Me, myself, and nature: living with dementia and connecting with the natural world – more than a breath of fresh air? A literature review

Abstract

Objective Despite growing awareness of the importance of engagement with the natural world for people living with dementia, little is known about the impact specifically for people living independently in their own home. This review identifies, analyses and synthesises existing research, incorporating first-person narrative accounts of the benefits and potential challenges experienced in forging meaningful connections with the natural world. Methods Six databases were searched from February 2000 to February 2021. Relevant organisations and authors were contacted, and a hand search of included study reference lists was conducted. The findings of included studies were synthesised using a thematic analysis approach. Findings Sixteen studies were included: 13 qualitative and three mixed methods. Eight themes and three sub-themes were identified, revealing how contact with the natural world held a significance for people living with dementia, associated with a sense of pleasure, comfort, stimulation, freedom and meaning. Support and the use of adaptive strategies afforded opportunities for continued engagement with meaningful outdoor activities and the promotion of identity, independence, social interaction, enhanced wellbeing and quality of life for people living independently with dementia. Conclusion Meaningful connections with the natural world offer far more than a ‘breath of fresh air’. When support mechanisms are in place, engaging with the natural world can be a valuable arena for enablement and continuity, providing a sense of connectedness to self, place and others.

Provision of Outdoor Nature-Based Activity for Older People with Cognitive Impairment: A Scoping Review from the ENLIVEN Project

“…A frst step was to assess the available evidence about the kinds of initiatives that have been implemented and tested and the routes through which these might confer benefts. Tere have been previous reviews focused on garden use and horticultural activities for people with dementia [16,27] and on mechanisms of beneft of nature-based activity [13,28], but we found no wide-ranging review covering the provision of any type of nature-based activity for older people with dementia or for older people with other forms of cognitive impairment. To address this gap, given the broad focus, we identifed a scoping review [29] as the most suitable approach.…”

“…Te health and well-being benefts of engaging with nature and the outdoor environment for people with a range of health conditions are increasingly acknowledged [8][9][10][11], and this extends to older people with dementia and cognitive impairment [12,13] and their family caregivers [14,15]. Suggested benefts of outdoor activity for people with dementia include providing pleasure and enjoyment, maintaining independence and meaningful occupation, promoting social inclusion, stimulating memory and the senses, and enhancing identity and self-esteem [13,16]. In support of this, greater perceived availability of local green and blue spaces was associated with better quality of life among a large cohort of people with mild-to-moderate dementia [17].…”

‘I can see what's going on without being nosey…’: What matters to people living with dementia about home as revealed through visual home tours

“…The importance of the multi‐sensory experiences of the natural world for people living with dementia has been cited as holding value for mental health and wellbeing. 44 The experience of remaining connected to the beauty of the natural world was mood‐enhancing. Peggy commented on liking her ‘wee side window’ because it brought more brightness into the flat.…”

Provision of outdoor nature-based activity for older people with cognitive impairment: protocol for a scoping review from the ENLIVEN project

“…Evidence indicates that for people with, or at risk of, cognitive impairment, the bene ts of outdoor activity include maintaining independence and meaningful occupation, promoting social inclusion, stimulating memory and the senses, and enhancing identity and self-esteem [1,2]. Connecting people with familiar everyday outdoor spaces and special places in the natural environment, and the activities and relationships that arise within these places, enhances social engagement and quality of life [3,4].…”