Research on horticultural therapy continually supports what many elders and support providers already know: People-plant interactions promote well-being in older adults.
Horticultural therapy (HT)—the use of plants, horticultural activities, and the natural environment to improve well-being—has been demonstrated to improve quality of life for older adults. For well over a decade, numerous research outcomes have shown that HT contributes to a variety of psychological, social, cognitive, and physical health benefits.
HT, which bears many similarities to adaptive gardening, is especially valuable in a memory care setting. Recent findings from a pilot randomized controlled trial demonstrate HT’s potential to bring about reduced apathy and improved cognitive function for elders with dementia. The study, headed by Yi Yang of the Taizhou University’s Department of Nursing, demonstrates the unique ways that HT is valuable in a memory care setting.
The results of this study specifically show that apathy among patients in the HT group was significantly lower compared to those in the control group, enhancing life satisfaction, reducing loneliness, and promoting healthy activity. Apathy is a common behavioral and psychological symptom of people with dementia and associated with a number of adverse outcomes.
The research on HT’s value to older adults has been ongoing since at least the early aughts, and literature reviews in the field reveal consistent evidence that HT is helpful. Earlier and more recent studies—including both indoor and outdoor gardening activities—have found unique benefits from HT for people with dementia. The connection with living plants provides a sense of peace and shelter, effectively reducing stress, depression, and anxiety, and generally improving quality of life.
HT activities include moderate physical exercise, which can improve flexibility, physical strength, and cognitive ability. HT in senior living holds promise for reducing the high costs that often pertain to long-term assisted living and dementia unit residents. The benefits of horticultural therapy and exposure to garden settings can include reduction of physical pain, improvement in attention, lessening of stress, modulation of agitation, and reduction of falls.
BeingPatient, an online resource for Alzheimer’s news and support, has recently published an article that focuses on brain health outcomes following HT. The article, written by Genevieve Glass, cites additional research supporting HT as a solution for dementia-related apathy.
This article also provides hands-on insight from Joel Flagler, a Rutgers University professor and registered horticultural therapist since 1984. Glass provides numerous quotes through which Flagler shares his experience: “Any time a person reconnects with nature, good feelings and healing can come[.] It’s important to remember that the plant doesn’t discriminate: The plant doesn’t care if the person has dementia, or they’re in a wheelchair, the plant is ready to respond to that person.”
Flagler also highlights the healing power of role reversal for those who normally find themselves on the receiving end of care. "When elders are provided with their own opportunities to serve as nurturing and responsible caretakers, we’re talking about real empowerment.”
He also acknowledges that for those living with dementia, empowerment can be relative. For those who are unable to care for a plant, he suggests crushing the leaves of aromatic plants and offering an invitation to share whatever associations or memories come up.
Eldergrow™ also resides on the provider side of HT, and can be described as the pioneer in senior living HT. The non-profit’s program is designed to bring gardening indoors for residents to enjoy through mobile, therapeutic sensory gardens. The diverse curriculum includes gardening, garden art, and culinary harvest sessions. The Culinary Herb Garden is a DIY program that brings the farm-to-fork concept directly into senior living. Fresh herbs, along with recipes and activities, are delivered each month as part of their “Herb of the Month” program. Eldergow’s unique model measures and documents wellness goals tied to such therapy, focusing on six therapeutic wellness goals: socialization, cognitive stimulation, sensory stimulation, spatial awareness, motor skills and creative expression.
Across the state of Florida, 22 elder care facilities will have access to Eldergrow’s national indoor gardening program. This support comes to Florida elders thanks to a $1 million civil penalty grant, which was awarded through the Centers for Medicare & Medicaid Services Region 4 office and the Agency for Health Care Administration. In accordance with roughly twenty years of research, this added support is expected to help elders through the ongoing impact of the pandemic. In addition to the benefits mentioned above, this HT grant is explicitly aimed at replacing isolation and loneliness with connection and support for elders through the remainder of the public health crisis.