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Research

The issue

Loneliness, social isolation and inactivity are significant problems amongst older people, particularly in residential care. Studies have shown a typical person in care spent just two minutes interacting with staff or residents in a six hour period outside of care tasks[1], that they are doubly inactive compared to people living in their own homes and 50% of care home residents never go outside[2]. The prevalence of severe loneliness in care homes is at least double that of community-dwelling populations[3].

This inactivity and lack of social contact compounds health and wellbeing problems. Lack of activity and the pleasure associated with activity are associated with higher rates of mortality or depression, reduction in social functioning and physical wellbeing, increased isolation and loss of quality of life.[4]

We want to tackle these issues by providing older people and people with dementia with the opportunity for more meaningful social interaction and purposeful outdoor activity. We do this through the provision of social and therapeutic horticulture activity.

This animation by our Bristol Ageing Better partners illustrates how loneliness can affect some people as they get older.

What is social and therapeutic horticulture activity?
Thrive (the national charity representing social and therapeutic horticulture in the UK) defines social and therapeutic horticulture as: “the process by which individuals may develop well-being using plants and horticulture. This is achieved by active or passive involvement”.

Essentially, it means we work together as a sociable group carrying out gardening and craft based activities which encourage sensory stimulation, prompt reminiscence, exercise vital muscle groups and create a sense of achievement and belonging.

Benefits
It is well evidenced that exposure to the natural world is good for you[5] and can lead to better mental health[6]. Furthermore, engaging in ‘green exercise’ such as gardening, has both mental and physical health benefits[7].

There are specific benefits of gardening and ‘green exercise’ for people with dementia. Garden activities provide multi-sensory stimulation with colour, smells and sounds of wildlife[8]. These can be used to provide opportunities to reminiscence and  accessible activities for people with any stage of dementia. Other benefits include:

– Improving sleep patterns[9] including longer sleep duration[10]
– Better continence and mobility[11]
– Better eating patterns[12]
– Enhancing verbal expression[13]
– Opportunities to relieve tension, frustration and aggression and bring about positive mood change[14].

Participating in meaningful activities in the garden has further benefits. Boredom and lack of free access to the outside contribute to challenging behaviour amongst people with dementia in care, which is often treated with costly anti-psychotic drugs[15].

Meaningful activities are recognised as a critical component of good quality dementia care[16]. Structured activities, bright morning light and the freedom to go outside to a garden area through an unlocked door minimises aggression and agitation in people with dementia[17].

Gardens activities can encourage social interaction for older people and people with dementia by encouraging and supporting them to engage with each other, their families, communities, care staff and environment.

Why we do this
Research shows that gardens are good for you! We do this because we believe that everybody has the right to enjoy the benefits of meaningful activity in the garden regardless of their health and social care needs.

Links to helpful reports

Combining contact with nature and social activity is a cost effective way of reducing stress and increasing health. Interview with Dr William Bird and Dr Matilda van den Bosch available here

Natural England Greening Dementia http://publications.naturalengland.org.uk/publication/6578292471627776?category=216216

Department of Health National Dementia Strategy: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/168220/dh_094051.pdf

National Institute of Clinical Excellence Dementia Quality Standard:   https://www.nice.org.uk/guidance/qs1

Kings Fund: Volunteering in Health and Social Care: http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/volunteering-in-health-and-social-care-kingsfund-mar13.pdf

Overview of evidence to support health benefits of food growing http://www.sustainweb.org/resources/files/reports/GH_Benefits_food_growing_for_health.pdf

Impact on the physical and mental wellbeing of people with dementia of using outdoor spaces http://clahrc-peninsula.nihr.ac.uk/research/impact-of-using-outdoor-spaces-on-the-physical-and-mental-well-being-of-those-with-dementia

Joseph Rowntree Foundation resources on dementia friendly communities: http://www.jrf.org.uk/topic/dementia-without-walls

Natural England: Is it Nice Outside? Consultation with people with dementia

 

 


[1] Home from Home, Alzheimer’s Society 2007

[2] Health Survey for England, Department of Health 2005

[3] Aging Health, 2012

[4] Pollock and Marshall 2012

[5] Mayer et al, 2009

[6] Pretty et al, 2005, 2007

[7] Mapes, 2011

[8] Cobley 2003, Kennard 2006

[9] Brooker at al, 2007

[10] Connell 2007

[11] Brooker et al 2007

[12] De Bruin et al 2010

[13] Chalfont, 2006

[14] Pallister, 2001

[15] Pollock and Marshall 2012

[16] National Institute for Clinical Excellence 2008

[17] Pollock and Marshall 2012