Daily garden use and quality of life in persons with advanced dementia living in a nursing home: A feasibility study.

The analysed sample was 20 participants, after 4 of the 24 selected participants could not take part. Only one nursing home was studied, and it was chosen because staff were trained in person-centred care and it had a suitable garden. The study compared the same participants over time, not against a separate control group. Participants went outside on only 25.4% of possible intervention days, with ward rates from 12.5% to 56.3%, so the intervention was not delivered as planned. The number of days outside during baseline was not measured, so the true difference between usual care and the intervention period is unknown. The intervention took place during the summer holiday season, when many caregivers were on vacation and workload was high. Follow-up instructions were unclear, so the negative affect change between intervention and follow-up cannot be interpreted. Quality of life and neuropsychiatric symptoms were rated by caregivers after observation, so the results depend on caregiver perception.

Do not conclude that garden use alone is an effective treatment. Participants also received usual care, caregiver contact, relatives, volunteers and activities outside, and the study cannot separate the contribution of any one component; neuropsychiatric symptoms did not change significantly.