Gardens providing the ‘home’ for increasingly acute aged care facilities
With residential aged care becoming predominantly high care, a growing movement is cautioning against facilities mimicking clinical hospital models, and is highlighting the importance of outdoor spaces.
It’s no secret that residential aged care is becoming increasingly high care. The expansion of community aged care signals the end of what were low care facilities, while dementia and palliative care is increasingly becoming the core business of residential care.
But despite the shift to high care, a growing movement of providers is cautioning against facilities mimicking hospital models at the expense of home-like features.
Specifically, they are re-stating the importance of gardens and outdoor spaces as effective tools in “memory care” and promoting psychological and physical wellbeing of both residents and staff.
Greg Price, residential manager at BaptistCare Maranoa Centre, said a decision to be more than a “sterile, clinical environment” led to his facility developing both an elaborate sensory garden and a rejuvenated tropical rainforest.
“Our mistake in aged care is that we tend to copy the hospital-type models a bit and have a clinical approach. We have to have that for care reasons – we are a care facility – but we’re also people’s home,” Mr Price told Australian Ageing Agenda.
The centre’s sensory gardens were two years in the making, informed by a literature review and trips to various botanic gardens.
Among the features of the gardens are a Japanese section, rose garden, veggie patch, raised garden bed, a fernery, and knickknacks dotted throughout as well as sculptures created by a local artist.
Every afternoon a group of residents go out and walk among the 100 meters of pathway that winds through the gardens, said Mr Price. Many sensory features, such as cowbell instruments and various signs, are designed to attract interest and trigger memories.
The centre engaged the local garden club to assist with selecting the plants for their scent and flowers. “We had to be careful in picking the types of vegetables that we planted so that they’re easy to access, don’t contribute to people falling over and are edible,” said Mr Price.
Rainforest project
Just 50 meters from the gardens, on what was previously discarded land, Maranoa Centre residents are also now enjoying a rejuvenated rainforest – a fairly unusual feature for the middle of a town.
With guidance from rainforest experts, and the support of community network Landcare, the facility successfully rejuvenated the site, planting around 80 trees and adding numerous pathways and planter boxes.
The rainforest, now home to 53 different species, provides a relaxing and cool outdoor area for residents to enjoy on a hot day, Mr Reid said.
“Some of the residents used to play there when they were kids, under the trees; they remember it really fondly. Some of them still go down there, many years later in their life, and enjoy the same area,” he said.
Areas for ‘discovery’
Another residential aged care provider utilising outdoor spaces is IRT, which recently opened its “laughter garden” at IRT Sarah Claydon, Milton, on the NSW south coast.
The garden provides areas for activity and discovery, including a walking track, a stylised creek and statues of Australian wildlife, said Cheree Howe, IRT area manager Southern Shoalhaven.
The $120,000 expansion and upgrade of the garden was designed by IRT in collaboration with the Dementia Training Study Centre at the University of Wollongong.
Karen Lissa, whose mother Marie McKillop is a resident at the facility, said she was excited to see her mother enjoying the new garden. “Mum loves gardening and I’m sure she really misses it. I am hoping the new garden and mural will encourage her to spend more time outdoors,” she said.
Ms McKillop said she enjoyed the Australian animal statues placed throughout the garden. “I think the garden is beautiful; I watched it being built from our TV room upstairs. Now I’ll be able to walk around more outside,” she said.
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What a great article! As nature as one of the ways spirituality is mediated (Mackinlay 2006), it is so important that the nature environment is maximised in aged care.
Having an outdoor area is a great start… but not the end point.
Too often doors to outside areas are locked and there is policy that residents must be accompanied by a staff member. Facilitating free and open access within a safe environment upholds key principles of choice, dignity of risk and an opportunity to nourish one’s spirit through nature.
Where older people are unable to go outside often, it would be great for the outside to be brought in through images, sounds, marking the seasons with autumn leaves, blossoms and flowers, and tactile reminders like pine cones, sand, shells. All of these can be reminders that can trigger memories and reminiscence of people, places and times.
It’s a pleasure to see that there is rejuvenation that care facilities are still a person’s home and should have all the domestic features including outdoor spaces. Typically many facilities view outdoor spaces as an afterthought when doing renovations or building a project, and a component they are happy to drop if budgets go off track.
When you look at dementia design particularly, safe and user friendly outdoor spaces are just as important as the indoor space. To list a few benefits:
– Vitamin D from being in the sun
– a space that can be shared and enjoyed by the resident with their visitors, whereby the room is not the only space available to the resident to be in with their friends and families when they visit
– often a quieter space to be in when the indoor activities may feel too overwhelming for the person with dementia
– opportunity to engage with nature; plants, birds etc
– opportunity to engage in lifelong meaningful activities such as gardening that reaffirm a person’s self identity and helps maintain physical skills and health.
I can only hope that care providers will pay greater attention to not just the importance of outdoor spaces, but also that no one wants to live in a hospital-like building permanently. Multi-storey care homes really need to be thought about more carefully before being built. They may yield more beds, but can compromise quality of life.
What a beautiful garden. So pleased to see gardens being given priority in aged care. Im a way off yet but I love gardening. If I cant get outside in the garden at least daily I feel like my throat has been cut. I could not imagine life without the outdoors/garden. It would send me into a very low mood to be cut off from it.
Top article Darren , as a very keen gardener how about you run a national garden competition , even if it’s by video / photo entries …. I’d better happy to discuss regards Michael
It’s wonderful to see more gardens and specialised outdoor spaces being created in aged care settings.
As a Horticultural Therapist, I witness the amazing health and wellbeing benefits from plants, gardening activities and access to freshly grown food.
I just hope that with the installation of beautiful spaces, aged care centres also have staff trained in running gardening programs, or have some knowledge of gardening as therapy, so the residents receive the full benefits from the gardens and food that is grown.