Most of us have brought flowers to a hospital room at some point. We’ve done it for obvious reasons. Flowers are pretty, they’re colorful and they add a little warmth to an otherwise sterile atmosphere. They’re conveniently sold in most hospital gift shops or at a handy stand outside the door. Bringing flowers to a hospital room is an old tradition. It is also quite a lot more.

Dementia gardens have helped thousands of Alzheimer’s patients feel, and function, better. But, before we get to the specifics of gardening and dementia, let’s talk about the history of horticulture as it relates to general health and healing.

The use of gardens as a therapeutic modality is nothing new. In ancient times, both the Mesopotamians and the Persians designed sensory gardens which included plants, flowers and water features. They quickly became popular places for rejuvenation and retreat. Europe’s early hospitals were built in ‘healing garden’ settings as well.

The Benefits of Green Space in Modern Times

Dr. Roger Ulrich, Professor of Healthcare Architecture at Chalmers University of Technology, has dedicated a career to studying the benefits of nature in hospital design. In 1984, he published an important study on the effects of natural surroundings on well-being and healing. Dr. Roger Ulrich was not alone in his pursuit. For decades before and after, some of the world’s top university and medical institutions have studied the results of incorporating green spaces and nature views into the scope of healing.

Information on many of these studies is available at the links below this article. Among many other benefits, some very interesting ones really stand out:

• Post-Surgical patients with window views of nature and in-room plants (as opposed to those without) experience higher tolerance to pain, less fatigue and fewer post-surgical complications.
• People with ADD and learning disabilities who garden regularly have shown improved focus and increased alertness in school, improved academic performance and an increased sense of confidence and success. They’ve also experienced better social interactions and better sleep.
• Outdoor gardening and park access lowers stress, increases energy and lowers cortisol (stress hormone) production, also decreasing symptoms of depression.
• Spending time in parks and gardens has led to lowered blood pressure and more regulated sleep cycles.
• Urban parks have proven to be relaxing and restorative, bringing communities together and encouraging socialization.
• Green views and green space access have proven to increase focus and productivity in work and school environments throughout the population.
• Organizations like Thrive ‘give gardening’ to people who have mental illnesses and disabilities, including veterans with PTSD – with great results.

Evidence from studies is so persuasive that doctors have begun prescribing outdoor activities to patients. A few insurance companies are reimbursing customer expenses for park fees. Healthcare facilities worldwide have begun installing healing gardens and green spaces for the benefit of patients, visitors and staff.

The side effects of gardening are few, if any. The benefits of nature, whether viewing or interacting with it, seem abounding. On an economic note, healthcare is expensive, and health costs relating to the elderly are becoming explosive as baby boomers progress into their 70s. Currently, dementia care in the U.S. costs over $200 billion per year. Dementia gardens, as part of Alzheimer’s health care, are worth exploring.

Dementia Gardens

Alzheimer’s dementia symptoms include reduced memory and intellectual functions, visual impairments, loss of language skills, difficulty with logic and decision making, and more. The disease is a prison of sorts. It takes away its hosts’ independence. Gardening is an inexpensive, effective, nonpharmacological intervention that can reduce dementia symptoms and improve the quality of life for Alzheimer’s patients and their caregivers. Dementia gardens are tailored to meet the safety, therapeutic, physical and sensory needs of people with Alzheimer’s dementia. They also appear to make patients feel good.

According to The Alzheimer’s Society, “exercising in the garden helps develop the appetite, boosts energy levels and promotes a better night’s sleep. Maintaining, as far as possible, existing skills that give pleasure and confidence.” That should say it all. But here’s more. Dementia patients who spend time gardening have benefitted from:

• Direct sunlight (increasing bone density, improving sleep cycles and moods).
• Lower levels of agitation and aggression.
• Decreased isolation and aggression.
• Better orientation to place and time and a temporary distraction from fixations
• A sense of ownership and community.
• Improved social interactions.
• Playing the role of caregiver for garden plants and wildlife.
• Increased physical activity as well as decreased falls and injuries.
• Higher maintenance of cognitive skills and interests. In some cases, the ability to learn or regain lost skills.
• Increased attention spans.
• Increased brain volume and gray matter.
• A less ‘institutional’ environment to share with visitors.
• A happier staff who find gardens relaxing and restorative during break times.
• Better understanding of and interest in Alzheimer’s patients as individuals. Enjoyment at seeing patients have fun.

Gardening on a daily basis was found to reduce dementia risk factors by 36%.

Garden Design Revolves Around Safety and Comfort

All plants must be edible and non-sharp in a dementia garden. Don’t use pesticides or herbicides and avoid sharp or complicated gardening tools. Also, avoid sharp or collapsible furniture. Choose water-resistant furniture materials.

Walking paths should be quick-dry, non-slip, non-trip, well-lit, level, drainable and wide, with handrails to ensure the safety of older dementia patients. They should also be clear of stakes, sprinklers and wires. If it’s possible, design round or figure 8 paths; they encourage walking and make the garden less confusing to navigate. The garden should also be viewable by staff, while still feeling private for residents.

Successful dementia gardens have included:

• Variety. A mix of flowers, produce, green plants and deciduous trees (different sizes, colors and type).
• Fast-growing plants like peas and herbs; Fruit trees and berries; Raised garden beds for functionality.
• Lots of opportunities for weeding, seeding, digging and watering.
• Distinct areas that encourage different sensory experiences.
• Areas for sun exposure as well as shaded areas.
• Covered or enclosed access for inclement weather garden viewing.
• Water features, feeders that residents maintain, fish ponds if space permits.
• Assorted, separate seating areas with safe, accessible lounge chairs.
• Garden furniture that residents bring from home (provided it’s safe).
• Occasional organized activities (chair yoga, discussion groups, a local string quartet). Afternoon refreshments.
• Sculptures (can be built and or donated by residents).
• Curiosities and fascinations – things that have to be opened or discovered.
• Off Season continuity. Gardening activities, as well as some favorite plants, can be taken indoors. Herbs grown in window boxes can be harvested, dried and canned for use in preparing special meals.

A few more thoughts. All spaces, staffs, budgets and resident populations are different and unique. All gardens will adapt as you build, use and observe them, making them continually better for your patient population. It’s all right to start small. Quality, safety and access are most important. When interactive gardens aren’t possible on your premises, greenery and flowers can still be a part of your residents’ world. Group gardening trips can be organized as well.

At Lakeside Manor, our residents love the outdoors. We’re surrounded by greenery for viewing and enjoying. We do lots of outdoor activities and offer personal gardening opportunities as well. To find out more about our programs and facilities, please contact us at your convenience. We look forward to speaking with you.

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