Horticultural Therapy
Summer 2024 - Independent Study

Hawthorn House Assisted Living Facility

Overview

For the second part of my independent study, I lead a Therapeutic Horticulture program at The Hawthorn House assisted living facility in Shalimar, FL. It was an eleven session series of activities involving flowers and plants that occurred every Wednesday from mid-May through the end of July. I had an average of eight participants in each activity. Most of them used either a wheelchair or walker, and some suffered from early-stage dementia.

I added new, got rid of, and modified horticultural activities from my first program at Twin Cities Assisted Living Facility in the Fall of 2023 based on experience and feedback. The Hawthorn House is part of the Air Force Enlisted Village, so all residents share a military background. It has better funding and staffing than the previous facility, so I was hopeful for high participation and impact from this summer program. Each activity sent the participants home with keepsakes they will cherish and share with their friends and family. They were all encouraged to incorporate plants into their everyday lives.

This program was designed for participating residents to:

Recall past memories and create new ones using sensory stimulation.
Improve motor control and dexterity.
Be creative.
Connect with nature and the present moment.
Create social connections with neighbors and facility staff.
Alleviate symptoms of depression and anxiety.

Activity #1: Raised Bed Planting

For the first activity of the program, I wanted to get a feel for the participants' abilities and allow them to get their hands dirty. I brought in a few trays of plants from home that were grown from seed. We planted them together in the existing facility garden in raised beds and other large pots. The facility is well-equipped with gardening tools, soil, and pots for residents to use and enjoy.
The plants used in this activity were specifically selected for their fragrance, beauty, and to help participants recall past memories. Plants like marigolds and basils are very common and I wanted the residents to feel a sense of familiarity. An important emotional goal of mine was to facilitate autonomy by giving the participants the ability to decide where and what to plant. This encouraged critical thinking and socialization between participants.

However, during this activity, I quickly realized that it was too hot for residents to be outside at 10 AM for even a short 30-minute duration. And that moving forward the remaining activities would have to take place indoors for their safety and for the desired outcomes to take place. I also found out that the on-site kitchen does use herbs from the garden which allows for participants to feel pride in and connection to their garden work.

Activity #2: Dried Flower Wreath

For the second activity, I brought in a large variety of dried flowers and greenery for participants to make wreaths. This activity allowed them to get creative and make a decoration for their doors. They selected the flowers they liked, and then cut and glued them onto a foam wreath base. All participants and staff commented on the strong fragrance coming from the dried flowers.

This activity focused on the participants' hand dexterity. They had to grab the flowers delicately in order not to break them, and then use scissors to cut them at the appropriate spot. While some had trouble applying enough pressure to get the stems into the foam, it was a great exercise.

Activity #3: Rosemary for Memory

Rosemary has been widely used to help improve memory and increase cognition. This activity was designed for participants to gain those benefits from two different avenues.

First, we continued the efforts of Activity #1 by planting a few rosemary plants in the outside garden beds. This allowed for their hands to get dirty again and handle the very fragrant plants. The participants and staff will be able to harvest from these plants for years to come.

Secondly, participants stuffed herb sachets with dried rosemary. An herb sachet is a small cloth bag, usually containing herbs or other aromatic ingredients. These sachets are small enough to fit in many places. My intention was for participants to keep them in their purses or on their nightstands.

Activity #4: Fresh Flower Arranging

For this activity, I brought in cut flowers from a local farm. They were in a variety of bright summer colors such as yellow sunflowers and pink cosmos. The rose scented geranium and basil were included for their fragrance and soft texture. Participants were encouraged to touch, smell, and enjoy the beauty of the flowers. This activity focused on participant dexterity and creativity.

This activity had by far the highest participation. Flowers spark joy in people, so the most residents chose to show up for this particular activity. We actually ran out of flowers for everyone. Luckily, a staff member brought us additional flowers that had been donated to the facility earlier that week. I was very pleased with the outcome of this activity.

Activity #5: Clay Plant Impressions

This activity was brand new to my program and was a great success. I brought in a variety of plant and flower cuttings from my garden. Participants and staff members gathered cuttings from the facility garden before the activity as well. Each participant was given one lump of air-dry clay and was instructed to press the plant materials into the clay. If they wanted to make that imprint bolder or carve the name of the plant into the clay, they were given toothpicks to draw with. The wax paper underneath the clay kept the mess to a minimum and allowed them to take their work back to their rooms with ease.

Participants claimed they felt like a kid again while kneading the clay and squishing the plant materials into it. They were also getting a great hand workout because this air-dry clay was quite dense. This activity was intended to give participants a lasting connection with nature and the recall of old memories was a wonderful bonus.

Activity #6: Dying with Plants

This activity was also new to my program, but not quite as successful as I hoped. The participants were each given a white bandana, a bottle of homemade purple dye made from butterfly pea flowers, and a few pink cosmos flowers.

They thoroughly enjoyed smashing the cosmos onto the bandanas to make spots of pink, and then adding in the liquid purple dye as well. Unfortunately, all the colors came out in the washer. I used vinegar as a mordant to pre-treat the fabric but that did not bond the dye as it should have.

Next time I dye naturally, I will experiment with using baking soda or alum to pre-treat the fabric we will be dying. This class has a strong potential and I am looking forward to refining it in the future.

Activity #7:Flower Pressing

This was a repeated activity from the last program. I brought in 60 cut zinnia flowers from my garden for this one. They were in a variety of bright colors including pink, orange, and yellow. The participants cut the heads off with scissors, patted them dry with a paper towel, and then pressed them into hardback books lined with newspaper.

The participants were encouraged to touch, smell, and enjoy the beauty of the flowers. This activity focused on participant dexterity. They even shared a laugh when they sat on the books to keep them flat. Once dried after a few weeks, the pressed flowers will be used in Activity #10.

Activity #8: Mandalas

This activity was intended for focus and relaxation. I brought in small shells, rocks, leaves, flower petals, and other natural materials. Participants were instructed to make a mandala on the table, starting with one piece in the center, and building in a circular shape from there.

While creating a piece of art, it also taught nonattachment because they disassembled it once the activity was done. Some participants were sleepy that day from their medications, so that was an unforeseen issue, but it did promote the relaxation I intended.

Activity #9: Indoor Potted Plant

This activity was a repeat from the last program due to the great participant and staff response. I brought in 3 different types of plants that require low light and little maintenance. Snake plants, Christmas cactus, and pothos. Each participant was given an empty ceramic pot and instructed to fill it with soil and arrange the plant(s) however they desired.

The goal was for them to have their own plant for their room to make it feel more like a home while also giving them the responsibility of something to care for. These pots were unique and all participants enjoyed making them.

Activity #10: Flower Frame

For this activity, each participant chose their own picture frame from an assortment I brought in. For those that attended Activity #7, they used their own book of dried flowers to get creative and make a work of art. I brought in a box of additional dried flowers for those who missed the previous activity or anyone who needed additional flowers to complete their frame.

The results of this activity were outstanding. All participants loved creating, and each piece was truly unique. They were excited to share them with staff and their loved ones. It helped with their dexterity and hand-eye coordination. Plus, giving them something to feel proud of has a positive compounding effect over time.

Activity #11: Tea Time & Re-Dying

This activity was intended to wind down the program and give the participants a chance to reflect and provide feedback. First, participants tie-dyed the bandanas again because the natural dye from Activity #6 came out in the wash. Then, we all had a cup of butterfly pea tea. Which is a sweet, mild tea that turns the water blue. When lemon is added it turns purple, which was very exciting for the participants.

The participants expressed that they enjoyed all of the activities I brought to them, and the keepsakes they will have to remember it with. The only suggestion I received was to have the program during a different season so that we could have activities outside in the garden. It was sad to complete the program, especially with my nana being one of the participants and the reason I chose this client group in the first place.

Conclusion

Residents of assisted living facilities are still my client group of choice, but I am looking to expand to new groups as well!

I learned so much from this second independent study project. The residents at this facility were in much better physical and mental states than in the previous program. This made it easier to instruct and assist them with activities. The staff was also more available during activity times, there was funding available to pay for supplies, and there was already an existing garden for residents. This was great but also a little less rewarding because I felt like the participants were not as in need of the activities. They had crafts, exercise classes, science experiments, and other fun activities at the facility multiple times per week.

I will now be doing more research on what client groups in my area need Therapeutic Horticulture. We are a military community with multiple bases, so I believe my next client group may be veterans or even active duty and their families. My research will show me what group is in the most need, and I am extremely excited to graduate with my certificate in Horticultural Therapy!

The Future for the Hawthorn House

During my summer program, The Hawthorn House received a grant from the Alzheimer's Foundation of America that got them an indoor garden bed from Eldergrow. So I am happy to know that they will now have an ongoing indoor and outdoor garden to enjoy after my program is over.

Horticultural Therapy Summer 2024 - Independent Study