinensis (sweet orange), Citrus paradise (grapefruit) and Citrus aurantifolia (lime) produces a mouth-watering aroma when used in a vaporiser to scent the room an hour before meals.

Many elderly people do not drink enough water and this can contribute to constipation. Firstly, they need to be encouraged to drink more water. As an aromatherapy treatment, a

SkinAs we age our skin loses its tone and elasticity due to the depletion of collagen and elastin, so care has to be taken when massaging elderly skin. To nourish and feed the skin, use a base carrier enriched with other carrier oils such as macerated oils of carrot, calendula or rosehip. To further enhance the blend, add essential oils of Chamaemelum nobile (chamomile Roman), Lavandula angustifolia (lavender true) and Aniba rosaeodora (rosewood).

Aromatherapy is an effective complementary therapy in the care of the elderly and is increasingly accepted at varying levels in care homes. Some use the aromatic qualities of the oils to improve the mood and atmosphere of the home, while others are completely engaged in the therapeutic healing qualities of essential oils. Whichever area or level of care for the elderly you are involved in read as much as you can on the subject and seek appropriate, advanced training where necessary.

NB: The information in this article is not a substitute for appropriate/professional training. The blending of essential oils should only be practised by qualifi ed aromatherapists.

Kate Nellist has more than 20 years’ experience in aromatherapy, including more than 15 years teaching clinical aromatherapy. She has taught post-graduate aromatherapy courses in the Far East, Australia, Scandinavia, France and throughout the UK. With her passion for continued and professional development, Kate provides courses at her training centre, the Cirencester Academy of Holistic Studies, and gives seminars for FHT. Tel. 01285 655657 or visit www.holisticstudies.co.uk

References and further reading1 Price L, Price S (1999) Aromatherapy for health

professionals. Churchill Livingstone, Edinburgh.2 Ballard CG, 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. The Journal of Clinical Psychiatry. July 2002, Vol. 63 (7), pp 553-8. Caddy R 1997 Essential oils in colour. Amberwood Publishing Ltd, East Horsley.

gentle abdominal massage, again using the citrus oil blend of essential oils in sunfl ower oil with 10 per cent avocado oil, may be useful. For those also qualifi ed in refl exology, the digestive system refl ex points on the feet may also be massaged using a cream containing the citrus oil blend. In some cases this may be an easier and preferred area to treat. Constipation is also connected with confusion, and in mild cases of confusion, clearing the bowels can rectify the situation almost immediately.

Pressure soresBed sores form when pressure to a bony area causes the blood circulation to be restricted to the tissues in that area. If the pressure is not relieved, deep ulcers can form. Commonly affected areas are the heels, sacrum, hips and buttocks. Pressure sores can be treated using a true thyme hydrolat, sprayed onto the ulcer to clean it, several times a day. Oils recommended for pressure sores include Helichrysum angustifolium (everlasting), Boswellia carteri (frankincense), Lavandula angustifolia (lavender true) and Pogostemon patchouli (patchouli). A blend of two drops of each essential oil with macerated oils of calendula (10ml), hypericum (10ml) and sunfl ower oils (30ml), can be applied to the wound area and surrounding tissue.

Pressure sores are diffi cult to heal and care must be taken to treat from the inside out. If the outer edge heals too quickly – leaving dead tissue and possibly infection on the inside – it is very likely to break down again. Always consult the client’s GP before treating open wounds.

Melisssa offi cinalis and agitation in dementia

Ballard et al carried out a double-blind, placebo-controlled trial to establish whether Melissa offi cinalis (melissa) would have a positive effect on agitation in people with severe dementia.2

Seventy-two people with clinically signifi cant agitation were randomly assigned to an aromatherapy group, receiving massage with a base lotion containing melissa essential oil, or a placebo group, receiving massage with a base lotion containing sunfl ower oil.

The blends were applied to the faces and arms of the patients in both groups, twice a day. No signifi cant side effects were observed and 71 patients completed the trial.

The results were compared between the groups over a period of four weeks. Sixty per cent (21 out of 35) of the melissa group experienced a signifi cant improvement in their agitation scores following treatment, compared to 14 per cent (5 out of 36) of the placebo group.

The authors concluded that aromatherapy with essential oil of Melissa offi cinalis is safe and effective for clinically signifi cant agitation in people with severe dementia, and that there is a need for further controlled trials.

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