Defining a therapeutic gardening activities protocol for elderly people living at nursery homes

Peer-reviewed studies have reported positive outcomes of gardening activities (GA) on old people with dementia: in particular, GA have been found to reduce stress and the incidence of inappropriate/disruptive behaviors, increase engagement and social interaction, improve quality of life, improve sleep and increase feelings of calm and relaxation. Nevertheless, the treatment procedures are often not fully described; only a few studies attempted to describe the proposed activities, and they are poorly detailed; there also is a lack of standardized gardening activities (protocols). The aim of the this study is: 1) to develop a standardized Therapeutic Gardening Activities Protocol (TGAP) for people with Dementia at Nursing Homes and Adult Day Services; 2) to evaluate the applicability of TGAP treatment. The "TGAP" is comprised of a welldefined and ordered succession of codified Therapeutic Gardening Activities chosen for their specific potential suitability for persons with mild to moderate dementia. Eight specific goals and more than 80 practical actions have been described. The actions have been organized in 18 different activities including planting seeds, plant caring, harvesting and so on. In order to evaluate the applicability of the TGAP treatment defined, a sample of 55 persons living at nursery home with a diagnosis of mild to moderate dementia have been recruited in a therapeutic gardening activities program 12 weeks long, subdivided in three different group of two nursery homes, for a total of 36 treatments. Each treatment took place one day per week for one hour; administered in small groups of six persons. Each treatment has been evaluated assigning a score (from 0 to 5) to every single participant for every practical action. The proposed activities have been carried out by the majority of participants (more than 90%) with a very good score (more than 4.5).