Benefits of Daily Outside Walks & Dementia Gardens for Persons with

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1 Benefits of Daily Outside Walks & Dementia Gardens for Persons with Dementia Sandra Stimson CALA ADC CDP CDCM Executive Director National Council of Certified Dementia Practitioners Cannot be reproduced without written permission from the NCCDP. Can only be copied and distributed for in-service training at your facility National Council of Certified Dementia Practitioners 1

2 Where flowers bloom, so does hope. Lady Bird Johnson 2

3 Outside Environments / Gardens Overlooked Designing the outside environment has been an overlooked opportunity to create meaningful places that are rich in association, encourage good health and exercise, and are responsive to the magic of the changing seasons Elizabeth Brawley 3

4 Existing court yards / gardens under utilized Some reasons might be Fear of getting lost Outside area not attractive No Focal Point Lack of seating or seating is flimsy Lack of shade 4

5 Uneven pavement (i.e. loose stone and mulch walkway) Not maintained, things broken, trash, weedy and over grown, etc. Area used by smokers No scheduled programs outside Court yard locked and only open certain times Staff not transporting to and from court yard 5

6 Lack of supervision or security 6

7 How Can We Change This Administration conducts a quality assurance survey to determine why under utilized. What would they like added to gardens area? Is there enough seating? Is there enough shade? Is there staff supervision? What time of day would you use the garden? Can you find your way to the garden? 7

8 Ask, staff, department heads, volunteers, family and residents why they do not use it and what would they like to see in the gardens Is there enough color? Are there focal points such as a water feature? Are there raised flower beds? Is it neat and good repair? Are the side walks safe and level to ground? 8

9 Do residents need assistance with transporting if in wheel chairs or walkers? 9

10 Implement Changes Utilize garden designs Hire a landscape architect that specializes in health care garden designs. Visit other health care setting to observe their garden designs. Implement changes from the Quality Assurance. Activity Directors to plan group events outside. 10

11 Director of Nursing and Unit Managers work to assign staff to assist with transporting to and from gardens. Assign staff member to observe garden areas. Place a phone outside for emergencies. Keep trash cans emptied. Do not allow smoking in garden areas. 11

12 Investigate and Plan for the Garden Location of the garden Grade including sidewalks Side walks planned for a circular or figure eight path way Design (shade, sun plants, flowers, trees, bushes, herbs) Focal Points Ramps Directional Cues 12

13 Guidelines to Remember In Development of A Garden Visibility Accessibility Familiarity Quiet Comfort Unambiguously Positive Art Opportunities for Physical Movement and Exercise Privacy areas Access to nature Clara cooper Marcus 13

14 Vintage Items Spark a Memory A clothing line with clothes hanging Old laminated table Old bench Old shed 14

15 Toxic Plants, Flowers, Seeds Check with your local garden center before planting to see which plant items to steer away from that are toxic. 15

16 Memorial Gardens Set aside a designated area to honor loved ones Perennial garden Engraved benches Paving Stones 16

17 Encourage Donations & Funds Water Features Purchase of seeds, perennials, bushes, trees. Let families know they are welcome to work in the gardens 17

18 Involve Your Community & Volunteers Garden club Master Gardener Clubs Local University Horticulture Departments They can assist in planting and making it visually appealing. They also have speakers 18

19 Fun Activities Are Important Putting area Swings Water Gardens with Koi Fish Trellis with climbing vines that attract humming birds and butterflies 19

20 Outside Environments Offer Opportunities for Residents Create Meaningful Places Rich in Association Encourage Good Health Promote Exercise Involve in the changing of seasons Elizabeth Brawley 20

21 Benefits of Outside Walks Emotional benefits Reminiscing Lifting mood Lift the spirit Relaxation Improved Self Esteem 21

22 Promotes personal space for reflecting It is a fun activity Distraction from stressors Calm agitation Increase confidence Opportunities for socialization Decrease loneliness 22

23 Offers opportunities for meaning, sun rise, sun set, birds, butterflies, flowers blooming, etc Opportunities for pleasure and enjoyment A Feast for all your senses 23

24 Physical Benefits Improving sleep Absorption of Vitamin D needed to maintain strong bones Fresh air therapeutic May lower blood pressure Offers a non pharmalogical approach 24

25 Distraction from pain Contribute to weight loss Increase appetite Contribute to digestion Strength and Conditioning when weak Maintain health Help with flexibility 25

26 Increase endurance Improve balance May strengthen and improve muscles Summons a person s own healing process 26

27 Care Plans Add outside walks as intervention to the care plans Hospice Patients Pain Residents who wander (provide supervision) Behavior concerns such as agitation Resident s who are self isolators Document response to interventions 27

28 Consistency Very Important for Dementia Patients Plan walks same time every day Take the same path through building to the garden area Use same door to egress to the court yard. 28

29 Healing Gardens Provide a Multi Sensory Experience Colorful flowers Varying Shades and Textures of green Sight and sounds of water Elements to attract birds and butterflies Fragrances Ornamental grasses that move with slightest breeze. The more we are engaged with the environment through all our senses, the lower are our rates of anxiety and the less we are aware of pain. Clara Cooper Marcus 29

30 Someone once said, It s the journey not the destination but in this case, the destination is extremely important, if you are to have positive outcomes for your patients. The destination in fact has everything to do with what the end goal is and that is a successful outside walking program and utilized dementia garden. 30

31 The love of gardening is a seed that once sown never dies" - Gertrude Jelyll 31