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ESSENTIAL OILS AND ALZHEIMER’S DISEASE

essential oils alzheimers care respite caregiver care giving

Let’s face it, essential oils are not a new phenomenon.

Their use can in fact be traced back for thousands of years and they have a rich history of application in various cultures and civilizations around the world, for medicinal, spiritual and cosmetic purposes.

A quick glance through the pages of history reveals that ancient Egyptians were amongst the first to use aromatic oils for spiritual, therapeutic and cosmetic purposes. Essential oils were also widely used in ancient China, around 3,000 years BC, with aromatic plants and oils revered for their healing properties, with texts from this period describing widespread medicinal use. Further, the ancient Indian system of medicine, Ayurveda, has used essential oils for therapeutic purposes for thousands of years.

Ancient Greek phsyicians such as Hippocrates also documented the use of aromatic oils for medicinal purposes, and their use was widespread in the Roman Empire, with oils such as lavender, rosemary and chamomile highly valued and used in baths, massages and perfumes

Their use continued throughout the Middle Ages and the Renaissance period and has endured into the nmodern era, with scientific study of essential oils commencing in the late 19th century, with the term “aromatherapy” coined by a French chemist in 1937, wheh he discovered the healing properties of lavender oil. 

Let’s be clear though – it’s not possible, nor would it be correct, in 2024 to claim that essential oils can cure medical conditions. However, there is a significant body of research that indicates that they can help with symptoms of certain medical conditions, when used in addition to mainstream medical care, not in place of it

Documented benefits of essential oils range from stress relief and mental clarity, to easing muscle aches and pains.

So what about potential benefits to someone living with Alzheimer’s disease? Well, there are not many studies that have specifically researched the benefits of essential oils for individuals living with Alzheimer’s disease, but there are a number of studies that do suggest that the use of essential oils can improve symptoms such as insomnia, or anxiety, with few to no side effects.

The easiest way to use an essential oil is to place a few drops of the oil in an essential oil diffuser, together with water in the diffuser’s reservoir, and leave it on for 30 to 60 minutes. The mixture of oil and water is then diffused into the air and, when inhaled in this way, it stimulates the smell receptors, which carry positive (or negative) messages through the central nervous system to the limbic system, which is the part of the brain that controls emotions.

There are of course many different essential oils to choose from. Of them all, Lavender has been referred to as the mother of all oils, in part because it is usually well-received by almost everyone, from children to older adults, and because studies have shown that it can have a calming effect on people. There have been small studies that have shown that lavender can help improve behavior and also improve sleep in patients with dementia. There is also evidence that it can help with the management of agitation, which can sometimes manifest in someone living with Alzheimer’s or other forms of dementia.

A few other oils and their potential benefits for Alzheime’rs are:

  • Lemon balm – studies have shown this oil as having potential benefits in reducing stress and anxiety.
  • Bergamot – it is an earthy scent, but can be uplifting and useful for helping people who are anxious or depressed, although the strong scent may not be to every individual’s personal taste
  • Ginger – has been shown to help alleviate symptoms of nauseas and upset stomach
  • Rosemary – rosemary oil can sometimes be used to help improve cognitive function and memory. While the evidence is not conclusive, some studies suggest that rosemary may have a positive effect on alertness and mental clarity.

CONCLUSIONS

  • While there is clearly a growing body of promising evidence, (and thousands of years of historical use), modern day research on essential oils and Alzheimer’s is still limited, and more rigorous clinical trials are needed 
  • Essential oils should not be used as a replacement for conventional treatments prescribed by healthcare professionals. They can, however, be considered as a helpful and complementary approach.
  • Essential oils clearly may offer some benefits for managing symptoms of Alzheimer’s and other forms of dementia, particularly in terms of improving mood, reducing agitation, and enhancing sleep quality.

BEFORE YOU GO

  • If you have any comments or thoughts on this, feel free to email us at customerservice@amindtocare.com
  • If you’d like to dip a toe into the world of diffused essential oils, check out our new ultrasonic water-based essential oil diffuser here: 
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Should We Always Tell the Truth to Someone Living with Dementia?

dementia care tips lying and protecting emotional well being

Living with Someone with Dementia

Dementia is a devastating and progressive disease that causes a decline in cognitive function, memory loss, and behavioral changes. One of the most difficult challenges for caregivers and loved ones of people living with dementia is how to communicate with them effectively. One question that often arises is whether it is ever right to lie to a person living with dementia.

Is it Okay to Lie to Someone with Dementia?

Your initial response to the title of this blog post may have been, “Yes, we should always tell the truth,” and “No, we should never lie.” After all, lying is generally considered to be unpleasant, negative behavior, and most of us are taught from a young age that honesty is always the best policy. Many of us will be familiar with the famous quote from Sir Walter Scott in his great 19th century poem, Marmion, “Oh what a tangled web we weave, when first we practice to deceive.”

However, when one is grappling with the day-to-day real world challenges of caring for someone who is living with Alzheimer’s or another form of dementia, carers often struggle with how to deal with or respond to situations or questions where the person they care for is being difficult, unresponsive, hostile or even seemingly absurd, or completely disconnected from reality.

Some might advocate that telling the truth is always the best course of action, no matter how painful it might be to the hearer.  However, when it comes to communicating with a person living with dementia, the issue can sometimes be more complex than a simple foregone conclusion.

People with dementia can often experience confusion, disorientation, and memory loss, which can lead to anxiety and distress. In some cases, telling the truth can actually exacerbate these feelings and make the situation worse.

Creative Lying and Therapeutic Deception

Imagine that a person with dementia is constantly asking about their spouse who passed away many years ago. Telling them the truth, that their spouse is no longer alive, may cause them to repeatedly experience the grief and sadness that flowed from that loss. This can be distressing not only for the person living with dementia but also for their caregivers and loved ones. In such cases, it may be more compassionate and beneficial to tell a “therapeutic lie” instead, such as saying that their spouse is out shopping or visiting a friend.

In other words, many carers believe that it is better to not challenge the absurdity, or reality disconnect in what is being spoken of, but rather to engage with the discussion and take it further, both to keep engagement and discussion going and to avoid the potential consequences of stress, agitation and upset.

Patti Davis, the daughter of US President Ronald Reagan, in her memoir “Floating in the Deep End,” coined the phrase “creative lying,” and how this would cause him to be less flustered when he was worried about missing what he believed to be an important obligation.” 

At a caregiver seminar that I attended in California, a young man who was caring full-time for his mother living with Alzheimer’s, addressed the group and shared that sometimes, usually towards the end of any given week, his mother would start to become difficult, unwilling to communicate with him and even hostile. She would refuse to take her medication. He prefaced what he was about to say with the words, “I apologize if some of you here are offended by this,” and then told the group that when his mother became difficult like this he would pop into the next room and put on a wig and a pair of clear-lens spectacles. He would then go back into the room where his mother was and would greet her by name and introduce himself as “Dr. Wilson” and say that he had come to remind her to take her medication. On every occasion, his mother greeted the “Doctor” warmly and happily took the medication.”

Interestingly, no one in the room full of professional and non-professional family caregivers offered any criticism of his actions at all, as he had clearly found a way to dissolve a difficult situation and achieve a successful conclusion, even though his actions were rooted in deception. 

I also heard a story once about a lady caring for her father who was living with dementia and how he became extremely agitated one day because a college had not sent him his certificate of achievement. This was impossible to resolve, as he had had no connection or involvement with the College in question and was certainly not due any kind of certificate. After a week of seeing her father become increasingly upset, agitated and angry about the failure of the certificate to arrive, his daughter created a Certificate of Achievement and presented her father with it when he enquired as to whether or not it had arrived. Once again, a piece of deliberate deception, but it diffused a difficult situation, dissolved agitation and removed stress.

Protect the Person with Dementia’s Emotional and Mental Well-being

However, it is essential to note that what we have referred to here as Therapeutic, or Creative lying, should only be used when it is necessary to protect the person’s emotional and mental well-being, to eliminate stress or agitation and maintain emotional equilibrium. The word “lying” itself seems so harsh, so absolute, yet we need to remember that, by selectively lying to the person they are caring for, a caregiver is actually supporting that person’s reality; lying to a person with dementia may be the right way to care for that specific person at that specific time because, depending upon the progression of the disease, they may be wholly unable to remember the truth, and repeatedly telling them they are wrong, or insisting on facts will simply cause them distress or pain. As the Alzheimer’s Association has stated, “it is important to put oneself in the shoes of your loved one, and acknowledge how frightening their situation must be.”

It must be noted that not everyone agrees that therapeutic or creative lying is ever the correct decision; they believe that distraction, or gently changing the subject, or rephrasing the question or issue can be just as effective at restoring calm or dissolving stress. This school of thought relies on a gentleness of response that soothes someone with dementia by essentially, avoiding or stepping around the problem or question that is causing anxiety. This approach does tend to assume that the person looking for their loved one, or worrying about a non-existent upcoming meeting, or waiting for a certificate in the mail, will either forget whatever is distressing them, or realize they were mistaken, or even eventually remember the correct facts and thereby peacefully move on.

A Complex and Sensitive Choice

In conclusion, the decision to lie or not to lie to a person with dementia is a complex and sensitive one and people may well have different and sincerely held views. But there does seem to be a significant body of real world evidence that suggests that therapeutic, or creative lying may sometimes be the best option to keep a person calm and maintain their emotional equilibrium. Ultimately, the decision to lie or not must be made on a case-by-case basis, taking into account the person with Alzheimer’s individual needs and circumstances.

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Dealing with Sundowning

sundowning

What is Sundowning?

Dementia is a general term for any condition encompassing memory loss, mental confusion, mood changes and other cognitive impairment issues that increasingly have a detrimental effect upon the ability of the person living with the condition to maintain a normal daily life. Within the scope of dementia, Alzheimer’s disease accounts for possibly up to 80 percent of all dementia cases.

Every person and every case is unique, but some symptoms will be common across many people living with the condition, and one of them is known as Sundowners Syndrome, or Sundowning.

Sundowning is the term given for a situation where a person living with Alzheimer’s disease and other types of dementia may start to experience a worsening of symptoms as the day begins to draw to a close and nightfall approaches.

At present, there is no definitive explanation as to why sundowning occurs, but it is believed that it affects something like 20% of all Alzheimer’s patients.

The progress of Sundowners Snydrome often appears to be in step with the progression of the Alzheimer’s disease itself. As the dementia worsens, so often does the recurrence and severity of the sundowning.

There is still a degree of mystery and uncertainty as to what exactly causes sundowning. There are a number of scientific and medical theories as to what may cause the phenomenon, and there are also believed to be certain “triggers,’ which can either cause or exacerbate it, but it is certainly something that Caregivers should be aware of and ready to try and manage, as far as possible.

The leading theory is that, as the condition of the Alzheimer’s patient worsens, the disease causes neuro-chemical changes in the brain that start to affect the internal biological “clock” of the patient; this can interfere with the part of the brain that would normally signal to a healthy person that it is time to wake up or go to sleep.

When someone experiences sundowning, it does not create any new symptoms, but rather it tends to exacerbate certain of the existing symptoms that the person has already been experiencing, particularly symptoms that adversely affect behavioral characteristics, rendering the person increasingly agitated, irritated, reckless and more and more difficult to manage.

Caregivers have reported that some people experiencing sundowning can become increasingly angry, irritated, anxious, agitated, paranoid and depressed; some even can become violent, hallucinatory, or overly emotional or upset and unable to sleep. Sleep deprivation itself can then contribute to a vicious cycle that can trigger further sundowning episodes.

Sundowning can start to occur from late afternoon and continue until late at night, and this can be especially challenging for a caregiver who may be already exhausted. It then tends to fade and the patient will return to a more normal state.

Common Sundowning Triggers

Sundowning can also potentially be triggered by certain situations or circumstances, and these could include:

  • Fluctuations in light levels – both low light and too much light have been found to be a trigger
  • Depression
  • Boredom
  • Lack of sleep
  • Hunger
  • Pain
  • Raised stress levels
  • Social isolation
  • Infection, such as a urinary tract infection

There is no cure yet for Alzheimer’s disease and, as sundowning is a known symptom that may manifest itself as the disease progresses, there is nothing that can be done to eliminate the phenomenon.

All a caregiver can do is be aware of the potential triggers and avoid them as far as possible, and to be ready to deploy strategies that have in some cases been seen to help manage the symptoms.

Management Strategies:

  1. Try to remain patient and calm

This is perhaps the most difficult of all things to implement, as dementia patients can often be extremely difficult to manage. In such circumstances, patience can be extremely elusive, but a raised voice, or sudden movement or changes in circumstances can worsen the situation

  1. Are there any immediate needs that can be met?

As mentioned above, feelings of hunger, thirst, lack of sleep, or pain, can potentially trigger a sundowning episode.

  1. Create a peaceful and tranquil setting as the day moves into the afternoon

Perhaps consider drawing the curtains early – this will reduce any lowering of light levels in the room as the outside light fades, as this has been noted as a potential sundowning trigger. A tranquil environment, with no distractions also can help, as will reducing noise, or the number of people in the room.

  1. Try to keep the patient active during the day

If possible, try to engage the person you are caring for with activities that will occupy their attention. One of the challenges in caring for someone with dementia is that they are often likely to nap during the day; this makes it harder for them to sleep at night. Board games, puzzles, craft exercises, even watching a favorite movie or TV show can all help.

A Mind to Care was born from a desire to make simple games and activities available to caregivers seeking to engage and retain the attention of people in their care. Many studies have confirmed that activities that engage the mind can significantly increase general well being.

Regular physical exercise can also help.

  1. Diet

Pay close attention to diet. Try to avoid caffeine or high sugar intake, particularly in the afternoon and strive where possible to maintain a good nutritional diet. Avoid alcohol.

  1. Stay Secure

One adverse effect of sundowning is that the patient may become prone to getting up at night, pacing the room, or trying to leave the home. It may be wise to fit locks on doors and windows, and perhaps a gate to prevent access to stairs, to avoid an accident or the patient wandering away and getting lost.

  1. Get some air

A brief walk or a short sit outside can be beneficial, as it is believed that exposure to daylight can help the body to reset its internal clock.

Other Resources about Sundowning are Available

There are many online resources providing advice and support on this and other issues facing caregivers; if you need help finding advice, let us know and we will steer you in the right direction.