Sunday, May 27, 2012

Relaxation Through Aromatherapy ...

"The sense of smell can be extraordinarily evocative, bringing back pictures, as sharp as photographs, of scenes that had left the conscious mind." 
                                                              Thalassa Cruso      


This morning, as I started my walk at the lake, I was met by a heady waft of clove-scented air, a breeze from the botanical gardens nearby. I knew, at once, that the row of salmon-pink azaleas behind "our bench" by the waterfall must be in bloom.

As had so often been the case in the springs since my husband's death, the fragrance of those azaleas transported me back to the last spring day that we sat on the bench together listening to the sound of the water and relaxing in the warmth of the sun. Immediately, my breathing deepened and slowed, my body relaxed and my mind returned to the peace of that lovely day. I stood still for several moments, breathing in the scented air, lost in a far-away time.

Our sense of smell, or olfactory sense, - with us from the time of birth, inextricably wound in our memory mechanisms, and particularly strong in people who are anxious - is powerfully evocative, both of good times and bad. (eg Soldiers' war memories can be triggered by the smell of diesel oil or gun powder, caregivers' trauma memories may be triggered by the antiseptic smells of clinics and hospital emergency rooms, those who've lost a loved one may find funeral memories activated by the scent of lilies or lilacs.)  This knowledge that humans can be strongly affected, emotionally and physiologically, by certain scents has been used by healers since ancient times and, today, forms the basis of aromatherapy practice.

While not widely accepted in North American medicine, aromatherapy is taught in French medical schools, prescribed by European physicians, reimbursed by many European health insurers and used in Japanese factories to enhance worker productivity. In the US, it is used increasingly among clinical aromatherapists and nursing practitioners. (Butje et al, 2008)

Research findings regarding the effectiveness of aromatherapy on its own, when separated from other practices such as massage therapy, are scant and the results are mixed due, in part, to methodological issues in the studies themselves. Despite this, most evaluators have urged continuing evaluation with improved methodology. The best treatment results have been found in cases where aromatherapy was tailored to the individual client by an experienced and holistically trained aromatherapist.

Inhaled scents have been shown to cause immediate changes in blood pressure, muscle tension, skin temperature, heart rate, and brain wave patterns and they also activate the release of neurotransmitters such as serotonin, endorphins and norepinephrine in the brain and to modulate neuroreceptors in the immune system, altering mood, reducing anxiety, and interrupting the stress response. (d'Angelo, 2002)

Another study has demonstrated a significant reduction in the use of both injectable and oral medications, and the need for restraints, when adolescents in a residential mental health facility were given a choice between these measures and aromatherapy when they were agitated (Fowler, 2006). Yet other studies showed a reduction in anxiety through the use of orange or lavender scents in dental patients awaiting treatment (Lehrner et al, 2005) and in anxiety in hemodialysis patients when lavender was used (Itai et al, 2000).

Interestingly, in a small study of 17 terminally-ill cancer patients who improved psychologically and physiologically through aromatherapy, though not significantly, the patients' caregivers reported increases in their own relaxation and sense of well-being during the lavender treatments (Louis and Kowalski, 2002).

Aromatherapists use specific combinations of aromatic oils delivered in specific ways for different types of emotional distress. (eg sandalwood, lavender and bergamot inhalations for anxiety, fear and panic attacks; sandalwood, lavender and lemon inhalations for chronic worry and overthinking; clary sage, geranium and lemon spray for depression; bergamot, lavender and roman chamomile lotion for insomnia; and jasmine, bergamot and clary sage bath salts for stress and tension, among others).

Though more research needs to be done, it is clear that the potential of aromatherapy as an accessible, low cost, low side-effect alternative to (some) psychopharmacology is promising.

Friday, May 18, 2012

Resources for Kids Who Are Caregivers ...

Hi everyone - Happy Victoria Day long weekend! I want to start off the weekend with some news about a great new-to-me resource for children and teens who are family caregivers.

I have written in the past about a most vulnerable and invisible population of family caregivers - children who care for a family member who is ill, frail, disabled or addicted. At that time, the only services I could find for their support were those in the United Kingdom's Young Carers programs.

That is until this past Thursday when, I'm delighted to say, I came across a great story on CNN (online) about one of their 2012 CNN Heros, Dr Connie Siskowski, and her organization for child caregivers, the American Association of Caregiving Youth.

The role of caregiver is one that many children carry out with little or no support. According to the Bill and Melinda Gates Foundation, 22% of American dropouts leave school to care for a family member. If family caregiving is stressful for adults, how much more so for these children and teens? With brains still developing and vulnerable to loss and trauma, with constant worries about what's going on at home while they're trying to learn at school, and with all the same physical, emotional and spiritual stressors that affect adult caregivers, it's no wonder that these kids drop out.

Dr Siskowski, a registered nurse in Florida and once a child caregiver herself, has made it her mission to bring this invisible population to light and has been doing so since 2002.  Through her non-profit organization, and with the help of many partner organizations and community volunteers, Dr Siskowski provides child caregivers with an amazingly comprehensive set of services including:

  • In school - skills-building classes, support groups, lunch and learn sessions, and community service hours awarded for time spent caring for a loved one
  • At home - linking families with resources, providing computers, tutoring and solutions for special needs
  • Out of school - overnight camp, fishing, dining, educational and fun activities 

Here in Canada, where about 12% of high school youth report being young caregivers, we now have the beginnings of a support organization in Young Carers Canada, an outgrowth of the Alzheimer Society of Ontario. This group is working toward registration as a not-for-profit, national organization and has three new projects coming into being in St Catharine's and Toronto, Ontario and in Cowichan, (Vancouver Island), BC. **

It will take some time for these programs to become established and for supports to be developed across the country so, in the meantime, what about trying a small support project, yourself, this weekend? Try making a list of all the adults and children you know who have disabilities, or chronic or life-limiting illnesses. Do any of them have children or teens in their families who might be involved in caregiving? If they do, is there a way that you could help them find a little respite?

Perhaps you could take them on an outing with your kids, take in a delicious meal, or drop over with a movie and fixings for an ice cream sundae, or stay with their loved one so they can have an afternoon off with their friends ...  The possibilities are endless and any one of them could make such a difference to a young person caring for a loved one and, perhaps, growing up too soon.

(**  Ending the Silence  is an excellent new video created by the Cowichan Youth Caregivers project to describe the needs of youth caregivers and how they can be met when the silence is broken.) 

Monday, May 14, 2012

Second Compassion Fatigue Conference ...

Just a reminder that the Second Annual Compassion Fatigue Conference will be held in Kingston, Ontario again on June 12 and 13.

This year, the focus will be on organizational health and hands-on wellness strategies, with keynote speakers including Joan Borysenko, a world renown author and psychoneuroimmunologist, who will speak on stress and burnout; Linda Duxbury, professor at the School of Business at Carlton University, Ottawa, whose topic is work-life balance; and humourist, Paul Huschilt who will help you to enjoy humour in the workplace.

Other workshop topics will include:

  • mindfulness, 
  • working with mandalas, 
  • moral distress, 
  • resilience, 
  • understanding conflict in trauma-informed workplaces, 
  • work-life balance, 
  • and humour for workplace wellness.

I won't be going to the conference this year, myself, (self care at the cottage has won out over time in town) but I would love to hear how those of you who've attended the two days have enjoyed the experience. Why not leave a comment here on your return to encourage others to attend next year?

So, if you are interested in attending a great Compassion Fatigue Conference in one of my favourite cities in the world, you can go to the conference website for more information and to register.

Regular Sustenance ...

It's a beautiful spring morning - clear, sunny, fresh, and cool. As I walked around the lake in the early hours, I noticed, as I have many times before, that someone had been there ahead of me, dropping a handful of birdseed at regular intervals along the 4x4 rim of the boardwalk. It brought to mind the importance of regular sustenance for anyone who cares for others, whether professionally, personally, or both.

There's an old Sufi saying that goes something like, "We should never give from the depths of our well, only from the overflow." This saying presupposes that our wells are filled to overflowing on a regular basis. And yet, how many of us can say that we have established a regular schedule of refreshment and rejuvenation - one that our bodies and spirits can look forward to and count upon? The little birds travelling from one pile of seeds to the next along the boardwalk know that they need to keep moving on to the next handful of seeds. How many of us can say we seek out sustenance with the same regularity?

While one-time treats like vacation trips, retreats, conferences, or celebrations are great and can do much to refuel us, they come and then they're gone. We all need something more to count on. We need daily nurturing that's planned ahead. (That's not to say that we must do the same thing each day or that we can't make spontaneous choices, rather that we do need to plan something rejuvenating for each day of the week.)

I do a lot of once-off refreshers but I also know there are a few indispensables that I need to give myself on a regular basis so I have an "overflow" from which to draw. For me, those indispensables include:

  • daily quiet time in the early morning for meditation, prayer, or inspirational reading,
  • weekly Wednesday mornings at the bakery with my spiritual growth group,
  • gratitude journalling every evening,
  • taking-in-the good,
  • almost-daily walks at the lake,
  • green smoothies midmorning, midafternoon and evening, and
  • playing my guitar for a few minutes every day.

What about you? What are your regular indispensables? If you don't have any, why not try adding one regular refueller to your schedule and noticing how it adds to your overflow?

Tuesday, May 8, 2012

New Information on BC Seniors Care ...

Hi everyone - just a note to let you know that this week, (May 8-11), CBC Radio 1, CBC TV and CBC online are presenting a special series on Big Business in Seniors Care, an investigation into who is profiting, how best to navigate the system and the realities of residential care.

This series should be of interest to anyone with a stake in the care of the aging (-and that should be all of us.). We are all aging, ourselves, and we all know and care about someone who is a "senior". Do take a look at the schedule below to see if you can tune in to one of these special programs or, alternatively, look at the CBC website at to catch up on programs you've missed.

Tuesday May 8: The Early Edition - 6:40 am

Business in Vancouver's Joel McKay will join us for a look at the Big Business of seniors care. We'll find out who's winning and who's losing in the push to a profit from a demographic tide.

BC Almanac - 12:30 pm

Margaret MacGregor of the UBC Faculty of Medicine has done research that shows for-profit companies deliver inferior care for seniors. David Hurford of the BC Care Providers Association says for profits serve a crucial role in the system. They'll discuss the  issues and take listener calls on BC Almanac at 12:30.

CBC News Vancouver: 6pm on CHEK and after hockey on CBC Television

The reality of residential care. Who's paying what and the role of private operators in the public system.

Wednesday May 9: The Early Edition - 6:40 am

For Rebecca Maurer the sandwich generation experience came sooner than expected. The Early Edition's Geoff Turner shares her emotional experience in the worlds of public and private seniors care.

CBC News Vancouver: 6pm on CHEK and after hockey on CBC Television

Navigating the system. What is the process when a person needs residential care? How do you choose the best option?

Thursday May 10: The Early Edition - 6:40 am

The system of seniors care can be a nightmare to navigate. But that struggle has produced another business opportunity. Rick Cluff will talk to Barbara Kirby and learn just what a "Certified Professional Consultant on Aging" does for seniors.

CBC News Vancouver: 6 pm on CHEK and after hockey on CBC Television

BC's Ombudsperson has issued hundreds of recommendations to improve the system. What is the government's response?  CBC News Vancouver at 6pm on CHEK Channel 6 and after hockey on CBC television.

Friday May 11: The Early Edition - 7:10 am

All week we've heard about the difficulties of the system of seniors care. On Friday, Rick talks to Health Minister Mike de Jong about what the government is doing to make the system work. We'll get his thoughts on the role of private business in seniors care  and we'll learn how the province is responding to the Ombudsperson's calls to action on senior's issues.  CBC News Vancouver: 6pm on CHEK and after hockey on CBC Television Campuses of care. How to plan for the future so increasing health care needs don't  mean uprooting your life.
To see extended the video and an interactive map of long-term care facilities in the Lower Mainland, go to

Another item of interest to seniors and those who support them is the latest article by Rob Vipond at Victoria, BC's, FocusOnline magazine. (You may recall his previous piece on the use of antipsychotic medication for chemical restraint in the elderly in BC.)

The current article focuses on the provincial Ombudsperson's report, The Best of Care: Getting It Right for Seniors in British Columbia (Part 2), and the need for increased government tracking and public reporting regarding funding and services in a very confusing system, more consistency in who is permitted to provide care, and an up-to-date web portal for displaying basic resources, assistance, and facilities so people can compare options in cost, staff qualifications, and inspection histories.

As Vipond says,

The ombudsperson's report becomes most disturbing as it identifies the severe dearth of legal or professional standards for either staff or facilities, whether public, private or mixed. Reviewing just a fraction of these findings, the report reveals that there are no enforceable standards for staff qualifications or staff numbers in residential care. Care aides receive no standardized training, and in private facilities need 't have criminal or abuse histories checked. There are no legal standards in residential care for bathing frequency, dental care, regularity of assistance with getting to the bathroom, call-bell response times, meal preparation and nutrition, or resident rights to even have visitors let alone informed consent to medications.
Like a rusty ship's hull springing new leaks with every movement, these worrying, eye-opening findings compound upon each other page after page. In assisted living, there are no legally binding standards for staffing, residents rights, food safety and nutrition or emergencies, and residents can be evicted with no notice, without appeal. (Government wrote improvements to these tenancy laws 15 years ago, but hasn't enacted them.) There are no legal quality of care standards for home support services. Extended care hospitals are not subject to routine, independent inspections-most have not been inspected in years - and aren't subject to any legal standards for hygiene, emergency preparedness, nutrition, general living conditions, or administration of medication. (Government developed legislation to correct this 9 years ago, but has not enacted it.)
"I think what is demonstrated here is the result of a number of years of movement from objective regulatory standards to outcomes," says Carter. "So essentially, as currently worded, the standards tend to be things such as, 'You need to have adequate staff. You need to ensure that staff are properly trained.' ... The difficulty is, how do you know when there's inadequate staff and inadequate training? ... Does that mean there should be a registered nurse on, or not?"
In contrast, her report shows a table of the precise, legislated staff qualifications and staff-to-child ratios for daycare centres. "In children's care, it's really clear," she explains. "You say, here are vulnerable children, and we're not going to just say 'adequate'.  We know that there's a certain number of staff that you've got to have. Some seniors in residential care, indeed perhaps a not insignificant percentage, are just as vulnerable." 
In that regard, one finding is particularly haunting: There are no legal requirements for health professionals to report outright abuse or neglect of seniors to anyone. "Again, the example is young children, where there is an obligation," comments Carter. "The people who are providing (seniors care) are dealing with a pre-qualified group who've got physical frailty or cognitive impairment or both, and it makes sense to say you really should be reporting if you think that they're abused and neglected."
To continue reading, go to FocusOnline ...
To find the full ombudsperson's report, go to

Much important food for thought ... and, hopefully, for action!

**  Thank you to Kathleen Hamilton at the BC Association of Advocates for Care Reform for keeping me up-to-date with happenings on the residential care front. Their website is worth a look and their cause is worth your support.