The Impact of a Dementia-Friendly Garden Design on People With Dementia in a Residential Aged Care Facility: A Case Study.

BACKGROUND: There is a paucity of evidence on the efficacy of garden design based on dementia-friendly environment (DFE) characteristics on the level of agitation, apathy, and engagement of people with dementia in residential aged care facilities (RACFs). OBJECTIVE: To investigate the effect of a garden improved according to DFE characteristics on agitation, apathy, and engagement of people with dementia in one RACF. METHODS: A case study design with a mixed-method approach was used. RESULTS: There was no significant improvement in the level of participants' agitation following visits to the improved garden, χ2(2) = 5.167, p = .076. A high level of engagement was found in participants during the intervention (Week 1-1, p < .01; Week 1-2, p < .01; Week 2, p < .01; Week 3, p < .05; and Week 4, p < .05) when compared to before intervention (Week 0). A higher level of apathy was found in participants at Week 0 when compared to during the intervention (Week 1-1, p < .05; Week 1-2, p < .01; Week 2, p < .05; Week 3, p < .01; and Week 4, p < .01). Five themes emerged from participant interviews: the presence of sensory-provoking elements in the garden, meaningful engagement in the garden, accessibility of the garden, garden impacts, and garden experiences that demonstrated the effectiveness of the garden. CONCLUSIONS: The garden promoted engagement and decreased apathy of people with dementia living in the RACF with the researcher's partial facilitation of the intervention sessions. The qualitative findings indicated the effectiveness of the garden in reducing agitation.

Understanding the Well-Being of Older Chinese Immigrants in Relation to Green Spaces: A Gold Coast Study (Australia).

In recognition of the aging population and the importance of health-supporting urban environments, including urban green spaces, to maintain well-being, scholars and policymakers have increasingly investigated the associations between urban green spaces and the well-being of older people. However, few studies specifically investigate minority older groups such as those with diverse cultural backgrounds, and many studies often ignore the design attributes of green spaces which may contribute to the well-being of those in such groups. In order to address these gaps, this paper explores how green spaces influence the well-being of older Chinese immigrants. This case study analyzes how older Chinese immigrants interact with green spaces on the Gold Coast, Australia, and adopts the value of place as a conceptual framework to understand the relationship. Two qualitative methods, namely, in-depth interviews and travel diaries, were used to collect data. The results show that parks, as a place, play a crucial role in older Chinese immigrants' ability to undertake outdoor activities. The relationship between green spaces and well-being can be classified into two themes. The first theme is concerned with how older Chinese immigrants perceive and experience green spaces. This finding indicates that green spaces can fulfill their values of keeping healthy, maintaining active lifestyles, and being social, all of which benefit well-being. The second theme relates to daily activities undertaken within green spaces. Issues of accessibility and personal preferences regarding activities complicate the relationship between green spaces and well-being. Good accessibility to green spaces is congruent with older Chinese immigrants' values of being physically active, while difficulties in conducting preferred activities counteract these values which then generate negative perceptions of green spaces. Overall, there is great potential for understanding how personal values can inform the design of inclusive green spaces for minority or less mobile groups.

Creating a dementia-friendly environment through the use of outdoor natural landscape design intervention in long-term care facilities: A narrative review.

There is an increasing volume of literature on the positive effects of outdoor natural landscapes on health and well-being. However, to date, there is a paucity of research on the effect of outdoor natural landscapes designed for people with dementia living in long-term care (LTC) facilities, in particular, those which have incorporated the characteristics of a dementia-friendly environment (DFE). This narrative literature review synthesizes current knowledge on the effect of outdoor natural landscape design, which is aligned with the characteristics of a DFE, to improve agitation, apathy and engagement of people with dementia living in LTC facilities. The reviewed studies predominantly support the positive effects of outdoor natural landscapes on agitation, apathy and engagement of people with dementia. However, there are concerns about the methodological approaches, principles incorporated in the applied outdoor natural landscapes' designs, and the environmental assessment. Further rigorous research is required to understand the impact of the outdoor natural landscapes, with the application of DFE characteristics in the design, on agitation, apathy and engagement of people with dementia living in LTC facilities.