It may feel like winter will never end, but your garden and landscaping team should already be planning for your residents getting outside as the weather improves. There are specific safety concerns that must be considered, but just as important is making it a space that contributes to people’s physical and mental wellbeing as Jane Stoneham, director of the Sensory Trust, explains.
Numerous studies show that well-designed gardens in care homes help older residents maintain, or even improve, their physical and mental health. Even without the research we know this instinctively to be true. It is obvious that things that motivate us to get out and be active will be better for us than things that keep us sedentary. And experience tells us we feel better when we wake up knowing we have fresh things to and see and do are far better than enduring days that are indistinguishable from each other. These are all ingredients that a well-planned garden can provide in a care home.
Other benefits are less obvious. For example, spending time outdoors can improve residents’ sleeping and eating patterns, reduce dependency on others and help them cope more effectively with some of the symptoms accompanying dementia and other health issues, such as anxiety and depression. In turn, happier residents, families and friends and less pressured staff – everyone gains.
In new developments, the best way to make a successful garden is to include it as an integral part of the overall design. The biggest mistake we see is leaving the landscape till last, when many of the design options have gone, along with most of the budget. The landscape must be considered from the earliest stages, developed in synch with the building and given the same attention to detail as the interior design.
Another benefit of an attractive landscape is creating a positive first impression to residents, staff and visitors
In existing care homes, the options for modifying the outdoor areas will be more limited but even in the smallest of spaces it is possible to make things better for residents. We recently helped with a low-budget transformation of a care home garden, and the owner described the results:
“The transformed garden was much more appealing to residents and staff, with vibrant sensory-rich plants, weaving paths, spaces for quiet contemplation as well as social activities. Impromptu picnics would occur, grandparents would once again kick a football with grandchildren, bird feeders and baths were introduced, and more residents could use the garden independently, allowing staff to focus on other tasks.”
We’ve learnt that successful garden design relies on good accessibility so residents can get to and around the garden, and a rich mix of features and activities so they want to. We are often asked to advise on designs and the following elements are ones we have found to be especially important:
Access – routes – journeys
The easier the garden is to get to, the more likely it is to be used and anything that acts as even a small obstacle may well deter people from making the effort to go out. This means thinking about the design of the building, not just the landscape – are there good views of the gardens from indoors, doors that give residents quick and easy access, and flush levels between indoors and outdoors so they work for everyone including wheelchairs and self-drive mobility vehicles?
Access within the garden relies on aspects like wide, firm, non-slip paths; choice of route lengths; plenty of seating; avoidance of obstacles and use of textural indicators to assist people with visual impairments. Also access to highlights, so for example residents can reach to dip their hands in the water feature or fill the bird feeder, including wheelchair users.
A choice of short and longer routes will enable residents to enjoy the landscape as they choose. These can be punctuated by features that serve as mini-destinations, in part to motivate people to be active and in part to add to interest and range of activities in the gardens. For example, seating areas, orchard, summerhouse, gathering point with seating and accessible gardening facilities.
The increased use of self-powered mobility vehicles means that power points may need to be included for recharging.
Seating – shelter – shade
Seats and tables are essential, along with shelter and shade. Some residents will only be able to go outdoors at all if there is a seat within close range, so seats just outside doors are important. Seats along paths will provide rest for people with limited stamina. Seats also give residents the chance to relax and spend time outdoors on their own or with others.
Back rests are needed to support people when seated, and arm rests to assist the action of getting up and sitting down. Low seats are difficult to get up from, and there should be space adjacent for wheelchair and self-powered vehicle users.
Indoor – outdoor connections
Good views from windows brings the gardens into the day to day lives of residents who can’t get outside and when the weather is poor, especially from late autumn to early spring. These can be enhanced by plants with winter flowers or berries or early spring blossom. Locating winter scent (eg winter honeysuckle) near the building will ensure the scent can be enjoyed by people indoors. Bird boxes, feeders and nectar-rich plants can be used to attract wildlife.
Windowsills can give residents the chance for light gardening, such as growing microgreens. For residents living in upper storey apartments they can be a chance to still have some plants even if they don’t have immediate access to a garden space.
The areas just outside the door are likely to be used most often so this is a good place to create attractive garden areas. These will ideally serve different uses, from sitting outside on a sunny day, having coffee or a meal outside, or gardening or taking stroll through the gardens.
Year-round interests, events and celebrations
As residents spend much of their time at home, the priority is to create a garden that is accessible and interesting throughout the whole year. This relies in large part on the planting design, and choosing displays for the different seasons, but interest can also come from art work and seasonal events and activities.
Celebrations can inspire residents to use the garden at different times of the year, and are a good way of linking with the wider community. For example, a Christmas tree can provide a focus for residents, staff, friends and family to decorate each year. Outdoor sockets, lights and decorations, can inspire residents and staff to think of other inventive ways to enliven the landscape.
Providing space for gatherings, garden parties, film nights etc. will also encourage wider social use and again an outdoor power supply will make it easier to connect lights, projectors etc. A space for an outdoor fire, or outdoor cooking area, will support barbecues and sharing food.
Containers, raised planters and gardening
While gardening is popular, not many residents are likely to want to do more than occasional activity, perhaps some light weeding or container growing. The challenge is to design to allow for people to engage as and when they want to, without this causing maintenance problems.
Raised planters are a good answer. They bring the soil and plants to a height where they can be reached and they can support light gardening, or larger-scale vegetable plot (or flowers, herbs etc). Including shelves for tools and a water butt makes it easier for people to join in.
Raised planters can also be integrated into the landscape as structural elements, adding enclosure to a space and backing to seating and positioning plants within easy reach of hands and noses.
Supporting creative activities
Other outdoor activities, such as DIY and craft work, need space and storage. Sheds are useful for both. This makes it easy to use things and put them away again, and this makes it more likely the garden will be used more widely. Craft work can be supported by growing relevant plant material – such as basket willow or flowers for drying – and can be extended to activities indoors.
An outdoor tap is essential if residents are going to garden, or do other activities that need water, even if it’s just to rinse their hands. Carrying heavy water containers from indoors makes it more likely that people won’t bother, or can’t without someone else’s help.
An ideal planting style evokes the feel of a domestic garden, reminiscent of residents’ previous homes, but without the associated high maintenance demands. It relies on long-lived shrubs and herbaceous perennials that are low maintenance but which provide high interest through their display (eg Crocosmia, ground-cover Geranium and Aster).
If you are investing in a new design it is a good idea to get professional help as you can waste money and get disappointing results by making poor choices. It is also an excellent opportunity to get residents involved, inviting them to identify their favourites and help research possibilities. Local garden centres can be a useful source of inspiration and are excellent for seeing what is looking good at different times of year.
The Sensory Trust advises on the development of accessible, engaging outdoor experiences. Our website has free guidance and details of our consultancy and new training packages. Do get in touch if we can help – email@example.com