Outside Space
Dementia, designers, and dandelions
Garden designers, Debbie Carroll and Mark Rendell, from Step Change Design, carried out a research project in the care sector to answer a simple question, ‘Why aren’t care home gardens used more actively?’ As they explain, the answers found had little to do with the design of the outside spaces, and more to do with the complex phenomenon of care culture.
We’ve been on an eye-opening journey. It’s fair to say that, at one point during our research project, we seriously questioned if, where, and how, a garden designer is actually needed in enabling care setting staff and residents to use their gardens more, particularly for those residents living with dementia. What is clear now, at the end of our research, and just ahead of publication of our Care Culture Handbook and Map (now available to purchase online, at
http://tinyurl.com/hgrdq37), is that we need to urgently share some insights and some possibly uncomfortable home truths with our peers in the garden design and landscape architecture sectors about the way we approach our design and consultation practices with our care sector clients.
AN ETHICAL QUESTION First, however, let’s backtrack, and give a brief overview of our research and how it came about. In 2012 we got caught up in a conversation about the unease we felt about
recently designed gardens in care settings that hadn’t appeared to be used, and needed to be designed again. We both sensed that if we didn’t explore this further, it could mean our garden designs not being used either, potentially calling into question our ability to satisfy not just our care sector clients, but their residents too. This was not an acceptable situation to us, either economically, or ethically. As we explored this issue, we started to ask what might we (in the design sector) be doing wrong? How big a problem was it across the UK? Why did the care sector believe that a brand new garden would make residents use their gardens more, and indeed why were they not using their existing gardens? What was missing from our practice that meant we failed to engage our clients with their new gardens?
A MODEST, SELF-FUNDED RESEARCH PROJECT
Over the winter of 2012, we designed a short- term, small-scale, self-funded research project to answer our original question that we could fit in between our busy work schedules. We aimed to recruit half a dozen care homes and then write up the findings, share them, build the learning into our future work, and return to our own busy design practices. Our modest ambitions were quickly overtaken by subsequent events. Sylvie Silver, chief executive
This garden was ‘typically domestic in feel and scale; a washing line in one area, scruffy lawn underneath, bird feeders, and some familiar plants like lavender and rosemary and wallflowers, but it didn’t seem to matter’.
of NAPA (the National Activity Providers Association), agreed to email her contacts in care homes across the UK and Ireland to find out if anyone would like to take part in our research project. Within two weeks, 50 care homes had got in touch. The care sector was clearly asking the same questions we were about their outside spaces.
The Care Culture Map and accompanying Handbook have been produced ‘to help care settings practically and clearly identify ways to use their gardens more’.
We scaled up our research activity and scope at this point, recognising that here was a rare opportunity to gather some rich and detailed evidence to categorically answer our initial question.
ANSWERING A CALL FOR MORE RESEARCH
A key inspiration for our research methodology came from Garuth Chalfont’s seminal 2008 book, Design for Nature in Dementia Care (published by the Bradford Dementia Group). In the book, Garuth made a direct call for more research into understanding how people with dementia engage with outdoor space. He even proposed the research methodology to follow, Environment Behaviour Studies, which we adapted for our research. We found the book to be inspirational, thought-provoking, and full of common sense and useful insights about the value of edge space, bringing nature closer to the care setting, and carers, and facilitators’ important role in aiding and maintaining the connection between indoors and outdoors, particularly for residents with dementia. Garuth Chalfont put the resident at the centre of design-led interventions in the outside space, a stance we would come to affirm during the course of our research analysis.
THE DATA GATHERING PHASE Over the summer of 2013, seven of the original cohort of 24 care homes withdrew, leaving
‘Why did the care sector believe that a brand new garden would make residents use their gardens more? What was missing from our practice that meant we failed to engage our clients with their new gardens?’
THE NETWORK Ap r i l 2 01 6 23
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