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Access to nature for dementia patients

Posted on Thu, 11/09/2014

Building work on a miniature version of a famous Victorian park has now been completed, as part of a project using nature to treat patients with Dementia.

Features from Gateshead’s beautiful Saltwell Park, which opened in 1876, have served as the inspiration behind a new nature area for Dementia patients at the QE Hospital’s Cragside Court.

The idea came about after work by doctors in Gateshead found that exposure to nature had a range of beneficial effects on patients and could trigger positive emotions and memories.

Dr Karen Franks, consultant in old age psychiatry and psychologist Kate Andrews have just published their findings as part of a new book looking at the benefits of outside spaces for people who have dementia.

The garden area has been transformed into a beautiful space evocative of Saltwell Park with more green space and a bandstand area.

As part of the research the team visited care homes with boxes of home grown vegetables, herbs, compost, hay, flowers and autumn leaves. They then worked with residents using a technique that explores in detail how patients make sense of their personal and social world.

The researchers found that access to nature and the natural world can play a key role in restoring a sense of purpose, unlocking memories from the past, bringing meaning to patients experiences and providing a calming affect for people living with dementia.

Dr Franks, who is based at the Queen Elizabeth Hospital in Gateshead said:

“Access to nature really helps evoke positive memories for our patients and many have talked about working in allotments, taking trips to the beach or family outings to Saltwell Park. Unfortunately patients can often spend long hours indoors and helping them connect with nature has a really positive effect which can also mitigate some of the more challenging behaviour associated with dementia.

“There is increasing recognition within dementia care that access to the natural world is beneficial for people with dementia, even in the later stages of their illness. We noticed that most of this work was about people who had lived in rural or suburban settings. This did not reflect the lives of many of our patients who had grown up and worked in Gateshead and surrounding areas. We wanted to try to capture the experiences and meaning of nature for people who had grown up in more built up areas and worked in pits and factories.

“It seems to have a very therapeutic effect for the patients and really helps to reduce the stress and frustration associated with the condition. It’s about connecting with the past and having a really positive experience.

“A relationship with nature is an integral part of an individual’s sense of identity and how they give meaning to their experiences. As practitioners I think we need to look at recreating some of these environments and think about how we can use outside spaces so they resemble parks, vegetable plots or growing areas.

“Most of the patients we worked with grew up in a very urban setting and throughout their lives sought out ways to connect with the natural world. They used nature as a way to bring balance to their lives and emotional state. Sadly, they became disconnected with this relationship later in life and you have to wonder if this may add further to the loss of a sense of purpose that appears to be experienced by many people with dementia.

“Lots of people in 24 hour care or in care homes often have poor access to nature and the outside world is rarely brought in except on the coats of visitors. We found that the sensory experience can be calming and refreshing for patients but also seems to trigger people’s memories.

“This is really beneficial because dementia forces people into an unfamiliar mental state and these positive memories of the past are both familiar and reassuring.

“We need to look at new ways of treating and managing the condition because more and more people will suffer from dementia and live longer. We’re really encouraging people in care homes or care settings to utilise nature and make the best use of their outdoor spaces.”

The QE has recently invested £35,000 in a new pilot scheme to create a more friendly environment for people with dementia in hospital wards. This includes a wide range of innovative new measures such as adapted lighting, new furniture, better signage and coloured cutlery to make a real difference for patients.

These changes aren’t being done in isolation and all staff at the Trust, including those who don’t work directly with patients, must complete a mandatory training session on dementia called Barbara’s Story. This is based around a powerful film of one woman’s experience of NHS care and what older patients need from hospital services.

The QE has also introduced a forget me not scheme where patients who have extra communication needs, are issued with a blue wrist band when they come to hospital, so that staff know they may need a bit of extra help.

A clinical dementia symposium and support group on dementia has also been organised so that staff can share best practice of treating or helping those patients with dementia.

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