Therapeutic Horticulture for Older Adults: Practical Steps for Enhancing Your Care Program

The aging population is rapidly growing, with many older adults seeking ways to enhance their quality of life. Did you know that therapeutic horticulture (TH) can significantly improve both physical and emotional well-being for older adults? This blog explores the myriad benefits of therapeutic horticulture for older adults, detailing how various professionals can integrate it into their practices to promote overall health and happiness.

Table of Contents

Understanding Therapeutic Horticulture

Definition and Overview

Therapeutic horticulture is a practice that uses plants, horticultural activities, and the garden landscape to promote well-being for its participants. Rooted in ancient practices, it has evolved into a structured therapeutic approach recognized for its holistic benefits.

This method of therapy uses activities like planting, nurturing, and harvesting plants to engage participants in meaningful and restorative ways, promoting well-being through connection with nature. There is growing research on the physical, mental & emotional health benefits of engaging people in garden and nature activities. 

Where TH for Older Adults May Take Place:
  • In the community, at community centers, community gardens, public gardens, non-profits, etc.
  • In residential and healthcare settings, such as assisted living, long-term care, hospitals, etc. 
  • Virtually on platforms such as zoom or by telephone
senior health

Benefits of Therapeutic Horticulture for Older Adults

Physical Benefits:

Enhanced Mobility and Flexibility: Engaging in gardening activities like planting and maintaining garden beds involves a variety of movements that significantly improve flexibility and range of motion. Tasks such as bending, stretching, and reaching contribute to greater mobility, helping to keep the body agile and limber.

For Physical Therapists: You can use therapeutic horticulture to develop targeted exercises that leverage gardening movements to enhance flexibility. For example, therapists can devise a series of tasks that require older adults to reach for tools or plants positioned at various heights, thereby promoting stretching and bending.

Strength and Endurance: Regular activities like watering plants, weeding, harvesting, raking and carrying soil can build muscle strength and improve cardiovascular endurance.

For Recreation Therapists: Recreation therapists can seamlessly incorporate these gardening tasks into a comprehensive routine that blends cardiovascular exercise with strength training. They can organize engaging sessions where older adults actively participate in activities such as carrying soil or watering plants for a set period. By gradually increasing the intensity and duration of these tasks, therapists can effectively build endurance and overall fitness, ensuring a balanced and enjoyable exercise regimen.

Sensory Stimulation: Gardening provides a rich sensory experience, engaging multiple senses through the diverse textures, vibrant colors, and delightful scents and tastes of various plants.

For Occupational Therapists: You can harness these sensory-rich gardening tasks to stimulate and improve fine motor skills, especially for older adults with conditions like arthritis. For instance, therapists might incorporate activities such as sorting seeds by texture or color, which not only enhances tactile sensitivity but also sharpens hand-eye coordination. These carefully designed tasks offer a therapeutic approach, using the diverse sensory elements of gardening to support and develop fine motor abilities in an engaging and effective manner.

Sample of a physical activity from the GrowTH Network Activity Database

Emotional and Mental Health Benefits

“I have introduced therapeutic horticulture in my memory care community by offering a simple herb garden that is grown in containers in our courtyard. From this herb garden, I am able to offer two programs that are centered around our dining experience. The first program includes creating table centerpieces with fresh herbs and the second program focuses on breadmaking that incorporates the fresh or dried herbs into the bread dough. Every Sunday afternoon, my residents look forward to the aroma of this fresh bread and willingly come out of their rooms for a taste of this comforting food. These programs enhance my resident’s well-being by creating a sense of purpose and supporting their need to connect with others. Caring for the herb garden also supports their need for physical wellness, as they plant the herbs and water them everyday.”
Tammy Bryant
Certified Therapeutic Horticulture Facilitator - CTHF™

Reduced Stress and Anxiety: Gentle gardening activities, such as planting seeds, pruning plants, and simply spending time immersed in the tranquility of a garden, can have a profoundly calming effect. These soothing tasks help to reduce stress and anxiety levels, fostering a sense of peace and relaxation. The rhythmic nature of gardening, coupled with the therapeutic connection to nature, provides a perfect antidote to the pressures of daily life, promoting emotional well-being and mental clarity.

For Nurses and Caregivers: They can develop a structured schedule that integrates these soothing TH activities into daily routines. For example, caregivers can organize morning sessions where older adults participate in planting and tending to a sensory garden, which includes plants chosen for their calming textures and scents. Sensory plants, particularly those with strong, pleasant aromas, can evoke memories for older adults, especially those with dementia or Alzheimer’s, providing a comforting and calming effect. 

Improved Mood and Cognitive Function: Maintaining a garden journal, where older adults can reflect on the growth and changes in their plants, offers significant cognitive benefits. This engaging activity enhances memory retention, sharpens attention to detail, and fosters critical thinking skills. Additionally, the sense of accomplishment and purpose derived from documenting their gardening journey can uplift spirits, leading to an overall improvement in mood and emotional well-being.

For Occupational Therapists: They can use garden journaling as a therapeutic tool to boost cognitive functions, particularly for older adults with dementia or early-stage Alzheimer’s. By guiding older adults in documenting their gardening experiences, noting changes in plants, and reflecting on their feelings, therapists can promote cognitive engagement and emotional expression. This structured activity not only helps enhance memory, attention, and critical thinking skills but also provides a valuable outlet for emotional well-being.

Sense of Purpose and Achievement: Growing and harvesting vegetables or flowers gives older adults a tangible sense of accomplishment. Watching their plants grow from seed and thrive can instill a strong sense of purpose and achievement.

For Activity Coordinators: You can develop programs that emphasize the beginning, process and completion and success of gardening projects. These programs might include goal-setting activities, such as growing a certain number of plants or creating a garden section, to provide older adults with clear objectives and a sense of achievement.

Sample of an emotive activity from the GrowTH Network Activity Database

Social Benefits and Community Engagement

Building Social Connections: Group gardening projects, such as community gardens or shared gardening spaces, serve as a wonderful platform for fostering social interaction and teamwork among participants. Engaging in group TH activities helps to build a sense of community, encourages the exchange of knowledge and gardening tips, and creates lasting friendships.

For Recreation Therapists: Rec therapists can facilitate gardening clubs where older adults collaborate on communal projects, such as planting a shared vegetable garden for community kitchen meals or creating a vibrant flower bed to grow cut flowers to use for arrangements. These clubs can encourage ongoing engagement, teamwork, enhance social bonds, and significantly reduce feelings of isolation.

Community Programs: Successful community-based therapeutic horticulture programs can bring older adults together and can serve as models for new initiatives. Integrating therapeutic horticulture into care homes and senior centers involves setting up gardens, training staff, and involving residents in planning and maintenance.

For Activity Coordinators and Care Home Staff: You can implement these strategies by creating dedicated garden spaces within care homes and senior centers. They can organize regular gardening sessions, invite local horticulture experts for workshops, and involve residents in the planning and maintenance of the gardens.

Sample of a social activity from the GrowTH Network Activity Database

How to Get Started with Therapeutic Horticulture for Older Adults

1. Understand the Basics:

Begin by familiarizing yourself with the principles and benefits of therapeutic horticulture. Recognize how TH activities can enhance physical, cognitive, and emotional well-being in older adults.

If you’re just starting to dip your toes into adding therapeutic horticulture to your practice/therapy with older adults, we recommend enrolling in our virtual, self-paced Intro to Therapeutic Horticulture course. It provides an overview of the principles and practices of horticultural therapy, including the physical, social, and psychological benefits of working with plants. It teaches how to facilitate, adapt, and evaluate therapeutic horticulture sessions while providing foundational horticulture and safety training. Learning from Katie McGillivray, joined by guest speaker experts in the field, students will finish this course with the skills to facilitate activities with individual clients and small groups.

This course provides an excellent foundation for those interested in enhancing their skill set, adding a therapy option, or pursuing a career in the field. It can be completed in four to eight hours, and graduates will obtain a certificate and digital badge as a Therapeutic Horticulture Ally.

2. Assess Participants' Needs and Strengths:

Evaluate the physical, cognitive, and emotional needs of the older adults who will be participating. This helps tailor  TH activities to their abilities and interests, ensuring a positive experience. The GrowTH Network Resource Library offers assessment tools that can aid you in this process. 

It is also important to remember that older adults bring a wealth of knowledge and experience to therapeutic horticulture programs, often drawing from many years of gardening. Their contributions can enrich the program, offering valuable insights, techniques, and stories that inspire and educate others.

3. Seek Feedback and Input:

It is important to connect with older adults to understand their preferences for the program’s activities and to see if they have skills to share. Involving participants in decision-making fosters a sense of ownership and empowerment, enhancing their engagement and the overall success of the program.

4. Start Small:

Try to focus on simple activities and small garden spaces – these can have a big impact. This also allows you the flexibility to adapt the program based on feedback and observed needs. Remember that it takes time to build relationships and design a program.

5. Create an Accessible Environment:

Design garden and activity spaces that are safe and accessible for all users.This may include raised garden beds, wide and smooth pathways, lightweight hoses, wide doorways, clear signage, hand rails and comfortable seating areas strategically placed for rest and relaxation.

6. Select Appropriate Activities:

Root in Nature’s GrowTH Network offers a robust database of step-by-step therapeutic horticulture activities, with four new activities added per month. The database is sortable in multiple ways such as domain of wellness, cognition level, material requirements and ability to deliver virtually. Using these sorting tags, you can select activities year-round that are conducive to your population, setting, budget and goals.

7. Incorporate Sensory Elements:

Include plants that offer rich sensory stimulation, such as those with familiar scents, vibrant and eye-catching colors, and intriguing textures. Sensory engagement with these plants can be particularly beneficial for older adults, especially those living with dementia or Alzheimer’s. Aromatic herbs like lavender and rosemary, brightly colored flowers like marigolds and sunflowers, and textured plants like lamb’s ear and succulents can evoke memories and storytelling.

8. Establish a Routine:

Create a consistent schedule for gardening activities, establishing a regular rhythm that older adults can rely on and look forward to. By holding sessions at the same time each day or week, you instill a sense of anticipation and excitement, encouraging routine participation. This predictable structure not only enhances engagement but also provides a comforting routine, which can be particularly beneficial for older adults.

9. Foster Social Interaction:

Organize group activities to foster social interaction and build strong community bonds. By engaging older adults in communal projects, such as planning and maintaining community gardens or creating flower arrangements for a community dinner, you provide opportunities for meaningful connections and teamwork. These collaborative efforts not only reduce feelings of isolation but also cultivate a vibrant sense of belonging and purpose. 

You can promote social interaction during activities through co-operative games such as trivia or by having participants pair up to share tools.

Katie McGillivray HTR, Course & Community Lead

“It is a great pleasure to work with, learn from, and garden alongside this population, many of whom have been gardening for most of their lives. As a Horticultural Therapist in community settings, my role often involves supporting senior participants in leading activities and sharing their knowledge and gifts in the garden such as a senior participant sharing how to make pressed flower cards for the holidays or how to grow tomatoes in pots in the spring. I see such strong social connections forming between participants during our sessions, which often extend beyond the garden (such as checking up on someone who is ill, carpooling,  going to other garden events) etc. and truly help build a strong sense of community. I especially love our intergenerational sessions, where wisdom flows between participants of all ages.”