Research shows that gardening activities and spending time in therapeutic gardens have the potential to reduce the risk of developing dementia and improve the quality of life of persons with dementia.
Challenging activities that require fluid thought processing combined with moderate physical activity are more likely to enhance cognitive functioning than routine activities 1. Analysis of a longitudinal population based study of individuals aged 75+ without dementia found that the risk of developing dementia was lower for participants who engaged in activities that combined cognitive, social, and productive elements 2.
Gardening is a productive, meaningful activity that can support cognitive and social functioning. A study of 2,040 elderly residents found that participants that gardened were significantly less likely to develop dementia than those who were engaged in activities such as reading or watching television 3.
As a cognitive therapy, gardening can be programmed to teach new skills, to regain lost skills, improve memory and attention, foster a sense of purpose and enhance social interaction 4.
Stress is associated with elevated cortisol levels. Elevated cortisol levels may affect memory and affective disorders. A pilot study of subjects ranging from 71 to 98 years of age showed impressively reduced cortisol levels for those who visited a therapeutic garden and participated in horticultural activities 5. Being in appropriately designed garden settings has the capacity to reduce stress and thus can have an important, non- pharmaceutical therapeutic role for the elderly and those who care about and for them 6.
Environments that provide stimulation while at the same time minimize stress can contribute to a person’s sense of self-worth 7. Gardening is particularly well-suited for older adults as it can be adapted to suit users of varying physical ability. Studies show that grading skills associated withhorticultural activities resulted in increased levels of constructive engagement and high levels of interest by people with advanced dementia in long term facilities 8.
Because of the limited ability of people with dementia to communicate, inappropriate behaviors may be interpreted as an index of anxiety and depression 9. While indoor confinement may lead to increased agitation 10 and medication management, having access to unlocked doors leading to a well-designed garden may improve these people’s autonomy and quality of life 11. In fact, inappropriate behaviors were reduced when residents in a dementia care facility were given access to a therapeutic garden 12. Further, a reduction in agitation and psychotropic medication was noted after opening a wander garden at another elder care facility. Not surprisingly, with decreased medication there is a significant reduction in falls (30%) 13.
Gardens are a natural amenity for elderly care facilities as they are a familiar setting to most residents, can support a wide range of physical and cognitive activities at a variety of skill levels, and are a meaningful setting where purposeful activities and social engagement can occur. Thoughtfully designed therapeutic garden and associated programming that consider the safety and abilities of residents and staff can be an effective means to reduce the effects of dementia including agitation, inappropriate behavior, and injuries due to side effects of psychotropic medications taken to manage dementia symptoms.
2. Wang, H.X., Karp A., Winblad, B., Fratiglioni, L. (2002). Late-life engagement in social leisure activities is associated with a decreased risk of dementia: a longitudinal study from the Kungsholmen Project. Am J Epidmiol 155, 1081-1087.
3. Fabrigoule, C., Letenneur, l., Deritigues, J.F.K., Zarrouk, M., Commenges, D., Barberger-Gateau, P.(1995). Social and leisure activities and risk of dementia: a prospective longitudinal study. JAGS 43, 485-490.
4. Detweiler, M.B., Sharma, T., Detweiler, J.G., Murphy, P.F., Lane, S., Carman, J., Chudhary, A.S., Halling, M.H., Kye, Y.K. (2012). What is the evidence to support the use of therapeutic gardens for the elderly? (Review). Korean Neuropsychiatric Association 9, 100-110. Retrieved from http://dx.doi.org/10.4306/pi.2012.9.2.100.
5. Rodiek, S. (2002). Influence of an outdoor garden on mood and stress in older persons. Journal of Therapeutic Horticulture, Volume XIII, 13 -21.
6. Kalevi, M., Hartig, T., Kaiser, F.G., Fuhrer, U. (2001). Restorative experience and self-regulating in favorite places. Environmental Behavior 33, 572-589.
7. Lawton, M. P., Nahemow, I. (1973). Ecology and the aging process. Psychology of adult development and aging. American Psychology Association 619-674.
8. Orsulic-Jeras, S., Judge, K.S., Camp, C.J. Montessori-based activities for long-term care residents with advanced dementia: effects on engagement and affect. The Gerontologist 40, 107-111.
9. Patel, V., Hope, R.A. (1992). A rating scale for aggressive behavior in the elderly. Psychol Med 211-221.
10. McMinn, B.G., Hinton, I. (2000). Confined to barracks: the effects of indoor confinement on aggressive behavior among inpatients on an acute psychogeriatric unit. Am J of Alzheimer’s Disorders Other Dementias 15, 36-41.
11. Namazi, K.I.I, Johnson, B.D. (1992). Pertinent autonomy for residents with dementia: Modifications of the physical environment to enhance independence. Am J of Alzheimer’s Care Related Disorder 7, 16-21.
12. Mather, J.A., Nemecek, D., Oliver, K. The effect of a walled garden on the behavior of individual’s withAlzheimer’s. Am J of Alzheimer Disorders 12, 252-257.
13. Detweiler, M.B., Murphy, P.F., Kim, K.Y., Meyers, L.C., Ashai, A. (2009). Scheduled medications and falls in dementia patients utilizing a wander garden. American Journal of Alzheimers Disorders Other Dementia 24, 322-332.