Interactive gardens for patients with Alzheimer's disease.

Discussion in 'Researchers, students and professionals' started by Hendrik, Sep 7, 2015.

  1. Hendrik

    Hendrik Registered User

    Sep 7, 2015
    4
    Dear all,

    I am currently working on a Bachelor of Science project assignment and have the task of designing an interactive garden for a care home that look after patients with Alzheimer's.

    I am aware of similar projects around the world that use simple technology in interative gardens and I am aiming to create an improved design.

    I therefore have two questions:

    1. What are the needs of patients and carers with Alzheimer's; who still have the ability to walk, for such an interactive garden?

    2. What are the short comings of existing interactive gardens?

    Thank you for you're interest and I hope you can all be of assistance.

    Regards,

    Hendrik
     
  2. balloo

    balloo Registered User

    Sep 21, 2013
    227
    northamptonshire
    I am a carer .I have never been to an interactive garden with NIL who has dementia but I know she likes touching things plants with soft leaves or smooth leaves , smelling things , she likes bright colours , all plants at higher level eg in pots or raised beds as when bending she gets unsteady on her feet. the foot path must be smooth and even with possible hand rails ,certainly if steps hand rails needed. plants my mother I law likes lavender, herbs, rabbits eyes( soft furry leaves bright colours eg tulips ,clematis, hope this helps
     
  3. Hendrik

    Hendrik Registered User

    Sep 7, 2015
    4
    Feedback

    Dear Balloo,

    Thank you for your response. This is exactly the sort of information I am looking for. Your idea could be perfectly linked to an interactive plant bed for patients suffering with this terrible disease. Patients who can feel and smell plants, sensors to determine what plant the patient is interacting with and give an audio feedback "tulip" for example. Giving more independence to the patient. Fantastic feedback!

    Any more ideas please let me know.

    Regards,

    Hendrik
     
  4. Jessbow

    Jessbow Registered User

    Somewhere to sit would be good,

    Bird feeding station

    Thorn-less roses!

    Wind chimes

    Running water
     
  5. loveahug

    loveahug Registered User

    Nov 28, 2012
    1,071
    Moved to Leicester
    pay close attention to the colour of the paths, they need to be coloured tarmac, many of those with dementia struggle as they see patterns as 3D (that includes tiles and slabs) and cannot see where they are putting their feet if the flooring is very pale. No steps and very shallow gradients will help those with balance problems.
     
  6. Aitchbee

    Aitchbee Registered User

    Nov 3, 2013
    87
    Agree with loveahug that patterned floors confuse people with dementia but my Mum would probably have thought black Tarmac paths were water or a hole and would have refused to walk on them.
     
  7. canary

    canary Registered User

    Feb 25, 2014
    10,719
    Female
    South coast
    Yes, somewhere to sit is a good idea and please have a place next to the seat big enough to "park" a wheelchair, so that the carer can sit next to them and talk about what they can see.
    Mum loves bright colours, touching the plants and watching the birds, but has lost her sense of smell and I believe that this is quite common with elderly people. Having raised beds and hand rails would be very helpful.
    You could add things that move like brightly coloured plastic windmills.
     
  8. loveahug

    loveahug Registered User

    Nov 28, 2012
    1,071
    Moved to Leicester
    oh yes definitely NOT black tarmac, just coloured as in blue, red or green...
     
  9. Katrine

    Katrine Registered User

    Jan 20, 2011
    2,839
    England
    #9 Katrine, Sep 8, 2015
    Last edited: Sep 8, 2015
    Hi Hendrik, what a great project you are working on. :)

    Good suggestions already from other posters. You will of course be taking care to avoid poisonous plants or those whose leaves could cause skin or eye irritation.

    If it was me, I would take this a step further, and design a productive kitchen garden with a wide range of salad and herbs, vegetables and (non-prickly) fruit. Since most of these will not have much flower interest you would add structure and colour with the addition of herbaceous plants. Hebes and lavenders are good because they have a long flowering season if you keep them pruned. Lavender is also great as a sensory plant.

    In a residential setting some people will enjoy supervised gardening, which is where a kitchen garden is particularly ideal. It is gardening with purpose, and so many people with dementia are longing for purposive activities.

    My other observations about gardens for people with dementia are based on personal experience, and fall in to two main themes.

    1) REDUCED VISUAL PERCEPTION

    Many people with dementia lose their ability to recognise colour as others would normally see it. It is like a sort of 'fade to grey'. The brain apparently filters out the information that it does not find essential. Flowers that are grown for display should therefore be brightly coloured, or white, contrasting with foliage.

    My MIL used to love her garden, and visiting gardens open to the public, but she doesn't seem interested in plants any more. I personally think they have all gone grey in her perception. If you could only see plants in shades of grey you would conclude that they were dead or dormant, wouldn't you? :(

    In the last couple of years that MIL lived at home on her own she struggled with the amount of work that she thought her garden required. Actually her son looked after it all for her, but she was always fretting about this or that needing doing. Strangely, some of the things she talked about were not relevant and didn't need doing. It was as if she was recalling some past season rather than being able to actually 'see' what was right in front of her. She continued to fret about the garden when she went into her first CH. She avoided supervised gardening, saying surely they had people to do that! Then in the CH where she is now she was back to fretting about needing to tidy up the planted areas and pots, so she didn't like being taken out into the courtyard gardens.

    A couple of years further on, and she now does seem to like the gardens but not really for their plants. She just likes sitting on a bench in the sun. BTW, plenty of comfortable benches is a must in your garden. There are always some CH residents who go outside for a smoke or a walk on a regular basis. They tend to have their favourite seats and this can mean there is nowhere for anyone else to sit down because the regulars do not welcome other people invading their space. Benches also need shade from the sun and shelter from the wind. A bench surrounded by a timber arbour can have climbing plants around it, which can be enjoyed by people who are not strong enough to walk far.

    2) PHYSICAL ACCESS TO PLANTED AREAS

    My mum was a very keen and skilled amateur gardener. She designed her current garden when my parents moved into their new-build house 13 years ago, when he was 84 and she was 78. It was mainly planted with shrubs and trees to be low maintenance, but so well designed as to have all year round colour interest. She was a proper gardener - unlike me - I haven't got that level of planting knowledge.

    I have in the last couple of years had to prune and restructure much of her garden due to the age of the shrubs and trees. My mum's original shrub plantings can be seen across a lawn from where she sits in the living room, although some are still recovering from the necessary heavy pruning! I also wanted to give my mum a close up garden experience from her wheelchair, so I extended the paving around the perimeter of the house and replanted the beds close to the house adjacent to the paving.

    This has given me the opportunity to remove all the prickly shrubs that might hurt her, and to plant some new things. I have put in some plants that are at eye level or below as she goes past in her wheelchair, including some annuals because of their vibrant flower colours. I have focused more on spring and summer flowering, but with some autumn and winter flowering heathers, and early spring bulbs, in case she does go outside in colder weather.

    My greatest success this year was a wildflower bed, which I think would go very well in your sensory garden. Any sunny area would be suitable, including a raised bed. I used a well-drained slope. A wildflower area is a great use of a sunny slope. The bees and butterflies love it and the flowers have been blooming continuously from May onwards (with seeds being sown in April).
     
  10. Hendrik

    Hendrik Registered User

    Sep 7, 2015
    4
    Useful

    Thank you very much for the time you have put into your reply.

    This is very useful information and i will most definitely use it when making my design choices. I'm really seeing a trend with features that allow for users to intereact, feel, and trigger memories. This is fantastic news and is already triggering a number of ideas.

    Any ideas, no matter how creative they may sound are always useful. Please do not hesitate to share this feed as the more replies, the more knowledge, I, and others are gaining.

    Hendrik
     
  11. Hendrik

    Hendrik Registered User

    Sep 7, 2015
    4
    Loveahug,

    Thank you, great info here. One question for you:

    Would you feel that having a path to follow using coloured ground/floor lighting possibly LED leading patients to interesting parts of a garden would be possible? Would patients find this challenging or done in the right way could this be a benifit to patients?

    Regards,

    Hendrik
     
  12. loveahug

    loveahug Registered User

    Nov 28, 2012
    1,071
    Moved to Leicester
    Hmm, I wouldn't want them set into the path because of confusing the brain. If there was lighting it would need to light the whole path without causing any light patterns (the 3D problem again).

    ps - 'patient' is not a good word in the dementia world as people with dementia will be cared for on a one to one basis by a carer (usually an exhausted relative) or in a residential unit context. If they were a 'patient' then you would expect the NHS to be paying, as it is most are either self-funded or funded by the Local Authority :rolleyes:
     
  13. Beate

    Beate Registered User

    May 21, 2014
    11,732
    Female
    London
    There is nothing wrong with the word "patients". I prefer it to "sufferers" anytime!

    My OH's day centre has a garden where they planted vegetables and fruit, then (under supervision) cut and eat it. It's brilliant.
     
  14. loveahug

    loveahug Registered User

    Nov 28, 2012
    1,071
    Moved to Leicester
    Oh I so agree, but when we had a dementia awareness course at work the very good lady dementia phsychiatric worker who ran the course ripped someone apart for using 'patient' although as a psychiatrist able to prescribe medication they do have 'patients' she explained. I do agree about 'sufferer' although mum 'suffers' hugely. It's all about context really I suppose.
     
  15. Dazmum

    Dazmum Registered User

    #15 Dazmum, Sep 8, 2015
    Last edited: Sep 8, 2015
    If possible, features in the garden should be made visible to residents from windows inside the care home too, as sometimes they may not want or be able to go outside into the garden. Strategically placed bird feeders or hanging baskets planted for different seasons at different levels, and those flower 'tubes' that fix to drainpipes could also be used if possible. Currently my mum loves a bright mauve buddleia which waves about and also attracts butterflies.

    Also plants and features for winter interest, although that's more difficult!
     
  16. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    Please don't forget residents need shaded areas and some like enclosed areas such as pagodas where they feel safe. My husband liked to watch local handicapped teenagers who came and planted seeds in the small greenhouse and later planted the seedlings in the garden. This created a feeling for the teenagers of being needed and helped residents to interact with the outside world somewhat.

    xxTinaT
     
  17. Raggedrobin

    Raggedrobin Registered User

    Jan 20, 2014
    1,427
    Something that bothers me about many care home gardens is that they are so blinking small. For people who have the need to walk/wander, as part of their dementia, a good long path would be very helpful. At Mum's care home the path is made of that sort of tarmac that you get in kid's playgrounds, so it has a soft bounce if you fall over.

    It has become de rigeur to have certain plants in interactive gardens; lavender, herbs etc but some of them look terribly dull in the winter because the nice smelly plants are seasonal. I think it would be nice ot have an environment where there is plenty to look at in the winter, too. I agree bird feeders and also seats. The care home my Dad went into made a pleasant, although very small, landscaped garden but by the time they had done that they didn't have enough money for seats! A handrail is always a good idea, too.

    I agree the idea of having brightly coloured plants, so stuff like dahlias and Crocosmia Lucifer, that sort if thing.

    I sometimes think one can overthink sensory/interactive gardens. For instance' people bung in bamboo because it rustles but if you just plant a tree, any tree, then you get the rustle from leaves anyway.

    Good luck with it all.
     

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