A new approach to living with dementia

While every gardener has their own favourite plants and unique ideas about the best ways to make them thrive, the benefits of gardening are universally acknowledged; planting, pruning and nurturing provides exercise, reduces stress and brings everyday moments of joy. Which is why intentionally-designed gardens are at the heart of Ryman Healthcare’s myRyman Life model of dementia care. Part of this project is the Care Companion staffing model, which is a revolutionary new approach to engaging with people living with dementia, where the focus is on being with people, rather than doing things for people. Regional Manager and Dementia Care Specialist Karen Lake says the Care Companion programme of person-centred dementia care supports residents to live the life of their choice, rather than applying a one-size-fits-all approach to their care. For avid, lifelong gardeners, that means their day includes the familiar routines it always has waking-up, getting into – their gardening gear, talking about their jobs for the day, and getting outside and helping things grow. “The Care Companion staffing model means that instead of jumping in and doing things for the resident, the care companion is there to smooth over the gaps created by things like short-term memory loss,” says Lake. “It is more about having a support person with you so you can go on living your life.” Early in the development of the model, one resident drew the attention of the village gardeners because of her daily habit of going outside and pulling up all the plants and bringing them inside. Lake says after talking to the resident’s daughter, they discovered she was a very keen gardener and working outside had always been part of her daily routine. “All she needed was somebody who could set her up with the right gear and work with her so they could do some meaningful gardening together. Once we did that, it brought some joy to her life and she was adding value to the gardening team. It became part of her daily routine.” Lake says before developing the myRyman Life model of dementia care for Ryman, she did extensive research both in New Zealand and overseas, talking with experts, people living with dementia and those who care for them. With more than 200 different types of dementia, each person’s experience is different. However, she says the environment they live in and the support they have around them have an influence on how independent they can be.

The stress-reducing benefits of spending time with nature in the garden are well-documented. Lake says this is important for people living with dementia as they often experience higher levels of stress than others. “Being outdoors and in the sunlight causes a release of endorphins that helps people feel less stressed and happier, and for people living with moderate to advanced dementia it’s all about happiness in the moment,” she says. “Another benefit we have discovered about gardening is that people living with dementia don’t do well in big, noisy spaces. There is just too much audio and visual stimulation. So we started to create these amazing gardens with low-stimulus.” The design team have started to include bubbling fountains, bird feeders and spaces where people are encouraged to linger. “Lush raised herb gardens, flower gardens and vegetable gardens attract residents accompanied by their care companions, to spend time pottering around outside in a safe and secluded outdoor world.” A new model of care means a new way of working for staff members, with many discovering how gardening aligns with their own values and interests. The model calls for a lower resident to staff ratio, and care companions receive extensive training. “Care givers are often trained to be task based,” says Lake. “We don’t need them to be task based in this instance. We want them to step back and actually be with the person, rather than do for the person. We want to enter their world, not pull them into ours.” Specialist dementia care is just one of the ways Ryman is pioneering retirement living and aged care. Options for independent living, assisted living and care at villages all around the country mean that if a resident’s health needs change over time, so can their level of care. It’s a personalised approach customised to the needs and preferences of each individual, and offers piece of mind to couples or friends, knowing they can still be near one another even if their health needs are different.