Gardening with Huntington's disease clients--creating a programme of winter activities

Gardening for health: a regular dose of gardening

There is increasing evidence that exposure to plants and green space, and particularly to gardening, is beneficial to mental and physical health, and so could reduce the pressure on NHS services. Health professionals should therefore encourage their patients to make use of green space and to work in gardens, and should pressure local authorities to increase open spaces and the number of trees, thus also helping to counteract air pollution and climate change.

Making a measurable difference in advanced Huntington disease care

Neurologists' role in the care of people with advanced Huntington disease (HD) (total functional capacity <7), often limited by a lack of clinical research to support good practice, includes the following: (1) provide comprehensive health records to an interdisciplinary care staff before admission to a more intense care setting (home health services, day program, assisted living, group home, long-term skilled nursing facility, palliative care); (2) consult with and refer to rehabilitation (occupational therapy, physical therapy, speech and language pathology), behavioral and psychiatric professionals for problem-solving strategies, which must be reviewed with direct care staff before implementation; (3) encourage and support qualitative and quantitative interdisciplinary research studies, and randomized controlled studies of nonpharmacologic interventions; and (4) assist in the development of meaningful measures to further document what works to provide a good quality of life for the patient and family and a comfortable thoughtful approach to a good death. Collaborative models of care depend on: (1) clear communication; (2) ongoing education and support programs; with (3) pharmacologic and rehabilitation interventions, always in the context of respect for the person with HD, a preservation of the individuals' dignity, autonomy, and individual preferences.

Design of evidence-based gardens and garden therapy for neurodisability in Scandinavia: data from 14 sites

AIM

A total of 14 Scandinavian therapy gardens were visited and data collected on plantings, therapeutic activities and assessment of effectiveness in Spring 2014.

METHODOLOGY

Data were gathered by a questionnaire and by interviewing staff in Sweden, Denmark and Norway. The data collection structured proforma used the post-occupation assessment method.

RESULTS

Gardening promoted physical movement, presented cognitive challenges and provided opportunities for social participation. Half the gardens were enclosed with sensory plants and 85% were adapted for wheelchairs. A total of 57% of gardens visited had simple designs with flowers, shrubs, lawns and trees. A social center was important especially for dementia clients. Planted pots were used in 79% of gardens. The effectiveness of therapy gardens was assessed at 71% of sites.

Participants', caregivers', and professionals' experiences with a group-based rehabilitation program for Huntington's disease: a qualitative study

BACKGROUND

Research suggests that rehabilitation is beneficial for persons with Huntington's disease (HD), but there is limited knowledge about participants' experiences with residential rehabilitation programs. We therefore did a study to explore patients', family caregivers', and health professionals' experiences with a group-based, residential rehabilitation program for individuals with early to mid-stage HD, focusing on three research questions: How did participants experience the structure and content of the program? What outcomes did patients experience? What challenges and success factors did health professionals report?

METHODS

Qualitative, explorative study, collecting data through in-depth interviews with nine family caregivers and 11 patients with early- and mid-stage HD, and focus group interviews with 15 health professionals. Data were analysed using systematic text condensation.

RESULTS

Some participants reported difficulties with defining individual rehabilitation goals, but written individualised plans and schedules were appreciated by all participants. Participants highlighted being member of an "HD-group" as a valuable experience, though tensions and conflicts could occur in groups. Participants typically reported improved gait and balance, increased self-confidence, and social benefits as outcomes. The intensive schedule was acceptable for most participants, but adjustments had been made to allow participants more time to eat, shower and dress between sessions. Success factors reported by health professionals were assigning every patient with a contact person, using clinical tests results to motivate patients, and supervising health professionals in patients' local municipalities.

CONCLUSIONS

Group-based residental rehabilitation was feasible for individuals with early- and mid-stage HD, and participants emphasised mental and social outcomes in addition to physical outcomes. The needs of persons with HD should be considerd when designing programs, to secure structure, continuity in personnel, and sufficient time between sessions.

Is gardening a stimulating activity for people with advanced Huntington's disease?

This study evaluated adapted gardening as an activity for people with advanced Huntington's disease (HD) and explored its therapeutic aspects. Visitors and staff completed a questionnaire and participated in structured interviews to capture further information, whereas a pictorial questionnaire was designed for residents with communication difficulties. Staff reported that gardening was a constructive, outdoor activity that promoted social interaction, physical activity including functional movement and posed cognitive challenges. Half the staff thought the activity was problem free and a third used the garden for therapy. Visitors used the garden to meet with residents socially. Despite their disabilities, HD clients enjoyed growing flourishing flowers and vegetables, labelling plants, being outside in the sun and the quiet of the garden. The garden is valued by all three groups. The study demonstrates the adapted method of gardening is a stimulating and enjoyable activity for people with advanced HD.