Planning for Success in Using 
Aromatherapy in Long Term Care

The main goals of Aromatherapy in Long Term Care are enhancing quality of life for residents and staff, and reduction of anxiety. The most important first step, however, is to generate enough enthusiasm and support from staff to maintain a successful program. Begin by bringing in someone who can do mini aromatherapy in-services designed to pamper your employees to let them feel that this will be a gift to everyone and not a burden.

For the mini programs to be well attended increase the number of staff on those days if your budget can handle it; provide the program on each unit. When I do this in LTC facilities, I put the EOs, a diffuser, hand massage oils, and pain relief lotion on a cart, travel unit to unit and give 15 minute programs. This can be done in a charting area, the lounge, or wherever they can hear what is going on in the unit and still experience neck rubs, smelling oils, seeing the diffuser and listening to minimal information. Handouts are made available. This often leaves them wanting more and piques interest in the topic.

A second issue is to what department and to whom will the responsibility and duty be designated? Unless your institution is in a parallel universe, health professionals feel stressed and overworked at all levels. Being asked to one more thing, no matter how great, may be the one too many. Often the Therapeutic recreation department is the path of least resistance. Aromatherapy can be introduced as an activity, minimizing the depth of policies, procedures, red tape and rules. Frankly, nothing in this article suggests that aromatherapy should be introduced or utilized as a medical modality. Other possibilities include Pastoral Care, Staff development or the Volunteer office.

For the residents, offer a few introductory Aromatherapy programs as a special activity through Therapeutic Recreation. Try diffusing sweet orange in the activity room during craft making or in the day room where less cognitively able patients often sit slumped in geri-chairs. Most likely there will be some observable improvement in the mood of at a least few residents. This observation will also impact on nursing and perhaps an interested, motivated person or persons will come forward and embrace involvement in implementing more serious programs.

Whichever route flows easiest, make sure all necessary persons are notified of the intent to begin an aromatherapy program. Omitting someone like the Medical Director who may only visit weekly, (this happened) may make for a rocky start. Also be absolutely sure to check for allergies to sweet orange, lavender or peppermint. I've never met anyone allergic to orange, but I have seen an uninformed, unsuspecting nurse allergic to peppermint wreak havoc during the start up of an attempted aromatherapy program.

Mood Stabilization and Other Uses

Diffusion of Sweet Orange essential oil is the method of choice for the group population. Many facilities have used only orange for a year before introducing other oils. Orange is wonderful; it is uplifting and anti-anxiety without being a stimulant or a sedative. If a second essential oil is added to you repertoire, choose Lavender. It is best not to introduce a second oil, though, until everyone has had about two months to observe the effects of the fist before another variable is introduced.

Use of EOs can factor into pain management programs for the effect that the emotional/endorphin release can have on pain threshold. Incorporate use of pain relief aromatherapy lotions to enhance fine motor skills or facilitate gross motor improvements. Diffuse invigorating oils to promote ease of breathing, and or motivation during exercise.

Memory Stimulation

The last use for aromatherapy is for memory stimulation with dementia or Alzheimer's. The main agony of these patients is they are just aware enough to know that they're not quite right. The primary focus must be easing the anxiety and emotional pain surrounding that fact. Trying to stimulate memory with random, nonchalant use of aromatherapy can actually be cruel. I am aware of a large conglomerate of LTC facilities that had an aromatherapy program in the 90's. After having had an opportunity to speak to the author of their aromatherapy manual, she told me she was instructed to make memory stimulation the first goal in order to get the program accepted by administrators in the corporation, but that she agreed with my perspective. Incidentally, once she left the company, the aromatherapy program fell off because no one had really embraced it.

Please try to keep records. Develop an easy behavioral assessment tool that includes simple behavior descriptions or statements like, he called out less often today, or less loudly. Look for changes on other shifts. If the person really responded to orange during the day, did he sleep well? Longer? Need less anxiety medications, pace less etc? Help to make your aromatherapy program work by recording anecdotal documentations to validate it's results.

The above information is not intended to stand alone as a single tool for incorporation of aromatherapy into a facility, but as a thorough introduction. Professional supervised training or consulting is recommended. Consult aromatherapy references for detailed essential oil properties, precautions and safety.

Although, It's a sad fact that for many residents, Long Term Care 
is the last earthly stop, we can now offer them a valid tool 
to help make their precious moments better.