Introduction

Now the number of people with dementia is rapidly increasing with the increase of the number of elderly peo- ple. The number of people around the world living with dementia is predicted to rise to 135 million by 2050 [1].

In Japan, the elderly population continues to increase and is expected to reach a considerable proportion of the overall population [2]. Recent reports indicate that the number of elderly people with dementia has rapidly increased with an increase in the aging population in all developed countries. In Japan particularly, by the year 2030, the proportion of the elderly people with dementia is estimated to reach approximately 3 million, almost three times the present number [3].

Although medications are available to slow the progression of dementia, none offer curative effects. Thus, non–pharmacological therapies play important roles in the general mental well-being of these people [4]. Non– pharmacological therapies, such as music, reminiscence, art, and reality orientation therapies, have been shown to effectively improve the quality of life (QOL) and prevent disability among elderly people. Among these therapies, horticultural activities encourage interaction between people and plants [5]. Over the past few decades, a number of relevant reports and studies have described the importance of horticultural activities for elderly people with dementia and reported positive results, including improvements in psychological [6], physical [7], social [8], and cognitive [9] aspects of individual functioning.

The authors have tried to develop a horticultural activities program for elderly patients with mild to moderate dementia [10]. The horticultural activities program for elderly people with mild to moderate dementia have been proposed [11] based on the theory of personhood in dementia, as reported by Kitwood [12], which emphasizes the need for caregivers to adopt individualized methods in approaches for dementia care. The horticultural activities program was designed to support mental, behavioral, social, and cognitive aspects of the well-being in elderly people with dementia.

The intervention method is as follows

The subjects were divided into groups of three or four. During every activity, a specialist (author), care worker (facility staff), and research collaborator supported the groups. The specialist had several years of experience in caring for elderly people with dementia as a nurse and was trained in techniques of horticultural activities.

The sessions lasted 30–40 min once a week for six weeks. The subjects cared for plants daily, in addition to participating in the horticultural activities program.

The seed or plant material used had the following properties: “good germinativeness,” “easy to grow,” “suitable to the season,” “caused sensory stimulation” (seeds and plants of various sizes, form, color, and smell), and “well-known.”

We have tried to examine the effects of an intervention of a horticultural activities program. These results suggested that this program is effective care method in order to improve vitality, cognitive function, and Behavioral and Psychological Symptoms of Dementia (BPSD) [13].

Further investigations trials with a greater number of subjects are necessary to confirm the effects of a longterm horticultural activities program for elderly people with dementia.

In addition, further studies on the spread of horticultural activities for elderly people with dementia are needed.

References

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2. The society of gerontological care, eds. Aiming at the establishment of care to support the elderly people’s dignity in 2015. Tokyo: Houken, 2004.

3. Shiba, M., Shimogaito, J., Kose, A., Fujiuchi, S., & Nishiyama, H., et al. (1999). Prevalence of dementia in the rural village of hanazonomura. Neuroepidemiology 18: 32-36.View

4. Kaplan, R. (1973). Some psychological benefits of gardening. Environ Behavior 5: 145-162.View

5. Mills, M.S. (1997). Narrative identity and dementia: A study of emotional and narrative in older people with dementia. Aging Society 17: 673-698.View

6. Willcox, R.T., & Mattson, R.H. (1979). Horticultural therapy maintains life satisfaction of geriatrics. Great Plains J Hort Therapy 1: 8-12.

7. Barinicle, T., & Midden, K.S. (2003). The effects of a horticulture activity program on the psychological well-being of older people in a long-term care facility. Hort Technology 5: 94-103. View

8. Hill, C.O., & Relf, P.D. (1983). Gardening as an outdoor activity in geriatric institutions. Activities, Adaptation & Aging 3: 47-53.View

9. Relf, D., & Dor, C. (1995). Horticulture: Meeting the needs of special populations. Hort Technology 5: 94-103.View

10. Masuya, J. (2011). Development of horticultural activities program to change behavior for the elderly with dementia. Jan J Academy of Gerontological Nursing 15: 54-63.

11. Masuya, J. (2012). Analysis of care method which matched individual characteristics of the elderly with mild to moderate dementia in horticultural activities. Jpn Society for Dementia Care 11: 576-589.

12. Kitwood, R., & Bredin, K. (1992). Towards a theory of dementia care: Personhood and well-being. Aging and Society 12: 269-287.View

13. Masuya, J., & Ota, K. (2014). Efficacy of horticultural activities program for the elderly people with mild to moderate dementia. Journal of Japanese society of People-Plant Relationships 13:1-7. View