Tuesday, December 15, 2015

Alzheimers and Dementia at Holiday Time

Maintaining (or adapting) old family rituals and traditions helps all family members feel a sense of belonging and family tradition. For an Alzheimer’s resident, this link with a familiar past is reassuring and builds self-esteem. Remember that your situation is different now; you must set your own limits early on and be clear about them with others. You do not have to live up to the expectations of friends or relatives. Simplify!

Encourage family and friends to visit, even if it is painful for them, but keep the number of visitors at any one time to a minimum. Explain to the guest as clearly as possible what they might expect from the resident–particularly odd or unusual behavior that may occur. Make clear that the resident’s memory loss makes it impossible for him or her to remember what is acceptable, but that he or she still needs contact with family and friends. In addition, several days before the guests arrive, begin showing the resident photos of the people you expect to visit. Spend more time each day explaining who each person is. If possible, arrange for the resident and the guest to talk on the telephone; they will all get a better idea of what to expect when they meet.

Try some simple holiday preparation with the resident several days ahead.  Observing preparations will familiarize him or her with the upcoming festivities and participating with you will allow the resident to experience the pleasure of helping and giving as well as the fun of anticipation and reminiscing.

Prepare potential quiet distractions (e.g. a family photo album or a simple repetitive chore like cracking nuts) to be used if the resident becomes upset of over stimulated.  Try to avoid situations that may further confuse or frustrate the resident–crowds of people who expect the resident to remember them, loud conversations or music, strange surroundings, changes in light intensity, overindulgence in rich food or drink (especially alcohol), changes in routine and regular sleep patterns.

If you receive an invitation to a holiday celebration, which the resident cannot attend, go yourself.  Enjoy the chance to be with friends and family and remember that your missing a fun occasion will not help your loved one.

Look at the holidays as a chance to start new, simpler traditions. Do not let “what you have always done” bind you to do something that will not nourish and comfort you. Give yourself permission to make changes and to be flexible.
Pick several memories of past holidays to reminisce with your Alzheimer’s family member. Do so frequently.
Sometimes it is impossible to get everything done. Others may want to help but are unsure what to do and are waiting to be asked.
Don’t forget the rest of your family, especially the children. Total involvement means happier times.
All too often, people place their own needs last. Don’t neglect yourself during the holiday season, plan to do something just for you.
Encourage participation in the holiday preparations and festivities. Allow them to help with wrapping gifts, baking and caroling activities.
Maintain normal routines as much as possible. Plan smaller, quiet gatherings that are less stressful. Remember your own limitations as well.
Alert visitors to changes in the person and provide hints for successful visits and appropriate gifts.
Don’t use them as a means to cope, as they can intensify depression and feelings of loss.
Arrange for respite care so that you can enjoy a movie or visit a friend to help reduce post-holiday stress.

• Easy to remove casual clothing
• Tapes of favorite music
• Home video of family members
• Videos of animals, travel, old-time comedy shows such as “I Love Lucy” or the “Honeymooners”
• Photo albums
• Gardening and flower arranging supplies
• Bird feeder
• Active games such as balls, indoor bowling
• Card games such as “Uno,” “Rumicube”, dominoes, trivia games
• Magazine subscriptions such as “Good Ole Days,” “Ideals,” “Reminisce”
• Puzzles with an adult theme and no more than 100 pieces
• Poetry and prayer books
• Stencils to trace, easy craft projects
• Sweaters
• Sewing cards, large beads to string
• Adult coloring books
• Colored pencils
• Tote bag
• Socks
• Old time radio tapes
• Hampers
• Coffee table type picture books
• Door decorations
• Teddy bears, hand puppets and life-like dolls
• Tablets and pencils
• Calendars

Friday, November 13, 2015

Ten Durable Truths for Managing People

  1. No matter how much you spend on marketing, you can’t sell something to people that they don’t want to buy. You must deliver a quality product, you can not spend yourself out of an operations problem with marketing dollars.
  2. If your employees do not believe in your mission, your agenda will not advance no matter how often the pay is raised or the boom is lowered.
  3. Your reputation is in the hands of your front line staff, they are the face of your company to your customers. Treat them exactly how you want your customers to be treated.
  4. You can never really trust someone until you have endured a hardship with them. Loyalty is often forged in the furnace of failure. People will decide who to respect and who to follow based upon how you respond to problems. Embrace problems, for they can be opportunities to build loyalty and trust.
  5. All work is teamwork. People perform best when they work together. Everyone needs to feel equally important. Each with their oar in the water pulling in unison, not because they are paid to do so, but because they believe its the right thing to do. Every team member has a crucial role to play in the operation.
  6. The lower you are on the totem pole, the more you crave respect. If your opinion is solicited and your contribution is respected, you will feel valued. Valued employees feel a sense of belonging and strengthen your reputation.
  7. Build employee confidence and empower them to make decisions on the spot. Confident and happy employees who are trained to believe what you believe are your best marketers.
  8. Recognition is the fuel for staff satisfaction. Seek out opportunities to celebrate success, recognition will energize weary associates. Praise in public discipline in private. 
  9. Lead by example. Operate in the center of the field of ethical behavior, never on the sidelines. Character is what you do when no one is looking. People want to believe in their leader, don’t let them down. Remember consistency = credibility. Treat the people below you the same as you treat people above you. 
  10.  People will evaluate your leadership not by all the things that went right, but rather by how you responded when things went wrong. Look for solutions to problems not blame. Supporting people when they are vulnerable is an opportunity to build a cohesive team. A good team leader listens to people and encourages them to take risks and not be afraid to make mistakes. No one ever learned anything from doing things right.

Friday, October 9, 2015

Depression and Dementia

In a recent study researchers found that depressive symptoms were more than twice as common among assisted living residents with mild or moderate dementia than among those without dementia. Depressed residents often do not have positive outcomes and are greater risk of discharge to nursing homes and death. Chronic depression can lead to loss of appetite and weight loss, lethargy, and a host of other premature health complications. Findings of the study document the high prevalence of depressive symptomatology among those with dementia. About 54% of the depressed and 33% of the non-depressed participants were taking antidepressant medication.1 Sixty-two of the participants of the study were depressed had no formal mental health treatment. Depression was more common among participants with severe dementia, behavioral symptoms and those with pain. The study also found that over half of the depressed participants were undetected by staff.
These results indicate a strong need to properly assess residents for depression. Seeking interventions for those suffering who are undiagnosed and corrective actions for those currently treated for depression who may not be depressed can derail potential problems. Identifying these at-risk residents and advising attending physicians and family members may help operators to avert unnecessary mental health triggered discharges, while improving the quality of life for each individual.
The Cornell Scale for Depression in Dementia (CSDD) was developed in response to a need in the industry for a diagnostic tool to quantify incidence of depression in elderly populations with dementia2. This simple 19 question tool enables operators to identify at-risk residents who are suffering from depression and are undiagnosed so that they might be treated, and also identify those who may be already prescribed antidepressants who may not in fact be depressed. This way attending physicians may be offered a nationally recognized diagnostic tool to use to evaluate and prescribe for their patients, rather than relying upon sporadic observations from caregivers and family members.
Using the Cornell Scale for Depression in Dementia (CSDD) operators can create a team consisting of nurses aides, LPNs and/or RNs familiar with the residents to review their collective impressions of each resident, evaluate and identify any depressive characteristics in each of the 19 symptomatic areas. This information can then be tallied and charted to evaluate risk potential. Medication dose, frequency and indication information is also collected to help evaluate the adequacy of any current treatments in place.
Upon collection of the pertinent data, the resident's physician or a consultant Psychologist or Neuropsychologist reviews this information and evaluates the appropriate treatment options for each individual, including perhaps a multidisciplinary review if appropriate. The involvement of mental health professionals in the assessment and treatment of depression in assisted living was found in the study to be alarmingly low. Less than 50% of the depressed participants were receiving any professional help.
Among the key domains of care, depression was the quality-of-life domain with the lowest perceived treatment success1. Perhaps the main reason for this is that such a high percentage of residents are undiagnosed, or inappropriately treated. Empowered with the survey results, management can develop treatment protocols for each resident now properly diagnosed, and train staff on the recognition of depression symptoms and how to effectively deal with them. Further, involvement from mental health professionals can contribute significantly to resident wellness.
The process is very simple and can be fun and enlightening with potential to positively impact the lives of the residents and contribute significantly to their overall quality of life and well-being.
1. Baldini-Gruber, Ann, Zimmerman, Sheryl, Boustani, Malaz, Watson, Lea, Williams, Christianna, Reed, Peter. Characteristics Associated with Depression in Long-Term Care Residents with Dementia. The Gerontologist. Vol. 45, October 2005, Page 50-55.
2. Alexopoulos, G.S., Abrams, R.C., Young, R.C., & Shamoian, C.A. Cornell Scale for Depression in Dementia. Biological Psychiatry, 23, 1988, Page 271-284.

Monday, August 24, 2015

Combating Appetite Loss in Seniors

It is not surprising to find that seniors almost unanimously name meals when asked what is the single most important aspect of their daily life in a retirement community. Mealtime brings seniors together for socialization and companionship, and for many it represents the only time during their day when they can share their frustrations about the effects of their own aging process with others who can relate to them. This is particularly true for new seniors or those with serious medical conditions or ailments. Although many seniors readily accept most of the effects of aging, they can be very challenging for others. Most people understand that as we age, the way in which we experience our world through our senses of sight, hearing, touch, taste, and smell changes as those senses deteriorate over time. As our visual acuity diminishes, we wear corrective lenses; with auditory loss, we wear hearing aids. However, the least accepted and least understood deprivations are those of taste and smell, the two senses that primarily control the body’s ability to experience food. Disorders of taste and smell are viewed as affecting the “lower” senses—those involved with sensual and emotional life—rather than the “higher” senses that serve the intellect.
The taste and smell of food have a major effect on levels of food intake and the maintenance of good nutrition. Losses and distortions in these chemosensory mechanisms contribute to a significant degree to anorexia in the elderly. Taste and smell are considered chemical senses because they are stimulated by molecules that contact receptors in the mouth, throat, and nasal cavity. The sense of taste is mediated by taste buds located on the dorsal surface of the tongue and on the epiglottis, the larynx, and the first third of the esophagus. Olfactory receptors are bipolar neurons located in the upper portion of the nasal cavity that project into the limbic system of the brain. The limbic system also processes information associated with emotions, so there is, in fact, a medical explanation for the emotional response we have to food. The olfactory bulb shows considerable degenerative changes during aging, and cross-sections of the bulb often look “moth-eaten” owing to losses in the number of cell bodies of neurons. Those losses are especially profound in patients with Alzheimer’s disease.
Because of reduced function in these key chemosensory systems, the natural biochemical responses designed to break down food as it enters the body are consequently also less active. When the body smells, tastes, or simply sees appetizing food, a number of biochemical responses are set in motion to aid subsequent digestion. For example, saliva builds up in the mouth, gastrointestinal juices are released into the stomach, plasma insulin is released into the bloodstream, and the pancreatic system is engaged. All these responses have the combined effect of aiding absorption of food and promoting overall nutrition. As the aging process affects the body’s internal response to food, seniors do not enjoy food as much or absorb it as well, and as a result they can become vulnerable to malnutrition, which can contribute further to health problems.
Taste and smell decrements arise not only from the normal aging process, but also from certain disease states, pharmacological and surgical interventions, the effects of radiation, and environmental exposure. Similar medical conditions and drugs affect the sense of smell. For example, most people have experienced the metallic taste of orange juice after brushing their teeth; the chemical in toothpaste responsible for this effect is sodium lauryl sulfate, which is also used to help fat-soluble drugs dissolve. Most elderly persons take their medications with their meals to offset the potentially harmful effects of the drugs on the stomach lining, which in turn affects their ability to taste and smell their food. Their senses are inhibited by these drugs, as is their digestive system, and this effect can at times induce a negative reaction and in severe cases lead to malnutrition.
Many medications commonly taken by the elderly are prescribed to be taken with food. Typically, seniors in a retirement community will take their medications in the privacy of their rooms before coming down to the dining room for a meal. By the time their meals actually arrive at the table 30 minutes or more could have passed, giving the medication taken on an empty stomach ample time to be absorbed into the bloodstream and the opportunity to adversely affect the seniors’ ability to taste and smell their food. Simply advising seniors to take their medications after they eat rather than before can have a profound effect on their overall dining satisfaction. In fact, at one community, after the seniors were educated about this concept, senior satisfaction in food and beverage service increased by 10 percent over the previous survey, while perceptions of all other conditions remained constant.
Measurements of taste and smell dysfunction in older adults reveal a progressive decline with age. Those losses tend to begin around 60 years of age and become more severe in persons over 70 years of age. In most retirement communities, the chef and cooking staff have an ability to taste and smell that is more than twice as acute as that of the people for whom they are cooking. In one study, persons between the ages of 20 and 70 had approximately 206 taste buds each. This number was reduced to 88 taste buds for persons between the ages of 74 and 88 years. The average age of seniors in retirement communities today is about 82 years. Therefore even the best-qualified chefs working with the freshest natural ingredients are working at a considerable disadvantage, and they will express their frustration in trying to address this problem using conventional methods. Seniors may inadvertently harm themselves by trying to amplify the flavors of their food by using too much salt at the table, or by eating too much dessert because they can still enjoy the sweet taste of many of these offerings. Compensating in these ways, however, only leads to nutritional imbalances and could be in direct conflict with doctor-prescribed dietary guidelines.
 Recent studies suggest that the amplification of foods and beverages with naturally produced flavors can increase preference ratings as well as subsequent intake and absorption in elderly persons with known chemosensory losses. These commercially produced flavor enhancers, which are inexpensive (adding less than a penny to the per-meal cost), are made by reducing food such as chicken and capturing and concentrating natural flavor and odor molecules. The concentrate can then be attached to a “carrier” (such as water, oil, or flour) and added to the food. This added flavor contains no fat, salt, or other harmful products traditionally associated with flavor enhancement. Table 8.6 gives the percentage of elderly persons who preferred flavor-enhanced foods in one study at Duke University Medical Center.
Flavor-amplified foods not only are preferred from a sensory standpoint, but also can influence the body’s natural biochemical response to food, actually promoting better absorption and, as a result, improving the immune status of elderly persons. In a study by Schiffman and Warwick in 1993, elderly persons were offered regular food for three weeks, then flavor-enhanced versions of the same food. Blood samples were taken before and after the use of the flavor enhancement. They showed an increase in levels of T and B cells (white blood cells), the body’s natural defense agents against disease and injury. Schiffman’s research confirms that as the body’s biochemical absorption of food improves, so do nutrition and immune status. This research suggests that the addition to recipes of natural flavors that increase the perceived flavor intensity would improve satisfaction with the food and compensate for chemosensory losses due to normal aging, diseases, and prescription drugs. It can be argued that the use of flavor enhancements can actually promote better health as well as improve senior satisfaction.
Learning that deprivation of taste and smell is a normal part of their aging process and that changes can be made to compensate for it becomes as natural to seniors as wearing glasses to augment failing eyesight. Additionally, seniors become aware that their enjoyment of food is enhanced by this flavor-amplification technique. It is also gratifying for them to see that management is willing to combine this knowledge with its culinary expertise to create a more tailored and flavorful dining experience.
The increased preference for flavor-enhanced food is extraordinary. In fact, many manufacturers of convenience products, such as Stouffers and Tyson, now list natural flavors among their ingredients. When a convenience product and its scratch-made counterpart are served, the convenience product is often better received than the homemade one. This is simply because the commercial product is higher in flavor than the homemade product as a result of added natural flavor. Certainly natural products are important and should represent the primary ingredient source. The addition of fresh herbs and spices and pretreating with marinades should not be abandoned. We walk a fine line, however: for if too many herbs and spices are added, the seasoning then overpowers the main ingredients. Often seniors’ delicate digestive systems become agitated when aromatic herbs and spices are not used in moderation.
Flavor enhancement improved food intake in 20 out of 30 foods tested. Research has confirmed an improved immune status as measured by the total level of blood lymphocytes, which help to fight diseases inherent in the elderly population. In addition, seniors feel better about their dining experience, and opioid (endorphin) levels increase as seniors’ ability to sense their food improves. It has actually been proven that seniors become physically stronger as well. With flavor enhancement, seniors are less interested in fatty foods and in adding salt to their entrees, and thus they are better able to adhere to their doctor-prescribed dietary guidelines.

Monday, August 3, 2015

Caregiver Stress - A respite can build your resilience

According to the results of a new study of the health of caregivers, there is mounting evidence that explains why caregivers often become patients themselves while caring for a loved one.
 Individuals caring for a spouse with dementia show four times greater annual increases than noncaregivers in interleukin-6 (IL-6), a key immune system molecule linked in previous studies to increased risk of cardiovascular disease, osteoporosis, arthritis, adult-onset diabetes, and a greater likelihood of death, Janice K. Kiecolt-Glaser and colleagues report in the June 30 edition of the Proceedings of the National Academy of Sciences.
Caregivers’ relatively higher levels of IL-6 may provide part of the biological explanation for a growing body of evidence implicating care giving as a risk factor for a variety of illnesses. In addition to showing accelerated increases in IL-6, caregivers report greater loneliness and feelings of stress and score higher on measures of depression than non caregivers.
 For caregivers whose spouses died during the study, elevated IL-6 and feelings of loneliness and depression persisted for at least three years following bereavement. One explanation for this persistence may lie in the well-documented social isolation and loss of support that result from extended care giving. Caregivers may emerge from their care giving responsibilities with many fewer social contacts than they had before their spouses developed dementia. Social isolation, which has also been linked to increased risk of illness and death, may be an important factor in perpetuating caregiver stress.
Often caregivers underestimate the demands of providing care for another can have on them.  While it is important to try to maintain a positive attitude, often caregivers experience feelings of helplessness and lack of control over their situation.  Caregivers who educate themselves about the diseases affecting their loved one will be better equipped to recognize and understand changes associated with progression of the disease and the aging process.  This way they can be more capable of anticipating and dealing with changes as they occur rather than being caught surprised and unprepared.
It is also important to set reasonable expectations.  A child can never change a lifelong relationship by taking on caregiver responsibilities as the need arises.  Be realistic and understand that if anything, the stress associated with caregiving can often expose already weak areas in a long term relationship in even the best of situations.  Appreciation for ones contributions should not be expected by the caregiver or from other family members.  Caregivers who provide care without expectation will be rewarded if gratitude is offered and not disappointed if it is withheld. Learn to take pride in your own accomplishments.
It is critically important to strive for balance in your life.  Personal fitness, good nutrition, and maintaining social contacts can all help keep caregivers energized.  If the caregiver is beginning to feel frustrated, angry or like a martyr, it may be time to consider a support group, or a respite.  Most communities, hospitals and churches host disease specific support groups where fellow caregivers can come together to share their experiences and help each other.  Sometimes it may be helpful to just come and listen to others and see how they have learned to cope with their caregiver responsibilities.  Often caregivers themselves can offer the best support to each other because of their own personal experiences.
Acknowledge your emotions and find an outlet for them.  Most caregivers will experience frustration, anger, guilt, resentment, self-doubt, and feelings of helplessness.  These can all lead to stress which as the study revealed can contribute to health problems of their own.  Caregivers need to find some time to nurture their own needs.  Better to consider lowering your expectations when they are unmet rather than allow yourself to become stressed out by them.  You can only do so much, better to say “no” if you can then have your own health slide attempting to do the impossible. Learn to ask for and accept help from others before its too late.  Most siblings will participate in solutions for the care of a parent if they are pushed, asking for help does not need to mean that the primary caregiver is relinquishing control or backtracking.  Its is better to teach others what the caregiver has learned and empower them to help than to try to do it all one’s self.
Maintaining a positive attitude is very important.  A stressed out caregiver is highly susceptible to depression.  Depression has been known to adversely affect the immune system.  This is why people who are left alone and isolated often suffer catastrophic health failures, while their socially active counterparts remain relatively healthy.  Learn to recognize when your care giving duties begin to drag you down and find a way to get away for some time alone or with friends. 
Day care, respite and other short-term stays in assisted living or memory care are available in most senior living communities at reasonable rates.  Residents who are around other people tend to perk up and complain less.  Most seniors find the experience very fulfilling after a short period of complaining about it.  It also introduces Mom to the concept and people living there and helps to derail her fears about it.
Mother may have “known best” when you were a child, but now that roles have reversed, it may be time for the caregiver to do what he or she thinks is best for them.  After all how often did your mother allow you as a child to talk her out of what she thought was best for you?  A short term stay can also afford the caregiver opportunity to recharge their own health and attitude treating both to a better situation.

Tuesday, June 16, 2015

Aromatherapy for Caregivers

Fragrance is an essence of long-term memories.  One whiff of a childhood aroma can set the memory in motion, bringing back thoughts, faces, and feelings long forgotten. Fragrance consists of volatile molecules that float in the air.  Millions of olfactory receptor cells line the nose, and aroma causes these nerves to fire and send messages to the limbic area of the brain.  From there, the messages travel to other parts of the brain, activating thought and memory.  The pituitary gland is also stimulated to release chemical messages that travel via the blood to glands and organs that create physical body responses.  This means that a scent has the potential power to activate a number of physical and emotional responses.

Aromatherapy is the ancient art of using essential oils to benefit your physical, spiritual and psychological well-being. Essential oils have been used for centuries as healing agents, fragrance for promoting health and relaxation, as well as a guard against bacteria, molds, fungi and other microorganisms.

Scientists have referred to essential oils as the life force of a plant.  Many essential oils are very complex molecules. A single oil can contain hundreds of constituents that are molecularly aligned in exactly the right manner to trigger a number of responses in the human body.  Essential oils are stored in minute quantities in special cells, ducts, or glandular hairs that are distributed among the roots, leaves, bark, stems, and flowers of the plant.  When concentrated, a single drop or two of distilled therapeutic-grade oil can produce quick and significant results.  

Essential oils can be absorbed in several ways; through our sense of smell, through our skin, even as a dietary supplement.  Aroma is absorbed through our nose to the brain where memory, hunger, moods, and even sexual responses are evoked.  Before knowing we smell an aroma, our subconscious mind reacts to it.  Aromatherapy can benefit stress-related problems and promote a positive state of energy, health and well-being.

Because of their molecular structures, essential oils are rapidly absorbed when applied to the skin.  Silky smooth to the touch, they penetrate the outer layer of the skin.  It is often possible to smell some oils on the breath shortly after applying them to the body.  The combination of touch therapy with the right essential oils can have a very natural therapeutic effect on someone, rather than treating the resident with psychotropic prescription drugs. 

All essential oils are “GRAS” – Generally Regarded as Safe (by the FDA) for internal use or certified as Food Additives, which can be safely taken internally as a dietary supplement. Some oils such as valerian, lemon, grapefruit, orange and tangerine are more effective when taken orally.

There is ample research to demonstrate the human response to essential oils. Some oils such as Peppermint, Rosemary, Jasmine, Lemongrass and Grapefruit stimulate and have an uplifting effect on the body.  Others such as Lavender, Rose, Geranium, Sandalwood and Ylang-Ylang have a relaxing or sedating effect on the body.  With Alzheimer’s residents, we can use uplifting oils in the morning to stimulate residents’ appetites and energy levels by diffusing the oils into the room or applying them directly to clothing or tissues.  In the afternoon when many dementia sufferers often experience anxiety or “sundowning”, relaxing oils can be used for individuals or in a small group setting to relieve the anxiety without the use of psychotropic medications.  Blends of oils have been developed specifically for this purpose, such as the blend of Peace and Calming, which includes the essential oils of Tangerine, Orange, Ylang-Ylang, Patchouly and Blue Tansy. Residents who have a habit of wandering during the night or with interrupted sleep cycles can find relaxation with a spritz of lavender oil on their pillowcase. A few drops on a tissue or diffused into their room can actually help with insomnia.

Other oils can be used to boost self-esteem and create a grounding effect for tearful residents. A special blend of Spruce, Rosewood, and Frankincense called Valor has been used successfully to restore confidence and well-being in people.  Another blend called Thieves was created based upon research about four thieves in France who protected themselves with Cloves, Rosemary, Lemon and Cinnamon while robbing plague victims.  This blend was tested at Weber State University, Ogden, Utah, and found to have a 99.96 percent effective rate against airborne bacteria.  Diffusing these oils can be very effective during the cold and flu season. Many hospitals in Europe routinely diffuse essential oils to purify the air. Simply put, essential oils act as the blood stream of the plant to ward off bacteriological attacks in their own natural environment. 

Here is a list of great essential oils for use in dementia care along with their application and effect:

Extraction Method: Steam distilled from flowering top.
Chemical Constituents: Monoterpene; á pinene, â.pinene, camphene; Sesquiterpenes; Non terpene alcohols (45%), geraniol, borneol, lavandulol; Esters: linalyl acetate (30-34%); lavanduyle, Oxides: 1,8 cineol; Ketones; Sesquiterpenones; Aldehydes; Lactones: Coumarins.

Action: Antiseptic, analgesic, antitumoral, anticonvulsant, sedative, anti-inflammatory.  Lavender is beneficial for cleansing cuts and wounds and is ideal for skin care, since it prevents the build up of excess sebum, a skin oil that bacteria feed on. Lavender has also been clinically evaluated for its relaxing effects.

Found In: Aroma Siez, Brain Power, DragonTime, Envision, Forgiveness, Gathering, Gentle Baby, Harmony, Legacy, M-Grain, Mister, Motivation, RC, SARA, Surrender, Trauma Life, LavaDerm Cooling Mist, Lavender Volume Hair & Scalp Wash, Lavender Volume Nourishing Rinse, Tender Tush Ointment, Satin Scrub-Mint, Orange Blossom Facial Wash, Sandalwood Moisture Creme, Sunsation Suntan Oil, Wolfberry Eye Creme, Satin Scrub-Juniper Dragon Time Bath Gel, Lavender Rosewood Bar Soap, Estro (tincture), Dragon Time Massage Oil, Relaxation Massage Oil, AuraLight, and ProGen.

Traditional Uses: The French scientist René Gatefossé was the first to discover lavender’s ability to promote tissue regeneration and speed wound healing when he severely burned his arm in a laboratory accident. Today, lavender is one of the few essential oils to still be listed in the British Pharmacopoeia.

Indications: Burns (cell renewal), sunburns (including lips), dandruff, hair loss, allergies, convulsions, herpes, headaches, indigestion, insomnia, high blood pressure, menopausal conditions, nausea, phlebitis, tumors, premenstrual conditions, scarring (minimizes), skin conditions (acne, dermatitis, eczema, psoriasis, and rashes) and stretch marks. It may be used to cleanse cuts, bruises, and skin irritations.

Other Uses: Lavender is a universal oil with many different applications. It may help arthritis, asthma, bronchitis, convulsions, depression, earaches, heart palpitations, high blood pressure, hives (urticaria), insect bites, laryngitis, nervous tension, respiratory infections, rheumatism, and throat infections.

Application: Diffuse or apply topically. Has a wide range of uses. Apply where you would use a deodorant. Safe for use on small children. May also be added to food or water as a dietary supplement.

Fragrant Influence: Calming, relaxing, and balancing, both physically and emotionally.

Safety Data: If currently under a doctor’s care or pregnant, consult physician prior to use.

Companion Oils: Most oils, especially citrus oils, chamomile, clary sage, and geranium.
Selected Research: Larrondo JV, et al. “Antimicrobial activity of essences from labiates.” Microbios. 1995; 82(332):171-2. Guillemain J, et al. “Neurodepressive effects of the essential oil of Lavandula angustifolia Mill.” Ann Pharm Fr. 1989;47(6):337-43. Kim HM, et al. “Lavender oil inhibits immediate-type allergic reaction in mice and rats.” J Pharm Pharmacol. 1999;51(2):221-6. 

Botanical Family: Labiatae.
Plant Origin: France, U.S..
Extraction Method: Steam distilled from leaves.  
Chemical Constituents: Monoterpenes: á. pinene (15-34%), â.pinene, camphene, myrcene, limonene á.terpinenes, terpinolene; Sesquiterpenes: â.caryophyllene; Monoterpenols: borneol (trace to 7%); Terpene Esters: bornyl acetate; Terpene Oxides: 1,8 cineol (trace to 20%); Monoterpenones: verbenon (15-37%), camphor (1-15%).

Action: Mucolytic, expectorant, antispasmodic, antibacterial, antiseptic, and balance endocrine gland.

Found In: Sandalwood Moisturizing Cream, and Legacy.

Traditional Uses: The name of the oil is derived from the Latin words for dew of the sea (ros + marinus), According to folklore history, rosemary originally had white flowers; however they turned red after the Virgin Mary laid her cloak on the bush. Rosemary verbenon has been used to lower cholesterol.

Indications: Respiratory infections, bronchitis, viral hepatitis, nervous tension, cardiac arrhythmia, cystitis, arthritis, and rheumatism.

Other Uses: Because of its lower camphor and higher verbenon content, this chemotype of rosemary is milder than the cineol chemotype and so is especially well-suited for chest, lung, and sinus infections. It is ideal for skin care, and can be used to combat hair loss.

Application: Diffuse, inhale, or apply topically on location. May also be added to food or water as a dietary 

Fragrant Influence: Less stimulating than rosemary CT cineol, rosemary verbenon can be clarifying for emotions and psychologically balancing.

Safety Data: Epileptics should use with caution.  If currently under a doctor’s care or pregnant, consult physician prior to use.

Companion Oils: Basil, eucalyptus, lavender, marjoram, peppermint, and pine.

This gentle fragrance is specifically designed for diffusing. It promotes relaxation and a deep sense of peace, helping to dampen tensions and uplift spirits.  When massaged on the bottom of the feet, it can be a wonderful prelude to a peaceful night’s rest. It may calm overactive and hard-to-manage children.  The oils in this blend have historically been used to help reduce depression, anxiety, stress, and insomnia.  This blend along with Mineral Essence may be a healthy alternative to Ritalin.

Blue Tansy (Tanacetum annuum) may help cleanse the liver and calm the lymphatic system, helping one to overcome anger and negative emotions promoting a feeling of self-control. It contains sesquiterpenes that can stimulate the pineal gland, which secretes the hormone melatonin, a hormone that enhances deep sleep.

Patchouly (Pogostemon cablin) was used in India in ancient times as a trade commodity because of its earthy, musty fragrance and its ability to mask many different odors. Its fragrance reestablishes equilibrium while simultaneously quieting emotion and energizing the mind.

Tangerine (Citrus nobilis) contains esters and aldehydes that are sedating and calming, helping with anxiety and nervousness.

Orange (Citrus aurantium) was believed to bring joy, peace, and happiness to those who possessed it. It is elevating to the mind and body.

Ylang Ylang (Cananga odorata) helps bring about a sense of relaxation and may help balance male and female energies. It balances equilibrium and inspires confidence and self-love.

Safety Data: If pregnant or under a doctor’s care, consult your physician prior to use. May be irritating to those with sensitive skin. Avoid eye contact. In case of accidental contact, put a few drops of any pure vegetable oil in the eye and call your doctor if necessary. Never use water.

Application: Diffuse, wear as a perfume, apply on bottom of the feet, on wrists, and outside of ears.  Put in bath water. Dilute with V-6 Mixing Oil or Massage Oil Base for a full-body massage.

Companion Oils: Lavender (for insomnia) and chamomile (for calming).

Fragrant Influence: A feeling of calming and emotional well-being.

This fragrance stimulates the right brain, bringing about more creativity, a sense of well-being, and joy. It has been found to be relaxing and calming, especially for children, and works well as an air purifier.

Orange (Citrus aurantium) was believed to bring joy, peace, and happiness to those who possessed it. It contains limonene, an antiviral compound, and citral, an antibacterial compound.  It prevents the growth of bacteria. It is elevating to the mind and body and brings joy and peace.  It has been recognized to help a dull, oily complexion.
Tangerine (Citrus nobilis) contains esters and aldehydes that are sedating and calming, helping with anxiety and nervousness. It is anti-inflammatory, anticoagulant, may help decongest the lymphatic system, and works as a diuretic.

Lemon (Citrus limon) has antiseptic-like properties and contains compounds that have been studied for their effects on immune function. It increases microcirculation, which may improve vision. It may serve as an insect repellent and may be beneficial for the skin. It has been found to promote leukocyte formation, dissolve cellulite, increase lymphatic function, and promote a sense of well-being. Its fragrance is stimulating and invigorating.

Mandarin (Citrus reticulata) is appealing, gentle, and promotes happiness. Apply topically or diffuse, especially at meal time and before sleep.  Because of its sedative and slightly hypnotic properties, mandarin may help with insomnia and is good for stress and irritability. It is antispasmodic, antiseptic, antifungal, supports hepatic duct function, and works as a digestive tonic.

Grapefruit (Citrus paradisi) works as a mild disinfectant. Like many cold-pressed citrus oils, it has unique fat-dissolving characteristics. It may be beneficial for digestion, obesity, reducing water retention, and cellulite.
Spearmint (Mentha spicata) oil helps support the respiratory, glandular, and nervous systems.  With its hormone-like activity, it may help open and release emotional blocks and bring about a feeling of balance. It is antispasmodic, anti-infectious, antiparasitic, antiseptic, and anti-inflammatory. It has also been used to increase metabolism to burn fat.

Safety Data: If pregnant or under a doctor’s care, consult your physician prior to use. May be irritating to those with sensitive skin. Avoid eye contact. In case of accidental contact, put a few drops of any pure vegetable oil in the eye and call your doctor if necessary. Never use water.  Grapefruit, lemon, mandarin, and orange, may be photo-sensitizing. Avoid exposure to direct sunlight for 3 to 6 hours after use.

Application: Diffuse, put in bath water, and dilute with V-6 Mixing Oil or Massage Base Oil for full body massage. Citrus Fresh may be worn as a perfume or cologne and be applied over the heart, on the wrists, and on the ears. It is excellent for children when dilution with V-6 Mixing Oil.

Fragrant Influence: This blend creates an enjoyable aromatic fragrance at home or at work. Simple diffusion can be achieved by putting a few drops on a cotton ball and placing it on a desk or table.

Note: A university in Japan experimented with diffusing different oils in the office. When they diffused lemon there were 54 percent fewer errors, with jasmine there were 33 percent fewer errors, and with lavender there were 20 percent fewer errors. When oils were diffused while studying and taking a test, test scores increased by as much as 50 percent. Different oils should be used for different tests, but the same oil should be used during the test as was used while studying for that particular test. The smell of the oil may help bring back the memory of what was studied.

Extraction Method: Cold pressed from rind. It takes 3,000 lemons to produce a kilo of oil.
Chemical Constituents: Monoterpenes: limonene (54-72%); Sesquiterpenes; Aldehydes; Coumarins and furocoumarins, contains flavonoids, carotenoids, steroids.

Action: Anti-infectious, disinfectant, antibacterial (spores), antiseptic, antiviral. Lemon improves microcirculation, promotes white blood cell formation, and improves immune function.

Found In: Citrus Fresh, Clarity, Forgiveness, Gentle Baby, Harmony, Joy, Legacy, Raven, Surrender, Thieves, Genesis Hand and Body Lotion, Lavender Volume Hair & Scalp Wash, Lavender Volume Nourishing Rinse, Berry Young Delights, Lemon-Sage Clarifying Hair & Scalp Wash, Lemon-Sage Clarifying Nourishing Rinse, KidScents Shampoo, Orange Blossom Facial Wash, Dragon Time Bath Gel, Evening Peace Bath Gel, Thieves Soap, Lemon-Sandalwood Soap, HRT (tincture), AlkaLime, AminoTech, Body Balance, CardiaCare, ImmuGel, ImmuneTune, JuvaTone, Mineral Essence, Power Meal, Super C, WheyFit, VitaGreen, and KidScents Detangler.

Traditional Uses: Lemon has antiseptic-like properties and contains compounds that have been studied for their effects on immune function. According Jean Valnet, M.D., the vaporized essence of lemon can kill meningococcus bacteria in 15 minutes, typhoid bacilli in one hour, Staphylococcus aureus in two hours, and Pneumococcus bacteria within three hours. Even a 0.2% solution of lemon oil can kill diphtheria bacteria in 20 minutes and inactivate tuberculosis bacteria. Lemon oil has been widely used in skin care to cleanse skin and reduce wrinkles.

Indications: Anemia, asthma, herpes, warts, shingles, bleeding, malaria, parasites, rheumatism, throat infection, ureter infections, and varicose veins.

Other Uses: Lemon oil may be beneficial for anxiety, blood pressure, digestive problems, respiratory infections, and sore throats. It helps promote leukocyte formation, improves memory, strengthens nails, cleans the skin, and promotes a sense of well-being. Lemon has shown to have antidepressant effects in research done by Komori, et al.,1995. It may alsohelp brighten a pale, dull complexion by removing the dead skin cells. It serves as an effective insect repellent and works well in removing gum, wood stain, oil, and grease spots.

Application: Diffuse or add a few drops to a spray bottle to deodorize and sterilize the air.  Add 2 drops to water for purification or combine with peppermint (Mentha piperita) to provide a refreshing lift. Add to food or water as a dietary supplement or flavoring.

Fragrant Influence: It promotes clarity of thought and purpose, as well as health, healing, physical energy, and purification. Its fragrance is invigorating, enhancing, and warming.

Safety Data: If currently under a doctor’s care or pregnant, consult physician prior to use. Lemon oil is very photosensitizing, so avoid applying it to skin that will be exposed to direct sunlight or UV light.

Companion Oils: Chamomile, eucalyptus, fennel, frankincense, geranium, juniper, peppermint, sandalwood, and ylang ylang.

This is an antiseptic blend formulated for diffusing to help purify the home and work environment. It cleanses the air and neutralizes mildew, cigarette smoke, and disagreeable odors.  When applied directly to the skin, Purification may be used to cleanse cuts and scrapes and may help neutralize the poison of bites from spiders, bees, hornets, wasps.

Citronella (Cymbopogon nardus) is antiseptic, antibacterial, antispasmodic, anti-inflammatory, insecticidal, antispasmodic, and soothing to the tissues.

Lemongrass (Cymbopogon flexuosus) has strong antifungal properties when applied topically.
Lavandin (Lavandula x hybrida) is antifungal, antibacterial, a strong antiseptic, and a tissue regenerator.

Rosemary (Rosmarinus officinalis) is antiseptic and antimicrobial and may be beneficial for skin conditions and dandruff. It may help fight candida and is anti-infectious and antispasmodic.

Melaleuca (Melaleuca alternifolia) is antiseptic, anti-infectious, antibacterial, antifungal, antiviral, antiparasitic, antiseptic, anti-inflammatory, immune-stimulating, decongestant, neurotonic, and protects against radiation.

Myrtle (Myrtus communis) is antibacterial and may support immune function in fighting cold, flu, and infectious disease.

Safety Data: If pregnant or under a doctor’s care, consult your physician prior to use. May be irritating to those with sensitive skin. Avoid eye contact. In case of accidental contact, put a few drops of any pure vegetable oil in the eye and call your doctor if necessary. Never use water.

Application: Diffuse 15 to 30 minutes every 3 to 4 hours. Apply topically to disinfect and cleanse.  Put on cotton balls to place in air vents in the home, car, hotel room, office, enclosed areas, etc. Put on cotton balls and place in air vents in the home, car, hotel room, office, and other enclosed areas for purifying and repelling insects.

Companion Products: Melrose, Citrus Fresh, and Thieves.

Valor helps balance electrical energies within the body, giving courage, confidence, and self-esteem.  It has been found to help the body self-correct its balance and alignment giving relief of pain. The oils in this blend empower the physical and spiritual bodies to overcome fear and opposition when facing adversity. It helps build courage, confidence, and self-esteem. Valor has been touted as a chiropractor in a bottle. It has improved scoliosis for some in as little as 30 minutes, while other individuals require several applications. Valor has also been shown to change anaerobic-mutated cells back to their aerobic natural state.

Rosewood (Aniba rosaeodora) is soothing and nourishing to the skin. It has been researched at Weber State University in Ogden, Utah for its inhibition rate against gram positive and gram negative bacterial growth. This oil is soothing, creates elasticity, and helps the skin rid itself of irritations and problems, such as candida. It is anti-infectious, antibacterial, antifungal, anti-viral, and antiparasitic.

Blue Tansy (Tanacetum annuum) may help cleanse the liver and calm the lymphatic system helping one to overcome anger and negative emotions promoting a feeling of self-control. Its primary constituents are limonene and sesquiterpenes.  European research shows that it works as an antihistamine, anti-inflammatory, and stimulant for the thymus gland reducing dermatitis, arthritis, sciatica, tuberculosis, and allergies.

Frankincense (Boswellia carteri) is considered a holy anointing oil in the Middle East and has been used in religious ceremonies for thousands of years. High in sesquiterpenes, it helps stimulate the limbic part of the brain, which elevates the mind, helping to overcome stress and despair. It is used in European medicine to combat depression.

Spruce (Picea mariana) helps to open and release emotional blocks, bringing about a feeling of balance and grounding. Traditionally, spruce oil was believed to possess the frequency of prosperity. Spruce is anti-infectious, antiseptic, and anti-inflammatory.

Carrier Oil: Almond oil.

Safety Data: If pregnant or under a doctor’s care, consult your physician prior to use. May be irritating to those with sensitive skin. Avoid eye contact. In case of accidental contact, put a few drops of any pure vegetable oil in the eye and call your doctor if necessary. Never use water.

Application: Apply 4 to 6 drops on bottom of feet.  Put on wrists, chest, and at the back of the neck, or along the spine in a Raindrop application.  When using a series of oils, as in the Raindrop application, apply Valor first and let it work for 5 to 10 minutes before applying other oils. This blend may be worn as a perfume or cologne.  (For more detailed instruction, see Raindrop Technique.)

Fragrant Influence: Gives a feeling of strength, courage, and protection.

Revered for centuries for their restorative properties to the body, mind and spirit, essential oils have been used by healers to treat a multitude of symptoms. It has been proven that the sense of scent combined with the sense of touch will reach the inner most parts of the person through the fog of Alzheimer’s disease. When fear, agitation, restlessness, or anxiety mounts, the use of aromatherapy can often help to control or ease the effects of these common behavioral issues in a natural, harmless, holistic approach.  For people suffering with Alzheimer's disease and related dementia and their families, that just makes good “scents.”  

To order these oils click www.alzheimersaromatherapy.com

Further Reading
Pearce, Benjamin W. Senior Living Communities: Operations Management and Marketing for Assisted Living, Congregate, and Continuing-Care Retirement Communities. Second Edition, Baltimore: The Johns Hopkins University Press, November 2007. pp. 368
Pearce, Benjamin. Elder Care Activities: 105 Great activities that you can do at Home, in Assisted Living, a Retirement Community or Nursing Home. Warwick, NY: Elder Care Advisor Press, March 2013.
Pearce Benjamin. Making the Move to a Retirement Community: A Complete Family Guide. Warwick, NY: Elder Care Advisor Press, March 2013.
Pearce, Benjamin. The One Minute Caregiver. Warwick, NY: Elder Care Advisor Press, April 2013.
Pearce, Benjamin. Assisted Living and Memory Care Design: An Operator's Wish List. Warwick, NY: Elder Care Advisor Press, March 2013.