'The nourishing soil of the soul': The role of horticultural therapy in promoting well-being in community-dwelling people with dementia.

Two-thirds of people with dementia reside in their own homes; however, support for community-dwelling people with dementia to continue to participate in everyday activities is often lacking, resulting in feelings of depression and isolation among people living with the condition. Engagement in outdoor activities such as gardening can potentially counteract these negative experiences by enabling people with dementia to interact with nature, helping to improve their physical and psychological well-being. Additionally, the collaborative nature of community gardening may encourage the development of a sense of community, thereby enhancing social integration. Despite increasing evidence supporting its therapeutic value for people with dementia in residential care, the benefits of horticultural therapy have yet to be transposed into a community setting. This paper will examine the theoretical support for the application of horticultural therapy in dementia care, before exploring the potential of horticultural therapy as a means of facilitating improved physical and psychological well-being and social integration for people living with dementia within the community

Leadership from the bottom up: reinventing dementia care in residential and nursing home settings

A number of recent policy initiatives have sought to improve the quality of dementia care in residential and nursing homes. Drawing on current literature and themes identifi ed from in-depth interviews with four managers working in these settings, this paper discusses the potential for different styles of leadership in developing a suitable organisational culture in which quality dementia care might develop and thrive. It argues that alongside valuable strategic imperatives coming from the UK National Dementia Strategy (DH, 2009), there is a corresponding need for more ‘bottom-up’ approaches within dementia care settings themselves through the empowerment of staff. It argues that this would enable more participatory approaches to organisational development. The paper specifically discusses the concepts of both ‘climate’ and ‘culture’ in institutional care for older people and how these features can be enhanced to support a more person-centered approach. Particular emphasis is given to the significance of leading a culture of learning, which we view as crucial to any transformation process

Survival adjustment or radical strategic transformation The experience of the Russian Provincial Company

SIGLEAvailable from British Library Document Supply Centre-DSC:7751.190(RP 1/98) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Improving care home design for people with dementia

With more people with dementia living in care homes in the UK than ever before, there is growing recognition that the design of such internal and external spaces should meet dementia friendly principles. This paper reports on one part of a study to evaluate the reliability and validity of two tools: The Design Audit Tool and the Environmental Audit Tool developed to audit how dementia-friendly internal and external environments (specifically care homes) are for people with dementia, and presents a qualitative analysis of the reports presented to care homes following each audit. Thirty care homes took part in the study to evaluate the design audit tools and, following good practice, received a home report detailing up to five design strengths and five limitations following the audit. Analysis of the home reports identifies variation and variability in meeting dementia-friendly principles as specified by both tools. Areas of variability included wayfinding, the use of colour and contrast, access to outside spaces, individualization of personal and communal spaces, lighting and opportunities to engage with the environment. This paper provides valuable insights into variability in care home design and identifies common areas of weakness and strength in care homes of different type, ownership and localities