A solution against patient confinement, this garden in a retirement home in the rural town of Saint-Geniez d’Olt in the South of France is the brainchild of a newly arrived psychologist, a former city dweller who could not stand to see residents cut off from their roots. « We were faced with a problem in our two locked units where our most dependent residents live. The units had no access to the outside because of an improper slope for wheelchairs. People have been stuck here for years and can rarely go out except when a caregiver can accompany them, » says Cecile Ratsavong Deschamps, the retirement home psychologist. « What struck me is that for most of the residents and their families, it is natural to be out and cultivate the land. But as they enter the retirement home, they give up on the outdoors and working the land. » The two locked units are home to 70 people, including about twenty who use walkers or wheelchairs. A third of the residents suffer from Alzheimer or related dementia, a third have former psychiatric disorders and another a third are in palliative care.
Cécile notes that « their agricultural life is the only thing they talk about in an animated way. They come alive. » With the medical staff, she started a working group to explore the issues of confinement and restraint. Naturally, an alternative to confinement is to go outside. The units have access to a 9,000 square feet patio, which had remained used because of safety issues with wheelchair access. Taking advantage of this space became a mission. « Through my reading of mostly American literature on the topic, I realized we needed the project to be coherent and adapted to our population. If we could not permit access for all, we would face certain failure. » One of her first steps was to create a non-profit association to run the project, a solution often used in France because it makes it easier to seek financial help from foundations and state agencies. Cécile is the president of Médecines, Cultures et Paysages.
Her working group proceeded methodologically starting with a study to determine the needs of residents, families and staff. They all expressed some wishes: a terrace in the shade, birds and fish and gardening, with a preference for flowers. The occupational therapist and the physical therapist joined the project and landscape architect Laurence Garfield went to work. Here is an early draft of her project. The design phase was financed by grants from the regional government, the town of Saint-Geniez d’Olt and a local bank. The retirement home also chipped in. « We have faced financial and institutional difficulties. It is not easy to implement such a project, » says Cécile.
The association has won two prizes, including one this year for accessibility awarded by the National Disability Council and the Association Access for all. « This award has enabled us to tell the outside about our project and to receive institutional recognition. This gives us momentum. » In addition to the garden that will eventually be freely available, the idea is to offer gardening and horticultural therapy workshops. « Nobody here is trained. We would like to send some people to train in Toulouse where psychology professor Jean-Luc Sudres offers a class at the University of Toulouse, » says Cécile. « We want residents to reclaim the land, which they had given up on, and to pass on their knowledge. »
Last May, the garden got under way. Volunteers took out hedges and plowed. Eight planting squares were prepared and wooden planters were recovered from the town hall (recycling and resourcefulness at work). « Since then, we have led the first two workshops in the memory garden. Three professionals – an activity specialist, an occupational therapist and I – can work with five residents at a time. We chose flowers, colors and where to plant them. I work on memories and on the transmission of their expertise. The activity specialist helps with planting. Residents will work on the planter boxes and she will work on the ground. » The first workshops were a success. « They were delighted. Everyone has room to express themselves in their own way. »
The intent of the team is to conduct a research project to measure the impact of the garden on the quality of life and behavioral disorders among residents. « We see a lot of anxiety, agitation and wandering because they are locked up inside. I notice that Anglo-Saxons work on evaluation. I feel that, in France, what is being done in this field is not valued as much. » For now, the garden is not open freely because that would require major improvements. « But it’s part of the project, » says Cécile, full of optimism. Last month, she got to present her project and evaluation work at the 33rd meeting of the French Society of Geriatrics and Gerontology.