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The Softer Side of Therapy

March 1, 2002
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Horticulture, Massage Therapy and Snoezelen get Results, tooby Sandra Hoban, Assistant Manageing Editor
The Softer Side of Therapy Therapeutic benefits without the "work" By Sandra Hoban, Assistant Managing Editor While traditional therapies are the backbone of rehabilitative / restorative care, some residents might be resistant to participating in a program that requires them to "work."

Others might become bored or frustrated with what they perceive as a lack of progress. Alternative therapies provide a break from the more regimented programs and are success based. To the resident, alternative therapies provide sensory and mental stimulation, along with therapeutic benefit-without the drudgery and frustration of being urged to "walk two more steps."

Instead, alternative therapies, such as puttering in the garden, enjoying the tactile stimulation of a massage or just sitting and absorbing sights, smells and sounds, can relieve resident ennui. These therapies encourage many of the same goals as traditional therapies, by having the resident perform the same exercises without their being perceived as "work."

For example, residents (including those with Alzheimer's and dementia-related diseases) can still retain hand functions by squeezing the soil instead of a rubber ball.

Horticultural, massage and Snoezelen«* are three types of therapies that provide their own particular physical and emotional benefits for the long-term care population. They are not intended to replace, but to enhance, traditional therapies.

Let's Get Growing!

Beverly Agard, a registered horticultural therapist employed at Ralston House and member of the American Horticultural Therapy Association (AHTA), has "greened up" the facilities in NewCourtland, Inc.'s (Philadelphia) long-term care network as part of the Eden Alternative. "NewCourtland wanted to address the three major plagues of nursing home life: loneliness, helplessness and boredom," remarks Agard.

NewCourtland considers its facilities as habitats and wanted to create caring places rather than places of long-term care.

Outside gardens with rolling pots and indoor gardens with tabletop workstations accommodate the physical limitations of the residents. A staff member does the heavy work such as turning the soil and moving any cumbersome containers and heavy gardening materials.

"All mobile residents are welcome and encouraged to participate," Agard explains. Seniors gain physical, emotional, spiritual, sensory and intellectual benefits from experiencing natural, living things. Prior to preparing their garden, these resident gardeners discuss what flowers and vegetable they want to plant. Agard finds that they prefer flowers such as the pansies and geraniums they used to grow in their home gardens. Tomatoes are a great favorite in the vegetable area of the garden.

Preparing the beds and potting plants, residents practice their hand-eye coordination by using a trowel to dig or scoop. They manipulate their fingers when making a hole in the soil to plant a seed. Feeling the textures of the soil and plant materials, while experiencing the sights, sounds and smells of the garden, stimulates all five senses: sight, sound, touch, smell-and even taste, when they sample an herb or vegetable they have grown.

"Spiritually," Agard states, "the residents feel reunited with a part of the healthy, living world around them. They are empowered because they are useful." The residents, she says, love to go outside and pick the garden-fresh tomatoes they've grown. "One resident likes to pass them out to the nurses to score brownie points," Agard laughs.

Socially, they receive the benefits of group interaction through sharing a commonality of purpose and enjoyment. In winter months, the groups dry the flowers they have grown and, using deep detergent caps, spend an afternoon creating dried-flower arrangements.

Other cold-weather projects include painting gourds and cooking-for instance, preparing a snack of crackers and cream cheese blended with herbs from the garden. This spring, Agard is planning a May Day party. She'll have the residents make garlands for their hair and serve punch and light snacks-pesto is a favorite.

To accommodate residents with Alzheimer's or dementia-related illness, Agard brings in plants that have a nice fragrance, such as scented geraniums, and helps them create potpourri bags. "Sometimes I'll simply pass around plants and flowers, such as lavender, so residents' senses can reconnect their minds to the pleasurable aromas and feel of these living things." She cautions that the therapists and staff must be very watchful to keep residents with dementia safe and prevent harmful or inappropriate behaviors, such as ingesting soil.

As a testament to what guidance and talent can accomplish, residents at two of NewCourtland's facilities won recognition in Philadel-phia's City Gardens Contest last year. Tucker House placed third in the Community Flow-er/Sitting Garden category and, in the same category, Germantown Village received an honorable mention.

Horticultural therapists work in many areas of health-care, including hospitals, assisted living, nursing homes and other long-term care facilities. To find an experienced horticultural therapist, AHTA maintains a directory available on its Web site at

A Compassionate Touch