A controlled trial of aromatherapy for agitation in nursing home patients with dementia.
OBJECTIVE
Two controlled trials of aromatherapy to decrease agitation in persons with dementia have recently produced promising results. However, both studies combined the use of essential oils with massage. Thus, it is unclear if the effect of the aromatherapy intervention was the result of smelling or the cutaneous absorption of the oils. The purpose of this study was to determine whether smelling lavender oil decreases the frequency of agitated behaviors in patients with dementia.


METHODS
The study design was within-subjects ABCBA (A = lavender oil, B = thyme oil, C = unscented grapeseed oil): 4 weeks of baseline measurement, 2 weeks for each of the five treatment conditions (10-week total intervention time), and 2 weeks of postintervention measurement. Oil was placed every 3 hours on an absorbent fabric sachet pinned near the collarbone of each participant's shirt.


METHODS
A long-term care facility specifically for persons with dementia.


METHODS
Seven agitated nursing home residents with advanced dementia.


METHODS
Agitation was assessed every 2 days using a modified Cohen-Mansfield Agitation Inventory. Olfactory functioning was assessed with structured olfactory identification and discrimination tasks, and with qualitative behavioral observation during those tasks.


RESULTS
Split-middle analyses conducted separately for each patient revealed no treatment effects specific to lavender, no treatment effects nonspecific to pleasant smelling substances, and no treatment effects dependent on order of treatment administration. There were no differences between participants with more and less intact olfactory abilities.


CONCLUSIONS
There is significant evidence in the neurologic and neuropsychologic literature that persons with dementia have impaired olfactory abilities. Concordant with this literature, this study found no support for the use of a purely olfactory form of aromatherapy to decrease agitation in severely demented patients. Cutaneous application of the essential oil may be necessary to achieve the effects reported in previous controlled studies.
Snow
Lynn A
LA
Houston Center for Quality of Care and Utilization Studies, Health Services Research and Development Service, Michael E.Debakey Veterans Affairs Medical Center, Houston, TX 77030, USA. asnow@bcm.tmc.edu
Hovanec
Linda
L
Brandt
Jason
J
D000368:Aged; D019341:Aromatherapy / Q000379:methods*; D003704:Dementia / Q000150:complications / Q000628:therapy*; D006801:Humans; D027523:Lavandula; D009735:Nursing Homes; D009822:Oils, Volatile / Q000627:therapeutic use*; D000857:Olfaction Disorders / Q000209:etiology; D010938:Plant Oils / Q000627:therapeutic use*; D011595:Psychomotor Agitation / Q000517:prevention & control / Q000628:therapy*; D012639:Seeds; D012903:Smell; D046930:Thymus Plant; D013997:Time Factors; D016896:Treatment Outcome; D027843:Vitis
D009822:Oils, Volatile; D010938:Plant Oils; C045718:lavender oil