Don't forget about the garden! The design of gardens for people with dementia

Abstract

Purpose: When designing a nursing home, architects and planners need to consider ways to provide patients and caregivers with a feeling of a natural setting and being a part of the outdoor world as well as considering themes such as having accessible gardens that take the total well-being of its residents 1. A substantial mountain of evidence suggests that participating in green and gardening activities for people with dementia provides a positive response in such patients 2-5. Experiencing the natural world and relaxing in fresh air and daylight are considered beneficial to well-being and health. The limitations of people with dementia often mean they are dependent on the people around them to provide them with opportunities to access a green environment as described above. This study focuses on the essential design needed for gardens to be enjoyed by people with dementia as part of an enriched living environment. Method: First, literature and studies providing evidence of the beneficial effect of gardening and gardens on persons with dementia were reviewed. The analysis focused on (i) the accessibility of nursing home gardens, (ii) ways we can entice people with dementia to go into the garden (independently), and (iii) ways we can motivate these people to want to stay in the garden, once they enter it. Results & Discussion: A green area offers nursing home patients, their families and caregivers many opportunities to socialize, to reminiscence and to regain an increased sense of autonomy. Therefore, encouraging people with dementia to stay in a green area more often and to participate in gardening and other activities is desirable. Caregivers can also benefit from the positive effects, such as improvements in mood and stress levels. Only limited evidence is available based on the effects of green environments on the quality of life of people with dementia, because of research limitations, small samples sizes and a lack of appropriate measurement instruments, as well as the researcher's inability to specify and define factors influencing the results, etc. Qualitative research data provide the initial guidelines for providing increased attention to the design of garden spaces and related activities. Despite the positive aspects of a garden, many Dutch nursing homes have gardens that suffer from poor accessibility. We also find that people with dementia often want to go back inside a nursing home once they enter an outdoor environment.