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Research and Projects

Impact of Using Outdoor Spaces on the Physical and Mental Well-Being of Those With Dementia

Theme: CLAHRC - Mental Health & Dementia
Status: Complete

This review was led by the Evidence Synthesis Team.

Why we did this review?

Many people living in residential care homes have dementia or dementia-like symptoms. Opportunities to help people to feel better without the use of medication are important. Spending time in a garden can be relaxing and calming for residents of care homes, their families and staff.

We were interested to find out what information was available about the effects of spending time in a garden on the wellbeing of people with dementia resident in care homes, as well as on their families and carers.

How we did this review?

The research was a systematic review carried out in 2014. This brings together all existing research on a particular question. To find studies that might help us to answer the question we searched the academic literature and contacted relevant organisations.

We found 17 small studies from the US, UK, Australia, China, Canada, Sweden and Finland. Most of these were done in the last 10 years and looked at the impact of gardens on the wellbeing of people with dementia. Three studies looked at the impact of horticultural therapy on the wellbeing of people with dementia.

What did we find?

  • Promising impacts on levels of agitation for those spending time in a garden

  • Gardens need to offer a range of experiences to suit different needs.

  • Families valued somewhere pleasant to meet that stimulated interest and conversation

  • Staff said residents found the gardens calming

  • Some people perceived the garden as a hazard and there was limited staff time available for supervision


Family member:

‘I can’t say how much of a difference the garden has made for [name]. It’s relaxing for us both to be out here. It has definitely improved [name’s] quality of life and I enjoy coming more too.’

Member of staff:

‘It gives them a sense of purpose and ownership and I also think they enjoy the feeling of looking after the birds and plants instead of being the ones to be looked after all the time; after all most of them were nurturers of some description in their former lives.’

Family member:

'She goes outdoors and walks around on a regular basis, but she also spends some time in her room . . . and she has a little bit of a view. I got her a little snowman birdfeeder ...Now, I’m not sure if she realizes that it’s hers today, but she smiles when she sees it and comments on it....’

Member of staff:

‘I do appreciate the fact that they allowed them the freedom to be able to go outside... [but] it creates quite a havoc for us to be watching them when we don’t have the staff to do that’

What next?

Our research suggests that although there are promising relationships between garden use and agitation in care home residents with dementia, future research is needed. Any further work in this area should focus on measuring key concerns in consistent ways, and on understanding and solving the causes of limited accessibility.

Further information

For more information, read a printable version of this summary. You can also read a recently published paper in the Journal of the American Medical Directors Association (JAMDA) and a recent news story on this work.

You can also watch a video of one of the team, Dr Ruth Garside, talk more about the project below.