Community green spaces underused for dementia care - report

News item first posted on: 14/03/16

Urban green spaces, including city farms and community gardens, are not being used enough to help people living with dementia and their carers, according to a new report from Natural England.

In one of the biggest surveys of its kind so far, people living with dementia and their carers were asked about outdoor activities and the places where they go. The report reveals that engaging in outdoor activities that have a purpose and activities that involve being with other people provide the greatest motivation.

But places like city farms and community gardens, are sometimes overlooked as an alternative for people living with dementia, or have not yet explored the possibility of working with carers and dementia support organisations.  

The new study – Is it nice outside? Consulting people living with dementia and carers about engaging with the natural environment – is the result of a collaborative project between Natural England, Dementia Adventure, the Mental Health Foundation and Innovations in Dementia.

Only 20 percent of the people living with dementia considered that their condition was a barrier to using outdoor spaces, whereas 83 percent of carers believed that dementia limited the person’s ability.

Findings from the report include:

  • Some urban green spaces such as allotments, city farms and community gardens are underused by people with dementia
  • Informal walking outdoors was the most frequently mentioned activity (38%) and was also seen as vitally important by carers for its beneficial effect
  • Wildlife or bird watching is one of the most popular activities for people living with dementia and 25% of the people interviewed said that they took part several times a week or every day
  • The most popular places to visit for people with dementia were associated with water (45%), such as lakes, rivers or the coastline and city parks and public gardens were also popular (30%)

The top barriers to taking part in outdoor activities and having contact with nature were:

  • Lack of confidence
  • Fears and safety concerns
  • Not having transport
  • Insufficient information about what places have to offer and their suitability for visitors with dementia
  • Lack of support to get to locations, to use facilities, and to participate in outdoor activities

The report makes a series of recommendations that could encourage greater use of natural spaces, including community-run spaces, by people living with dementia and their carers.

For example, managers of outdoor spaces could work with local dementia action alliances to develop a Trip Advisor-style ratings system to provide information about local dementia-friendly open spaces.

Other recommendations from the report address ways to make visits to green spaces more dementia-friendly through implementing the principles of dementia friendly communities at outdoor sites by: training staff to be dementia aware; improving training on how to sensitively and effectively support people living with dementia; and, improving understanding by managers of outdoor spaces of the types of facilities, activities and information that people living with dementia say they need.

Jim Burt, Principal Adviser for Natural England’s Outdoors for All programme said: “There is already strong evidence to show the positive benefits of engagement with the natural environment for people living with dementia and this survey adds to that body of evidence. Importantly, it heard directly from both those living with dementia and their carers, and the research has revealed important new information and insights. This work will now help our partners and the wider health community to take action that will enable people with dementia to have more and better quality opportunities to be active in the great outdoors.”

For many people living with dementia and their family carers the answer is yes, people want and need to get out into the fresh air, to walk, be near water and watch and listen to the birds.  The fact that these simple outdoor pleasures are not equally accessible for some of the thousands of families living with dementia is another reminder for us to work across care and conservation boundaries and implement the solutions contained in the report.

Toby Williamson, Head of Development and Later Life at the Mental Health Foundation says: “The benefits of outdoor activity for peoples’ wellbeing, whether it’s walking, wildlife watching, or just ‘being in nature’, are well known. But concerns about safety and access can mean that many people with dementia do not share in those benefits.”

The research that the Mental Health Foundation and Innovations in Dementia undertook for Natural England and Dementia Adventure in this report showed that people with dementia, and their families and friends, wanted to continue to visit green spaces, such as parks and rivers, and participate in outdoor activities. It identifies simple, practical changes that organisations responsible for green spaces can make to ensure they are dementia accessible and inclusive, so people with dementia and their carers can continue to enjoy being outdoors.

The findings from this project will now be used to help design a large-scale demonstration project to deliver services in the natural environment for people living with dementia and their carers. The recommendations will also be valuable to other natural environment providers in shaping projects to further their work with people living with dementia.

The report can be downloaded from Natural England’s Access to Evidence publications catalogue.