Explore how nature and outdoor activities can transform the lives of those with dementia and their families.

This post is by Ellie Robinson-Carter. Ellie is Creative Spaces Project Manager at Sensory Trust, alongside her role as Online Tutor for the MSc in Dementia at The University of Hull. 

The experience of dementia 

When a person receives a diagnosis of dementia, often their world can feel like it is shrinking. It can take some time for the person and their family to process and adjust. We are passionate about keeping people living with dementia and their families connected to the places they love, as well as continuing to discover new places and create new memories.

This can make a huge impact on how well a person feels they can live with dementia, giving individuals hope and connection to their sense of self.  

This approach is championed on the online MSc in Dementia at The University of Hull too. The course underpins the importance of people with dementia receiving relationship-centred care which revolves around the individual’s preferences and wishes. In particular, the Living Well module explores the importance of social, physical and emotional health, and the benefits of nature and outdoor activity.  

September is World Alzheimer's Month and this year's theme looks at the risk factors for dementia and how the risk can be reduced. Find out more about the campaign on the Hull Online LinkedIn and Facebook accounts. 

Nature and the outdoors  

Sensory Trust is a national charity based in mid-Cornwall which helps transform the lives of disadvantaged people in the UK through inclusive and sensory nature experiences.  

Creative Spaces is Sensory Trust’s flagship dementia project which connects people with dementia, their carers and intergenerational groups to nature and supports their access to outdoor spaces. The project runs nine dementia-friendly nature-based groups across Cornwall, ranging from weekly to monthly, which involve accessible walks, arts and environmental-action activities.  

There is a growing amount of research which shows the benefits of spending time in nature. A 2021 Mind report shows spending time in nature: improves mood, reduces feelings of stress or anger, helps us take time out and feel more relaxed, improves physical health, improves confidence and self-esteem, helps us be more active, reduces loneliness and connects us to our local community.  

Connecting to people 

We have found that nature is a fantastic tool for starting conversations with people with dementia and finding a way into something that matters to the person we are supporting.  

It could be noticing flowers in the hedgerows and learning about a person’s love of mountain walking when they were younger or looking on to a cricket pitch and hearing about their love of sport.  

We all have connections to nature, and so it presents a multitude of starting points for sharing stories and learning about each other, which can help significantly to enable a person with dementia to be part of the conversation.  

The MSc in Dementia at The University of Hull captures the importance of finding bespoke ‘ways in’ to connect with people with dementia. Many of the course's dementia advisory group (a team of people living with dementia who helped to conceptualise and write the degree programme) reflect on the value of spending time with others and being able to go to the places that matter to them. 

Image credit: James Darling

Distraction 

Sensory Trust have found that nature can be an effective tool when distraction is needed. If a person becomes fixated on something that is causing them anxiety or stress, we can find something in nature to change their focus. For example, a beautiful flower or a view across the fields.  

Walking 

It is evident that meaningful conversations happen when the members are out walking together, as opposed to sitting down together. The project staff and volunteers often find that new members of the groups stick together, but gradually the person with dementia and their carer will speak to others in the group.  

This may seem like a small thing, but this effectively gives the person with dementia space to meet and talk to new people, within a group who understand are empathetic about their situation. As well as this, it offers carers space to talk to others who understand their circumstances. 

Noticing progress 

People often associate dementia with deterioration and a person gradually reducing in capacity. However, there have been many occasions at the groups where there has been evidence of improvement.  

For example, people with dementia can sometimes adopt a shuffling walk, due to eyesight and physical mobility changes. We have noticed on many occasions that people who attend the group become more confident with walking and their walking gait increases after being at the groups for even just a short time.  

Volunteers have commented that people’s body language can transform after just a few sessions of being at the groups: “They may tell us that they’re not quite sure where they are, and that they aren’t sure if they have been before, but their body language has changed from being like a wilted flower, to a watered one - with shoulders back and head held high.” 

Inclusive activities in nature  

Sensory Trust have designed an extensive range of inclusive activities which are available to view and download on their website. These have been developed through working with beneficiaries and are all dementia friendly.  

From recording what sounds they can hear in nature using paper plates and pens, to recording the textures of the environment with calico and wax crayon, all of the activities have simple steps and are low cost but provide valuable benefit - from reducing anxiety to experiencing the feeling of accomplishing something new.  

Overcoming barriers to access 

One of the biggest losses people describe is losing their driving licence. With Cornwall being a particularly rural county, this makes accessing outdoor spaces very challenging - especially when public transport is unreliable and can be hard to understand/feel confident to use.  

The Creative Spaces project prioritises transport support, meaning those who no longer drive can access remote locations and join the groups through attending with volunteer drivers.

Many members say that this is a lifeline, and they wouldn’t be able to attend without this. The walking routes chosen are flat and accessible, and are chosen based on the individual needs of each group member. The moto for the walks is: “it’s an amble, not a ramble!”  

Ensuring quality of experience  

In addition, each walk is assessed for sensory quality. Sensory change is something most people with dementia experience, therefore, being mindful of sensory information that may overwhelm or provoke anxiety is important.

For example, we look for: 

• What is of interest in the short, mid and far distance? If a person is unable to see far away, is there enough interest in their immediate surroundings? 

• Is it possible to hear natural sounds, such as birds, water, bamboo in the breeze? If a road is close-by, does this dominate the sound? 

• Is there the opportunity to extend the walk if members feel they want to go further? Encouraging members to increase their walking distance helps to keep their bodies active and healthy, as well as giving them feelings of satisfaction. 

If you’d like to read more about Sensory Trust or the Creative Spaces project, please visit www.sensorytrust.org.uk. You can also contact Ellie on erobinsoncarter@sensorytrust.org.uk or 01726 222900.  

The MSc in Dementia at The University of Hull focuses on experience, quality of care and how to live and die well with dementia. Study online and part-time and start in January, May or September: