Background

Living with Dementia

Dementia is broadly defined as “a loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life”.1 Alzheimer’s disease is the most common type of dementia, but there are many others. Dementia mainly affects older adults but it is not a normal part of aging.2 In Canada, 7.1% of people 65 years and older suffer from dementia; more than two thirds are women. The prevalence and gender gap increases with age.3

Dementia can be overwhelming and can cause great suffering for people living with dementia and their caregivers. As there is no known cure, dementia care should focus on healing anxieties and grief experienced by those affected.

 

Drawing by Meredith Wilson

Access to Nature

It is well understood that incorporating nature into the lives of people living with dementia and other intellectual differences has significant benefits for overall health and well-being. Studies have shown that both passive and active engagement with nature can promote increased energy levels, improved motor functioning, improvement in sleep and more.4, 5, 6 Further, engagement in structured nature-based activities can contribute to a reduction in anxiety and loneliness, improved cognitive function, and opportunity for social connection.7, 8

Unfortunately, in Canada, opportunities for people with dementia to connect meaningfully with nature are a rarity. The existing model of care is traditionally a pathogenic, inherently disease-centered approach that focuses on the treatment of impairments rather than health and wellbeing .9 As such, many existing adult day services are not aligned with the preferences and needs of participants or caregivers, nor do they address overall quality of life.10, 11 There is a significant need to shift the culture of dementia care in Canada from a disease-centered approach to a person-centered approach that caters to the specific needs of those affected with the goal of overall health and well-being.12

 

Drawing by Meredith Wilson

Green Care Farming

Green Care Farming serves as an alternative model to traditional indoor day programs that offers numerous health benefits for both people living with dementia and their caregivers. Green Care Farming takes a variety of forms, and often involves meaningful engagement with the agricultural landscape through passive enjoyment of plants and animals and active involvement in farming tasks.13 The setting is typically small-scale and home-like. Emphasis is placed on autonomy, independence and participating in stimulating and enjoyable activities with a small group.

Care farming can alleviate the stresses of living with dementia and improve joy and wellbeing through the experiences of being away from everyday life and engaging with nature, being within a meaningful context of place and tasks, and being among others with similar experiences and contributing to a communal goal. 14

 

Drawing by Meredith Wilson

The Role of Design

Landscape architecture can contribute to the growing field of Green Care Farming through the thoughtful employment of evidence-based design that enhances the therapeutic experience of the landscape and the overall effectiveness of the program. Landscape architects have a unique skillset that includes multi-sensorial design, grading and drainage, spatial design, and planting design that can be used to create meaningful engagement with nature and its healing properties.

Further, these fundamental principles of landscape architecture can be translated and made accessible for other practitioners to apply to care farm projects when working with a landscape architect may not be possible. That, in essence, is the intention of this project.

Literature Cited

1 Alzheimer’s Society. (Retrieved 2021, July 4). What Is Dementia? https://www.alz.org/alzheimers-dementia/what-is-dementia.

2 Centers for Disease Control and Prevention (CDC). (2019, April 5). Alzheimer’s Disease and Related Dementias: What is dementia? https://www.cdc.gov/aging/dementia/index.html

3 Public Health Agency of Canada (PHAC). (2017). Dementia in Canada, including Alzheimer’s Disease. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/dementia-highlights-canadian-chronic-disease-surveillance.html

4 Noone, S., Innes, A., Kelly, F., & Mayers, A. (2017). ‘The nourishing soil of the soul’: The role of horticultural therapy in promoting well-being in community-dwelling people with dementia. Dementia (London, England), 16(7), 897–910. https://doi.org/10.1177/1471301215623889

5 Stubbs, B., Eggermont, L., Soundy, A., Probst, M., Vandenbulcke, M., & Vancampfort, D. (2014). What are the factors associated with physical activity (PA) participation in community dwelling adults with dementia? A systematic review of PA correlates. Archives of Gerontology and Geriatrics, 59(2), 195–203. doi: 10.1016/j.archger.2014.06.006.

6 Barnacle, T., & Midden, K. (2003). The effects of a horticulture activity program on the psychological well-being of older people in a long-term care facility. HortTechnology, 13(1), 81–85. https://doi.org/10.21273/HORTTECH.13.1.0081.

7 Lun, C. (2013). A review of horticultural therapy and caregiver’s burden. International Journal of Organisational Innovation, 5(4), 138–146.

8 Chen, Y. M., & Ji, J. Y. (2015). Effects of Horticultural Therapy on Psychosocial Health in Older Nursing Home Residents: A Preliminary Study. The journal of nursing research : JNR, 23(3), 167–171. https://doi.org/10.1097/jnr.0000000000000063

9 de Bruin, S., Oosting, S., van der Zijpp, A., Enders-Slegers, M., & Schols, J. (2010). The concept of green care farms for older people with dementia: An integrative framework. Dementia, 9(1), 79–128. https://doi.org/10.1177/1471301209354023

10 de Bruin, S., de Boer, B., Beerens, H., Buist, Y., & Verbeek, H. (2017). Rethinking Dementia Care: The Value of Green Care Farming. Journal of the American Medical Directors Association, 18(3), 200-203. https://doi.org/10.1016/j.jamda.2016.11.018

11 Chi, P., Gutberg, J., & Berta, W. (2020). The Conceptualization of the Natural Environment in Healthcare Facilities: A Scoping Review. HERD: Health Environments Research & Design Journal, 13(1), 30–47. https://doi.org/10.1177/1937586719845118

12 de Bruin, S., Buist, Y., Hassink, J., & Vaandrager, L. (2021). ‘I want to make myself useful’: The value of nature-based adult day services in urban areas for people with dementia and their family carers. Ageing and Society, 41(3), 582-604. https://doi.org/10.1017/S0144686X19001168

13 Hassink, J., Vaandrager, L., Buist, Y., & de Bruin, S. (2019). Characteristics and Challenges for the Development of Nature-Based Adult Day Services in Urban Areas for People with Dementia and Their Family Caregivers. International journal of environmental research and public health, 16(8), 1337. https://doi.org/10.3390/ijerph16081337

14 Sudmann, T., & Borsheim, I. (2017). ‘It’s good to be useful’: activity provision on green care farms in Norway for people living with dementia. International Practice Development Journal, 7, 1-14. https://doi.org/10.19043/ipdj.7SP.008

How to Cite this Blog 

Wilson, M. (2021). Into the Farmyard: A Design Guide for Green Care Farms. UBC Blogs. www.blogs.ubc.ca/carefarmscanada/.

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