Aromatherapy in Hospice & Palliative Care
Passive therapies often work best in situations in which patients are unable to actively participate in treatment. For that reason, aromatherapy in hospice and palliative care environments is just what the doctor ordered. If the doctor is a homeopathic or holistic doctor, that is. Holistic medicine, more and more, is embracing the benefits that certain essential oils have on our health. In fact, I am seeing aromatherapy reviewed in more mainstream medical publications more than I did just ten years ago.
Essential oils, like lavender, frankincense, rosemary, melissa, bergamot, and others have properties beyond their marvelous fragrance. Lavender promotes sleep and augments mood while reducing stress. It is calming and balances emotions. There is evidence that frankincense reduces arthritis, eases asthma, and may even fight cancer. Rosemary improves cognitive performance and memory, relieves pain, and improves general mood. Bergamot relieves stress, anxiety and depression. Like lavender, bergamot relieves insomnia. The essential oils listed here and below are antiseptic and antibacterial, and help to keep surfaces and air clean.
A host of other essential oils are useful in medical treatment environments like hospice and palliative care. The mentioned oils are available here and give you an assortment that will benefit those in your care as well as your staff.
Some Essential Oils for Hospice and Palliative Care
It is often prescribed that an essential oil be applied directly to the skin. For example, we even advise below that a few drops of bergamot at the temples can reduce hypertension. Bergamot is a fairly mild oil, but some, like cinnamon, thyme, and oregano, can irritate the skin. While this is a standard and accepted practice, use caution. Don’t put an oil on the skin that hasn’t been so prescribed. Even if applying to the skin has been suggested, test a single drop before proceeding. The best bet is to consult a certified aromatherapist if there is any doubt.
You can purchase the oils listed here on our store. We carry a line of very high quality oils – Oshadhi. Sometimes these can get expensive if you run a diffuser a lot. We do sell other lines of essential oils in larger quantities. They are all good oils.
If you are interested in an aromatherapy oil not in this list, let us know. We have a full line, we just advertise here those we think are most beneficial for hospice and palliative care .
- Lavender – Worldwide, lavender is the most used essential oil. Lavender is antibacterial and antiviral. Use this oil to clean and disinfect surfaces and the air. Traditionally, lavender is said to be calming and to balance strong emotions. It is also antidepressant and useful in cases of insomnia. Use it in the evening to promote better sleep, or any time of day to promote better mood. It is known to soothe inflamed skin and promote healing. Lavender has been widely studied and found to relieve many of the symptoms of dementia including Alzheimer’s disease. As with many essential oils and aromatherapy in general, modern science is beginning to catch up to what the ancients knew about lavender. Recent clinical studies1,2 confirm this herbs benefit for general vital signs and for sleep quality, as well as its effect on Acute Inflammatory Response and other health benefits.
- Lemon Balm – Another essential oil that has been studied in connection with Alzheimer’s disease and dementia, (Melissa officinalis) helps to calm and relax. It is perhaps best known for its ability to heal cold sores. It is used to treat eczema and generally improves skin health. Put 4-6 drops of oil in 1 ounce of a carrier oil or moisture cream and apply directly to the skin. (See below for ways to use essential oils.) Melissa shares many of lavender’s characteristics. It is antiviral and antimicrobial, improves mood, and is helpful to those suffering from anxiety, depression, and insomnia. Studies4 show it is effective for treating the agitation associated with Alzheimer’s disease. It is possibly an anti-cancer agent, and may relieve hypertension.True melissa can be quite expensive; it can take as much as 7 tons of the lemon balm leaf to produce one pound of oil. Inexpensive versions often contain cheaper oils, like citronella.
- Peppermint – This will likely be the most recognizable aroma in your essential oil repertoire. Peppermint is stimulating and is used to both stimulate the mind and calm the nerves. It is said to rectify absent-mindedness, and studies3,6 show it improves memory and cognitive performance. Diffuse it in the morning to energize the patient, clear respiratory passages, and stimulate appetite. As a massage oil or lotion peppermint relieves fatigue and muscular tension. Also soothes stress and irritability. Use it in a bath to improve circulation, invigorate, and soothe inflamed skin.
- Rosemary – In act 4 of Hamlet, Ophelia says, “There’s rosemary, that’s for remembrance.” Indeed, the memory improving effect of rosemary was known for thousands of years before Shakespeare’s time. Modern science is beginning to recognise what the ancient Greeks and Romans knew long ago. Rosemary does indeed improve memory and cognitive processes. Stimulating and uplifting, rosemary positively affects both body and mind.
A recent study5,6 by Mark Moss and Lorraine Oliver reported some compelling evidence that exposure to rosemary oil improves cognitive performance in both speed and accuracy measures.5 Furthermore, they found that higher concentrations of 1,8-cineole, the active part of rosemary essential oil, resulted in higher performance levels; this in addition to the improvement in mood they reported in the same study. Other tested benefits of rosemary are its antiseptic, anti-microbial, anti-fungal, anti-inflammatory, and anti-oxidant properties. - Bergamot – Refreshes. Relieves insomnia. Used in Ayurvedic medicine and Italian folk medicine for digestive problems, for skin health, and to relieve fever. Bergamot’s benefits include mood elevating, calming, and balancing, and stress and anxiety relief. Use in a diffuser to get relief from mild depression and reduce blood pressure. A few drops at the temples can also reduce hypertension. To relieve pain, rub a few drops on the affected area, or massage with an oil or cream created by adding a few drops of oil to a tablespoon of a carrier oil.
- Ylang Ylang – Antidepressant, antiseptic, antispasmodic and sedative. Used topically or internally, phytochemicals in ylang ylang possess antibacterial and anti-fungal properties. The oil also improves human immune function and is anti-inflammatory. One recent paper3 published in the International Journal of Neuroscience reported improve cognitive performance when ylang ylang was used together with peppermint. The more medical science learns about diseases like cancer, Alzheimer’s disease, heart disease and many others, the more inflammation is seen as a contributor. Natural methods of inflammation reduction are always good additions to a health regimen.
Dioscorides receives a mandrake root, an illumination from the 6th century Greek Juliana Anicia Codex.
Brief History of Aromatherapy
The modern history of aromatherapy began when French chemist and perfumier Rene Maurice Gattefosse serendipitously shoved his hand into a vat of lavender oil. He did that because he had suffered a serious laboratory burn, and the lavender was the most convenient liquid nearby. To his surprise, the oil aided healing beyond its mere cooling effect. That was 1910, and Gattefosse went on to treat WWI soldiers with various essential oils.
I like to cook, and we cooks occasionally burn ourselves. I keep a vial of lavender oil around for that very reason. It really does help to heal burns. Not only does it take the sting out, burns heal without scarring.
But the use of herbs and essential oils for healing goes back a lot farther than 1910. They are a part of Traditional Chinese and Ayurvedic medicine. Jars of fragrant oils have been found in tombs of ancient Egyptians.
This atomizing diffuser is one of the best money can buy and comes with a five year warranty.
Using Aromatherapy in Hospice
Diffusers – The easiest and most effective way to deliver aromatherapy is with an essential oil diffuser. A diffuser is simply a way to dispense oil into the air to be breathed. There are several types and styles, each with its own pros and cons.
This reed diffuser is an example of an evaporative diffuser for aromatherapy.
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- Evaporative Diffusers – These include reed, ceramic, and terra cotta diffusers. Oils are absorbed by the medium or otherwise exposed to the air and left to evaporate. Certainly the simplest method to implement and manage, unaided evaporation is only effective in very confined areas.
This atomizing diffuser is one of the best money can buy and comes with a five year warranty.
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- Heat Diffusers – Oils are heated using a candle, bulb, or heating element to speed the evaporation process. These can, therefore, be used in slightly larger areas than simple evaporative diffusers. Many people choose these because they are silent, but the heat can change the character of the oils, making them less effective. Furthermore, the compounds in the oils can be forced to evaporate at different rates (fractioning), lessening the overall effect.
- Fan-Style Diffusers – A variation of the evaporative diffuser, these use a fan to evaporate and disperse essential oil into the air. More effective than simple evaporative techniques, and without the higher temperatures of heat diffusers. Like heat diffusion, these can also cause fractioning of the oils.
- Nebulizing Diffusers – Also called “atomizing diffusers”, these are the best option in terms of control and dispersion of essential oils. Compressed air atomizes oil and sprays it into the environment without heating, diluting, or fractioning. Not only does the nebulizing diffuser deliver aromatherapy oils unadulterated, it can do so for a much larger area than other diffusers. The one drawback is that the pump used can be fairly noisy. Atomizing diffusers often come with controls to adjust volume and create on-off cycles. They tend to be more expensive than other diffusers, but are usually well built and last longer. The one we offer comes with a 5-year warranty, making it in our opinion a much better buy than almost any other diffuser on the market.
- Ultrasonic Diffusers – These are essentially humidifiers. Oil is mixed with water, which is then diffused into the air using ultrasonic waves. They are generally inexpensive and cover a fairly large range, so they can be used in larger rooms than most of the other options. Many now come with timers and shut off automatically when the water basin is empty. Some now have soft lights that can be set to rotate through a number of colors, adding another level of sensory stimulation. The drawback to ultrasonic diffusers is that the water and the ultrasound can change the character and the quality of the essential oil, and cause fractioning.
In the bath – The warm water of a bath will release the healing effect as well as the aroma of your oil. Some guidelines and cautions: Essential oils are, well, oils. They don’t mix well with water but will sit on top and can bead full strength on the skin. Some can sting when, warmed, they contact the skin. It is best to first add the essential oil to a carrier oil, like coconut, jojoba, olive, or light (not toasted) sesame oil in the proportion of five to twelve drops per tablespoon (½ ounce) of carrier oil. The carrier oil itself will add to the therapeutic quality of the bath. Alternatively, instead of a carrier oil, mix the oil in similar proportions with your favorite lotion, shampoo, bath gel, or similar bath product. Mix only single use quantities; in a longer term, the oil can interfere with certain preservatives and other ingredients in the product. Finally, don’t add the oil while the bath water is running; much of the benefit will end up scenting the bathroom, which is nice, but not what you want. Add the oil after the tub is filled. And don’t add other substances like salts including Epsom salt, cornstarch, or baking soda to the bath water.
Don’t limit yourself to using single oils. Experiment with combinations, like lavender and frankincense for the ultimate in relaxation.
Oil in the bath water can make the tub slippery, so be careful entering and exiting the tub.
Some oils to avoid include cinnamon, clove, oregano, savory, spearmint, thyme (except linalool type), and wintergreen in the bath, which can irritate the skin and mucous membranes.
As massage oil or lotion – Use a carrier oil or an unscented, high-quality lotion to dilute the essential oil. Gentle massage is one of the most used forms of alternative therapy in hospice and palliative care. Massage therapy7 has been found to decrease pain, relieve fatigue, and provide meaning and respite to palliative-care patients. It is a simple thing to combine massage therapy and aromatherapy.
Resources for Aromatherapy for Hospice & Palliative Care
¹Effect of Lavender (Lavandula angustifolia) Essential Oil on Acute Inflammatory Response. Gabriel Fernando Esteves Cardia, et.al. Evidence Based Complement Alternative Medicine, 2018: 1413940.
²Effect of Lavender Aromatherapy on Vital Signs and Perceived Quality of Sleep in the Intermediate Care Unit: A Pilot Study. Jamie Lytle, Catherine Mwatha, Karen K. Davis, American Journal of Critical Care, (2014) 23 (1): 24–29.
³Modulation of Cognitive Performance and Mood By Aromas of Peppermint and Ylang-Ylang. Mark Moss, Steven Hewitt, Lucy Moss, Keith Wesnes;International Journal of Neuroscience, Vol. 118, Iss. 1, 2008
4Aromatherapy 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. Ballard, O’Brien, Reichelt, Perry; Journal of Clinical Psychiatry; 2002 Jul;63(7):553-8.
5Plasma 1,8-cineole correlates with cognitive performance following exposure to rosemary essential oil aromatherapy. Mark Moss, Lorraine Oliver; Therapeutic Advances in Psychopharmacology, 2012 Jun; 2(3): 103–113.
6Herbs that can boost your mood and memory. Northumbria University, Newcastle; 29th April 2016.
7Massage Therapy Important In Palliative Care. Massage Magazine; July 13, 2011.
