Introduction

The approaches to palliative and supportive care are holistic; they differ in philosophy from curative strategies in that they focus primarily on the consequences of a disease rather than on its cause or specific cure – they are pragmatic and multidisciplinary, with very little distinction between palliation and support (National Council for Hospice and Specialist Palliative Care Services [NCHSPCS] 2000). This chapter gives an insight into palliative and supportive care, together with the use of essential oils. With the help of aromatherapy, people have enjoyed a quality of life better than they might otherwise have experienced.

Defining palliative and supportive care

Although originally written for those with cancer, the definitions of palliative and supportive care ‘…can be used for people with any life-threatening illness.’ (National Council for Palliative Care [NCPC] 2002)

Supportive care helps patients and their families to cope with cancer and its treatment – through the process of diagnosis and treatment, to continuing illness, possible cure or death and into bereavement. (NICE 2004). Where cure is not an option, care is focused on helping them through the difficult times ahead and maintaining optimum independence with the best quality of life possible. Supportive care is an integral part of palliative care.

Palliative care involves the total care of patients with advanced progressive illness which no longer responds to curative treatment. It is needed when the best quality of life for them and their families becomes the most important issue, and where the management of pain and other symptoms, and the provision of psychological, social and spiritual support, are paramount. Palliative care neither hastens nor postpones death: it merely recognizes a patient’s right to spend as much time as possible at home, and pays equal attention to physical, psychological, social and spiritual aspects of care wherever the patient is (World Health Organization [WHO] 1990).

Palliative and supportive care does not see the patient in isolation but as part of a family unit – whatever that family unit might be. Many patients die in residential care where members of staff and other residents are part of the ‘family’: indeed, they may be the only ‘family’, and therefore experience the loss themselves. Those providing day-to-day care and support to patients and carers are facing the reality of death – it is often forgotten that they too need support.

Aromatherapists could teach a simple massage technique to these people – even the patient – to give them the opportunity to give and receive caring touch. It can be a transforming experience, as so often the loved ones feel helpless in not knowing how to show they care, or are frightened of ‘doing the wrong thing’. Similarly, the patient often feels s/he is giving nothing in return for the love and care shown, and being able to participate in a simple massage can make a world of difference.

End of life care – the definition suggested by the NCPC states that: ‘….all those with advanced, progressive, incurable illness….’ should be given such care. When this final stage begins is difficult to determine as it depends on many factors, not least on individual personal and professional points of view and the nature of the condition.

Decline at the end of life (see also, below, under Common characteristics) falls broadly into three main categories, those who will:

(Department of Health [DOH] 2008 End of Life Care Strategy).

Palliative and supportive care requires the expertise of a multidisciplinary team whose members include doctors, nurses, physiotherapists, occupational therapists, social workers, clergy, counsellors, complementary therapists etc., but to be effective it must be tailored to the needs of patients and their families. Often both palliative and supportive care are provided by the patient’s family and other carers, and not exclusively by professionals (NICE 2004). The aromatherapist, even if treating a patient independently, is still part of the team and should recognize the importance of keeping the team informed of his/her part in the patient’s care.

The disorders involved

Until now, palliative and supportive care has been largely confined to those with cancer – at least 50% of all patients in the UK with this condition will have had such care at some time in the course of their illness (Addington-Hall 1998). However, in developed countries more people die of chronic circulatory and respiratory conditions such as chronic heart disease (CHD), stroke and chronic obstructive pulmonary disease (COPD). Few palliative care services have focused on their needs or those of others with non-cancerous life-limiting conditions when they near the end of their life (NICE 2003; Ahmedzai 2006; Gore et al. 2000).

The ageing population is increasing rapidly – it is estimated that by 2033 in the UK, 23% of the population will be over the age of 65 (Office of National Statistics 2009). Many, if not most, will have two or more coexisting chronic conditions that will significantly impair their quality of life. Palliative and supportive care has now broadened to include all those with life-limiting conditions, notably:

Pain – an example of the complex nature of a symptom

According to Twycross and Lack (1984) the perception of pain is modulated by the patient’s mood and morale, the meaning of pain to the patient and the

fact that pain may remain intractable if mental and social factors are ignored.

Pain is a warning of actual or potential tissue damage or pathology and creates some muscle tension (guarding) to protect the area. It elicits an arousal and an emotional response, and is modified by mental state and emotions (Marieb 1998). Most people with pain usually become anxious about the possible implications; this leads to more muscle tension, and muscle tension increases the pain that increases the emotional response, and so on, each perpetuating the other into a vicious circle that can become a spiralling process (McCaffery & Beebe 1989).

Localized pain and essential oils

Massage with analgesic essential oils brings its own benefits, but if massage is not advisable the application of essential oils in a lotion – or with a compress or spray – can also bring a reduction in pain.

Factors to be considered that might be contributing to the pain include inflammation, tension, swelling or nerve involvement etc. A significant reduction in pain may possibly be achieved by using the following.

Oils containing esters and sesquiterpenes, which are generally regarded to be anti-inflammatory, antispasmodic and calming, making them very useful for pain, include Chamaemelum nobile [Roman chamomile], Lavandula angustifolia [lavender] and Citrus aurantium var. amara (fol) [neroli].

Box 15.1 Some factors affecting pain threshold

Threshold lowered by:	Threshold raised by:
Discomfort Insomnia Fatigue Anxiety Fear Anger Sadness Depression Boredom Introversion Mental isolation Social abandonment	Relief of symptoms Sleep Rest Sympathy Understanding Companionship Diversional activity Reduction of anxiety Elevation of mood Analgesics Anxiolytics Antidepressants

  Page 278 

Pogostemon patchouli [patchouli] and Commiphora myrrha [myrrh] are also anti-inflammatory, and Lavandula angustifolia [lavender] and Zingiber officinale [ginger] are useful for their analgesic properties.

Where there is pain combined with anxiety or depression Cooper has found a blend of Boswellia carteri and Commiphora myrrha to be most helpful.

Figure 15.1 • Pain spiral

From observing, listening and talking to patients over many years, Sue Whyte believes that the principle of the pain spiral may apply to other physical symptoms the patient may experience. Similarly, their general outlook on life will contribute to their mood and confidence; the coping strategies they use – and their personality – do not usually change because they are ill, although they may subsequently do so. The effects of the close, subtle interplay between the physical, psychological, social and spiritual aspects should never be underestimated. Any negative factors in the person’s life will lower their tolerance level to symptoms, whereas positive ones will raise it. Most people, when in low spirits, find that everything seems to be worse; likewise, when feeling full of the joys of spring, they can cope with anything. Illness is no different. However, even the most cheerful and positive of people can be knocked off balance and succumb to physical symptoms that nothing seems to ease. For example, feeling sick all the time – made worse by the sight, smell and sometimes even just the thought of certain things – can be a major problem for some patients, making them more anxious and distressed.

In Chapter 8, Price discusses the effects that essential oils have on the emotions, which may or may not be a placebo response: according to Tisserand, if a smell is appealing, it soothes the mind (Tisserand 1992 p. 99). Placebo or not, if the experience of aromatherapy is pleasant and relaxing, even for a short time, it will surely have some beneficial effect on the patient’s mood and morale long enough to interrupt the vicious circle, thus helping them relax (Hadfield 2001), enhancing factors that raise a person’s tolerance level to their situation. This has a dual effect:

• it enables the patient to cope more effectively with their illness and day to day problems

• by reducing stress alone, pressure on the immune system is lessened (Alexander 2001, Fujiwara et al. 2002, Kuriyama et al. 2005).

Evidence from various studies discussed and cited by Tavares (2003) is encouraging, as it supports much of the anecdotal evidence given in many books and articles regarding the positive effect aromatherapy and massage can have on symptoms and quality of life (Bowers 2006, Corner et al. 1995; Downer et al. 1994; Gatti & Cajola 1923; Grealish et al. 2000; Lee & Lee 1992; Pan et al. 2000; Wilkinson et al. 1999; Wilkinson S. et al. 2006).

Aromatherapy intervention

Cancer, HIV/AIDS, MND etc. are not in themselves a contraindication to massage or aromatherapy treatment. Irrespective of the disorder, holistic principles still apply – it is the person who is being treated, not the disease. This does not mean that specific problems cannot sometimes be helped by the judicious use of essential oils with or without massage. If in doubt, do not treat the person without discussing the situation with an experienced aromatherapist working in palliative care, nursing or medical staff. In many cases the doctor or nurse will have limited understanding of the use of massage and essential oils, unless the practice of aromatherapy has been established in the service. There is, however, a growing number of specialist aromatherapists who have worked in palliative care for many years who may be contacted through the local hospice or professional aromatherapy organizations such as IFPA or the National Association of Complementary Therapists in Hospice and Palliative Care (NACTHPC).

Nevertheless, when a patient is expecting aromatherapy, it is important that they receive some form of treatment, providing it is safe and likely to give benefit. If it is unsuitable, an explanation should be given as to why, along with possible alternatives or an appropriate referral.

Aromatherapists need to be sensitive to complex situations and be able to adapt their approach and treatments accordingly. Working with patients in palliative care requires some knowledge and understanding of the disease processes, the medical interventions involved, and how these affect patients and their families. This will then enable the therapist to assess a patient fully and determine the most appropriate aromatherapy treatment.

Use of essential oils

Essential oils may be considered safe, as they are used in low concentrations. However, where a boost is needed, the careful clinical application of a higher concentration has proved safe and effective.

Although there is no conclusive evidence that some oils have oestrogen-like properties, it is preferable to err on the side of caution in their use with patients who have oestrogen-dependent tumours (Tisserand & Balacs 1995, Sheppard-Hanger et al. 1994). If there is doubt about the significance of any symptoms and signs found during consultation or the safety of using essential oils and/or massage, the aromatherapist must discuss this with the other professionals on the team.

A ‘nite-lite’ vaporizer with a naked flame is not permitted in hospitals, but may be encountered in the home. It should always be placed in a safe position and never left unattended.

Cautions and contraindications

As the purpose of aromatherapy is to bring a net gain to patients, weighing up any contraindications to the use of essential oils or massage against the potential benefits is very important, especially at a distressing time for a patient.

• Some diseases and/or their treatments can alter a person’s sense of smell and taste, the fragrance of some essential oils perhaps being intensely disliked; although some patients are able to tolerate oils which may bring relief, others find even pleasant smells abhorrent.

• Nausea may be a contraindication, especially if severe or likely to be recurrent, because:

just the thought of smelling anything can be nauseating

an essential oil (smell) given to relieve nausea – especially if repeated – may at a later date evoke unpleasant memories and/or precipitate nausea and vomiting, i.e. the Pavlov response. The likelihood of this happening is reduced if a blend of two to four oils is used, e.g. Pimpinella anisum, Foeniculum vulgare var. dulce [sweet fennel], Mentha x piperita [peppermint] and Anthemis nobilis [Roman chamomile] (Gilligan 2005).

• Account should be taken of the possible adverse effect the aroma might have on other patients in the room.

• Seizures and epileptic fits can be precipitated by smells – check with staff or family if this is a possibility.

• Skin allergies or sensitivities: patients undergoing palliative chemotherapy often have increased skin sensitivity – if in doubt do a patch test first.

• Be aware of patients with asthma or other respiratory conditions, as volatile substances can precipitate coughing or aggravate breathing difficulty. However, chosen with care, essential oils can bring fast relief. They can help panic attacks associated with severe breathing difficulties (both Whyte and Cooper have found that Myrtus communis [green myrtle] inhaled from a tissue has a calming effect on breathing, especially when severe anxiety is present.

• Cooper has found the following essential oil blend to be useful for respiratory symptoms that occur frequently in lung cancer – shortness of breath, discomfort, upper body tension, potential infection and coughing:

  Page 280 

Pinus sylvestris [pine], Cedrus atlantica [cedarwood], Boswellia carteri [frankincense] and Melaleuca viridiflora [niaouli] (see also Appendix A2 on the CD-ROM).

The essential oil blend alone can be used in inhalation; it can also be put into carrier oil for gentle upper body massage or into a lotion as a chest rub. Using these methods, patients have frequently reported less upper body tension and discomfort, easier breathing and a feeling of control. Having something to use themselves which is not a medical intervention and for which they have a choice appears to empower the person.

Another blend, Picea mariana [black spruce] and Abies balsamea [Canadian balsam], can be useful for inhalation by breathless, fatigued patients.

Massage

There is confusion in many people’s minds concerning the use of massage with those who have cancer. Books and courses often say that it is contraindicated, yet massage and aromatherapy are two of the most popular and frequently used therapies in palliative and supportive care (Lewith et al. 2002, Macmillan 2002). This paradoxical situation has arisen because many believe that massage can spread cancer cells through the body by stimulating the lymphatic and vascular circulation. Breathing and the normal physical activity of daily life also stimulate the flow of blood and lymph, and if patients feel well enough they are encouraged to take exercise within their own tolerance level (Sikora K personal communication). Massage would appear to be safe as long as it is gentle and pressure over tumour sites and lymph glands is avoided (Holey &Cook 2003, McNamara 2004).

Unless people with a chronic illness are fairly robust physically and feeling reasonably well, it is unlikely they would tolerate a whole body massage, and in those who can, it would probably be modified – omitting particular areas such as the abdomen or chest. For others, it is more likely to be a part body massage such as the feet or back and shoulders etc., or, in the case of the very frail, holding hands and perhaps stroking.

Preventing cross-infection

As a result of their condition and/or treatments, patients’ immune systems are often highly compromised, making them more vulnerable to infection. This is more likely to occur when they are debilitated. It is incumbent on therapists to make themselves familiar with universal infection control procedures if they are working in an environment such as a hospital or hospice, where they may come into contact with patients’ body fluids. Similarly, if treating people with infections such as methicillin-resistant Staphylococcus aureus (MRSA), advice should be sought on local infection control procedures.

An aromatherapist in good health with good energy levels, following a high standard of hygiene and infection control practices, will have a minimal risk of cross-infection. To prevent this, aromatherapists should follow basic hygiene practices at all times, the most important being thorough hand washing before and after treating a patient (even if gloves have been used), plus the judicious use of essential oils, many of which have been proved to suppress S. aureus and other microorganisms (Moon, Wilkinson, & Cavanagh 2006, Williams et al. 1998, Caelli et al. 2000).

Essential oil blends

The following information is based on Cooper’s experience over more than 16 years of using essential oils in an NHS integrated supportive and palliative care service:

Mouth ulcers due to chemotherapy or disease in the mouth

5 mL Calendula officinalis macerated [marigold] – promotes healing and reduces inflammation (Fleischner 1985, ESCOP, Price & Price 2008

2 drops Commiphora myrrha [myrrh] – contains a high proportion of anti-inflammatory and slightly analgesic sesquiterpenes and antiseptic alcohols

Apply 1 drop directly to the mouth ulcer using a cotton bud three times a day.

Candida in the mouth

1 drop Aniba rosaeodora [rosewood] (or Melaleuca alternifolia [tea tree]) in honey and water – to be used as a mouth rinse 3–5 times a day.

Tea tree is perfect for treating mucous membrane infections of the mouth and gums, and for Candida-related infections (Schnaubelt 1998).

Rosewood contains up to 90% alcohols, which are antifungal, antiseptic and free from irritation.

Vaginal Candida

3 drops Aniba rosaeodora – antifungal, anti-infectious, antiviral

2 drops Lavandula angustifolia [lavender] – antiviral, antiseptic

Use in the bath frequently and in white lotion for direct application.

Malodour due to discharging or fungating wounds

The following oils appear to be useful in practice although they have not been tested for their odour fighting effects.

Vaporize Thymus vulgaris ct. thymol, ct. linalool [sweet thyme] with Eucalyptus citriodora [lemon scented gum], or Citrus bergamia [bergamot] with Lavandula angustifolia

As an alternative or addition to vaporization, place a few drops of the oils on a pad and place over the top of any wound dressings.

Case 15.3 Dry cracked skin on feet and legs

Rachel Clark, BSc, MIFPA

Assessment

Mrs B (62) was diagnosed with chronic obstructive pulmonary disease. She used to be active and finds it difficult to cope with the present loss of independence. She is on portable oxygen, enabling her to get out of the house, but is frustrated by being unable to do things she would like to do and wants to get back to work. Mrs B becomes very breathless on exertion and feels panicky in enclosed spaces; most of her joints ache, she aches particularly in her chest, and gets cramp regularly (a side effect of seretide inhalers).

Mrs B has suffered with painful, cracked and dry skin on her feet and elbows for the last 2½ years, during which time she has tried numerous proprietary lotions and creams, with little or no relief.

Intervention

An aromatherapy blend was prescribed for her to apply morning and night:

70 mL white carrier lotion, 20 mL shea butter and 10 mL Calendula officinalis (to aid healing) were blended to create an emollient base to retain moisture. Essential oils added were:

• 5 drops Lavandula angustifolia – antibacterial, anti-inflammatory

• 5 drops Boswellia carteri [frankincense] – calming, anti-inflammatory, cicatrizant 2 drops Melaleuca alternifolia [tea tree] – antifungal, anti-inflammatory, phlebotonic

• 2 drops of Santalum album [sandalwood] – skin healing (anecdotal evidence).

Outcome

Mrs B used the cream twice daily for 3 months, the improvement being noticeable after 2 weeks, and the texture of her skin gradually improved. She now uses the blend less often: the skin on her legs, feet and elbows is visibly better. She is pleased with the result and was able to enjoy Christmas free from the usual discomfort and pain.

  Page 283 

Pruritus (skin itching)

A specific blend of essential oils may be combined with a lotion base for symptoms that may not be responding to medical treatment, for example itchy skin complaints, or to help with pain relief (Clark, 2010).

In 15 years Cooper has not found anything better than the (Shirley Price’s recipe of Santalum album, Lavandula angustifolia and Mentha x piperita in white lotion; she uses it extensively for pruritus associated with liver disease and jaundice. It often gives more relief than any prescribed medication, and patients frequently say it is the best relief they have had. The excellent effect is well known in the Walsall area, with Macmillan nurses, hospice nurses and palliative care consultants all requesting it for their patients.

For patients with a sensitivity to menthol, Anthemis nobilis [Roman chamomile] has been used to good effect in place of Mentha piperita.

The following blends have been used by the specialist complementary therapy team in NHS Walsall working with Cooper after receiving positive evaluation and feedback from users.

Bone/joint pain or discomfort

A blend of 50 mL carrier lotion with the following essential oils has consistently proved effective in relieving this type of pain.

Commiphora myrrha [myrrha] – anti-inflammatory

Boswellia carteri [frankincense] – analgesic, anti-inflammatory

Melaleuca viridiflora [niaouli] – analgesic, anti-inflammatory

In an audit carried out in NHS Walsall during 2009 it gave partial or good relief to 100% of patients who used it, being the only one in the audit to give relief to all users (see Box 15.2).

Box 15.2 NHS Community Health – Complementary Therapy Audit Aromatherapy Prescription Blends audit – April 2009 – December 2009

Aromatherapy blends are given to patients as a support to symptom control in cancer care, palliative and end of life care.

Standard blends developed by the team have previously shown effectiveness to help relieve the following common problems: anxiety, insomnia, bone/joint pain, dry skin, pruritus (itching) and hot flushes.

Other blends are provided for other symptoms or for the above problems as an alternative if needed.

Each blend is based on the chemical components present in essential oils and these are blended to give the best synergy and chemical combination for optimum therapeutic effect.

Reasons for the audit

a) To discover to what degree patients felt the blend had relieved their problem or symptom, i.e. good relief, partial relief, no relief or made symptoms worse

b) To discover if the patients experienced any negative side effects from the prescription blend

c) To obtain patients’ comments of the effectiveness of aromatherapy blends supplied by the complementary therapy team

A simple audit questionnaire was developed and given to each patient who received a blend (see Box 15.3).

Sample of comments made by patients on audit questionnaires

• Excellent service and I would like to thank the NHS for making it available.

• The blends helped with relaxation – I did not feel so tense after using blends.

• Inhaling the oil gives me a uplifting experience and relives the nausea.

• Eases pain – no analgesic pain killers taken now due to this cream.

• It does help with sleeping.

• Feels much more comfortable, skin less dry, less itching and feet no longer feel like the skin is cracking – appear better visually.

• Just to say thank you for this cream – it really works. Thank you for the therapy and such fantastic service and staff.

• Very effective to help with nausea after chemotherapy.

• Very pleasant smell and very easy to use, easily absorbed – helps peripheral neuropathy.

Findings and recommendations

The outcome of the audit is extremely positive, indicating that patients welcome these complementary approaches as a beneficial supportive treatment option in their care. Figures from the audit indicate that 91% of patients had relief from symptoms by using these blends, 58% had good relief and 33% had some relief. Only two patients out of 139 answered yes to negative effects as a result of using blends.

It appears that individual blending for patients on a one to one basis is slightly more effective than standard blending. The team recommends, however, that all but one standard blend should continue to be used as the success rate is good.

The blend provided for bone and joint pain gave relief to 100% of patients, which may indicate a case for further research, as some patients felt that it was better than non steroidal anti-inflammatory drugs.

It is recommended that:

• the standard blend for hot flushes be removed as this appears to be the least effective

• individual aromatherapy blends should continue to be provided on a needs basis

• the therapist should use their professional judgement in deciding on a standard or individual blend.

Box 15.3 Results for standard blends

Results for standard blends are as follows

This shows that 91% of patients stated some relief, 43% being good and 48% being partial; 8% showed no relief.

Other non-standard blends as above showed 91% of patients reporting some relief from symptoms: 68% received good relief, 23% partial relief and 9% indicated no relief.

Overall blends indicated by patients: 58% gave good relief, 33% gave partial relief and 9% gave no relief. This shows that 91% of patients had some relief of symptoms from treatment with aromatherapy blends.

Case 15.4 Myeloma

Gill Price, MIFPA

Aromatherapist

Assessment

Sarah (52) was diagnosed with myeloma. She was low in mood, tearful, suffering from anxiety, and had considerable pain in her shoulders. In 2002 she received radiotherapy and spinal surgery with rods and plates, and also had a spinal fusion of T4–T7.

Intervention

A course of reflexology did not help the pain. Aromatherapy was tried to help reduce the discomfort between the shoulders and the pain to the right shoulder and side of neck.

A blend of essential oils in sunflower oil was used.

• Zingiber officinalis [ginger] – analgesic, general tonic

• Citrus limon [lemon] – anti-inflammatory, calming

• Origanum majorana [marjoram] – analgesic, calming.

Gentle effleurage was given to the upper back and trapezius muscle, which was very hard and tense. After a few minutes Sarah commented that she could feel the heat penetrating the muscle and she began to relax.

For 5 weeks Sarah had a weekly 20-minute massage treatment and was given a lotion incorporating the same oils for use every morning and evening.

Outcome

Sarah reported a significant reduction in pain in her right shoulder and upper back; she also appreciated the feeling of wellbeing gained from the treatment.

  Page 284 

  Page 285 

Dry, cracked, fingertips (often seen as a side effect of cancer drug treatments)

Excellent results were achieved from a blend of:

100 mL carrier lotion, 25 mL shea butter and 15 mL calendula oil with 5 drops each of the following analgesic, anti-inflammatory and cicatrizant oils:

Boswellia carteri [frankincense] and Lavandula angustifolia

2 drops of Melaleuca alternifolia [Tea tree] – also anti-infectious

2 drops Santalum album [sandalwood] – anti-infectious, decongestant and moisturizing to the skin.

Evaluation stated relief of symptoms in 48 hours.

  Page 286 

Further use of this blend has proved helpful for very dry skin and also on patients prone to cellulites; definite improvements were noted.

Case 15.5 Skin soreness

Tracey Dickie

aromatherapist

Client assessment

T was a 75-year-old man diagnosed with cancer of the larynx; he had had surgery for tumour removal 6 months ago and had completed a course of radiotherapy to the neck and right side of his face. He was now 7 days post radiotherapy.

T’s main complaint was a soreness and burning sensation to his face and neck, which meant he was unable to shave. This upset him greatly, as he took pride in his appearance: wearing a shirt and tie was difficult as this rubbed on the skin on his neck. Use of an aqueous cream had not helped.

Intervention

An aromatherapy blend was mixed to alleviate T’s discomfort and was applied twice daily to his cheeks, chin and neck for 1 week.

• 60 g aloe vera gel – soothing to the skin

• 30 drops Chamaemelum nobile [Roman chamomile] – anti-inflammatory, soothes irritation.

Outcome

A week later T was clean shaven and wearing his tie. The gel had provided relief from the burning and soreness (he said ‘the scent wasn’t too bad either’!). T continued to use the gel for 1 month, reducing the application to once daily, after which he discontinued it. No further soreness of burning sensation was experienced.

Inflamed sore, cracked, fingers and toes (Possible side effect of chemotherapy tablets)

90 mL carrier lotion, 10 mL evening primrose oil with 5 drops each of:

Rosa damascena [rose otto] – anti-infectious, anti-inflammatory, cicatrizant

Santalum album – properties as above

Pelargonium graveolens [geranium] – analgesic, anti-infectious, anti-inflammatory, antiseptic, cicatrizant

Good results have been achieved after 7 days use of this blend – hands softened and healed and feet able to be walked on again.

Summary

With its popularity continuing to grow, aromatherapy is one of the three most frequently used complementary therapies provided by hospices and palliative care units in the UK – the other two being massage and reflexology (Wilkes 1992; Macmillan Cancer Relief 2002).

The effects of caring touch should never be underestimated, the shared experience between the giver and the recipient being to their mutual benefit. Aromatherapy massage and therapeutic touch are pleasant, non-clinical experiences, and the use of essential oils provides another clinical tool in healthcare practice, giving both professionals and patients a further choice along the healing or therapeutic pathway.