The physical environment of Green Care Farms and its relation to residents’ activity engagement

Abstract

Background and aim

For people with dementia, being actively engaged in activity can slow down cognitive decline and increase quality of life. Green Care Farms (GCFs) integrate nature and animals into daily life aiming to encourage engagement in activity. This environment might trigger engagement, in the present moment, as well as during longer periods of time. This study explores the environmental design of GCFs in relation to residents’ use of the environment and engagement in activity, contributing to understanding the role of the built environment.

Methods

Maps, floor plans and photos of four Dutch GCFs were compared. Ecological momentary assessments (n = 5436) were conducted including 151 residents. Observations noted residents’ place of stay, the activity, which they performed and whether they were actively engaged in it. Data was analyzed with descriptive analyses and a general linear model.

Results

GCFs highly varied in their spatial design; however, all provided an environment rich in sensory stimulation. On average, residents spent 10.1 % of their day outdoors. The variety of places used strongly differed between residents. Nevertheless, engagement in activity was generally high (86.4 %), particularly in outdoor and activity spaces. The activities in which residents engaged were mostly recreational activities, looking around, social activities or eating and drinking. Engagement triggered engagement in subsequent moments in time.

Discussion and conclusion

This study showed that certain places within GCFs are meaningful in encouraging activity engagement. Considering different interests and dementia stages, it is important to create varied, meaningful opportunities for engagement both indoors and outdoors.