Today, throughout Western Europe, Green Care Farms are a developing an innovative care concept that recognizes the importance of the psycho-social needs and quality of life for participants. Green Care is an umbrella term used to describe a broad spectrum of health promoting interventions that all use both biotic and abiotic elements of nature. Therapeutic programs that are currently considered green care programs include animal-assisted therapy, horticultural therapy, wilderness therapy, care farming, and green exercise (Sempik, et al. 2010).
Generally, green care programs provide day care/rehabilitation for individuals with dementia, developmental, intellectual and physical disabilities. This care concept has also been proven successful for those battling addiction and mental illness. Participants spend much of their day outdoors in a plant-rich environment. They have many opportunities to freely interact with each other as well as with workers and caregivers at the site. The natural environment encourages participants to be more physically and socially active. Working with plants and sometimes farm animals, provides a sense of purpose and empowers the participants to take the role of caregiver instead of “patient”. This concept has been especially successful for people dealing with dementia, in part because personal caregivers and family members are encouraged to be part of their loved one’s treatment.
Green care offerings at day care facilities for various populations is slowly gaining interest here in the US. From the description above, one can easily envision how horticultural therapy would greatly contribute to this creative approach to wellness. A progressive program through University of Washington Memory & Brain Wellness Center is embracing green care interventions with Garden Discovery Walks offered to those with dementia and their care partners in the Greater Seattle, Washington area.
Laura Rumpf, HTR is a registered horticultural therapist and HTI graduate, currently living in Seattle. Laura conducts the monthly Garden Discovery Walks in conjunction with the University of Washington Memory & Brain Wellness Center and Seattle Parks & Recreation. This is a free program for those with memory loss and their care partners. The primary purpose of the program is to provide a sense of community and socialization that mitigates isolation and anxiety. Laura points out an important aspect of Garden Discovery Walks, “This program is as much for the care partner as it is for their loved one.”
Garden Discovery Walks occur from March through November at a different public garden space within the city of Seattle. Fifteen participants and their care givers enroll through Seattle Parks & Recreation. A typical session involves two elements; first, a mindful stroll through a garden, taking the time needed to enliven all five senses. Laura sets a specific theme for each walk, for example, cherry blossoms in March. And second, as they finish the garden walk, the group gathers for a horticultural activity. The activity reflects the experience of being in the garden, thus entwining both parts. Each participant can take home their garden creation as a reminder of their experience. Because Laura recognizes the benefit to the care partner, she makes sure they also can engage as well. “Care partners almost always do their own project, independent of that which they help their loved one do. When I see care-partners get into a flow state while deeply involved in their work, I encourage that by engaging with their loved one so that they can fully gain the benefits of this state”.
This innovative program, the only one in the country to offer dementia friendly recreation, is becoming quite popular. “The response to Garden Discovery Walks has been so good that people wanting to join are on a wait list. We are exploring ways to expand the program and to adapt it to a population who may need more support to access it.” The biggest challenge to expanding the program is finding an acceptable site that meets specific criteria: transportation needs of the participants, safety, wide pathways, a covered or indoor area with tables for the activity and socialization, and an accessible bathroom on site. Because the participants are coming from several different locations and are involved in other programs, scheduling can be complicated.
Laura is involved in other Seattle Parks & Recreation programs at Rainier Beach Urban Farm and Wetlands (RBUFW). RBUFW is an eight-acre farm located in the heart of Seattle. The property is managed by the Tilth Alliance and owned by Seattle Parks and Recreation, where programs are offered to community members of all ages and abilities. Classes offered at the farm range from permaculture and organic gardening techniques to educator workshops and summer garden camps for children. One group Laura has been involved with are the East African Elders, who for the last decade have been working to restore the farms wetlands. In exchange, the group receives a stipend plus fresh produce. More importantly are the mental health benefits that comes from social interaction with other immigrants who share the same language, transportation and economic barriers. “It goes without saying that everyone who participates on the farm gains the benefits of physical exertion and fresh air.”
The Bridges Program serves high school students with developmental disabilities along with their teachers and aides, to RBUFW each week. Laura has worked with this program since September 2018. “I work toward their goals of social skills, vocational skills, and sense of self esteem by engaging them in farm production tasks.” Laura collaborated with the teachers to develop a list of primary goals and objectives for each student. The students present a wide range of abilities; therefore, garden tasks must be adapted to ensure everyone believes they can participate. Students also have the opportunity to interact with others who work at the farm, “This has been an important component in the program, using appropriate social skills when greeting or interacting with others outside the group, but in a safe and non-judgmental environment”.
Laura would like to see horticultural therapy programming expand at RBUFW, “I would love to see the farm act as a hub for various groups for whom HT would greatly benefit. Groups that I have proposed are those with dementia, immigrant elder women (currently very underserved), care-givers, tech workers and those in the surrounding neighborhood who could benefit from self-empowerment.” Laura is very aware of her significant relationships with both University of Washington Brain & Wellness Center and Seattle Parks & Recreation, “[They] have been very important, not only for employment opportunities but to the promotion of HT. They have platforms, not available to me, on which they have advertised, highlighted and endorsed these programs and HT in general. This partnership is so important to the HT field and I believe can be replicated across the country”.
Considering the programs described, one can see similarities between green care and the practice of horticultural therapy. This is not to say they are equivalent. Horticultural therapy is a distinct profession. Therapeutic techniques and treatment processes among disciplines are often interchangeable and depend as much on the type of program and setting in which the program occurs as the specialty of the therapist applying them (Haller & Kennedy, 2019). As stated earlier, “green care” is seen as an innovative care concept. Central to this concept is the setting/location where health promoting interventions occur. What remains unclear is how goals and objectives of treatment are determined or how outcomes are measured.
Laura Rumpf has favorably combined aspects of green care (involvement of the care partner and conducting sessions at an urban farm) with the time honored and evidence-based practice of horticultural therapy to produce solid and effective programming with a broad outreach. Her collaboration with University of Washington Memory & Brain Center along with Seattle Parks & Recreation has not only made these programs possible but has ultimately created public awareness and promoted the practice of horticultural therapy.
*Due to the COVID-19 pandemic, the Discovery Garden Walks have been cancelled and the public parks are closed to visitors. But the Discovery Garden Walks do continue each month with video recorded versions. Below is a link to the March Discovery Garden Walk through Bradner Gardens.
de Boer, B., et al. 2015, Living at the Farm, Innovative Nursing Home Care for People with Dementia-Study Protocol of an Observational Longitudinal Study”. 2015, BMC Geriatrics 15:144.
Haller, R. L., Kennedy, K., L., Capra, C. L. 2019, The Profession and Practice of Horticultural Therapy, Boca Raton, FL., CRC Press.
Hassink, Jan, et al. 2019. “Characteristics and Challenges for the Development of Nature Based Adult Day Services in Urban Areas for People with Dementia and Their Family Caregivers”. International of Journal of Environmental Research and Public Health 16, (1337).
Sempik, J., R., Hine and D. Wilcox, eds. 2010. Green Care: A Conceptual Framework, A Report of the Working Group on the Health Benefits of Green Care, COST action 866, Green Care in Agriculture. Loughborough, UK: Center for Child and family research, Loughborough University.