As we’ve seen, art is a successful means of engaging and connecting with people with dementia. However, the sensory realm is another dimension that can be manipulated to affect their mood and emotions. Studies have shown that people with dementia tend to be less agitated, depressed or confused if they are surrounded by things that are familiar to them. Thankfully, more administrators of care communities are adopting an even wider, holistic, person-centered view of treatment that reflects the needs and wants of the person with dementia. That is why Sensory, Memory or Healing Gardens have become prevalent in many healthcare settings along the continuum of care.
In designing a Sensory or Memory Garden, the goal is to create a homelike feeling that helps clients or residents remain oriented to their surroundings for as long as possible. Here are some general guidelines to follow but these are entirely dependent on the cognitive level of the residents or clients:
- In a residential community, it is best if the garden is visible from an attendants’ or nurses’ station, adjacent to the exterior edge of the building. Since wandering is a big concern, 8-ft. walls hidden by larger plants are suggested. The best scenario is to have an electronic door that can be left open to the garden during the day so residents can come and go as they please.
- Single loop, winding paths are preferred. Short, subsidiary loops can also be therapeutic as long as there are open sightlines to encourage strolling or wheeling without fear of getting lost. Walking has been shown to reduce depression, often associated with dementia. However, if the path is too unpredictable, it can produce agitation.
- Brick paths or pavers are recommended, but should not be too light in color to cause “blinding” by the sun. Also, too much high contrast between pavers can be disorienting; the darkness of some pavers can be interpreted as a hole or ditch.
- Raised beds provide a natural barrier between the walkway and the plantings. People can still touch or smell the plants but won’t get tangled in them.
- Lighting needs to be constant and even: “Up-lighting” from the ground can be blinding and produce too much glare that may cause a lack of balance or orientation; on the other hand, downlighting can cause shadows and be disrupting, especially for those with vision loss.
- Plenty of benches to sit in shady areas, or sturdy chairs in clusters of seating are a necessity. While gliders are fine, rocking chairs can be a challenge due to balance issues.
- Pergolas can produce unwanted or disturbing shadows and wind chimes are not necessary because certain random sounds can cause agitation.
- Specially-designed water features, however, can produce soft, white noise that allow for private conversations and a soothing atmosphere.
PLANTS AND ACTIVITIES
Everything in our daily lives is guided by our senses. Gardens and certain plants can connect people to personal memories. Viewing, touching, smelling and tasting aromatic culinary herbs may elicit forgotten memories of preparing family dinners from long ago. Smells from plants such as lavender, sage and chamomile can be very soothing. Of course, anything planted in the garden needs to be non-toxic.
- Some suggested imaginative activities in a therapeutic garden setting, often led by a Horticultural Therapist or Occupational Therapist, may include:
- Providing adaptive tools to dig, hoe, rake or water the soil to tend to the plants, preferably in a raised bed, just like when a person lived independently.
- Installing a clothesline and providing a basket of dish towels can help residents recreate the self-care task of hanging up laundry.
- Offering a carriage with a life-sized baby doll to allow residents to replicate the joy of pushing a baby through a park.
Being “one” with nature has been proven, through evidenced-based research, to elevate a person’s mood and is among the top “four positive distractions that can improve health and well-being along with comedy/laughter, companion animals, and music.” A Sensory Garden can nourish the senses by incorporating memory-evoking smells of flowers and herbs. It can also encourage a sense of belonging and connection which are so critical to the health and well-being of individuals with dementia.
Daniel Winterbottom and Amy Wagenfield,
Therapeutic Gardens: Design for Healing Spaces, 2015.