Therapeutic gardens as a design approach for optimising the healing environment of patients with Alzheimer's disease and other dementias: A narrative review

Purpose: The first half of this paper documents the role of nature in healthcare environments and its impact on wellness, with a particular focus on gardens. The second half presents a scientific evaluation of the role of gardens as a therapeutic intervention to optimise the clinical outcomes in patients with Alzheimer's disease (AD) and dementia, including a review of the innovative application of technologies alongside nature to promote cognitive rehabilitation in this particular patient population. Methods: Using search engines such as the Institute for Scientific Information (ISI) Web of Science, PubMed, ProQuest Central, MEDLINE, Scopus and Google Scholar, a relevant literature search on the positive health implications of therapeutic gardens (TG) on AD and dementia patients in the healthcare milieu was conducted. Results: The health implications of TG for AD and dementia patients span physical, social, psychological and cognitive effects. Virtual reality (VR) technologies that display natural environments also offer positive cognitive outcomes for AD and dementia patients. Conclusion: TG should be used to improve the health and wellbeing of AD and dementia patients, and its application should be extended to other patient populations to promote quicker recovery. Future directions in the design of TG, with a focus on patients with AD and other dementias, is also discussed. (C) 2019 Elsevier Inc. All rights reserved.