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HISTORY/ BACKGROUND. Ward 17 is a 15 bedded ward for older adults with organic mental health needs. 1997 A continuous improvement team was formed to address the need to develop the enclosed courtyard area. Some purchases of garden furniture were made and a draft policy was drawn up. 2002 In May of this year a group of interested staff formed the Project team.

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THE PROJECT TEAM. STEVE DOBSON - Ward 17 Staff Nurse RUTH ENDICOTT - Ward 17 Nurse Auxiliary LYNDA HOLROYD - Ward 17 Technical Instructor PAULINE PARKINSON - Ward 17 O.T. Helper NICOLA PLASTOW - CCT/ Ward 17 Senior O.T. DEBBIE SCHOFIELD - Ward 17 Nurse Auxiliary SUZANNE WIGHTMAN - Clinical Nurse Manager

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KEY POINTS For good design for Dementia Care (Chapman, Jaques and Marshall, 1994) Buildings should be as homely as possible Given the right cues, people with dementia may be able to find their way around An environment should provide opportunities for purposeful activity Safe outdoor space should be created Staff should have their own separate space

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AIMS To provide access to a therapeutic outdoor garden area To offer increased opportunities for social and recreational activity To provide an area for purposeful and therapeutic activity To offer increased opportunity for assessment To provide an alternative area to receive visitors To promote opportunity for relaxation and privacy in a pleasant outdoor area

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EVIDENCE BASE # Healing landscapes at hospitals, hospices and similar sites are recognised as such rather than merely covering the ground. This concept is gaining prominence due to the theoretical work of Ulrich (1984) and Kaplans (1989). # The unique requirements of landscape design for care settings are becoming internationally recognised ( Stoneham and Thoday 1994) # Gardening is part of our national culture and older people are particularly involved in this activity ( social trends : 1998:28 ) # Kings Fund – Financial support to “enhance the healing environment” # The NHS Plan – emphasises improving the NHS environment

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# MIND (2000) - describes conditions on wards as depressing # Sainsbury Centre for Mental Health (1998) – describes mental health settings as non-therapeutic # UKCC (NMC) produced a report in 2002 on “ preventing and managing violence in mental health care” and called for calming features in the environment # North American research has shown that 95% of people with dementia report a positive mood change after sitting in a garden # The creation of a healing garden for people with dementia resulted in a 19% reduction in the number of violent incidents ( Prof. Mooney)

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Work completed Patient and carer consultation Staff consultation – Graffiti board Expert advice Presentation organised Financial consideration – budget, account Safety considerations Person centred focus

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PATIENT AND CARER CONSULTATION COURTYARD SUGGESTIONS. May 2002 “ Illuminated wishing well” “Lights in the garden” “Hopscotch” “Washing line with pegs” June 2002 “ Clematis climbing” “Miniature cherry” “Nice chairs” “Lavender” July 2002 “I like roses, I had roses in my bouquet” “I like roses – for the perfume. I had roses & freesia’s in my wedding bouquet” “My favourite flower is sweet pea they are easy to grow” “I like daffodils the way they nod their heads”

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August 2002 “ Yellow rose of Texas” “ Daisy, daisy” “ Whispering grass” “ We’ll gather lilacs” - Songs with flowers in them August 2002 - Discussion group/ reminiscence. “ I remember blowing fairy clocks to tell the time” “ Holding buttercups under your chin to see if you liked butter, the glow was always yellow” “ Collecting rose petals in a jar to make rose water perfume” “ Making daisy chains”

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STAFF CONSULTATION Graffiti board May – August 2002. “ Raised flower beds … more Accessible for older people” 12 “ Multi-sensory garden … scented plants and herbs” 9 “ A safe water feature” 7 “ Wind chimes” 4 “ Good seating- wooden with cushions” 4 “ Games – draughts” 4 Trellising, Parasols, sun awning, grass, Lawned area for bowls, lighting, handrails.

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FINANCIAL CONSIDERATIONS Sponsorship board Tree in the garden Courtyard donation account Stakeholder involvement/support i.e. Groundforce Thrive Open Art Leeds University Local business National Charities

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