Report by OT Award 2018 Winner Anastasia Barnes

Garden Project for Dementia Clients

Anastasia Barnes, a senior occupational therapist at the Emerald Centre in Colchester, was the proud winner of the Cosyfeet OT Award 2018. The £1000 award helped to fund the creation of a sensory garden where dementia clients and their families spend quality time, gardening and relaxing together. Here she reports on the project:

We recently celebrated the official opening of a very special garden at the Emerald Centre. Clients and their families, supported by staff, worked very hard to create the sensory garden, which was officially opened by the Mayor of Colchester.

The Emerald Centre is part of the Essex Partnership University Trust. The centre houses services for people with a diagnosis of dementia. These services include initial memory assessments, consultant reviews, medication monitoring, crisis intervention assessments, home treatment, occupational therapy, psychological assessment / treatments and a 24-hour helpline. The centre also houses group therapies and activities, including cognitive stimulation therapy and a vascular wellbeing group.

An individual suffering from dementia, whether the cause be from Alzheimer’s disease, vascular problems or any other brain injury, have in common a group of symptoms associated with an ongoing decline of the brain and its abilities, including thinking, memory, language, understanding and judgement.

Although the most common is Alzheimer’s disease and is generally diagnosed in people over 70, there are individuals who have a diagnosis before the age of 65. This is referred to as early-onset dementia and can have a profound effect on the individual, their family and friends.

It is important that whatever age a person is diagnosed with any form of dementia, they continue to feel worthwhile, useful and understood. With this in mind, when the opportunity arose, we decided to create a garden where people could enjoy being together in a creative way, using and maintaining the skills and creativity they might have, giving them a sense of purpose and pride.

The Garden

At the Emerald Centre there is an enclosed garden area that was little used and only maintained by Trust gardeners to prevent overgrowth.

The project was started when a volunteer offered to decorate the four very large clay pots in the garden with mosaic tiles to add some colour. We decided to expand on this and invited our clients and carers to become involved in creating a sensory garden which would be a therapeutic space they could enjoy. The garden project for our client group was designed to encourage and promote the following:

• A sense of achievement / building confidence / self esteem
• To boost energy levels and help with sleep difficulties
• Working with others to promote social interaction / reduce isolation
• To create a sense of purpose / meaningful activity
• Exercise to promote physical health and wellbeing / help to maintain mobility and flexibility  
• To help maintain skills / encourage memories
•  Enjoyment / pleasure / reminiscence
• A place to share experiences and create new memories with their family and friends

It is well documented that gardening is beneficial for mental health and wellbeing. Studies have found that the mental health benefits of gardening are extensive, reducing problems such as anxiety and depression. It can also reduce stress, help combat high blood pressure and help improve overall physical fitness.

According to Ulrich (1999)* being involved in garden activities can help improve memory and assist with maintaining rational thinking and cognitive function. The activities in the garden help to arouse the five senses of sight, sound, touch, smell and taste. Garden activities can also promote a feeling of calmness and reduce problems associated with dementia such as boredom, depression, aggression, agitation and increased stress.

It was a huge undertaking and hard work to begin with. We were fortunate to have the help of a group of volunteers from the university and an enthusiastic group of Girl Guides to clear the space and ready the garden for our clients to begin their project.

Fliers were sent out to our clients and their families or carers informing of a start date for the group and requesting donations of old unused garden equipment or any spare plants. We applied to the Trust for funding to enable us to purchase gardening tools and entered the Cosyfeet OT Award programme. We were overjoyed to win, and the £1000 award enabled us to purchase, paint, plants, arbours and seating.

The client group was divided into two, with the clients who wanted to work outside in the garden busy designing areas, painting benches, planting, weeding and generally creating the garden. The ‘inside’ group were busy creating artwork for the garden that included making bird boxes, painting pots and using household items to create various sculptures.

The project has grown since the opening and we now have a very well attended group who are enthusiastic, creative and motivated to continue developing ‘their’ space.

The project has proved to be an enormous success. We have observed the benefits first hand with our clients forming relationships, talking, laughing, being physically more active and best of all inviting their families and friends to enjoy the garden with them.

Case Study A - Maria Hinch, aged 63

Maria was diagnosed with vascular dementia six years ago. She also has a diagnosis of depression and arthritis /spondylitis, which causes Maria chronic pain.

Maria lives with her husband Norman, who is supportive, but Maria likes to remain as independent as possible and continues to cook and bake.

When the garden project started, Maria joined and it quickly became apparent that Maria’s skills in art and craft would be a huge benefit to the group, as this is an area that Maria excels in.

In the past, Maria has found it difficult to be in groups but now she reports she enjoys the interaction in the group.

“For me it’s a source of social interaction and an outlet for my creativity. I also paint and do art and crafts at home, but I love seeing my work on display in the garden. It makes me feel proud”, says Maria. “The garden group has enriched my life and the people I have met have made a huge difference to my life.”

Case Study B - Wendy Welham, aged 63 and husband Ivan, aged 62

Wendy and her husband are founder members of the group. Wendy was diagnosed with vascular dementia in 2017 but has a long history of bipolar disorder. She also experiences panic and anxiety episodes, making it difficult for her to cope in large groups.

Wendy has osteoarthritis and this affects her mobility, requiring her to use a frame to walk. Initially she was reluctant to attend the group without her husband and although Wendy would be happy to attend alone now, Ivan also enjoys the group so he continues to attend. His expertise in the garden has been invaluable to the project.

“The garden group is everything to me. It helps with my mood and my memory,” says Wendy. “Working in the fresh air and mixing with others helps keep me mobile and lifts my spirits; I look forward to attending each week.”

“I enjoy attending with Wendy every week. When I’ve felt stressed with my role as a carer it’s been good to be with others,” says Ivan. “The physical activity has helped me keep fit and I’ve enjoyed being part of creating the garden and watching it develop.”

Ulrich RS (1999) Effects of gardens on health outcomes: theory and research. Chapter in CC Marcus & M. Barnes (Eds.), Meds. Healing Gardens: Therapeutic Benefits and Design Recommendations. New York: John Wiley and sons, 27-86

The Cosyfeet Occupational Therapy Award supports one winner each year in developing their professional knowledge and skills while benefitting others. The £1000 award is open to any OT or OT student who is planning voluntary work, a work placement or research, whether in the UK or abroad. It is designed to contribute to travel and expenses.