Key Points

• Studies show that aromatherapy can be a useful tool in helping common complaints from adults 75 and older.

• It’s important to create aromatherapy synergies for older adults with considerations for thin, delicate skin and possibly compromised kidney, liver, and cardiovascular function.

• The proper application and combinations of botanical oils can relieve anxiety and depression, insomnia, and pain in older adults. 

Aromatherapy is an inherently gentle practice. While essential oils hold great power and potency, they also are gentle enough for all populations, including the frail and elderly. In this article, we’ll discuss gentle aromatherapy treatments that address conditions prevalent in adults 75 and older, as well as condition-specific combinations of essential oils based on their physiological and psychological effects. 

Selected Application Methods 

The aromatherapy synergies discussed in this article are for older adults with thin, delicate skin and possibly compromised kidney, liver, and cardiovascular function. You can safely apply any of the synergies described in this article (unless noted otherwise) through full-body massage, shortened massage of selected body areas, hand and arm massage, foot massage, aroma mist, or diffusion in the client’s living space. 

Every client’s health picture is different, so choose an application method based on the individual’s needs. For example, one client may enjoy a full-body session while another may be in a hospital bed with tubes running to various machines, making a short foot massage the best option. Maybe you’ll touch a client’s hand, talk to them softly, and diffuse aromas into their room, or sit with them and offer an aromatherapy hand and arm massage. Use your best judgment about what the client will safely enjoy and err on the side of caution.  

Application of Aromatherapy Massage 

For full-body massage, massage of selected body areas, hand and arm massage, or foot massage, add six drops of an aromatherapy synergy to one ounce of natural massage oil or cream. Avoid lubricants that contain mineral oil, lanolin, fragrance, or dye, as these ingredients interact negatively with essential oils. Apply the aromatherapy lubricant with massage techniques appropriate to the client’s level of health. Use a plain (no aromatherapy) lubricant on the client’s face if you offer face massage—older adults have thinner skin and are often prone to sensitivity. 

Application of an Aroma Mist 

Combine 6–12 drops of an aromatherapy synergy with one ounce of water in a bottle with a fine-mist top. Show the client how to spritz the mist in a high arc over their head and shoulders, and then have them inhale deeply and slowly as the mist falls around them. Make sure your clients understand that they should avoid spraying directly onto their faces. Some essential oils might absorb through the thin skin of the eyelids and irritate the eyes. 

Application of Aromatherapy Through Diffusion 

When we diffuse essential oils, we spread them into the air of a living space, where we inhale their aromas and enjoy them. A nebulizing diffuser converts volatile plant oils into tiny particles and disperses these particles into the air as a waterless mist that remains suspended for about 80 minutes. Nebulizers produce light aromas and work well for general stress relief and sleep disorders. 

Electric diffusers disperse plant oils in a mist of water and produce more aroma than nebulizing diffusers. Electric diffusers are inexpensive and easy to clean. Choose cold mist diffusers that won’t expose essential oils to heat. You can set diffusers with timers to release oils for 15 minutes every 60–90 minutes. This timing works well when diffusing essential oils for sleep disorders. Add 6–9 drops of an essential oil synergy to a diffuser following the manufacturer’s directions. 

Aromatherapy Benefits for Selected Conditions 

The effects of aromatherapy come from the changes that occur in the body, mind, emotions, and spirit of people exposed to essential oils. From our work as massage therapists, we know that an effect is the result or consequence of an action. When a therapist gives a client a massage (action), the client’s mind and body respond in predictable and sometimes unpredictable ways (effects).

Effects work the same way in aromatherapy. We expose our clients to essential oils (action), and they respond in predictable and sometimes unpredictable ways (effects). Here, we’ll talk about selected essential oils for specific conditions. These oils are appropriate for older adults when used at a 1 percent concentration. 

Anxiety and Depression 

As people age, they live through an increasing number of significant life changes. Their parents die, their children leave home, they retire from careers, and they outlive spouses, siblings, and friends. Physical and health challenges lead to a loss of independence, fear of falling, medication side effects, and concerns about money. Researchers estimate the prevalence of anxiety symptoms in adults ages 65–86 is between 15 and 52 percent. Older adult depression in the general community ranges from 1 to 5 percent but jumps to 11.5 percent during hospitalization and 13.5 percent in those requiring ongoing care.¹ 

For anxiety, combine six drops of lavender (Lavandula angustifolia) with eight drops of bitter orange (Citrus × aurantium) and two drops of ylang ylang (Cananga odorata). Both lavender and bitter orange are agents that calm an overactive amygdala. We know that the amygdala is the brain’s “smoke detector” and is constantly on the lookout for things that might be dangerous. So, when we feel anxiety, it primes the amygdala to be more reactive. Inhaling these amygdala-soothing oils helps reduce the hypervigilance of an overactive amygdala, thereby calming anxiety. 

Ylang ylang is a star-shaped yellow flower that comes from the Philippines. It demonstrates both neurosedative and antidepressant activity. Neurosedatives sedate the central nervous system by slowing down brain activity. 

For depression, combine five drops of frankincense (Boswellia sacra), eight drops of lemon (Citrus limon), and one drop of jasmine (Jasminum grandiflorum). As real jasmine is expensive, you can substitute ylang ylang or clary sage (Salvia sclarea) if you prefer. All three of these essential oils demonstrate notable antidepressant activity in research. Lemon is particularly interesting because it increases noradrenaline, which is stimulating. With depression, people often feel low or stuck, so the inclusion of a noradrenalin stimulant improves energy and boosts mental clarity. 

Older Adults and Dementia 

Research links several essential oils to improved cognitive function and reduced agitation in older adults with dementia.² Regarding improved cognitive function, scientists believe that essential oils high in hydrocarbon monoterpenes (very light molecules) are especially effective because they easily penetrate the skin or the mucus membrane of the respiratory tract, enter systemic circulation, and cross the blood-brain barrier.³

Create a diffuser synergy with nine drops of grapefruit (Citrus × paradisi) and three drops of silver fir (Abies alba). Alternatively, combine eight drops of sweet orange (Citrus sinensis) with four drops of cypress (Cupressus sempervirens). Another option is eight drops of lemon and one drop of eucalyptus (Eucalyptus globulus). Diffuse one of these synergies in the client’s living space during waking hours (not at night, as these formulas may disrupt sleep). 

Approximately 13 studies conducted in resident-care facilities discuss the use of aromatherapy for agitated behavioral issues related to dementia. Unfortunately, each study involved small numbers of participants.⁴ However, four essential oils emerge as possible agents that decrease agitation—lavender, sweet orange, melissa (Melissa officinalis), and Atlas cedarwood (Cedrus atlantica). Try combining five drops of lavender with eight drops of sweet orange, two drops of melissa, and 10 drops of Atlas cedarwood. Diffuse these oils in the client’s living space or combine them with a massage oil and apply them to the skin during a massage. 

Insomnia  

Several inhaled essential oils help people fall asleep, stay asleep, and improve their sleeping and waking patterns. Gamma-aminobutyric acid (GABA) is the primary inhibitory neurotransmitter in the central nervous system. When GABA levels are high, people feel sleepy and relaxed. Bitter orange, clary sage, cypress, frankincense, lavender, melissa, Roman chamomile (Chamaemelum nobile), rose (Rosa × damascena), sandalwood (Santalum album), and valerian (Valeriana fauriei) essential oils demonstrate GABA-promoting effects.⁵ 

Another factor in insomnia is adenosine, which acts as a central nervous system (CNS) depressant to promote sleep and suppress arousal. During the day, adenosine gradually builds up in your CNS, causing sleepiness as the day passes into the night.

During sleep, adenosine binds to receptors to inhibit wakefulness. As a result, levels of adenosine drop. When adenosine levels get low, you wake up, and the process starts over.

In the limited research on adenosine and essential oils, inhalations of hops (Humulus lupulus), lavender, melissa, and valerian facilitated adenosine binding to improve sleep quality.⁶

Combine six drops of lavender with two drops of hops, eight drops of bitter orange, and five drops of frankincense. Add these oils to a carrier oil and apply through massage close to bedtime, or diffuse them at low levels at night. Remember that sleep-promoting oils work best at low or ambient levels. Ambient means below conscious detection. If a room smells strongly of essential oils, it may disrupt sleep. 

Low Immunity 

With age, the immune system becomes slower to respond to threats, and the risk of getting sick increases. We can reduce the occurrence of airborne pathogens by diffusing an essential oil synergy composed of one drop of lemongrass (Cymbopogon citratus), eight drops of bergamot (Citrus bergamia), and two drops of thyme (Thymus vulgaris) in a living space. Don’t apply this blend topically, as lemongrass is a skin irritant, and thyme might burden the kidneys, liver, and cardiovascular system if absorbed through the skin. 

For an immune-boosting massage lubricant, combine four drops of frankincense, two drops of sweet marjoram (Origanum majorana), eight drops of mandarin (Citrus reticulata), and five drops of lavender. Add six drops of this synergy to one ounce of massage oil or cream. 

Pain 

Chronic pain is a common condition encountered by health-care professionals working with older adult clients. Analgesic, anti-inflammatory, and antispasmodic essential oils are potent allies against musculoskeletal pain. Unfortunately, many are too aggressive in their actions to be suitable for use with older adults, even at low concentrations. Try a combination of two drops of sweet marjoram, five drops of lavender, four drops of blue cypress (Callitris columellaris), and three drops of turmeric (Curcuma longa) at a 1 percent concentration in a massage lubricant (six drops of essential oil to one ounce of massage lubricant). 

Even if you can’t massage the area of the body experiencing acute pain, a massage of the hands, feet, or shoulders feels relaxing. It allows essential oils to penetrate the skin and enter blood circulation for a systemic, pain-relieving effect. 

“That’s Nice” 

As we consider how essential oils can be used with our elderly clients, I can’t help but think about my lovely grandmother, Muriel. When she passed, I held her hand, spritzed aromatherapy high above her bed, and recited poetry. She didn’t say much in those last days, but once she said, “Oh, that’s nice,” and tightened her fingers around my hand. It’s a moment I’ll never forget. 

Notes

1. L. E. O. Kennair et al., “Depression, Anxiety, Insomnia, and Quality of Life in a Representative Community Sample of Older Adults Living at Home,” Frontiers in Psychology 13 (2022), https://doi.org/10.3389/fpsyg.2022.811082. 

2. C. Holmes and C. Ballard, “Aromatherapy in Dementia,” Cambridge University Press, 2018. 

3. S. Agatonovic-Kustrin et al., “Models for Skin and Brain Penetration of Major Components from Essential Oils used in Aromatherapy for Dementia Patients,” Journal of Biomolecular Structure and Dynamics 38, no. 8 (2020). 

4. E. L. Ball et al., “Aromatherapy for Dementia,” Cochrane Library Database of Systematic Reviews, August 2020. 

5. L. Huang et al., “Pharmacological Profile of Essential Oils Derived from Lavandula Angustifolia and Melissa Officinalis with Anti-Agitation Properties: Focus on Ligand-Gated Channels,” Journal of Pharmacy and Pharmacology 60, no. 11 (2008); S. Abuhamdah and P. L. Chazot, “Lemon Balm and Lavender Herbal Essential Oils: Old and New Ways to Treat Emotional Disorders,” Current Anaesthesia & Critical Care 19, no. 4 (2008); R. Awad et al., “Effects of Traditionally Used Anxiolytic Botanicals on Enzymes of the Gamma-Aminobutyric Acid (GABA) System,” Canadian Journal of Physiology and Pharmacology 85, no. 9 (2007).

6. T. Fung et al., “Therapeutic Effect and Mechanisms of Essential Oils in Mood Disorders: Interaction between the Nervous and Respiratory Systems,” International Journal of Molecular Sciences 22, no. 9 (2021); R. Schellenberg et al., “The Fixed Combination of Valerian and Hops Acts Via a Central Adenosine Mechanism,” Planta Medica 70, no. 7 (2004); N. M. Stojanovic et al., “Lemon Balm (Melissa officinalis L.) Essential Oil and Citronellal Modulate Anxiety-Related Symptoms—In Vitro and In Vivo Studies,” Journal of Ethnopharmacology 284 (2022).

Resources

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Aponso, M. et al. American Chemical Society. “Relaxation Effects of Essential Oils Are Explained by Their Interactions with Human Brain Neurotransmitter Receptors and Electroencephalography Rhythms.” Neuroscience (2021).

De Sousa, D. P. et al. “Essential Oils and Their Constituents: An Alternative Source for Novel Antidepressants.” Molecules 22, no. 8 (2017).

Dobetsberger C. and G. Buchbauer. “Action of Essential Oils on the Central Nervous System: An Updated Review.” Flavour and Fragrance Journal 26, no. 5 (2011).

Heuberger, E. “Effects of Essential Oils on Human Cognition.” Handbook of Essential Oils: Science, Technology, and Application 3rd ed. CRC Press (2020).

Lizarraga-Valderrama, L. R. “Effects of Essential Oils on Central Nervous System: Focus on Mental Health.” Phytotherapy Research 35, no. 2 (2020). 

Williams, A. “Aromatherapy Foundations for MTs Serious About Authentic Aromatherapy.” Massage Mastery Online, 2021.