10/7/2015. Understand the benefits of using aromatherapy massage in palliative care. Goals of palliative care:
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1 Aromatherapy Massage: Integrative Support in Palliative Care Kathi Sowada MSAOM, RN, LAc, HN-BC Understand the benefits of using aromatherapy massage in palliative care Objectives Goals of palliative care: Prevention and relief of suffering Ensure the best quality of life High incidence of psychological distress Patients with co-morbidities of anxiety and depression tend to experience more severe symptoms and poorer outcomes. Integrative therapies can assist with the goals of palliative care by providing relief from common symptoms. Anxiety Psychological og ca distress Pain Nausea Relevance (Kraft, 2012) Relevance According to the American Nurses Association (ANA) Position Statement, nurses are obligated to provide compassionate and comprehensive endof-life care. This includes promoting comfort and relieving pain. (American Nurses Association, 2010) MN Board of Nursing Statement on Integrative Therapies Ensure patient safety Possess reasonable skill and knowledge Provide patients with information Maintain ethical and quality standards Abide by regulations (Minnesota Board of Nursing, 2010) Relevance Practice considerations 1
2 The benefits of essential oils The benefits of touch The power of presence Touch can help stimulate patient s self awareness Touch can restore a sense of balance and control (Berger, Tavares, & Berger, 2013) Why aromatherapy massage? Why aromatherapy massage? Essential oils: naturally extracted aromatic plant essences Aromatherapy: the therapeutic use of essential oils for holistic healing Used to balance, harmonize, and promote the health of the body, mind, and spirit. Enhances the innate healing process. (National Association for Holistic Aromatherapy, 2015a) Aromatherapy/essential oils Lavender (Lavandula angustifolia) Roman chamomile (Chamaemelum nobile) Ginger (Zingiber officinale) Mandarin (Citrus reticulata) Aromatherapy Calming Comforting Relaxing Useful for Anxiety Insomnia Agitation Headache Calming Soothing Relaxing Useful for: Insomnia Anxiety Anger Frustration Lavender Roman Chamomile 2
3 Warming Stimulating Rejuvenating Useful for Digestive symptoms Pain Cold hands and feet Grounding and strengthening Ginger Calming Soothing Uplifting Useful for: Stimulating appetite Headaches Nervous tension Depression Mandarin Jojoba (Simmondsia chinensis) Coconut (Cocos nucifera) Sesame (Sesamum indicum) Sweet Almond (Prunus amygdalis var. dulcis) Apricot Kernel (Prunus armeniaca) Carrier oils Quality Chemical composition Method of application Safety considerations Dosage/ Skin integrity Age In case of skin reaction or exposure to mucous membranes: Dilute area with oil-based substance (carrier oil, vegetable oil, cream, honey) Rinse with water Observe area Safety considerations Safety considerations (National Association for Holistic Aromatherapy, 2015b) 3
4 Sensitivity of patient Carrier oil 0.5% 1% 2.5% 3% 5% ½ ounce 1-2 drops 3 drops 7-8 drops 9 drops 15 drops 1 ounce 3 drops 6 drops 15 drops 18 drops 30 drops 2 ounces 6 drops 12 drops 30 drops 36 drops 60 drops 4 ounces 12 drops 24 drops 60 drops 72 drops 120 drops Presence of rashes, lesions, or wounds Intravenous access in the hand Deep vein thrombosis in the arm Excessive bruising (Kolcaba, Dowd, Steiner, & Mitzel, 2004) Blending a massage oil Massage considerations Appropriate for those who are fragile or approaching end of life Easy to learn Different from massage Series of stroking movements Set sequence: 3 repetitions of each step Set pressure: 3 out of 10 Set pace: slow and constant Can encourage loved-ones to be involved (Wellings, 2015) M technique (Wellings, 2015) M technique Position patient and self comfortably. Warm oil or lotion in hands. Apply oil to hand and forearm in 3 long strokes. Avoid damaged or inflamed skin. M technique 4
5 Rub top of hand with thumbs Center going outward Wrist to knuckles Beginning at little finger Circle each joint 3 times Repeat 3 times Scissor hold and press tip of finger Pull down from knuckle to tip Repeat each finger Turn hand over, palm up With thumbs, rub from center to outer From wrist to knuckles Repeat 3 times Turn hand back over, palm down Rub up and down forearm 3 times Repeat technique on other hand National Association for Holistic Aromatherapy M technique YouTube video Learning the M technique Helpful Resources 5
6 American Nurses Association (ANA). (2010). Position statement: Registered nurses roles and responsibilities in providing expert care and counseling at the end of life. Retrieved from Statements/etpain14426.pdf Berger, L., Tavares, M., & Berger, B. (2013). A Canadian experience of integrating complementary therapy in a hospital palliative care unit. Journal of Palliative Medicine, 16(10), Kolcaba, K., Dowd, T., Steiner, R., & Mitzel, A. (2004). Efficacy of hand massage for enhancing the comfort of hospice patients. Journal of Hospice and Palliative Nursing, 6(2), Kraft, K. (2012). CAM for depression, anxiety, grief, and other symptoms in palliative care. Progress in Palliative Care, 20(5), Minnesota Board of Nursing. (2015). Statement of accountability for utilization of integrative therapies in nursing practice. Retrieved from National Association for Holistic Aromatherapy. (2015a). What is aromatherapy? Retrieved from National Association for Holistic Aromatherapy. (2015b). General safety guidelines. Retrieved from Roberts, K. & Campbell, H. (2011). Using the M-technique as therapy for patients at the end of life: Two case studies. International Journal of Palliative Nursing, 17(3), Wellings, V. (2015). Applying the M technique in palliative and end-of-life care. British Journal of Healthcare Assistants, 9(4), References 6
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