There were many occasions during my father’s nine years in three different care homes when I honestly wondered if having dementia was a byword for keeping people in captivity. Day after day, week after week, residents were kept cooped up indoors, which during most of the year was relatively understandable due to the English weather, but on hot summer days people would still be sat inside, in their bedrooms or the lounges, sometimes not even with a window open, eating in stuffy conditions where food can begin to smell very unappetising, watching mindless television, consigned to a life most criminals do not endure.
It strikes me, writing this on a beautiful hot, cloudless English summer day, how torturous it must be to be kept inside, tempted by that blue sky and sunshine, feeling the heat, and being without anyone in the world to help you go and make the most of it. Everyone in those homes was retirement age, a supposedly golden time in your life of relaxation and enjoyment. You do not have to be stuck in an office, factory, shop or restaurant earning your living, you have done your work, now is your time to sit back and soak up the good things in life – why should having dementia change that?
For me that is the key point – dementia is perceived to change everything, and yet the disease is not who the person is, and unless as a result of their dementia the person has developed a phobia of going outdoors, scared perhaps of the uncertainty, unfamiliarity or perceived vastness of it, or has another medical condition that requires them to remain indoors, then there is no reason to keep them inside during perfect summer weather.
Sadly there were so many days, identical to today, where we would be the only family sitting outside with our relative. Carers were generally too busy, too short-staffed or lacking in the confidence needed to utilise the lovely garden, and successfully negotiate any health and safety challenges that might come from bringing residents outside. Even more disappointingly most relatives demonstrated a similar reluctance, even though they saw how much dad enjoyed his long hours of fresh air, sunshine, alfresco dining and napping under his panama hat.
Whilst familiarity and security in their environment is very important for people with dementia, stimulation and reminiscence are too. Most people will have enjoyed outdoor life when they were younger, and those with dementia may have particularly strong memories of summer days free and happy in the sunshine. If someone has led any sort of outdoor life in the past, and shows a willingness or interest in being outside, especially in such glorious weather, denying them that is akin to keeping them a prisoner in a life that they have not chosen and do not deserve.
There was a lady at one of my dad’s homes whose family openly admitted that she had loved the outdoors her whole life, sitting out in all weathers, tending her garden, eating all her meals outside and having family BBQ’s. They said she would have felt like a ‘caged bird’ to be kept inside, and on the occasions when she was brought out into the garden, listening to her talking about the birds and flowers while lapping up the sunshine made it very clear just how much she loved it. Yet because she could not ask to go outside, both the carers and even her family very rarely took her into the garden. Her dementia effectively consigned her to being a spectator on a life that she must have been longing for but no longer had.
Providing people are well cared for and supervised outside (as they should be wherever they are), it is the most wonderful place to be for the fresh air and sunshine (a lot of people, especially the elderly, are deficient in vitamin D for example), and also for the emotional wellbeing provided by the natural stimulation of birds, plants and wildlife. Many care homes have sensory gardens (that I wrote about here) where scented, tactile plants are growing, and water features provide visual delight and also much needed serenity, calmness and tranquillity.
Another key benefit, and one that is often completely overlooked, is the advantages to eating outside. Fresh air, and even some mild exercise if appropriate, can stimulate appetite. Poor eating and drinking can often be a problem as dementia progresses, but appetising food served outside can help to remedy this. BBQ’s, done safely, can provide wonderful aromas to tempt an otherwise flagging appetite, and even having afternoon tea parties outside can revitalise jaded routines.
Good weather, of which we get precious little in the UK, generally puts most people in a better frame of mind, and this is no different for those who are living with dementia. Not only does their health and wellbeing benefit from some consensual outdoor activities, families and carers can have immense enjoyment from helping to facilitate this. Some of our most special memories, and photos, of my dad during his dementia come from our many hours sat outside with him. These were positive, happy times when the simple beauty of nature could make dad’s dementia an almost distant memory. Nothing really beats exploring the great outdoors with your relative, and if they love it as much as my dad did, you will be so glad that you had that experience together.
Until next time…