Why dementia-friendly gardens are more important than ever

Why dementia-friendly gardens are more important than ever

By Angeli Ganoo-Fletcher, landscape director at PRP

PRP’s landscape team highlight why good landscape design is crucial for people with dementia, and reflect on how gardens have become important safe and secure places, especially during recent periods of ‘lockdown’.

A well-designed landscaped garden in the right setting can help improve the quality of life for residents, create enjoyment and encourage those with dementia to live a more active and stimulating life which can help combat the effects of declining cognitive ability.

The principles of landscape design for elderly people with cognitive and sensory impairment is an increasingly active field of study. Evidence suggests that as visual and cognitive ability changes, certain people with dementia will increasingly function on a sensory rather than intellectual level. We should design environments in ways that make them easier to use by older and disabled people, while keeping hold of the qualities that make them special, fun and engaging.

The therapeutic benefits of a safe, attractive and carefully planned external living environment should be well recognised. The potential for exposure to sunlight to assist the body’s manufacture of vitamin D is of particular importance in older people. A well-planned garden can form part of a holistic treatment plan providing scope for physical exercise to relieve tension or aggression alongside personal space for reflection and privacy. Landscape design should reflect changing needs and allow for activities that are familiar and encourage participation, encouraging an active lifestyle and supporting their physical and emotional wellbeing.

Four key themes to consider when designing for dementia:

Access, Movement & Orientation

• Provide level access to garden areas from communal rooms or private patios.
• Routes through external areas should be laid out in a legible manner, level and barrier free to promote confidence and independence.
• Provide clear navigational markers around the garden and along the building margin such as strongly scented plants or garden features.
• Consider including sculptures or memorable features throughout to aid wayfinding.
• Introduce ‘circular’ walking routes which return the resident to their starting point. Routes must never terminate at dead ends and exit gates should be concealed.

Memory & Mental Mapping

• Access to external space can trigger positive memories and provide a sense of achievement.
• The attributes of a garden including particular images and smells can stimulate memories - giving a strong sense of normality, security and refuge.
• Involvement in gardening experiences offers the opportunity to reminisce and engage in familiar activities such as hanging the laundry, picking flowers and growing herbs and vegetables for the kitchen.

Sensory Stimulation

• The external environment should provide opportunities for quiet contemplation, to ease stress, any sensory impairment, anxiety and aggressive behaviour, which are all potential symptoms of dementia.
• Introduction of stimuli for the visually impaired in planting through colour or textural ‘contrast.’
• Ensuring that the right material is used that avoid glare or shiny paving which may be mistaken for slippery surfaces.
• Provide strongly scented plants as ‘markers’ in the garden environment - at corners, seating areas or access points and encourage people to touch plants.
• Provide raised beds which helps in making the plants more accessible to wheelchair users and those who have difficulty bending.
• Illuminate pathways, trees and features within the garden to enhance security and enable the gardens to be enjoyed at night (this is particularly important for people experiencing acute sensitivity to sunlight).

Shelter & Shade

• Consider the provision of a heated summer house or winter gardens containing indoor plants to enable access to the garden environment at all times of year.
• Use pergola, climbing plants and trees to create light shade.
• Creating a sheltered garden will encourage greater use.
• Create a planting palette which reflects ‘seasonal change’ to facilitate a patient’s association with natural timelines and chronology.

A good example of where these principles have been implemented, is PRP’s recently completed care home development at Beachcroft House. The scheme is set within a Victorian terrace surrounded by trees and gardens, and at ground level a landscaped garden that is easily accessible for care home residents. Short walking routes have been created that lead to sheltered spaces to sit and rest and there is also a large area with space for tables and chairs so that when the weather is good, residents can eat outside. Dementia-friendly design considerations such as these ensure residents can benefit from their natural surroundings and can improve their mental health and wellbeing.

As we look ahead to the post-pandemic world, well designed landscaped gardens are going to play an even more important role for everyone’s health and wellbeing and not just for those with dementia. It will be our responsibility as landscape architects to put these considerations at the forefront of our designs and ensure we are creating places that are inclusive for all people.