Gardening and dementia
The therapeutic power of gardening is well known, but can gardens and plants actually help comfort and calm people suffering from dementia, asks Este Gerretsen?
Can plants and gardens have a positive effect on the lives of people affected by dementia?
In the dementia wing at Radius Care Hawthorne, an aged care facility in Christchurch, Brian Nettleton – tall, neatly dressed and in his late 70s – is trying to open a door to get into the garden. He is someone the staff in the dementia wing refer to as a fiddler and a wanderer. He’s often found trying to fix a perfectly good tap, door or appliance (he spent many years working as a plumber). He has always loved – and still loves – being outside surrounded by growing things.
“My hubbie always loved his garden,” Brian’s wife Cheryl says. “Watching plants grow, getting dirty in the soil and being able to eat from the garden was important to him. Now with dementia it is doubly so. Being outside in the garden relaxes him. It gives him a sense of freedom to feel the sun on his face and being amongst it all. ‘This is beautiful,’ he often says when the staff or myself take him outside. I believe it allows a sense of normality for him in a very confused world.”
Dementia is what Alzheimers NZ calls an umbrella term used to describe a group of symptoms that affect how well our brains work. The older one gets, the higher your chances of developing dementia symptoms, the most common of which is Alzheimer’s disease.
With most people, it is their shortterm memories that are more affected, while they might still have good recall of things that happened a long time ago.
With New Zealand’s population ageing, the number of people affected by dementia is also increasing. Alzheimers NZ predict that by 2050, more than 170,000 New Zealanders will be diagnosed. The number of facilities being built to care for symptomatic people is increasing too, many of them featuring manicured lawns and garden spaces.
Now are these beautiful gardens at aged care facilities simply there for the aesthetic appeal or do gardens really have a positive effect on the lives of people with dementia?
Radius Care Hawthorne, one of the facilities in Christchurch with a D6 secure dementia care unit (the highest level of care available), is an older building with all the rooms on ground level, overlooking a garden.
The gardens are well established, with mature trees and several secure courtyards and hidden corners to explore. Residents can enjoy an edible garden with apple trees, bay trees, herbs, and a sensory raised garden bed which has a variety of mints to taste, lavenders to smell and striking grasses next to velvety lambs’ ears to touch. Another garden has an audible water feature, bright sensory activities, textured plants and an arch planted with fragrant jasmine. There are various old-fashioned plants here, especially blooms that were popular in the 1980s such as rhododendrons, dahlias, roses and camellias.
For residents who use wheelchairs, there is an accessible raised garden bed (especially popular with residents keen to grow veges).
I asked Jacqui Boylen, who manages the facility, whether she felt the gardens improved the lives of the facility’s residents. She says while most families’ primary concern was the standard of care provided, many also appreciated the fact that their family member had a garden view and the option of getting their hands dirty or picking an apple from the ‘Ballerina’ apple trees.
She laughs as she tells me about a previous facility she worked at where they had new planters built for some residents to plant their own tomatoes. The competition between them got so stiff that she had to get the local police officer in to give the residents a friendly reminder that it is all in the name of fun and that they had to respect each other’s space in the raised garden beds.
One of their secret weapons is gardener Graeme Olds, who has been working in aged care gardens for 30 years and is employed here three mornings a week. He is 83 years old – he credits the job for keeping him fit and healthy, and his age for giving him an understanding of what the residents would like to see and experience in a garden. So he prefers to use plants from the eras that dementia residents tend to remember, he says.
Radius Hawthorn’s diversional therapist Leianne Hamilton, who’s been working in aged care for more than 30 years, told me why it was so important to get dementia residents involved in the garden. Her job involves finding activities that had a positive and calming effect on residents, and to do this, she tries to access pleasant memories for them. “Once I took an unsettled resident for a walk in the garden, and while walking past the Japanese anemone he paused and referred to them as blooms dancing in the wind. He went on to tell me that it is his wife who does most of the gardening. These happy memories are priceless for dementia residents and are a useful tool in keeping them calm and happy.”
The concept of healing gardens is by no means a new one. Plans have been found for a garden including medicinal plants and meditative spaces, that were drawn up for the abbot of St Gall more than 900 years ago. Beds for sick people were to be situated in such a way that they could overlook the gardens.
There are more modern interpretations too. The Remember Me Garden by designers Jane Bingham and Penny Hearn, at the 2017 Royal Horticultural Society’s Tatton Flower Show in the UK, was designed in a hexagonal shape to symbolise the journey people with dementia must travel. It used a variety of plants that were popular in the 1970s, including mop head hydrangeas, nasturtiums and antirrhinums. The garden design included a memory shed called
The Room of Inklings, with objects in it to help trigger peaceful gardening memories.
One element that some of the best dementia gardens I researched had in common was simplicity. Residents must be able to feel safe and not overwhelmed. A dementia garden should assist them in finding bits of themselves. It should create a calming space of familiarity that can help still the wandering mind.
My very first gardening job was helping senior citizens in my local community with all their gardening needs to ensure they could stay in their own home for as long as possible. Often I would walk away from gardening jobs with beautiful fragrant feijoas or a bucket full of earthy spuds. People would share their fertiliser recipes, or pass on tomato seeds that had been in their family for generations.
So now I think of those lovely men and women transitioning into the next stage of care, and how it must be daunting and stressful. I think it is worth asking how we could make that transition easier, and what could be done to make people affected by dementia feel more at home, happier and healthier. How can we create a calm space that triggers happy familiar memories? And it seems to me that gardens are the answer. Always.