Study population
Participants were recruited from three LTC facilities located in Brisbane, Australia, owned and operated by the one provider and with a combined total of 284 beds. The facility environments, staffing models and philosophies of care were similar across the three facilities. To ensure the intervention was targeted to residents who it was assumed would get the most benefit from the intervention participants had to meet the following inclusion criteria: 1. aged 60 or over to avoid recruitment of persons with early onset dementia; 2. living in a participating nursing home for at least three months to avoid potential effects from transition to the nursing home; 3. cognitive functional impairment indicative of a dementia condition; MMSE score of 24 out of 30 or less; and features of Alzheimer’s disease according to American Psychiatric Association DSM-IV-TR [19]; 4. a documented history of a minimum of two weeks of agitation or aggression in total (consecutively or 14 single days), within the past three months; 5. a documented history of physical and/or chemical restraint for agitation and aggression, including PRN (as required) medication; 6. consent for participation from resident’s family or health-attorney; 7. no known allergic reaction to lavender oil; and 8. no recent skin tears, lacerations, bruises, or redness and swelling that might interfere with hand massage. Exclusion criteria were: 1. a diagnosis of schizophrenia or mental retardation to avoid the complication of dual diagnoses impacting on treatment effect; 2. expected to be transferred to another residential facility within the next 3 months.
We invited the facility care managers to identify residents who appeared to meet the selection criteria from a population of 284. They then sent information and informed consent forms to next of kin of the 165 residents identified. Randomisation assignments were given to participants following baseline testing; these were generated using a random number table and a person not involved in the study randomised participants into three groups in each residential care facility. Participant demographics were obtained from the facility manager who copied information required for the study from resident records.