Effectiveness of a dyadic technology-enhanced home-based horticultural therapy on psychosocial well-being among people with dementia and their family caregivers : multimethods pilot study

Abstract

Background: Horticultural therapy (HT) has been proposed to be an effective intervention for improving the psychosocial well-being of people with dementia and their caregivers. However, constraints such as limited land space in high-density cities, unstable weather, and lack of gardening experience may hamper the delivery of HT to people with dementia and their caregivers. Objective: This pilot study aimed to examine the feasibility and preliminary effects of a technology-enhanced home-based HT for people with dementia and their caregivers using a hydroponic indoor growing system. Methods: A single-group pre-post design was adopted. A total of 37 dyads of people with dementia and their caregivers participated in 3 weekly face-to-face sessions, followed by 8 weeks of home-based horticultural activities. Outcomes were measured at baseline and postintervention (at week 11), including feasibility outcomes, cognitive function, neuropsychiatric symptoms, and happiness levels of people with dementia. Caregivers’ outcomes included positive aspects of caregiving, perceived stress levels, depressive symptoms, caregiver distress, and happiness levels. Semistructured focus group interviews were conducted with the caregivers to further explore their horticultural experience. Results: Intervention feasibility was established with a completion rate of 83.78% and an attrition rate of 2.63% (n=1). Significant improvements were detected in caregiver distress (P<.05) and the happiness level of people with dementia (P<.01). The qualitative findings indicated that HT improved the psychological well-being of both people with dementia and caregivers, enhanced the relationships between caregivers and people with dementia, expanded the caregivers’ social networks, and enhanced the autobiographical memory of people with dementia. Conclusions: This pilot study provides evidence on the feasibility of using a hydroponic indoor grower to conduct home-based HT for people with dementia and their caregivers. The findings suggest positive effects on the psychological well-being of both people with dementia and their caregivers. Caregivers reported potential positive effects of HT on the autobiographical memory retrieval of people with dementia. Due to the pilot nature of this study, a control group was not employed. Therefore, large-scale randomized controlled trials are encouraged to further confirm the effectiveness of the intervention.