Last week Noreen was in London spending a day in the illustrious surroundings of the Great Hall at St Barts Hospital.
The ‘Transforming Mental Health and Dementia Provision with the Natural Environment’ conference brought health and social care sectors together with the natural environment sector to inspire each other to work together.
The morning kicked off with an introduction from Gina Radford, Deputy Chief Medical Officer, followed by three short presentations from Gregor Henderson (Public Health England), James Cross (Natural England) and Alistair Burns (National Clinical Director for Dementia, NHS England). These were followed by a number of workshops and then the day concluded with a panel discussion which included Rachel Brooks (Care Farms UK) Craig Lister (Green Gym), Gregor Henderson and Rachel Stancliffe (Centre for Sustainable Healthcare).
Gina Radford captured our attention at the beginning with a very personal story of her father who had dementia and her memories of how he had loved being in the garden. For her, it is intuitive that nature is good for us but research is not as robust as it should be. She urged us to look beyond traditional therapeutic options at the same time as setting out the challenges of how we embed nature into mainstream thinking, how we have a more ‘joined up’ voice, and how we learn and share good practice.
One of the issues highlighted in Gregor Henderson’s talk was the unequal access to greenspace across England, for example, people living in the most deprived areas are less likely to live near greenspace. Alistair Burns also noted that people living with dementia experience barriers to the outdoors – 35% go out once a week or less and 10% go out once a month. He outlined the Well Pathway for Dementia, preventing well, diagnosing well, signposting well, living well, and dying well. He could see a clear role for the natural environment enabling older people to ‘live well’ with dementia. He emphasised person centred care and the need to focus on the ‘lived experiences’ of people living with dementia.
I attended two fascinating workshops. The first one was led by Victoria Hill and Dale Cranshaw from Growing Support, a social enterprise involved in delivering weekly gardening sessions in care homes, gardening groups, social housing and community gardening. Gardening not only enables social interaction and meaningful activities but allows care homes residents to ‘get their hands dirty’ and so helps keep vital senses alive.
Amongst the operational challenges Growing Support encountered was the poor understanding of capacity of people with dementia; care home staff’s attitude could often be summed up with ‘s/he won’t be able to do that’. By providing training and resources for care staff, Growing Support is seeking to build capacity in care homes. Another challenge is measuring impact: it is possible to observe the immediate impact of gardening sessions with the Great Cincinnati Chapter Wellbeing Observation Tool, but it is difficult to find appropriate tools to demonstrate longer term impact. The problem is compounded by care home resident’s short term memory loss, limited verbal skills and sensory impairment which impacts their capacity for consent.
The second workshop focused on the findings from a 10 week pilot woodland activity programme for people with early stage dementia and was delivered by Forestry Commission Scotland. The findings from the programme demonstrate the wellbeing benefits gained from trees, woods and forests. These included physical and mental wellbeing, meaning and identity and social connectedness. Being in the woodlands enabled nature connections by sensory stimulation, triggering memories of past experiences and awareness of nature’s cycles and the changing seasons.
The event concluded with an interesting panel discussion when Rachel Bragg introduced an infographic on the different contexts in which an individual may engage with the natural environment.
The key messages from the event were the need for partnership working and developing relationships, consistency in language, evidence and evaluation tools, and scaling up of small projects.