Living with dementia magazine May 2012
Gardens for people with dementia
As places to visit, explore and spend time in, gardens have a lot to offer people with dementia. Danny Ratnaike talks to Kim Grove about making sure they are safe and engaging.
Gardens can provide great pleasure but their design makes a big difference to what people with dementia can get out of them.
When she was a nurse Kim Grove worked on an elderly care ward and in the community, and she's always been interested in gardens. These strands came together in a new way after visiting her grandmother in a care home.
'She and many others at the home had dementia and I remember taking my Nan to sit in the garden, the furniture of which she found very uncomfortable. The garden was not at all interesting or suitable for people with dementia.
'One resident came into the garden, walked straight down the path and tried to get out of the gate at the end of it. Luckily it was locked, but they repeatedly went through the house, back out into the garden and straight to the gate as if walking in a circle.
'When my Nan died, I wanted to do something about gardens for people with dementia.'
Well-being and safety
Being outdoors offers fresh air and exercise, as well as vitamin D from sunlight. Kim says,
'The presence of plants, flowers, water and wildlife has a healing effect, even when viewed from indoors. Gardens can also provide peace and quiet which can help to ease stress, anxiety, agitation, aggressive behaviour and pain.
'People can be diverted from gates and exits by having paths that lead them around the garden instead. A series of cleverly placed planters or hiding the exit behind trees and shrubs can also help.'
People with dementia can experience sensitive skin or rashes as a side-effect of medication or from touching particular plants.
Level, non-slip surfaces are important for people who are unsteady on their feet, while ponds and water features with any depth need careful consideration.
'Include areas that provide protection from the sun, such as an arbour or pergola covered with climbing plants to sit in, and don't use toxic plants or plants that might cause skin irritation.'
'Rails can be placed along pathways and beside steps and ramps which can help people with dementia use the garden independently.'
It is important to think about the scents and colours of plants and how stimulating or relaxing they are, and to take the route a person with dementia might take around the garden into consideration.
'When they enter the garden it must be obvious which way they should go. Markers such as containers, specimen plants or prominent features can help them to find their way.
'People who have dementia sometimes want to sit by themselves, away from a crowd. At other times they may prefer to have company. If space allows, a mixture of individual and shared seating areas may be helpful.
'Raised planting beds can be included in the garden if people still want to carry on their love of gardening but have mobility problems, are unable to bend or are quite frail. For those with a sensory loss, they allow the person to be closer to the plants enabling them to see or smell them more easily.'
Enjoying and engaging
If a garden is being adapted or designed for someone with dementia, it helps to involve them as early as possible.
'Carers can help them to exercise and become familiar with the garden by walking beside them or wheeling them around, pointing out various elements or plants, and getting them to taste edible plants, put their hands into water or stroke soft plants.
'They can help people to reminisce by talking about the garden and their past gardening experiences. Familiar activities such as putting out washing, growing and picking flowers, or growing, cooking and eating fruit and vegetables can also help with the development of memory books.
'Alternatively, they could help to develop therapeutic activities such as sowing seeds, planting seedlings, deadheading flowers, making compost or harvesting vegetables.'
The National Gardens Scheme (NGS) has chosen Alzheimer's Society as its guest charity for 2012. The NGS donates millions of pounds to various charities as a result of people in England and Wales opening their gardens to the public, and recently awarded £150,000 to the Society.
'NGS gardens can offer people with dementia a day out from their normal environment, giving them additional benefits such as exercise, relaxation and vitamin D. Some may also offer reminiscences of activities that people did in their own gardens in the past.'
For details of NGS gardens, look for their guide the Yellow book 2012 in bookshops and garden centres.
For more information from Kim - including her booklet Gardens for people with dementia: a guide to make them safe and secure (£5.99) - see www.kimgrove-gardendesigner.co.uk or call 01406 330575.