Access to well thought out gardens can be therapeutic for everyone, including people with dementia, on so many levels. They are spaces to breathe fresh air, relax, socialise, engage in physical activity, watch wildlife, be creative and grow things to eat and/or enhance the outside environment. However they are also places where there is potential for people to be harmed, especially if they have sensory, physical or cognitive problems. Here are some questions that will assist the process of identifying potential hazards and risks. Solutions that minimise the impact of these can then be explored. These will let the person enjoy the garden safely and reap the multiple benefits to health and wellbeing that being outside affords.
- Can the person appreciate the need to consider the weather. Will they dress appropriately to match the conditions? For example will they wear adequate footwear? Do they dress appropriately when the weather is cold? Do they use sun protection, for example UV clothing and sunglasses, a hat and suntan lotion? Do they recognise the need for adequate hydration especially when doing strenuous work or when the temperature rises?
- Are tetanus injections up to date?
- Is the person aware of the hygiene precautions that they need to take after gardening?
- Does the person suffer from hayfever or other allergies that could cause breathing difficulties, skin irritation or distress? How have they managed these conditions in the past and can they do so independently now?
- Do they need a secure environment to keep them safe? Think about whether there are dangers associated with leaving the garden and whether gates and doors need to be secure. Are walls high enough? Are there any structures that the person might try to climb in order to leave the garden such as shed, trellises and ladders?
- What is the terrain like? Are paths and surfaces even? Are there gradients? Does the nature of the risk change with different weather conditions, for example if it is icy, wet or if there are fallen leaves?
- Are there trip hazards and/or lack of contrast that might pose particular problems for people with visuo-spatial or sensory difficulites?
- What is the level of the person’s mobility and do they recognise the limitations that any loss of function may present? Are there rails? Is there seating so that the person can rest if they need to?
- Is there shade and shelter available?
- Does the size of the garden have the potential to pose a problem? For example could the person get lost or disoriented?
- Could certain plants present a hazard for example due to toxicity, their potential to be irritants or because they are thorny?
- Could the use of some tools be hazardous and does a person have an appreciation of the risks? What supervision does a person need to use garden equipment?
- Do chemicals used in the garden pose an additional hazard because of the person’s dementia and are they stored adequately?
- Is there any animal life that may pose a threat? This might be because certain creatures might sting and bite but there also could be infection issues, for example around faecal matter and contaminated foodstuff.
- Are there sources of flames such as barbecues or bonfires to consider?
- Do water features present any particular risk.
The level and type of precautions needed will vary widely according to the individual using the garden and the particular environment. For some, perhaps those in the early stages of dementia who are accomplished gardeners, few adaptations might be required. However reviewing what is required will be necessary as needs change over time. For those who have more complex needs more forethought may be required in terms of changing the environment or levels of supervision to keep them safe whilst enjoying the outdoors.