A Framework for Improving Healthcare Environments of Alzheimer’s and Dementia Patients using Therapeutic Gardens

The design of healthcare buildings for individuals with Alzheimer’s disease (AD) and dementia, using nature can create a therapeutic environment that positively affects architectural quality and health outcomes. Clinically, AD is known to progress in three stages, including mild (early stage), moderate (middle stage), and severe (late stage). This present study focuses on the middle and severe stages of AD and dementia based on the therapeutic advantages of nature for improving their quality of life. Therapeutic gardens, which have been shown to be the most successful nature-based complementary treatment option applied in the form of therapeutic gardens (TG), and Horticultural Therapy (HT) for individuals with AD and dementia was explored in this research. Prominent theories by Roger Ulrich, and Wilson Edward, which cut across architecture, landscape design, environmental psychology, and hospital management was used to underpin this study. A critical and systematic review method was adopted for this study. A qualitative content and thematic analysis was used in the critical review section. Literatures were retrieved from four (4) database, including Elsevier Science Direct, Sage Journal Online, Taylor and Francis ProQuest dissertation and thesis global in the systematic review section. The findings of this dissertation established that TG and HT should be integrated as an Evidence-Based Design (EBD) intervention in the design of AD and dementia care facilities. These approaches have yielded positive outcomes, including reduced agitation, stress, anxiety, negative mood, improved cognition and general wellness in patients. Virtual reality (VR) was found to simulate a range of nature-based environments that enhances cognition and overall experience of AD and dementia patients. Factors synthesized from the literature were used to develop a conceptual framework for utilizing the health benefits of TG in the design of spaces. This study likewise closes the gap between research and practice through EBD recommendations to guide architects, health care practitioners and policy makers.