Gardening in care homes

• Doing it yourself Open

  Participation from individuals may vary vastly, from watching the activity to full participation, and will provide a feeling of wellbeing. It is important to have discovered what type of gardening that each individual has an interest in, and to develop areas appropriately.

  You don't have to be a horticulturist to benefit from the creative participation in gardening activities. Gardening has many health and therapeutic benefits for older people, especially edible gardening. Working with plants allows older people to interact with nature and regain a sense of self and pride.

  Garden beds, equipment and tools can all be modified to create a garden that is interesting, accessible and productive. Some medical conditions and physical disabilities may restrict older people from participating in gardening. However, with planning and a few changes, you can create a safe, accessible and pleasant space.

  The following suggestions can be adapted to suit the needs of all individuals, regardless of their physical or mental health and wellbeing. A risk assessment should always be completed. Older people can protect themselves while gardening by working when the weather is cool, like in the morning or late afternoon.

  Practical tips:

  • Deliver gardening sessions in a creative, imaginative and enthusiastic manner
    • Encourage staff, volunteers and family members to join in
    • Create a greenhouse, or potting house feel indoors using tables with seed trays or pots on
    • Encourage use of all motor skills
  • Provide advance notice to participants so that a potentially new experience is offered in a non-threatening way
    • Warm up before gardening and encourage frequent breaks
  • Structure the time of the session appropriately
    • Forty-five minutes is regarded as a good length of time for participants to feel that they have been active without becoming over-tired
    • Wash hands thoroughly after gardening
  • Remove distractions that can break up the flow of the session
    • Participants may have a regular routine and may become anxious if tea breaks don’t happen at the same time
    • Pre-warning about a change of routine or planning the session times to coincide with the breaks may be wise
  • Ensure that the sessions are held in an accessible space where people can watch at a distance initially
  • Ensure sufficient staff are available to assist with the care aspects such as helping participants to join the group, providing refreshments, going to the toilet and other personal needs

  Points to consider:

  • Gardening increases levels of physical activity, increasing levels of mobility and flexibility
    • Use lightweight tools that are easier to handle
    • Use foam, tape and plastic tubing to modify existing tools for a better grip
    • Have stable chairs and tables to use for comfortable gardening
    • Use retractable hanging baskets, wheelbarrows and containers on castors to make suitable movable and elevated garden beds
  • Don’t underestimate the emotional and intellectual impact of selecting the items to grow
    • Include structural plants
    • Consider colour combinations of plants, both of foliage and flowers
  • Activities that can be participated in
    • Selecting plants, cuttings and seeds
    • Digging, planting, watering, weeding, pruning, etc.
  • Planting
    • Consider all of the seasons so that there is interest all year round
    • Plant bulbs in clusters, i.e. specific shapes and colours
    • Consider future use of produce:
      • Edible plants, fruits and vegetables
      • Flowers for flower-pressing activities
      • Flowers for fresh flower arranging indoors
      • Produce for collage materials
    • Plant shrubs and flowers to attract local wildlife
  • Consider all of the senses
    • Bring sound to the garden by encouraging birds with bird feeders and water bowls
    • Use of bright colours can help for those with low vision
    • Feature scented and edible plants
    • Sensory enjoyment – smelling, touching, looking, listening, remembering
  • Considerations
    • Provides stimulation and interest in nature and the outdoors
    • Can provide nutritious, home-grown produce
    • Crafts and hobbies associated with plants
    • Harvesting food and flowers
    • Food preparation
    • Conversation about progress of planted areas and pots
      • Going through seed catalogues, some available on DVD
      • Discuss famous gardens and gardeners or watch flower shows on TV or DVD
    • Invite others to join in e.g. family members
    • Make it a regular event

• Working with others Open

  Here are some ways in which other organisations can support the art activity. Start by searching locally for what’s available.

  Creating a garden

  If the outdoor space of your care home is under-used or has never been developed, consider approaching an organisation or a garden designer with an interest in this work. This may require funding unless the organisation has access to charitable money. Consult with residents and staff for their ideas and wishes so the consultant proposes the plan for the garden and associated activities that best meets everyone’s needs such as being:

  • Easy to use
  • Accessible to frail and disabled residents with varied routes around the space and is easy to ‘work’ if you’re sitting in a wheelchair or seat; raised beds and the use of ‘pots’
  • Attractive and appeals to all the senses
  • Produces vegetables and fruit to eat, flowers to cut, birds to watch feeding
  • Provides shelter and shade so the garden is accessible in rain and sun
  • Looks interesting all year round with changing colour and growth
  • Attracts wildlife or provides a home for pets
  • Is a place to socialise and celebrate

  Where possible, the organisation should involve residents and staff in preparing the ground, planting seeds or plants, placing bird feeders and so on. If someone is unable to take an active part, they can still watch the work being done from the garden or from inside. Some companies run table-top gardening sessions. All these will promote sensory stimulation, exercise vital muscle groups and encourage reminiscence between participants. Perhaps you can involve community volunteers to look after the care home’s hens or pig?

  Going out to gardens

  Garden centres are good places to visit as they are often have accessible toilets and a café; there is plenty to see and enjoy. The local park is another place to visit and there may be events such as music or dog competitions which will add to the interest. Some gardens are only open at certain times of the year; check first that they are accessible.

• Examples of good practice Open

  Here are some examples of how the art activity is used in practice. Search locally for what’s available in your area.

  Abbeyfield Breath of Fresh Air programme

  This programme involved the Royal Horticultural Society Wisely and volunteers to create a sensory garden for residents with dementia.

  Thrive Gardening Together
  Video

  This project brings residents together for indoor table-top gardening sessions and the charity’s horticultural therapist Daron Gardner passes on his skills and knowledge to care home staff, to enable them to carry on gardening with the residents once the project has ended.

  Growing Support

  Helps establish gardening groups in care homes and it works alongside carers to deliver social and therapeutic horticulture activity sessions. Activity sessions are designed to provide sensory stimulation, exercise vital muscle groups and prompt reminiscence. Community volunteers work alongside participants.

  Tangible Memories: Objects of Escape

  Virtual reality technology and interactive furniture are used as a way for older people to access memories. In the comfort of a rocking chair, using virtual reality goggles or audio speakers, it is possible to experience favourite places and the great outdoors in 3D or in stereo, through 360º images or evocative soundscapes. These journeys of the imagination can rekindle past memories and help to assist reminiscence and storytelling.

  Creative Spaces: a growing project

  The outdoors is used to bring creativity, conversation and enjoyment into the lives of people living with dementia. One of the early projects focused on reconnecting residents living with dementia at Trevarna care home, Cornwall with their community through the use of the home’s gardens. Nature-based activities and exploration of landscapes such as the Eden Project were used to inspire ideas for new gardens. Using input from staff and residents a landscape architect was commissioned to create the gardens.

  The Trust also produces design guidance in new design or renovation of care home gardens.

  Designing landscapes for dementia care

  The Happy Chick Company

  This activity engages residents in care homes in the hatching of chicks from an egg and enables them to become involved in caring for the chicks.

• Resources Open

  Creative Spaces: a growing project

  The author talks about the many benefits which arose for a care home when a new garden was developed for it. (Journal of Dementia Care)

  Gardens and health: implications for policy and practice

  This report looks at the impact of gardens and gardening on health and wellbeing, and explores what the NHS and the wider health and social care system can do to maximise this impact. Gardens are often thought of as intimate private spaces attached to private households but they can also be large private or formal gardens open to the public, or part of hospitals, care homes or hospices. (The King’s Fund)

  Active living at Rose Lodge

  The author describes the active living programme Rose Lodge in Devon, run for their residents who have dementia. The programme included social activities and outdoor activities in their specially designed garden environment. (Journal of Dementia Care)

  Does being in a garden or other outdoor space affect the well-being of people with dementia resident in care homes? (Review BYTES)
  
  Gardening and growing for people with dementia: Factsheet

  This factsheet gives evidence of benefits of horticultural therapy for people with dementia. (Growing Health)

  Therapeutic gardening boosts wellbeing in care homes

  This article identifies the benefits of gardening for residents in care homes and it describes the work of Growing Support. (www.carehome.co.uk)

  Dementia Garden Design Research Project: Summary of Findings

  The authors, who are garden designers, summarise key findings of their research to find out why gardens around care homes, particularly for people with dementia, were not being used more. (Thrive)

  Gardens and gardening for people with dementia: Briefing

  This briefing outlines the benefits of gardens and gardening for people with dementia and it provides ideas for designing and using a dementia garden. (Thrive)

  What is the impact of using outdoor spaces such as gardens on the physical and mental well-being of those with dementia? A systematic review of quantitative and qualitative evidence

  (Journal of the American Medical Directors Association)

  Garden design

  Sensory Trust: Sensory garden design advice
  Sensory Trust: Designing landscapes for dementia care
  iGrow: Creating a sensory garden