By: Teo Spengler
Gardening is one of the healthiest and best activities for people of any age, including seniors. Gardening activities for the elderly stimulate their senses. Working with plants allows seniors to interact with nature and regain a sense of self and pride.
More senior home garden activities are being offered to elderly residents of retirement homes and nursing homes, and even to patients with dementia or Alzheimer’s. Read on to learn more about gardening activities for the elderly.
Gardening is recognized as an excellent way for older people to exercise. And a large percentage of those over the age of 55 actually do some gardening. But the lifting and bending can be difficult for older bodies. Experts recommend modifying the garden to make gardening activities for the elderly easier to accomplish. Gardens for nursing home residents also make many of these modifications.
The suggested adaptations include adding benches in the shade, creating narrow raised beds to allow easier access, making gardens vertical (using arbors, trellises, etc.) to reduce the need for bending, and making greater use of container gardening.
Seniors can protect themselves while gardening by working when the weather is cool, like in the morning or late afternoon, and carrying water with them at all times to prevent dehydration. It is also particularly important for elderly gardeners to wear sturdy shoes, a hat to keep the sun off their face, and gardening gloves.
More nursing homes are realizing the healthful effects of gardening activities for the elderly and increasingly plan senior home garden activities. For example, Arroyo Grande Care Center is a skilled nursing home that allows patients to work on a functioning farm. The gardens are wheel-chair accessible. Arroyo Grande patients can plant, care for, and harvest fruits and vegetables that are then donated to low-income seniors in the area.
Even gardening with dementia patients has proved a success at Arroyo Grande Care Center. Patients remember how to undertake the tasks, especially repetitive, although they may quickly forget what they accomplished. Similar activities for Alzheimer’s patients have had similarly positive results.
Organizations that help the elderly at home are also including gardening encouragement in their services. For example, Home Instead Senior Care caregivers aid elderly gardeners with outdoor projects.
This article was last updated on
Read more about Accessible Gardens
Therapeutic gardens can be great additions to long-term care communities. Here is a look at how three providers have transformed ordinary spaces into beautiful places for residents to congregate.
Everyone knows that gardens and proximity to nature can be beautiful, calming, brimming with pleasing sights and smells. But can gardens become important elements of health care delivery and contribute to therapeutic goals? Can they meaningfully enhance quality of life for residents of eldercare communities? Three LeadingAge members say their onsite gardens are integral to the experience they offer to residents—even to the marketing of their services.
At Friendship Village of Schaumburg, Schaumburg, IL, the “Secret Garden” was an underutilized, enclosed courtyard that earned its moniker because no one seemed to know how to find the entrance. But after building a new entrance from the Willows Assisted Living Unit and removing some overshadowing trees and iron-contaminated soil, this L-shaped patio was transformed into a life-enhancing, much-frequented garden oasis for the unit, says Friendship Senior Options Foundation Manager Kate Garbarek. “Over three years, we raised $500,000 to reconstruct the Secret Garden. Now it’s hard to imagine life here without it. It’s a central part of our campus and one of our favorite places to engage our residents.”
Staff representing maintenance, marketing, activities, dining and nursing participated in planning with the landscape architect to maximize the garden’s functionality, Garbarek says. She convened focus groups of residents to gather their input.
The new garden, completed in September 2013, includes raised beds for residents to touch, feel and smell the plants as well as a rose-colored walking labyrinth and a trickling water fountain. Everything from the color of the concrete to the selection of patio furniture was specifically chosen to engage seniors with the outdoors, she says. Now they use it as a meeting place and bring family visitors out to enjoy it.
The garden has hosted ice cream socials on sunny days, cookouts, and a men’s pizza lunch, says Judy Petersen, the assisted living unit’s director. It is regularly used for exercise classes, parties, family functions and concerts.
“If residents go out there alone, staff will notice and bring them a bowl of ice cream—or, in winter, a cup of hot chocolate,” Petersen says. Nature can have a big impact on people, physically, socially and spiritually, she adds. “They feel more connected with each other and with nature. I just had a conversation with a resident, and it went down a spiritual path. I don’t know how to quantify that, but sometimes when you’re out in nature, it’s just good for the soul.”
It also helps that one of the main dining rooms overlooks the garden, Garbarek adds. “Residents in our independent living area sit against the windows now to look out and enjoy the garden, sometimes carrying their coffee or dessert outside for socialization. Others go out to water using the rain barrels whenever they see a plant needing a little extra hydration.”
Although there are few quantitative studies documenting the impact of gardens and access to nature on residents in long-term care, a growing body of evidence suggests that exposure to gardens can improve sleep, reduce agitation and enhance cognition in the elderly and in people with dementia. Gardens can reduce stress, anxiety and the need for pain medications while improving memory, attention and self-esteem—with few or no adverse side effects.
The first challenge facing providers who want to add therapeutic gardens is to find accessible outdoor space and then make it easy to get to, safe and inviting. For such an investment to pay off, residents should want to use it. Evidence-based design characteristics of therapeutic gardens identified by the American Horticultural Therapy Association include space for presentation of scheduled and programmed activities, features to improve accessibility, well-defined perimeters and easily recognizable garden patterns, and a profusion of plants and people/plant interactions.
Other considerations include the importance of both sun and shade, space for groups and privacy, considerations of safety and security for the residents, and design for easy maintenance. In long-term care settings, gardens can enhance social interaction promote activity, exercise and physical health provide multi-sensory stimulation and engage the brain. But the garden should be planned based on the activities that are likely to take place in this outdoor space.
Jeanne Mulley, dementia service manager for residents in early stages of dementia at St. Ann's Community at Cherry Ridge in Webster, NY, says, “When I started, this unit had an activity room, and off that room was a garden, which was small and circular with non-skid pavement. We worked with our foundation to identify an anonymous donor who could support the expense of turning it into a real garden. We hired a local landscaper who has designed gardens for hospitals. He brought a great vision for what was possible.”
The Rainier Grove Memory Garden is very pretty and used by residents year-round in pursuit of peace and tranquility, Mulley says. “Some residents play a role in the gardening, and our groundskeeper is very supportive of that. For things they make crafts-wise, like birdhouses or windsocks, residents can see the end product displayed in the garden. Families call our garden the dementia-free zone—you just go outside and enjoy some freedom. They are looking for plants that have fragrance and bloom at different times. We also have a bubbling boulder fountain surrounded by six river birch trees,” she says.
“In the springtime our first tulip blooms. After that, the garden has tomatoes, cucumbers, squash, and herbs, which we harvest in the fall. Some of the produce went into our Italian Week dishes this year,” Mulley says. The community’s activities therapist makes good use of the garden, which is visited every day by some residents. “It’s also one of the biggest factors when families are choosing a community for their loved one. It gives them peace of mind to know that the garden is secure. It enhances quality of life and allows residents to experience the same pleasures they had before they were institutionalized, offering healthy choices that don’t require the interventions of staff.”
The work of maintaining these gardens typically falls to the community’s maintenance or grounds staff, plus whatever help can be mobilized from residents or volunteers. Some residents who have fond memories of gardening may want to grab a shovel or a trowel and start digging, while beds raised to wheelchair level can enhance their participation. But more often residents just sit and enjoy the garden.
At Providence Benedictine Nursing Center in rural Mount Angel, OR, a grant from the Oregon Community Foundation supported a horticultural therapy intern to manage and maintain its therapeutic garden for 12 weeks last summer, but also to engage residents and their families in garden activities, events such as “Art in the Garden” and nature-based learning for staff on how to maximize use of the gardens.
The community hopes to establish a small endowment for a permanent horticultural therapy and garden maintenance program, says director of social services Melissa Kennelly, who is also a horticultural therapist. “The goal of horticultural therapy is to provide relevant, interesting, preferred activities for families and staff to use with residents that promote quality of life, well-being and socialization.”
Planning for the garden, in an under-utilized inner courtyard, dates back to 2004, recalls Polly Youngren, who was then assistant director of nurses and had recently completed a horticultural therapy course. “We hired a landscape architect and held three planning meetings, inviting residents, families and staff to participate.” The garden opened in 2006, designed with a continuous curving walkway, flowers planted for year-round blooming, birdfeeders and a roofed structure.
It has become a feature that gets used by the community a lot, says Susan Gallagher, director of the Providence Benedictine Nursing Center Foundation. “It has totally changed how we think of our community. We had a younger resident who was told that she needed to go to a nursing home because there could be no weight-bearing on her leg for ten weeks. ‘I was afraid to go to the nursing home,’ she said. ‘But I love your garden. It has kept me sane.’”
Plants can be a conversation starter, Gallagher adds. “Grandma can talk about her red tulips or tell her grandchildren, ‘I had Lamb’s Ears in my yard at home.’ We plant tomatoes, strawberries, blueberries. You can pick them off the vine. This is their home residents should be able to take visitors into their back yard. Staff, too, have had a positive response to the garden, and the other units started saying, ‘We want our own garden.’”
Therapists use the garden when working with patients on the skilled unit, says Emily Dazey, the center’s director. “We specifically widened the walkways, added hand railings and put in a small gravel pathway so that physical therapists can walk with people on different kinds of surfaces. Occupational therapy can work with people digging in our raised beds,” she explains. “The senses are stimulated … touch, smell, the sound of the water feature. We do specific life enrichment programs in the garden, but lots of spontaneous things also go on there as well.”
Dazey says quantifiable outcomes for garden therapy would be hard to come by, “although we receive comment after comment on our satisfaction surveys about how important the garden was to people, for providing a quiet place alone, a beautiful place to connect with others, and many other reasons unique to each individual. We are a teaching nursing home, and we’d love to do research with our garden program. For example, we know that some activities or applications work better than others. We’d like to have a grant to study that,” she says.
“I don’t know how we managed to provide as meaningful an experience for our people without the gardens. The main garden has become so lush and beautiful. Each time I’m out there, I am reminded that this truly is a creation of our supportive community.”
Maintaining physical activity, cognitive function and social interaction, all helps someone who has dementia to remain stimulated, feel valued and helpful.
Being involved in gardening can really contribute to a person’s wellbeing. Gardening is on-going and ever-changing., anyone who has a garden will recognise that there is always something to do! Even if you have no garden, and have only limited space (perhaps for a few pots on windowsills) this is an activity that can give great pleasure. It can distract, engage, add to routines and be a focus for physical activity.
Gardening can provide a fantastic opportunity for stimulation of all the senses. There are the sensations of touch – soil, flowers, bark (but mind the thorns!), and perhaps the feel of a gentle wind, of sun or rain. There is visual stimulation – an amazing range of colour and shapes, sunlight, as well as the wildlife a garden can offer. There are the smells of flowers and vegetables, of herbs or of a freshly mown lawn. And there are the sounds – birdsong, insects, and rustle of wind in trees and of course, there is taste – eating fruit, vegetables, and even edible flowers such as nasturtiums or marigolds.
It may be that someone’s memory difficulties and cognitive disability can get in the way of a whole sense of what is happening in the garden However, much activity for someone who has dementia is in the ‘here and now’, and the enjoyment of sharing a current task. This can be so rewarding in a garden, where the calmness of the surroundings can also lead to developing and sustaining relationships, not only through doing things together but also through the talk that always takes place.
There are many physical benefits – including dexterity skills and broader exercise through potting, planting, digging, sweeping, weeding and pruning – which can lead to reduced agitation and improved sleep.
There are cognitive benefits too – in terms of getting the person to help plan the activities, and perhaps to choose seeds and consider how flowers and vegetables are organised in the garden.
There are also huge benefits socially. For example, a caller on the Admiral Nurse Dementia Helpline said recently that she and her mother had never had so many conversations with others on their street as they did when they cut her hedge for an hour last summer, with Mum sitting on a chair, directing, while the daughter did the hard work!
There are many gardening activities which could involve the person living with dementia, whatever their disabilities. If they are physically able, they may be able to be prompted to do the tasks themselves. Otherwise, helping, or even just watching and feeling involved can be enough.
Tasks are there to do all year round, both indoors and outdoors.
The depths of winter can be a quiet time for gardeners, but there are still lots of tasks you can do together, such as cleaning tools or maintaining bird tables and feeders for small garden birds.
In February is a time to start planting seeds indoors or in a greenhouse and you can start to see the winter bulbs coming through – snowdrops first, then crocuses and daffodils showing their heads. A sure sign Spring is on the way.
The Alzheimer’s Society in the UK has published a book called Taking Part: Activities for People with Dementia that includes tips on making a safe garden space. Among the guide’s recommendations are:
Plant your garden with thornless, non-toxic plants to prevent accidents. Provide gloves, hats, non-slip shoes, kneeling pads or stools, and safe (not sharp) tools with easy-grip handles. Garden gear in bright primary colors can be easier for dementia patients to identify on sight.
Situate the garden near a window if you can. There’s some evidence that just looking at the garden from indoors can help people with dementia by reminding them that the garden is there and calling up other positive memories. If the garden produces flowers for arrangements or fresh vegetables and herbs for the table, the benefits extend even farther.
With free guidance from your local extension service, you can choose garden plants that will thrive in your local climate. (You can search for your nearest county extension or cooperative office here.) The right assortment of plants can give the garden blooms and/or produce throughout the year, along with fall foliage and some evergreens to brighten up winter days. You may also want to include plants that attract butterflies and hummingbirds for extra visual interest and to benefit the local environment as well as your loved one with dementia.
Casey Kelly-Barton is an Austin-based freelance writer whose childhood was made awesome by her grandmothers, great-grandmother, great-aunts and -uncles, and their friends.
Kanwal Gardens Care Community is located on the Central Coast in a tranquil bush setting with all rooms enjoying leafy garden views. We enjoy a peaceful coastal lifestyle surrounded by nature, with all the amenities of the region and the local hospital close at hand. Known for our extensive landscaped gardens and beautiful koi pond, our gazebo overlooking the pond offers space for spending time with loved ones or moments of quiet reflection. We support all kinds of care needs at our aged care home and our memory care neighbourhood provides a safe an inclusive environment for residents living with dementia.
Our care community is a warm and loving place for people from all walks of life. Activity often centres around our garden, where residents enjoy potting plants or tending flowers, walking or watching our ducks, chickens and koi. With spacious indoor and outdoor living areas, there are plenty of places to relax, savour our chef’s delicious food and engage in hobbies.
It’s an environment where you’re free to enjoy your interests, independently or with others, continue to learn and try new things, and participate in our home life – so you can enjoy your day, your way.