Quality of experience during horticultural activities: an experience sampling pilot study among older adults living in a nursing home

Effects of horticultural therapy on health in the elderly: A review and meta-analysis

Aim

Given the current aging population, the demand on medical facilities, facilities for elderly care, and even their high prevalence, it is crucial to investigate the advantages of older people. The purpose of our study was to systematically review the existing literature on the health effects of horticultural therapy as a treatment option for the elderly.

Subject and methods

Article searches were conducted through five databases: Web of science, Science Direct, PubMed, EBSCO, and Google Scholar, according to the standard method of systematic evaluation and meta-analysis. Thirty-two published articles were included, and 27 relevant variables were meta-analyzed to assess the benefits of horticultural therapy in terms of physical and psychological functioning in the elderly.

Results

Results show that horticultural therapy may be helpful in helping seniors lose weight -0.195 (95% CI -0.507,0.117), reduce their waist circumference -0.327 (95% CI -0.637, -0.017), lower their stress -0.339 (95% CI -0.610, -0.069) and cortisol -0.902 (95% CI -0.728, -0.002) levels, improve their physical flexibility 0.302 (95% CI 0.036, 0.569), social interaction 0.370, (95% CI 0.115, 0.624), and daily vegetables and fruit consumption 0.688 (95% CI: 0.287, 1.089).

Conclusion

Horticultural therapy may be a useful tool for enhancing the physical, mental and social aspects of the elderly. However, there is substantial heterogeneity and wide variation in the quality of the included studies. Further high-quality studies, rigorous controls and adjustments for significant confounding variables, and larger populations are needed in the future to further our understanding of the link between horticultural therapy and elder health.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10389-023-01938-w.

Electroencephalography (EEG)-Based Neural Emotional Response to Flower Arrangements (FAs) on Normal Elderly (NE) and Cognitively Impaired Elderly (CIE)

Background: The purpose of this study is to explore the differences and similarities of EEG -based neural emotional response toward flower arrangements (FAs) between the normal elderly (NE) and cognitively impaired elderly (CIE) in arranging flowers. Methods: The study participants included 16 elderly individuals: eight elderly people with normal cognitive function and eight elderly people with cognitive dysfunction. They were divided into two groups to arrange flowers, and six mood indicators (Engagement, Excitation, Focus, Interest, Relaxation and Stress) were measured with EEG before and after the experiment. Results: The similarities were that there was no significant difference in Excitement, Relaxation and Stress between pre-test and post-test for NE and CIE. The differences were that there was a significant difference on Engagement and Interest in CIE, and they both increased, but there was no difference with respect to them in NE. While there was a significant difference on the Focus of NE, it was decreased, but there was no difference for it with respect to CIE. Conclusions: A similarity on EEG-Based Neural Emotional Responses to flower arrangements between NE and CIE was that they both felt relaxation. The differences were that the Focus of NE decreased and the Interest and Engagement of CIE increased. CIEs were more interested and engaged in FAs.

Nature Experiences of Older People for Active Ageing: An Interdisciplinary Approach to the Co-Design of Community Gardens

In Western countries, the concepts of healthy ageing and active ageing, that is, concepts that favour health, participation, and security to increase the quality of life of older people, have become key issues. Hence, the effective design of public green spaces in urban areas is crucial, as visiting these areas encourages social relations and interactions in natural, healthy contexts. Consistent with these perspectives, existing landscape design criteria emphasise the importance of considering not only the functional and aesthetic elements, but also the ecosystemic and biophilic relationships between people and the environment, producing positive effects for both. To maximise the impact of such design criteria, proper engagement strategies are desirable, both to assign an active role to older people themselves and to inform the fine-tuning of the design process according to the specific needs of the local population. This study presents an interdisciplinary co-design method that encourages and informs a biophilic approach by describing the experiences of people in natural environments, actual and designed, through the application of attention restoration theory (ART). The case study was developed through six focus group meetings with older people for the co-design of a restorative area in a community garden in the Ortica district in Milan (Italy). Results show how the main needs expressed by participants can be classified into the ART factors of "compatibility" (a multifunctional garden), "fascination" (sense of contact with nature), and "being away" (metaphorical escape from nursing homes). The garden designed includes biophilic principles that respond to such needs, and specific links with designed elements were identified. For example, "being away" (e.g., isolation from daily routine and visual occlusion of the surroundings) and "compatibility" (e.g., pergola and aesthetic value) are the factors that include the elements that more satisfactorily answer previous needs. "Fascination" also includes many positive aspects, allowing space for improvements (e.g., more water elements, interaction with animals). Implications of the method are discussed, including the importance of subjective experience in informing design, the use of different psychological constructs to describe it, and the methodological alternatives for psychological assessment.

Effects of Types of Horticultural Activity on the Physical and Mental State of Elderly Individuals

This study aimed to evaluate the effect of types of horticultural activities among elderly individuals in a senior citizen learning camp. We arranged four horticultural activities: Grass Doll, Kokedama, Rocky Leaf Prints, and Herb Tasting and Smelling. Twenty-seven senior citizens (60 to 76 years) were recruited to participate. We assessed their physiological and mental state before and after the activities by measuring heart rate variability (HRV), pulse rate, blood pressure, salivary amylase activity (SAA), and Profile of Mood States (POMS). Results showed that SAA was significantly lower after the Rocky Leaf Prints, Herb Tasting and Smelling, and Kokedama. Pulse rate had a downward trend after the four horticultural activities. The ratio of low frequency (LF) over high frequency (HF) results showed that the Rocky Leaf Prints had a larger downward trend, followed by Herb Tasting and Smelling. POMS scores indicated significant improvement for Rocky Leaf Prints and Herb Tasting and Smelling. The types including artistic creation and food tasting were promising methods for psychological relaxation, stress reduction, and vigor enhancement for elderly persons. Findings showed that the impact of activities involving contact with plants was more significant in short-term activities. We hope this study can help plan the horticultural activities of the elderly in the future.

Sustainable Co-Design with Older People: The Case of a Public Restorative Garden in Milan (Italy)

The demographic aging and the evolution of lifestyles require new strategies to promote the well-being and active aging of elderly. Active aging depends on many factors: some of these are related to objective data such as physical environment, others are personal elements; it is important to improve environmental physical factors to encourage personal attitudes to the green spaces in use. To design a small sustainable restorative green space in Milan, Italy, restorative garden design criteria are summarized in the first section of the paper and both social and environmental sustainability are considered. The methodology section describes the co-design process and how it was applied to include different older user groups in the design of the area. In the results section authors apply a taxonomy based on the four properties of restorative settings according to the Attention Restoration Theory by Kaplan (compatibility, being away, extent, fascination): this provides a unified system to classify users’ expectations and to describe the final project. The proposed co-design process combines social and environmental sustainability, as it provides designers an insight about the user’s experience in nature. Such information can be fruitfully integrated with professional competences about comfort aspects and environmental protection in order to improve the whole design project.

Cross-National Comparison of Environmental Factors Important to Facility-Based Senior Living

OBJECTIVE

Focusing on environmental factors important to facility-based senior living, this research intends to identify cross-national similarities and differences in perspective on elderly care between senior-living professionals in the United States and China.

BACKGROUND

American models of senior-living facility design have been introduced in China. In social and cultural context, environmental factors important to facility-based senior living are expected to be different by nation and need to be clarified.

METHOD

Questionnaire data were collected from 188 staff members working in senior-living facilities in the United States and China. Seven factors summarized through literature review were investigated. The frequencies of each factor selected by the participants as one of the three most important factors were ranked. The influence of personal and social factors on environmental perception was analyzed using analysis of variance tests.

RESULTS

Common area and cross-facility home-like decoration were similarly valued by both groups as two of the three most important factors. Residential room was valued more in the United States whereas natural lighting was valued more in China. Chinese participants with more work experience valued building layout more. Amenities were valued less than expected in both countries.

CONCLUSION

Environmental factors important to facility-based senior living are different between countries. American models of senior-living facility design should be adjusted for use in China. There is much to be gained from investigating the similarities and differences in perspective on elderly care.

The Effectiveness of Horticultural Therapy on Older Adults: A Systematic Review

OBJECTIVES

Although the therapeutic effects of horticulture on older adults have been widely investigated, a recent and comprehensive synthesis of available evidence on outcomes is lacking. We systematically reviewed evidence for the therapeutic effects of horticulture on older adults.

DESIGN

A systematic search of PubMed, MEDLINE, Sage Journals, ProQuest, Science Direct, and CINAHL was conducted. Articles were selected if they were quantitative studies published in English from 2008 to 2018.

SETTING AND PARTICIPANTS

Articles were selected if they included participants aged 60 years and older and used horticulture as the main intervention.

MEASURES

Experimental studies were appraised using the Physiotherapy Evidence Database Scale.

RESULTS

The systematic search yielded 20 articles. Significant pre-post improvement was reported in quality of life, anxiety, depression, social relations, physical effects, and cognitive effects. However, between-group results were lacking or nonsignificant.

CONCLUSIONS AND IMPLICATIONS

There is evidence for benefits of horticulture among older adults, particularly in long-term care facilities. Nonetheless, as the robustness of evidence is lacking, more rigorous randomized controlled trials and between-group effects need to be investigated.

Efficacy of a horticultural activity program for reducing depression and loneliness in older residents of nursing homes in Taiwan

Promoting psychological health in older populations is important. This study evaluated a horticultural activity program for reducing depression and loneliness in older residents of nursing homes in Taiwan. A convenience sample of 150 older residents of three nursing homes were recruited and randomly assigned to either an experimental group or a control group. The experimental group (n = 75) participated in an 8-week horticultural activity program. The control group (n = 75) received routine care. Generalized estimating equations analyses revealed significant time by treatment interaction effects for depression (p < .001) and loneliness (p < .001). This study provides a reference for improving psychological health in older people.