Intro to the series
In this monthly series we will be exploring ways to make the most of the outside spaces around your care setting and help your residents benefit from stepping outside and enjoying meaningful activities there, as and when they choose. Step Change Design focuses on encouraging care settings to take a fresh look at their care culture practices in order to engage actively and meaningfully with their outside spaces with their residents. Our work is based on a large scale research project we carried out to understand why care setting gardens are not more actively used. We have produced a poster-sized diagnostic tool, the Care Culture Map and Handbook, to help you review and improve on your activities and practices relating to the outdoors. We provide a training, design and consultancy service to the care sector to help create actively used gardens from a better understanding of your overall care culture.
2. Simple outdoor activities and crossing the threshold
By Debbie Carroll, Step Change Design Ltd.
Stepping outside is something we are able to do most of the time in our day to day lives and is something that we take for granted. For those living in a care setting, and particularly for those who may need a hand to be able to step outside, it may require more effort or the need to ask for help to act on this most natural of desires.
Also, in some care settings, this simple everyday act can be discouraged or made overly complex, becoming wrapped up in rules and permissions that may not be fully understood by residents as well as some staff. How can we make it easier to go outside for those residents who wish to go out and what simple things can we do outside with them, whatever the weather or time of year?
There are lots of activities that can be easily woven into the daily life of your care home to integrate the outdoors regularly into activity provision. Here are just a few tips and ideas that can help you engage your residents with the outside space:
You don’t have to be a gardener to step into the garden
During our study we heard phrases from members of staff such as, ‘I’m an outdoor person but not a gardener’ to explain the reason for not feeling able to support residents effectively in the garden. If this may be a concern among your staff then why not ask residents what they enjoy most about being outdoors and you may find some easily achievable activities come to light that don’t require any gardening skills at all. In reality, for many people the things they did, and enjoyed most, in their own gardens may never have included gardening.
Here are a few ways that your residents can enjoy their garden. Plan how you can you ensure this happens easily and promptly for them:
Sitting in the sun, or shade, with a cup of tea
Spending time with friends and family, simply chatting
Enjoying a meal outside
Wanting a ‘breath of fresh air’, a change of scene, or a break from something indoors
Taking a walk to see what is happening around the garden, the changing seasons and the plants growing and the wildlife that is there
Watching birds and insects
All of these require no more equipment than somewhere comfortable to sit and remaining alert to grabbing the opportunity to cross the threshold to enjoy the moment outdoors. We also found in our study that taking refreshments outside often extends the time spent in the garden. With a little planning, the refreshments you usually take indoors could be easily enjoyed outside.
Overcoming ‘default thinking’
Almost any activity you do inside can be done outside, with small adjustments (including providing appropriate clothing). Why not take a fresh look at your activity planners and care plans for residents to see what they could do just as easily outside? You may identify the need for extra cushions or throws, or seating that can be moved around the patio more easily.
It’s a good idea to review and sense check your activity provision regularly to ensure that the outside is included wherever possible, and especially for those who would wish it. This does not need to be complex or expensive but look for ways to enable residents to naturally continue to engage with the outside as they may have done prior to moving into care.
Being helpful
A care setting is the residents’ home and as such there are often tasks to carry out that they may wish to be involved in so that they feel they have an active role in looking after their own home. In the list below, you may need to liaise with other areas of the home, such as the laundry, to help make these tasks happen while some simply need typical equipment that you probably have already:
Hanging out the washing – this also requires keeping an eye out for rain to bring it in if need be, creating an ongoing link from inside to outside throughout the day, and checking when it is dry
Sweeping up leaves, possibly to go onto a compost heap – this activity helps to keep active and warm, especially on those autumn days after windy weather.
Tidying the garden – putting things away, collecting items that have blown around, getting the garden ready for spring, cleaning equipment and tools, rearranging the contents of the shed.
Get Growing!
Whether you or your residents have green fingers or not, it can be fun to have a go at growing things. This can be as simple as tending a house plant on a window sill through to caring for plants in the garden itself. Garden activities lend themselves to both group and one-to-one activities so can be easily adapted, or broken down into smaller tasks, to suit the interests and abilities of your residents. And bear in mind that it’s OK if your residents know more about gardening than you do. You could ask them to teach you something!
Growing plants can be an ideal activity to support the transition from indoors to outdoors quite naturally. Where a resident knows a lot about gardening, encourage them to lead on some of these activities, where they wish to. Take a look at the following sequence of activities that starts indoors and progresses across the threshold into the outdoor space. Different elements of the sequence may be particularly meaningful to a specific resident or group of residents, enabling a wide range of involvement of residents across the home over time:
Things to do indoors
Review seed and plant catalogues to choose what residents may wish to grow
Prompt conversations that may reveal new information about their lives and interests outdoors to spark further activity ideas
Vegetable gardeners in particular often look forward to ordering seeds to plan the growing season ahead and the crops this will provide
Things to do indoors or outdoors
Sow seeds in pots, place on window sills, in greenhouse or straight outside for some plants, make labels and write or draw on them
Encourage residents to look after the pots and trays by regularly checking to see if there is any sign of life and to keep the soil moist
Water seedlings regularly until large enough to plant out or move on to larger pots
Things to do indoors that link to the outdoors
Potting on, this is planting the seedlings out into the soil or into larger pots once they are large enough to handle
This stage is often when plants may need to now go outside so stepping over the threshold is a natural step
Things to do outdoors
Preparing the area of the garden (or the troughs and beds) to grow plants
Watering, caring for and cutting flowers or harvesting vegetables require regular visits to the garden – what a great way to invite residents outside
When picking flowers, it’s a great conversation starter to ask about favourite colours and fragrances. Flowers look nice in arrangements and can also be pressed to make pictures and cards. How could you help support these activities? And how can you include those residents who are unable to go outside but would still like to be included in these activities?
Fruit and vegetables harvested from the garden can be used in meals, in pickles and jams or baked, blanched or frozen for future use. How could you support these activities for those residents who would like to do them?
Inside out
Consider other activities that can create a natural link to the world beyond the window, and so naturally lead to stepping outside and experiencing the joy of engaging with a world beyond the four walls of the home. Some ideas to consider:
Bird watching:
Inside – have bird books, binoculars and bird identifying charts near windows
Outside – fill bird feeders and bird baths. Ensure these are placed nearer lounge windows in winter so residents can easily see them in use
Inside/Outside – take part in Big Bird Watch or similar citizen science projects
Art in the Garden
Create art work to go in the garden, possibly bird boxes and other wildlife attracting items
Create collages, art work, with materials collected from outside such as coloured leaves, cut flowers
Meet and Greet
Consider where visitors or contractors arrive from, and enable residents to be able to meet them on arrival, just as they would have at home
Some parts of the country have customs around sharing news with neighbours on the front door step. How can residents who would have enjoyed this be able to sit and enjoy watching the wider world come and go and connect more strongly with their community via the front space of the care setting?
The way we relate to the outdoors varies from person to person, region to region and reflects the types of lives we lead and much about our personalities. For some residents, they never had time to sunbathe; their familiar tasks in the garden revolved around the washing line and talking with neighbours over the fence. For others, they enjoyed nothing more than the smell and solitude of their old shed, far removed from the hustle and bustle of everyday life.
The key to creating meaningful occupation in the garden is to understand your residents as individuals and find out how they want to engage with their garden in their own way. And don’t worry about having a tidy garden or a pretty space – for many residents this is not important as this will simply fulfil their desire to grab a brush or deadhead the flowers!
Connect with Step Change Design on Twitter Debbie Carroll @stepchgdesign
About Care Culture Map and Handbook
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