JS Festival in Tochigi 1st National Elderly Welfare Facility Conference

Aromatherapy for Sundowning: A Tochigi Research Presentation

Sundowning is one of the most distressing experiences for people living with dementia and the staff who care for them. The late-afternoon confusion, pacing and emotional outbursts leave families feeling helpless, particularly during long Australian summer evenings when daylight stretches well past dinner. From Brisbane to Perth, frontline workers have searched for gentle, evidence-based approaches that ease these episodes without adding to a resident's medication load.

The 1st National Elderly Welfare Facility Conference and Research Meeting, known as JS Festival in Tochigi, offered a forum where one such approach took centre stage. Researchers gathered in Tochigi Prefecture, north of Tokyo, to share findings from Japanese aged-care homes. Many protocols discussed sit comfortably alongside what is being trialled in facilities across Melbourne and Adelaide, where the Royal Commission into Aged Care Quality and Safety has sharpened the focus on non-pharmacological care.

Among the workshops, the aromatherapy study drew a steady crowd. Delegates were curious about the methodology, the choice of essential oils and the practical steps a facility would take to replicate the results. What struck many was the modesty of the intervention: a few drops of carefully selected oil, diffused in a common area at a set time, paired with a calm handover from afternoon to evening staff.

For Australian practitioners who could not attend in person, the conference has become a way to test local practice against international experience. Many of the lessons discussed — staff training, environmental design, family engagement — feel familiar on this side of the Pacific, but seeing them presented in a different regulatory and cultural context adds depth and prompts fresh questions.

What Sundowning Looks Like in Practice

Sundowning is not a disease but a cluster of behaviours that intensify as daylight fades. Residents may become restless, anxious, verbally repetitive or aggressive. They might try to leave the building, believing they need to catch a bus home or pick up children from school. Sleep-wake cycles are disrupted, and the strain on the household — whether a family home in suburban Adelaide or a dementia-specific unit in regional Western Australia — can be considerable.

Researchers emphasised multiple causes: fatigue, unmet needs, disorientation, pain and a drop in lighting that makes familiar rooms feel unfamiliar. Addressing any one of these can soften the others. Aromatherapy fits as a sensory cue, signalling to the body that the day is winding down and that rest is close.

The Tochigi Research Design

The Japanese team presented a twelve-week study across three residential facilities in the Kanto region. Participants were residents with a documented pattern of late-afternoon agitation. The researchers used a crossover design, alternating aromatherapy diffusion and a control scent over four-week blocks, with nursing staff rating behaviours using a standardised tool.

A practical guide for first-time delegates released alongside the event explained how the team built measurement into routine care. Rather than asking staff to complete extra paperwork, the researchers trained team members to record observations during shift handovers. That simplicity, the presenters argued, would translate well to Australian homes where staff time is already stretched thin.

Selecting the Right Oils

Lavender featured throughout the protocol, sourced from growers who supplied the same chemotype (Lavandula angustifolia) used in clinical trials. Bergamot and sweet orange were blended to lift mood without overstimulating. The team avoided heavy camphoraceous oils in the evening blends, noting that some Australian practitioners prefer locally distilled eucalyptus products, which can be too activating close to bedtime.

For Australian readers, this raises questions about supply chains. Tasmania's Bridestowe Estate and smaller lavender farms in the Yarra Valley produce high-quality lavender essential oil, while Byron Bay region growers produce tea tree oil. Imported oils remain standard in most facilities, but locally grown alternatives could support regional producers — a consideration that aligns with the Aged Care Commission's encouragement of community-connected care.

What the Findings Revealed

The Tochigi team reported a measurable reduction in the frequency and intensity of sundowning episodes during the aromatherapy weeks. Falls during the evening period also dropped, although the sample size was too small to claim statistical significance for that outcome alone. Staff reported that handovers felt calmer and that residents were easier to settle into bedtime routines.

A follow-up summary of the festival's research highlights noted that the most engaged facilities were already doing something simple: dimming lights, closing curtains, playing soft music and offering a warm drink alongside the diffusion. The aromatherapy was one element in a larger sensory environment, not a standalone fix.

Practical Steps for Australian Facilities

Translating the protocol to an Australian context means paying attention to local realities. Facilities considering aromatherapy should also acknowledge the new Aged Care Act and Star Ratings framework, which expect providers to demonstrate evidence-based non-pharmacological strategies. Documentation should cover the rationale, oil selection, dilution ratios and any resident consent.

Many Australian facilities partner with brands like Chill Chillin for aromatherapy products, while others work with local apothecaries or produce their own blends under clinical guidance. The product matters less than the consistency of use, the staff training behind it and the way it integrates into the evening routine. A diffuser placed in a hallway without staff awareness will do little; one introduced as part of a documented care plan can become a quiet anchor for the end of day.

Documentation and Family Communication

One under-appreciated lesson of the Tochigi work was the care taken with documentation. The research team produced clear, accessible materials for families, explaining what was being diffused, why and how to give feedback. Residents' representatives were invited to comment before the study began. Australian facilities can borrow this transparency — informed consent, easy-read information sheets and regular updates to family members.

Designing these materials well takes thought. Resources for clear visual communication can borrow from fields as varied as event publishing and community print design, where layout, typography and plain language matter. An example of careful layout and presentation of complex content can be seen in this thoughtful print design work, which shows how clean presentation helps readers absorb detailed or emotional information without confusion.

Looking Ahead

The Japanese researchers were clear that aromatherapy is not a cure for sundowning. It is one tool among many, and it works best when combined with environmental cues, predictable routines and well-rested staff. Australian research, including work at the Wicking Institute in Hobart and various Melbourne-based trials, is exploring similar sensory interventions, with growing appetite for cross-cultural exchange.

For practitioners weighing whether to introduce aromatherapy in their own service, the Tochigi presentation offered a quiet but firm message: small, repeatable, well-documented interventions can make late afternoons less fraught for everyone in the building. The next step for many Australian homes will be careful pilots, honest evaluation and open sharing of results.

Recommendations for Care Homes Considering Aromatherapy