Evaluating the effects of diffused lavender in an adult day care center for patients with dementia in an effort to decrease behavioral issues: a pilot study

Abstract

Objectives: To evaluate the effects of diffused lavender on the frequency of behavioral issues [BIs], defined as a composite of restlessness/wandering [RW], agitation [AGT], anger [ANG], and anxiety [ANX] in an adult day care center. Secondary objectives evaluate systematic differences on the frequency of BIs between age cohorts, gender, and individual behaviors. Design: Pre-post quasi-experimental study. Setting: Private nonprofit adult day care center for patients with dementia. Participants: Elderly patients older than 65 years of age with a clinical diagnosis of dementia, who require daytime monitoring. Intervention: Lavender aromatherapy twice a day for 20 min during a two-month period during active clinic days. Measurements: Behavioral issues were recorded using the behavior/intervention monthly flow record during the pre- and post-intervention periods. Results: There was no significant difference on frequency of BIs between pre-intervention and post-intervention periods (p = .06). There was a significant difference between pre-intervention and post-intervention total number of AGT occurrences (129 vs. 25; p value < .01). There was no significant difference between age cohorts for computed difference of RW, ANG, and ANX issues. There was a significant difference between age cohorts for computed difference of AGT (p value = .04) as the 70–85 age cohort showed less agitation compared to the 85–100 age cohort. Conclusion: The use of diffused lavender twice daily has shown to reduce the frequency of agitation in elderly patients with dementia, especially in the 70–85 age cohort. Though diffused lavender did not show statistical differences in the frequency of other behaviors (restlessness/wander, anger, anxiety), the study population may have been too small to find a difference.

NonPharmacological interventions for managing wandering in the community: A narrative review of the evidence base

“…Therefore, any papers describing the trial of nonpharmacological interventions that included a characteristic of wandering as an outcome measure (frequent locomotion, pattern, temporal aspects, navigation deficits, boundary transgression), were included in the review. Of the 11 studies included there was only one randomised controlled trial (RCT) (Baker et al, ) and four quasiexperimental studies (pre and postmeasures) (Moore, ; Moorman Li et al, ; Rowe & Alfred, ; Rowe et al, ). There was also one descriptive longitudinal study (Woodhead, Zarit, Braungart, Rovine, & Femia, ).The five remaining papers were single case studies (Evans, Carey‐Smith, & Orpwood, ; Feliciano, Vore, LeBlanc, & Baker, ; Lancioni, Perilli, Singh, O'Reilly, & Cassano, ; Orpwood, Adlam, Evans, Chadd, & Self, ; Padilla, Gonzalez, Agis, Strizzi, & Rodriguez, ).…”

“…The aim of the study by Moorman Li et al () was to explore the effect of using diffused lavender oil to reduce a number of behavioural issues that included restlessness/wandering. Behavioural symptoms of dementia were measured via observation, although how wandering was classified or how frequently participants ( n = 23) were observed was not reported.…”

“…Activities that may be part of a person's usual routine such as colouring in (Lancioni et al, ) and physically active and social activities (Woodhead et al, ) require few resources and were found to reduce the intensity of walking by participants postintervention. However, other low cost activities, such as slow massage (Rowe & Alfred, ) and aromatherapy (Moorman Li et al, ), were not found to impact restlessness, pacing and walking as measured by subjective observation or a single item on the Agitated Behaviour Scale. The use of meaningful activity has been suggested to be important when considering activities for people with dementia.…”

“…The included studies evaluated interventions that either engaged the person with dementia directly with an external stimulus to reduce the intensity of walking by participants (Baker et al, ; Lancioni et al, ; Moorman Li et al, ; Rowe & Alfred, ; Woodhead et al, ) or utilised technology or environmental modifications to make walking safer by keeping the person within safe boundaries (Evans et al, ; Feliciano et al, ; Moore, ; Orpwood et al, ; Padilla et al, ; Rowe et al, ). While only Moore () and Padilla et al () confirmed that the participant/s exhibited wandering behaviour at baseline using a validate tool (Revised Algase Wandering Scale [Algase, Beattie, et al, ]), the studies included participants with dementia living in the community who exhibited potentially risky aspects of wandering (pacing, intrusion of out of bounds areas, eloping behaviour, and repetitive walking), and in some cases the trialled intervention was reported to positively impact these outcomes.…”

“…Therefore, any papers describing the trial of nonpharmacological interventions that included a characteristic of wandering as an outcome measure (frequent locomotion, pattern, temporal aspects, navigation deficits, boundary transgression), were included in the review. Of the 11 studies included there was only one randomised controlled trial (RCT) (Baker et al, 2003) and four quasiexperimental studies (pre and postmeasures) (Moore, 2014;Moorman Li et al, 2017;Rowe & Alfred, 1999;Rowe et al, 2009).…”