Potential Therapeutic Benefits of Participation of People with Dementia in Care Farms
Written By:Eilon Caspi Ph.D. (Adapted)
Regular attendance and participation in activities and chores on dementia-friendly Care Farms could enable people with dementia to realize a number of health, functional, psychological, social, and spiritual benefits. The variety and naturally integrated qualities of Care Farms promote the well-being and health of participants with dementia.
Potential therapeutic benefits of participation of people with dementia in Care Farms include:
1. Being outdoors and maintaining connections with nature
In addition, at a certain point in the disease, many people with dementia may be at risk of significant weight loss and dehydration. Regularly attending a Care Farm could improve food and fluid intake.
2. Working on a Care Farms offers many opportunities for naturally occurring physical activities
3. Multisensory Stimulation is provided through the inherent characteristics of farms and the wide variety of activities offered
Being in nature offers frequent spontaneous (“organic”) opportunities for using these senses.
This inherent feature of Care Farms is important as many people with dementia especially those in mid-to-late stages are often deprived of adequate multisensory stimulation both at home and in long-term care residences.
4. Doing the different chores on theCare Farm can give people with dementia the feeling that they are needed, useful, and contributing members of society
5. Many grew up on farms, loved working in gardens, and enjoyed the company of pets.
An older man with Alzheimer's disease engaged in two-thirds of episodes of "aggressive" behaviors with other residents on the unit in which he lived (usually as the exhibitor of these behaviors). But once you gave him a chicken to hold in his arm during a pet therapy group activity, he was clearly content and emotional (you could see tears in his eyes when he recalled and shared experiences from as a child growing up on a farm). The preventative effect was clear: he did not engage in "aggressive" behaviors during this personally meaningful activity...
6. Plenty of opportunities for learning and personal and occupational growth
People with dementia can learn well into their disease such as through
The broad and diverse range of activities and chores done on a Care Farms can promote choice, personalization,strongersense of autonomy and identity, and varied opportunities for learning and growth when adapted to the person’s current preferences and cognitive abilities and disabilities.
7. Working closely together with the farmer/therapist and peers may provide natural opportunities for socialization and friendships (with the farmer/therapist and with peers)
8. The unique, personal, and humane approach of the care farmer/therapist toward people with dementia is considered a big part of the success of Care Farms.
To be successful in building these relationships, most the farmer/therapist will need to receive high-quality dementia-specific training in areas such as:
9. When planned and delivered well, engagement of people with dementia in the different activities and chores on Care Farmscould help reduce various forms of behavioral expressions and promote positive emotional states
It could lead to reduction in feelings of anxiety and “aggressive” behaviors and use of psychotropic medications (which are mostly ineffective, have many adverse and risky side effects, and are expensive)
10. Care Farms offer natural opportunities to meet the spiritual needs of people with dementia (such as through simply being, regular connections with nature, caring for animals, working in the fields, and growing and harvesting vegetables and fruits)
While the spiritual needs of people with dementia are critical, this integral aspect of their psychological well-being is often overlooked in the community and in many long-term care residences
11. Many farms are normal in character and naturally set up in ways that could give the person with dementia a sense of being at home
To ensure that the farm is dementia-friendly, other features of the physical environment must be evaluated, addressed and provisions made for:
12. The combination of strength-based and empowerment-oriented approach along with the “normal life” characteristics
The informal non-medical atmosphere of Care Farms are dedicated to people with dementia to assist in reducing the widely-held and harmful stigma experienced by many people living with the disease
How many times we hear people living with dementia refusing to attend a day center or moving to a traditional nursing home?
13. Respite for Family Care Partners
Safety Considerations Prior to any engagement of people with dementia on Care Farms
Selected examples of potential risks may include:
Research is needed to identify the full spectrum of potential and actual safety risks for participation of people with dementia on care farms.
The knowledge generated in these studies could inform development and implementation of dementia-friendly and safe Care Farm programs.
Beyond those caused by dementia, limitations and disabilities caused by the aging process (e.g., physical; functional; hearing; vision; chronic diseases, etc.) must be proactively evaluated, identified, and addressed and compensated for in a timely manner.
Careful and routine evaluation and written documentation of these physical and cognitive limitations/disabilities is key for implementation of safe and dementia friendly Care Farm programs for people living with dementia.
The evaluation must be ongoing because dementia is a moving target as abilities and disabilities change over time. As importantly, evaluation must include identification of remaining abilities and strengths of participants with dementia.
Insights gleaned from these evaluations need to inform efforts aimed at engaging these individuals in personally meaningful and enjoyable activities and chores on Care Farms.
Could this major gap in services for people with dementia be bridged by implementation of large-scale financial reimbursement mechanisms and other incentives that would encourage farmers/therapists to develop and offer Care Farm programs for this vulnerable population?
The information in this document is written by Eilon Caspi Ph.D. (June 23 2015), is partially based on these sources:
Bruin et al. (2010). The concept of green care farms for older people with dementia. Dementia, 9(1), 79-128.
Bruin et al. (2009). Day care at green care farms: A novel way to stimulate dietary intake of community-dwelling older people with dementia? The Journal of Nutrition, Health, & Aging, 14(5), 352-357.
Bruin et al. (2009). Green care farms promote activity among elderly people with dementia. Journal of Housing for the Elderly, 23, 368-389.
Hassink et al. (2010). Care farms in the Netherlands: Attractive empowerment-oriented and strengths-based practices in the community. Health & Place, 16, 423-430.
Hassink et al. (2012). Care farms in the Netherlands: An unexplored example of multifunctional agriculture – Toward an empirically grounded, organization-theory-based typology. Rural Sociology, 77(4), 569-600.
Schols & van der Schriek-van Meel (2006). Day care for demented elderly in a dairy farm setting. JAMDA, 7, 456-459.
* Eilon Caspi - Special thanks to Maarten Fischer for inspiring me to learn more about this innovative model during his presentation on this topic at the 2014 Gerontological Society of America Annual Scientific Meeting in Washington D.C., generously giving me an informative and moving tour in several pioneering and visionary Care Farms with whom he collaborates in Montana, sharing the above research articles with me, and for his helpful feedback and suggestions for improving this document.
You are invited to watch this inspiring short film(Vimeo) on a Green Care Farm “De Port” in Keplen-Oler, the Netherlands: https://vimeo.com/109903443
Implementing green care farms for people with dementia
At the 31st International Conference of Alzheimer’s Disease International (ADI), held in Budapest, Hungary, from April 21–24 2016, Simone de Bruin, PhD, from the National Institute of Public Health and the Environment, Bilthoven, the Netherlands, discusses the value of green care farms that provide agricultural activities and care services for people with dementia and their caregivers.
Wellness Care Farm