Outdoor environments that speak to the soul

‘Outdoor Spaces for People with Dementia’ - Matthew Taylor; Guest lecturer at College Of Fine Arts, UNSW 19th March 2014

Meredith Gresham of HammondCare notes at the 2012 dementia conference that “About 80 per cent of people living in residential aged care facilities have a diagnosis of dementia and a major problem confronting staff are dementia related behaviours of concern (BOC)”.

Memories. Image source: www.cyberkidzone.com.au

Gardens have many well-known benefits in relation to exercise and activity for mental and physical health. Particularly in dementia specific care, gardens and outdoor therapeutic activities can lessen the confusion and agitation experienced by residents,  providing a higher quality caring environment.

”Outdoor spaces offer unique opportunities for a wide range of stimulating, potentially life enriching activities such as assisting someone who has been a lifetime gardener, to maintain some form of outside gardening spot” , Brawley E C 2001.

An integrated design approach to the design of aged care facilities and in particular, dementia care, is critical to ensuring individuals have access to, and opportunities for, ongoing learning and personal growth and development (Thomas and Johansson 2003).

Design development incorporating facilities, personal growth and development-Uniting Care Ageing; Hamlyn Terrace.Sketch by author

Current aged care alternative models such as “The Eden Alternative” identify how healing and therapeutic gardens play a vital role in facilitating access and contact with children, animals and nature to build the human habitat. Successful therapeutic gardens are equally visible and accessible to all staff, residents and visiting families. Whereby, resident activity is encouraged through the incorporation of a variety of outdoor activity elements including vegetable gardens, orchards, clotheslines, water features, men’s sheds, mail boxes, bus stops and animal coups. These garden elements provide familiar visual cues to assist in the coherence of the space to develop feelings of safety and calmness.

Visual cues- The Salvation Army; Collaroy RAC Images by DC Photography Designs

Contact with plants and the seasons is an important element for dementia gardens in the way that the plants can evoke memories through scent, textural qualities and taste.

Textural planting-Hammondcare Miranda. Images by Author

The integration of pet and outdoor therapy such as feeding animals, tending the vegetable gardens, fruit picking and general gardening for residents with dementia is shown to have a significant impact in reducing signs of sadness and significantly increased signs of pleasure in a staff supported environment. (Cox Burns Savage 2004)

It is important to understand the role of the garden areas in the overall treatment of dementia and integrating the garden design with best practice is vital in providing a quality living environment for residents, staff and visitors.

Familiar playful garden elements -HammondCare Miranda. Image by author

References:

Brownie, S 2011, ‘Culture change in aged care: the Eden Alternative(TM)’, Australian Journal of Advanced Nursing, vol. 29, no. 1, pp. 63-68.

Cox H, Burns I, Savage S. (2004). Multisensory environments for leisure: promoting well-being in nursing home residents with dementia. Journal of Gerontological Nursing 30(2):37-45.

Thomas, W., and C. Johansson. 2003. Elderhood in Eden. Topics in Geriatric Rehabilitation, 19(4):282 290.

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