1. A large percentage of the patient population served on Senior
Behavioral Medicine Unit (SBMU) has a diagnosis of dementia. SBMU
patients commonly present for treatment due to increased confusion,
agitation, and aggression. In some patients, these behaviors further
increase between 3-6 pm. This is known as sundowning. Sundowning
leads to a more disruptive, stressful milieu for patients and staff alike.
Several recent studies have reported beneficial reductions in agitated
behavior with the utilization of aromatherapy. If the SBMU team can
reduce or lessen the impact of the associated behaviors of dementia
patients, then this will positively impact patient care, patient
satisfaction, and staff satisfaction. The unit will also experience a less
disruptive and stressful milieu for both patients and staff. This impact
could, ultimately, have a positive effect on patient disposition, as well.
Thus, allowing patient placement and discharge to occur in a shorter
amount of time, reducing overall length of stay.
2. • Goal # 1: Statistically significant reduction in overall average behavior
scale score (Maximum score = 16) for the patients, as a group, on
aromatherapy day versus placebo day.
• Goal # 2: Total number of patients experiencing an improvement in the
Pittsburg Agitation Scale score (PAS) on aromatherapy day versus placebo
day.
• Goal # 3: Statistically significant reduction in the use of the total number
of adjunct behavior interventions for the patients, as a group, on
aromatherapy day versus placebo day.
• Goal # 4: Total number of patients requiring the use of adjunct behavior
interventions will be reduced.
• Goal # 5: Statistically significant increase in the median number of sleep
hours for the patients, as a group, on aromatherapy day versus placebo
day.
3. • Lavender was diffused in the SBMU
dining room and in front of the
nurse’s station from 3-5pm, May 19,
2014 - May 28, 2014, alternating with
placebo every other day.
• A nose plugged rater assessed the
behavior of patients for one hour
following the diffusion period,
utilizing the PAS.
• In addition, the number of sleep
hours and adjunct behavior
interventions, such as PRN
medications, merry walker
utilization, and seclusion were noted
during this timeframe.
• Data was analyzed to determine
efficacy.
4. • Share the results with the SBMU nursing staff and physician.
• Engage an aromatherapy champion to serve as a change agent to lead the
team in further utilization of the technique.
• Implement standardized, nightly utilization of lavender to enhance sleep
for all SBMU patients.
5. • PAS score did not correlate
with statistically significance
data.
• Three PRN medications were
utilized on placebo days,
whereas no PRN medications
were utilized on lavender
days.
• The difference in sleep hours
was statistically significant,
very significant!
• Lavender promotes better
sleep!
6. Holmes, C., et al. (2002). Lavender oil as a treatment for
agitated behavior in severe dementia. International Journal
of Geriatric Psychiatry, 17, 305-308.
