The power of working with flowers can be therapeutic for caregiver and loved one alike.
When Beth (not her real name) is pinching off the dead leaves of houseplants or watering the garden outside, she seems normal, at peace and as though she has a sense of purpose. Beth, however, is an Alzheimer's patient living at Parc Provence, an assisted-living community for senior adults in St. Louis, Missouri. Angie Keeven, director of resident well-being there, says that Beth, who's only 59, would be taking care of plants if she were able to live at home, so that's what she does at Parc Provence. In the winter, she works in the greenhouse, and in the summer, she gardens outdoors. Her room faces the garden that she so lovingly tends, so when Beth requested wind chimes be added, her wish was quickly-and willingly-granted.
Gardening therapy can work equally as well for loved ones and caregivers who live at home as it does for those in an assisted-living setting. Depending on the mobility of the one in your care, you can garden either indoors or outside. And no matter how small or easy the project, working with living plants will help both of you "bloom."
The Magic of Gardening
For seniors with disabilities or illness, too often the easiest form of fall-back entertainment is television or videos. Gardening gets them away from the screen and fills at least some of their day with gratifying and tangible work.
In many cases, working in the dirt with plants also provides socialization because at least two of you are involved. Engaging other members of your caregiving team in gardening therapy is a good strategy to broaden the scope of that companionship.
"Gardening requires certain steps or sequences," says David B. Carr, MD, a geriatrician at Washington University in St. Louis. "Lots of patients, especially those with Alzheimer's or dementia, need guidance or mentoring because they can't go through all the steps alone, but they can do some of them." Carr describes one of his male patients whose wife was the brains of their gardening operation. "She told him how deep to dig the hole, what to put in it and how to water it. This way of attacking the activity worked for them," he notes, "and they got to spend quality time together.
"It has been my experience that those patients (with Alzheimer's or dementia), doing activities (gardening being one example) do better in the long haul and have a slower rate of decline than those who don't do anything," says Carr. "Gardening is one of the non-prescription interventions that has the ability to slow the rate of cognitive decline."
According to Eva Shaw, PhD, author of Shovel It: Nature's Health Plan, gardening reduces stress, lowers blood pressure and helps fight depression. A study done by Kaiser Permanente showed the brainwave activity of a gardener mirrored that of someone praying or meditating. "Hospitalized patients' wounds heal faster and they require fewer pain killers and antidepressants when they are merely looking at a painting of a garden," says Shaw. "Imagine the effect a real garden can have."
Caregivers reap most of the same benefits as their loved ones, plus some additional advantages when they introduce gardening into their caregiving mix. As a caregiver, you get to actually step away from the focused, everyday caregiving process for a while as you do something totally pleasurable together. A loved one with Alzheimer's or dementia will spend less time asking you repetitive questions and more time gardening-which is definitely a de-stressor. And creating something living together gives you both a sense of purpose.
Gardening, Shaw notes, allows the caregiver to nurture the patient while the patient nurtures the plants. And gardening can be therapeutic even if you've never gardened before.
The Way to Your Garden
A gardening project might begin with a visit to a public garden or a private one that a neighbor doesn't mind sharing. You also can check out gardening books from the library or look up gardening sites on the Internet. Then you'll have to decide if you'll start with houseplants, grow from seed, buy plants at a nursery, or, perhaps, plant a vegetable garden. Will you grow your plants indoors or out? Might your loved one's mobility determine what you grow and where you grow it? Just make sure your loved one is very involved in the choices. And try to incorporate fragrance. Carr points out that the sense of smell is affected early in Alzheimer's patients and gardening is a good way to try to retain that sense of smell. If you can, garden outdoors where fragrances are more pungent, colors more brilliant.
Shaw reminds us of how important our relationship with nature is and how we seek it out in times of stress, commenting, "that really hit home when people flocked to gardens and parks after 9/11." Many employees at The Lighthouse for the Blind in Seattle spend their lunches and breaks in Ethel Dupar's Fragrant Garden. "It's very relaxing, with the birds singing and the fountain playing-people light up when they're out there," says head gardener Helen Webber.
Whether you opt for an indoor or outdoor garden, start with something simple and easy to ensure first-time success. "I recommend starting small," says Carr, "especially with an Alzheimer's patient, and focusing on one bed at a time. If that goes well, then move on."
The easiest way to begin, advises Shaw, is to plant a variety of bright and cheerful flowers in a container that you put outside. Or grow salad greens like lettuce, parsley and cilantro that you can eat. (Making a handpicked salad could be a later mutual activity.) "The most foolproof way is to buy something already in bloom from a reputable, quality nursery," says Shaw.
Although buying from a nursery is safe and almost guarantees success, planting from seed might be more fun, call for more tasks and, in the end, be more satisfying for everyone. And if you are smart about what you plant, you'll see results without too long a wait. Shaw points out that herbs like thyme and cilantro are a snap to grow from seed. And, according to Webber, flowers that easily grow from seeds include nasturtiums and marigolds, as well as colorful-leaved coleus. Peas and radishes are the best vegetables to grow from seeds and handle easily. "Whatever gardening you take on," Webber says, "customize it to your loved one and to you."
Garden Beds and Paths
No matter what you decide to plant, use good soil. In most cases, the soil outside your home will not be the best choice. Webber recommends using potting soil, from a local garden center, for both houseplants and container gardening because these are both artificial environments for plants. In garden beds, you'll want lots of organic matter in the soil so, if you want to see the results of your efforts quickly, mix composted manure, available in garden centers, with the soil there.
To make the garden more accessible if your loved one is in a wheelchair or mobility-challenged, create wide paths for better maneuverability. Building raised beds makes gardening more comfortable for both of you because they eliminate the need for a great deal of bending over.
Geriatrician Carr believes that Alzheimer's and dementia can best be managed by including in the patients' daily routine activities that provide them with cognitive stimulation and socialization as well as stress management. "I wish more physicians would prescribe activities to all their patients," Carr says.
And what better activity, no matter who's in need of some gentle therapy, than shared time in the garden?