For those living with a neurological condition such as dementia, plants and gardens provide a connection with the natural world. Gardens offer carers much-needed respite and people living with dementia a safe space to socialise and maintain their physical and mental wellbeing.
More than 900,000 people are estimated to be living with dementia in the UK, of which 40% feel lonely and 34% do not feel part of their community.
Taken from: Supporting people with dementia: A guide for community gardens
If you are looking to adapt a garden for a loved one living with dementia, garden designer Charlie Hawkes and co-author of a guide on making community gardens more accessible for people living with dementia Liza Griffin, have shared some tips on how to get started.
1) Take a person-centred approach
Dementia is unique to the individual, so when creating a dementia-friendly garden, it’s important to spend some time figuring out the needs of the person you are adapting it for.
If someone has only just been diagnosed, it’s likely that they have full awareness of their condition, so begin by talking to them and including them in the process. What do they want and need from the space? Do they want colour, movement or the sound of water? What facilities are important?
Liza Griffin cared for her husband for many years and has co-authored a guide on making community gardens more accessible for people living with dementia.
“It might be about designing activities, or providing a tranquil place where people can forget they are living with dementia and just enjoy being in the garden,” says Liza.
2) Future-proof your garden
People often develop different challenges and thinking problems, such as difficulties with vision, language, behaviour and movement as the condition progresses. Think about the capacities of your loved ones and work with those and try to anticipate potential challenges that might appear down the line.
Dementia is a progressive condition, which means that your loved one might experience additional symptoms as time goes on. For example, a person living with dementia may not experience a visual impairment initially, but this might occur later, so it’s worth taking this into consideration when you are adapting the garden.
Garden designer Charlie Hawkes worked with The National Brain Appeal to create a garden for the 2023 RHS Chelsea Flower Show for people with rare forms of dementia.
“I wanted to open up the garden to everyone, so I spoke to people who were living with or affected by dementia and drew out common themes, to make The National Brain Appeal’s Rare Space Garden as inclusive as it could be,” says Charlie.
3) Create a single route around the garden
People living with dementia can often feel lost, so you don’t want the garden layout to contribute to this. Keeping the garden level and having a layout that’s easy to navigate will be a huge benefit and will help your loved one to feel safe and calm.
Bear in mind that someone with a memory led dementia may find themselves having moved from A to B but might not remember the journey between those two places. Don’t create paths with dead ends or multiple routes, instead create one route with places to stop, which are immediately adjacent to the central pathway.
“There were three seating areas in the RHS Chelsea garden. Each had a structural shelter over them, and the edges of each shelter were painted a different bright colour. This meant that even though the language of the garden was consistent, each space had its own colour, which distinguished it from the others,” says Charlie.
4) Aim for a high contrast environment when designing for visual forms of dementia
Create a high contrast environment in your garden; make sure that the paving is one colour, and the furniture is a different colour or material so that it stands out from the paving and the surrounding plants.
Keep the structure of the furniture simple as complex things such as armrests and seatbacks can make them less accessible for someone with a visual form of dementia.
A visual form of dementia called posterior cortical atrophy led the design for Charlie’s RHS Chelsea garden, The National Brain Appeal’s Rare Space.
“People with a visual form of dementia’s eyes can be working perfectly, but the bit of the brain receiving signal from their eyes doesn’t function as it should. This means that vision can fragment, and they can’t see properly; causing them to become confused,” says Charlie.
The part of your brain that is responsible for image recognition analysis differs from the part that’s associated with motion detection. Colour differentiation can be a retained strength, but motion detection can be one too.
“For example, they might find a low contract environment such as an all-white bathroom difficult especially with the added reflectivity from a mirror and glass. It might cause everything to amalgamate into one, which makes it hard to differentiate between it all, or to try and interact with the space,” says Charlie.
Include plants that follow the concept of contrast and simplicity so that they are visible to people with visual forms of dementia.
“The RHS Chelsea garden had a green base to keep it calm with a pop of colour from blue benches and plants such as Tulipa sprengeri. We added blocks of Rodgersia podophylla as visual anchors; it’s a bold plant with a chocolate tinge to its leaves. This helps it to stand out from the rest of the planting,” says Charlie.
5) Keep your loved ones safe
Safety in the garden is hugely important; take precautions to ensure that someone living with dementia can’t wander off and get lost. Make sure that pathways are wide enough, use signs and clearly mark out areas of the garden. Ensure that poisonous plants are not easily reachable and, in a community garden, that volunteers have an awareness of dementia.
People are so different in their range of experiences and stages of dementia, so this is something that needs to be thought about on a case-by-case basis.
“You can’t plan for every eventuality, but you can speak to the person living with dementia and their carer and ask them what their needs are, rather than trying to plan everything,” says Liza.
6) Use all the senses
“People living with advanced forms of dementia may not be able to physically get involved but being able to hear the wind in the trees, listen for the birds, smell the plants and flowers and herbs and be in a space that has a sensory richness, is important for their wellbeing,” says Liza.
With dementia, you never know which of your senses might be impacted, so consider as many ways as possible of incorporating them into your garden.
“It could be through the sound of running water, or by including scented plants such as Phlox divaricata subsp. laphamii ‘Chattahoochee’ or Azalea ‘Daviesii’,” says Charlie.
7) Make it fun
If you’ve adapted a garden to suit someone living with dementia, someone without dementia should be able to use it and enjoy it as well. Gardens and gardening offer such a range of activities, and it might be fun to do it together.
There will be people who were previously keen gardeners, and there can be an embodied memory of that. But there are also people who haven’t had much access to outdoor space, and they can still get involved.
Start with simple things such as planting seeds in pots. Choose something that grows quite quickly, which can give you a sense of purpose. “It takes patience and it takes support, so it’s not an easy fix, but you can really improve the quality of someone’s life just by encouraging them to do a little something,” says Liza.
8) Get involved with community gardening
Living with dementia can be lonely, so it’s important to be reminded that you are part of a community.
Community gardens are diverse spaces and bring people from the neighbourhood and beyond together. They provide opportunities for getting involved in activities from simply meeting people and having a coffee, to taking part in gardening itself.
Community gardens are spaces for everyone, so ensuring that they are inclusive is imperative. Design activities and have specific times or places within a garden that are particularly helpful or attractive for people living with dementia.
“It’s not just the spatial design; it’s also about the environment. Are people aware of dementia? Have they been trained to treat people with respect and dignity? Is the place welcoming for a diverse range of people. For example, people from Black and Afro-Caribbean communities have higher rates of dementia, so it’s essential to make these places diverse and inclusive for everybody,” says Liza.
Hospital gardens provide spaces to restore our stress levels and connect with the sounds, sights and smells of the outdoors. The relationship between nature and health is important.
There are more resources on living with dementia available from the Alzheimer’s Society, Age UK, Dementia UK and Rare Dementia Support.