Original Study
Green Care Farms as Innovative Nursing Homes, Promoting Activities and Social Interaction for People With Dementia

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Abstract

Objectives

Innovative care environments are developed for people with dementia to encourage person-centered care. This study aims to investigate whether residents of green care farms that provide 24-hour nursing care participate more in (physical) activities and social interaction compared with residents of other nursing homes.

Design

Longitudinal observation study.

Setting

Nursing homes in the Netherlands (green care farms, traditional nursing homes, and regular small-scale living facilities).

Participants

A total of 115 nursing home residents at baseline, 100 at follow-up.

Measurements

Ecological momentary assessments (nĀ =Ā 16,860) were conducted using the Maastricht Electronic Daily Life Observation Tool. Residents living at green care farms were compared with residents living in traditional nursing homes and regular small-scale living facilities. The following aspects were collected for this study: the activity performed by the participant or occurring in his or her vicinity, the engagement in the activity, the level of physical activity during the activity, the physical environment (location where the activity occurred), and the level of social interaction during the activity.

Results

In total, 9660 baseline observations and 7200 follow-up observations were conducted. Analyses showed that residents of green care farms significantly more often participated in domestic activities (PĀ =Ā .004, SEĀ =Ā 1.6) and outdoor/nature-related activities (PĀ =Ā .003, SEĀ =Ā 0.9), and significantly less often engaged in passive/purposeless activities (PĀ <Ā .001, SEĀ =Ā 1.7) compared with residents of traditional nursing homes. Furthermore, residents of green care farms had significantly more active engagement (PĀ =Ā .014, SEĀ =Ā 0.9), more social interaction (PĀ =Ā .006, SEĀ =Ā 1.1), and came outside significantly more (PĀ =Ā .010, SEĀ =Ā 1.1) than residents of traditional nursing homes. Residents of green care farms were significantly more physically active (PĀ =Ā .013, SEĀ =Ā 0.8) than were residents of regular small-scale living facilities. No other significant differences were found.

Conclusion

Green care farms can be a valuable alternative to traditional nursing homes. They provide an attractive, homelike environment and activities that positively influence engagement and social interaction. Research is needed to study how successful elements of green care farms can be implemented in existing nursing homes.

Section snippets

Design

A longitudinal observational design was used, including a baseline measurement and 6-month follow-up.9 Ecological momentary assessments (EMA)19 of residentsā€™ living in different types of nursing home facilities were conducted. These repeated assessments allow researchers to assess affect, behavior, and environmental factors (both socially and physically) close in time to the actual experience.19, 20 Residents were observed at a baseline measurement and a 6-month follow-up.

Setting/Sample

The experimental group

Results

Consent was obtained from 115 (73%) of 158 eligible residents. At follow-up, 100 residents still participated in the study. This resulted in 9660 baseline observations and 7200 follow-up observations.

Discussion

The current study shows that green care farms are a valuable addition to the nursing home spectrum. Residents living at green care farms are more active than are residents of traditional nursing homes. Furthermore, when activities are carried out, residents are more often engaged, have more social interaction, and come outside more often at green care farms. Compared with residents of regular small-scale living facilities, residents of green care farms were more physically active during their

Conclusion

In conclusion, green care farms have demonstrated that they are a valuable alternative to traditional nursing homes, as they provide residents with engagement in activities, social interaction, physical activity, and increased opportunities to go outside. These findings can be valuable for existing nursing home facilities, given the current focus on person-centered care for people with dementia in nursing homes, which emphasizes factors such as social interaction and participation in

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  • Cited by (0)

    The authors declare no conflicts of interest.

    This study was funded by the Netherlands Organisation for Health Research and Development (ZonMW): 728010002. They had no role in study design, analyses, interpretation of the data, writing the article or in the decision to submit the article for publication.

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