Benefits of sensory garden and horticultural activities in dementia care: a modified scoping review

J Clin Nurs. 2014 Oct;23(19-20):2698-715. doi: 10.1111/jocn.12388. Epub 2013 Oct 15.


Aims and objectives: To provide a review on the benefits associated with the use of sensory gardens and horticultural activities in dementia care.

Background: Maintaining quality of life is important in dementia care. Sensory gardens and horticultural activities are increasingly used in dementia care, yet their benefits are uncertain.

Design: A modified scoping review with descriptive analysis of selected empirical studies.

Methods: Systematic searches in Amed, CINAHL, MEDLINE, ISI Web of Science, Embase and Scopus were used. Search terms were the free-text concepts 'healing garden', 'horticultural therapy', 'restorative garden' and 'wander garden' which were combined with dementia and Alzheimer.

Results: Sixteen studies were included with included participants ranging from eight to 129 participants. Research designs were case studies (n = 2), survey (n = 1), intervention studies with pretest/post-test design (n = 11) and randomised controlled studies (n = 2). Of these 16 studies, eight examined the benefits of sensory gardens, seven examined horticultural therapy or therapeutic horticulture and one examined the use of plants indoors. This study offers a review of the research addressing benefits of sensory gardens, therapeutic horticulture, horticultural therapy and other purposeful use of plants in dementia care. The reported findings are mainly on issues related to behaviour, affect and well-being. The findings are in general mutually supportive, however, with some contradictory findings. In addition, sleep pattern, well-being and functional level seem to improve.

Conclusions: These types of nonpharmacological interventions may improve well-being and affect and reduce the occurrence of disruptive behaviour. Additionally, the use of psychotropic drugs, incidents of serious falls, sleep and sleep pattern also seem to improve.

Relevance to clinical practice: To further improve the use of the existing or planned gardens, an educational programme for staff that also includes skill training is recommended.

Keywords: dementia; horticultural therapy; nature intervention; nonpharmacological intervention; outdoor activities; sensory garden; systematic review; therapeutic horticulture.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Dementia / nursing
  • Dementia / psychology
  • Dementia / rehabilitation*
  • Gardening*
  • Humans
  • Quality of Life*