THE

MEMORY SENSORY GARDEN

AT CEDAR PARC

A PROJECT PROPOSAL

The Memory Sensory Garden

Introduction

The starting point for this presentation paper is the idea that memory gardens could be regarded as a therapeutic activity and can actually stimulate sensory sensations in the care of persons with dementia. Dementia is a syndrome with a cluster of symptoms.

However, the increasing incapacity for abstract thinking, making judgements and memory problems are the most prominent symptoms of dementia disorders.

According to the Portland Memory garden project team every garden is unique and a very special place. They are designed to create memories as well as stimulate fond memories of days gone by. Every one can enjoy a memory sensory garden but the features make them especially appealing to older adults and those living with Alzheimer’s disease and other memory disorders.

Background Information

Cedar Parc is a twenty-four bedded ward caring for elderly patients who suffer from Alzheimer’s disease and dementia. The ward has a mixture of male/female patients caring for continuing care, respite care and people awaiting placement in a nursing home. Cedar Parc is part of Ysbyty’r Tri Chwm which is a specialist unit catering for people with mental health problems in old age. The patients on Cedar Parc suffer from varying degrees and different levels of Alzheimer’s disease and other dementia’s. The majorities are in the latter stages of their illness, some are disabled and chairbound and others nursed in bed. However that will not distract or be an obstacle in all our residents having the opportunity of enjoying the benefits of the memory sensory garden. Those people, who are chair bound and nursed in the sitting room, could be transferred via wheelchair to experience the garden. Also those patients who are nursed in bed directly adjacent to the garden will have the same opportunity of sensory stimulation.

As mental functions decline people with dementia operate more on a sensory level rather than an intellectual level. Therefore the bed patients will still have the opportunity to hear and experience sounds and smells of the garden through plants, water features, birds and the activity of people in the garden providing a climate of four seasons of sensory stimulation. The concept of the memory sensory garden is a new idea, which the team at Cedar Parc would like to take on as a much larger project.

The current garden at Cedar Parc, though developed with the best intentions to display colour and fragrance never attained it’s potential. It has been a cause of great frustration that the garden could not be used in a therapeutic way. One of the consequences of Alzheimer’s disease and dementia is that people wander and suffer from confusion. The garden in that scenario was never safe for our patients to use.

Benefits

Gardening as we know is a good therapy for both young and older people. According to the centre for child and family research, gardens have been designed to provide a safe and stimulating environment for patients. Therefore gardens and gardening have been used to provoke memories in reminiscence therapy and in the care of patients with Alzheimer’s disease and the other forms of dementia.

BUPA (2002) in their article “gardening may keep Alzheimer’s disease at bay” fully endorses that gardens and gardening have been widely used as a therapy for individuals with Alzheimer’s disease. The idea is that a garden helps to stimulate the brain with refreshing colour and scent. It also gives people a contained world that has a past and present reality. This can be particularly helpful when the rest of the person’s life may be becoming confused and complex as a result of a condition.

The Portland Memory Project (2002) lends an extensive list of benefits from being in the garden these are as follows.

Physical Benefits

· Exercises the eyes through visual scanning, and seeing near and far.

· Exercises hands and fingers, arms and upper body.

· Motivates the person to walk, stoop, bend, reach and maintain balance.

· Gives enormous pleasure through the senses:- seeing, smelling, feeling, and hearing.

· Gives mild to moderate exercise in co-ordination, strength, stamina and physical activity and frequently nothing else will.

Cognitive Benefits

· Enhances orientation

· Exercises the attention span

· Gives practice in following simple directions

Social Benefits

· Promotes interaction by encouraging discussion about common interest.

· Lends it self to many social activities; clubs, garden socials.

Psychological benefits

· Provides a safe nurturing and familiar environment.

· Provides opportunities to relieve tension, frustration and aggression.

· Provides a place to gather friends and family for emotional support.

· Serves as a personal sanctuary.

Reflecting on the benefits of the memory sensory garden. Many of the key points highlighted by the Portland project clearly recognise the holistic benefits of gardens. The staff at Cedar Parc have been disappointed at not being able to use or experience the garden in a therapeutic way. In fact the garden has become another world, detached from the inner world of the ward environment. It has therefore not created opportunity to witness at first hand the delights of what should be a unique and special place to visit.

Development process

The preliminary development process commenced with meetings with the team leader at Ysbyty’r Tri Chwm and the ward manager at Cedar Parc. The process has since evolved through a series of meetings with staff, relatives and the recent involvement of the Blaenau Gwent Arts development team and the BTCV a voluntary group. Along with offers from the Local College the scene was set.

We aim to arrange an interactive workshop for everyone who is involved to contribute to the design and share ideas. Contact has also been made with the local Health Care

Trust to gain support for the project.

Community partnership is the key theme of this project becoming reality. The Welsh assembly is very supportive of such partnership arrangements to assist with improvement and delivery of quality Care to our patients.

The team at Ysbyty’r Tri Chwm have a good record of encouraging such partnership arrangements. This has been evident in recent months with projects involving Crossroads, Age concern, The Blaenau Gwent branch of the Alzheimer’s society, the Blaenau Gwent arts development team and the hospice of the valleys.

Garden Design and features

The memory sensory garden should be a rich environment enjoyed throughout the four seasons of the year. It should create the opportunity for connection with the natural world of flora and wildlife.

As mental functions decline, people with dementia operate more on a sensory level. It is therefore essential to provide positive sensory stimulation for them to gather information about their environment. The Garden will therefore provide real opportunities for the person with dementia to recall experiences from the past and provide countless subjects for discussion with family and friends.

It is essential that the garden should have easy access and that pathways are smooth and low in glare. The garden beds should be raised for safety purposes and easy viewing from wheelchairs and for those who are confined to bed. Handrails along the pathways will help those who have difficulty in walking. The garden will also need a means of protection from the sun and the wind. It is also important that the design should consider a “figure of eight” looped path (this includes no dead ends which has been a feature of many garden designs for people who have dementia). There should also be areas where seating is provided to sit, relax and enjoy the garden.

Planting as already mentioned is a highly important aspect of any garden. Many plant varieties can evoke childhood memories as well as sparking pleasant memories of the past. They should include plants that are interesting to look at, to touch and to smell. Another important feature is the role of water in the garden such as bubbling water fountains and special water features. Overall the garden should be brightly coloured with an adult theme, providing sensory stimulation throughout the four seasons of the year.