Dementia-friendly environments: Gardens
The importance of outdoor spaces
As well as giving exposure to natural light (which provides vitamin D, so important to good health), a garden or outdoor space provides a place for familiar activities such as digging or cutting grass or hanging out the washing, and a place for exercise. A garden also offers a unique opportunity to provide a feast for the senses. Fragrant and vibrantly coloured plants and shrubs can provide excellent sensory stimulation.
A garden provides a place for familiar activities such as digging or cutting grass or hanging out the washing, and a place for exercise.
Mood and behaviour
For people with dementia who walk a lot, time spent in gardens can help them relax and feel calm. People with dementia will generally be less likely to become agitated and distressed if they can have regular access to fresh air and exercise and a quiet space away from others (for more on this, see the Aggressive behaviour feature in Behavioural challenges section.)
The garden should be easy to find from inside – furniture shouldn’t block the view of the garden or the pathway to it. A garden needs to be a safe and secure environment with barrier-free access and no steep levels. It needs to be a space that takes account of a range of sensory and mobility problems, but does not make people feel imprisoned.
Planting can help by softening the appearance of walls and fencing. Avoid poisonous plants. If possible provide seating both close to and away from the building to encourage movement and to offer a place for conversation, quiet reflection and enjoyment of the changing seasons.
Paths should lead back to the point where they began and avoid sudden changes of direction or dead ends. They should be wide enough for two people to walk along together. Usually loose gravel and bark are not appropriate for people to walk on because they can be difficult to negotiate.
Provide resting and sitting areas along the path for people with limited mobility. These should have enough space for a solid bench and wheelchair and be sheltered from the sun and wind. A patio can provide a sheltered sitting area. Manhole covers provide a visual barrier for many people with dementia – they may see them and think they are a hole. Ensure the path avoids patterns and significant contrasts that the person might perceive as an obstacle to step over.
Create an interesting outlook with a bird table, water feature or decorative planter. Plants in these areas with special characteristics (fragrance, colour, sound or touch) can stimulate senses, spark memories of gardening hobbies and encourage conversation. The design of the garden can encourage wildlife. Pet animals such as rabbits in an enclosed run could add interest. A few chickens would provide activities such as egg collection or feeding and changing the water.
Versatile outdoor space can provide opportunities for games, barbecues and other events, all providing meaningful activity and valuable exercise. Rest and recreation areas should be visible from the home to ensure people are safe while enjoying themselves but, in the case of care settings, not
Access and download additional resources
Further reading Open
Dementia Services Development Centre (2007) Best practice in design for people with dementia, Stirling: Dementia Services Development Centre, Stirling University.
Dementia Services Development Centre (2008) Design for people with dementia: Audit tool, Stirling: Dementia Services Development Centre, Stirling University.
DSDC Virtual care home: The University of Stirling’s Dementia Services Development Centre has produced this ‘Virtual care home’, which allows users to navigate around the various areas within a care home (such as bedrooms, en-suite bathrooms, kitchens, lounges and so on), and read advice about things to consider and ways to improve the care environment for people with dementia.
Pollock, A. (2001) Designing gardens for people with dementia, Stirling: Dementia Services Development Centre, Stirling University.
Useful links Open
Dementia-friendly health and social care environments
This 2015 resource from the Department of Health presents design guidance in relation to new buildings as well as the adaption or extension of existing facilities, and includes case studies drawn from projects funded by the Dementia Capital Programme.
Design Resource Centre
The University of Stirling’s Dementia Services Development Centre (DSDC) has always been a leader in the area of dementia and design. The DSDC website includes the Design Resource Centre. This section includes links to a substantial range of publications and resources in the area of dementia-friendly design including information on the importance of lighting, colour and contrast, getting outside, and orientation and signage. The site also includes the DSDC Virtual Care Home and the DSDC Virtual Hospital. Both these resources allow users to navigate around the various areas within a care home or hospital (such as bedroom, ward, ensuite, kitchens, lounges and so on), and read advice about things to consider and ways to improve the care environment for people with dementia.
Developing supportive design for people with dementia
This is the final report of The King’s Fund’s Enhancing the Healing Environment (EHE) Programme, which ran from 2009 until 2012. The well-illustrated report includes descriptions of the 26 EHE projects completed in NHS Trusts to improvement the environment of care for people with dementia, and also includes the EHE assessment tool and overarching design principles.
Home environment and dementia
This NHS Choices web page sets out good introductory information on how to improve the environment for a person living with dementia. It covers topics such as lighting, flooring, colours, noise and outside spaces.
Making your home dementia-friendly
This 2015 Alzheimer’s Society booklet is aimed at people living at home. It covers a wide range of topics such as lighting, flooring, furniture and furnishings, knowing where things are, and enjoying the outside.
Related pages from this section Open