The purpose of this study is to improve the overall cognitive function of patients with dementia in Yunlin County, Taiwan, by designing an indoor gardening flower combination game suitable for home and maintenance institutions. This paper uses qualitative research (participatory interviews, case studies, and contextual observation methods in the demand exploration phase) and quantitative research (experimental methods and the Mini-Mental State Examination (MMSE) and Barthel Index questionnaires in the product verification phase). This study adopted a four-stage service design: demand exploration, demand definition, design implementation, and product verification. In the stage of demand exploration, 14 elderly people with mild or moderate dementia were interviewed, and two cases were selected for two in-depth observations of horticultural treatment activities. Common obstacles and potential demand points were listed after integration: (1) The safety of elderly patients with dementia can be improved by employing horticultural treatment activities transferred from outdoors to indoors; (2) the objects and facilities used in horticultural activities should be improved to reduce the attention burden of elderly patients with dementia; 3) the elements of reminiscence or familiarity of the mentally handicapped elderly should be increased; 4) the process of gardening and planting can be used by two or four people to improve social and language skills. According to this study, an indoor gardening planting table game was developed. This game includes a group of flower combination prompt cards (including five flower groups: camellia, cherry blossom, chrysanthemum, kapok, and lotus), a group of color and number prompt rings, and a flower base, which provides planting of up to 25 flowers and is matched with the number prompt color rings; then, the combined flowers are planted into the base. In the final experience experiment, 7 participants with free movement of the upper limbs and mild or moderate dementia were selected by the MMSE and Barthel Index to participate in a 5-week experiment. After using a combination of progressive low-level, medium-level, and high-level flower combination tasks, the results showed that the overall performance of the elderly patients with mild or moderate dementia in the MMSE test was improved by the indoor gardening planting table game. However, the treatment effect-size presented a low effect magnitude.
Keywords: attention improvement; contextual inquiry; dementia elderly; horticulture therapy; indoor gardening table game for dementia elderly.