Why Scotland is opening a dementia center in a national park

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When Gillian Councill and Kenny Wright of the nonprofit Alzheimer Scotland met people living in the Cairngorms mountains of their country, they heard a refrain: locals with dementia could not go out into nature as they once loved.

An old Cairngorms National Park Ranger explained that he was still an avid mountain biker, but after showing up for a swim lesson at 9 p.m. instead of 9 a.m., he knew it was getting harder to get around on his own. Another man, who had spent many hours hiking and cycling in the area, said he began to worry when he got lost.

The loss of those beloved connections to nature was significant. Outdoor activities like bird watching and hiking have well-known benefits for physical and mental health, for example. But for someone with dementia, giving up these activities can also feel like a deep part of their identity is being erased.

Following a number of conversations with people with dementia living in and around Cairngorms National Park, Wright and Councill began experimenting with ways to bring those they serve back into the outdoors. It was five years ago. This autumn their vision will have a permanent home, in a new center for people with dementia located in the Cairngorms National Park itself.

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Even for people who have spent much of their lives outdoors, dementia makes nature more difficult to access, says Wright. Planning and organization is an obstacle. A person with dementia may be physically fragile and need a helping hand to navigate the landscape safely. Some may face resistance from family concerned about the risks. Particularly in care settings, even spending time outdoors in a garden, which may have obstacles or slippery surfaces, can be a challenge due to understaffing.

So when Wright and Councill decided to test outdoor events, they started small. With help from government agency Forestry and Land Scotland, they found a small clearing nestled in the Scots pine forest near Cairngorms National Park. Loch Morlich. It seemed made for a tent, recalls Councill. From here a short walk led to a white sandy beach where the bald peaks of the Cairngorms range towered over the lake. In the clearing, organizers hung a makeshift canopy, climbed a tree to rig it, and set up vintage flower-bedecked lounge chairs and camp furniture they brought from their own garages. But on a cold day in September 2017, when they hosted the first event, Wright recalls having no idea if anyone would show up.

They did it. About 18 people came, including people with dementia and their family members, all bundled up for the day outside, Councill recalled. The group told stories around a campfire, drinking tea and munching on ginger cake with white icing baked by Councill’s mother. At the end of that day, Councill knew that the outdoor sessions had to continue.

“It felt like people had the opportunity to reconnect with something that was sorely missing in their lives,” she says. During monthly outdoor sessions, participants identified trees and birdsong. They learned local folklore and practiced woodcarving. They continued to meet that first winter at a nearby reception center. The following year, Alzheimer Scotland used grants to purchase a large teepee style tent with a wood stove so they can continue to meet outside.

As Councill spent her days leading the teepee sessions, she noticed how, on the outside, the anxieties and stress associated with dementia dissipated. “You know that feeling of trying to remember something or trying to realize something?” says Councill, describing the pressure many people with dementia can feel in particular. “Nature has a special way of removing that. It’s like people can just be a little bit more.

Wright saw the impact of the project in multiple ways: He recalled watching a friendship blossom between two men with dementia. “I can imagine them walking through the woods, just having a good laugh,” he says. One woman, an enthusiastic gardener who had missed the outdoors since moving from a house to an apartment, became anxious on the ride, not recognizing the route. But when she got out of the car, Councill recalled, she lit up and exclaimed, “Oh, I’m home.”

Another resident, who remembered swimming in rivers and “getting dirty” growing up in the Aviemore area, walked around every day, Councill says. But on some days she also attended a care center with a locked door where, according to her family, she spent a lot of time trying to get out. On walks in the woods, Councill saw the woman stretching her arms to the side, Titanic style. “For me, it was a real symbol of freedom,” she says.

As word of the project spread, a waiting list grew. At other services for people with dementia, Wright notes, there is usually turnover as it becomes more difficult for some to participate as their condition progresses. But that didn’t happen. “If people might have trouble engaging in a particular activity, it didn’t really matter,” he says. Just being in the tent and in the middle of nature was a sensory experience. “They enjoyed it a lot and felt like they were part of something, I think.”

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Nature-based activities can help maintain one’s sense of identity, says University of Worcester dementia researcher Simon Evans, especially for people who have enjoyed the outdoors throughout their lives. And while for some this may be gardening or other low impact activities, some people with dementia may also wish to pursue extreme sports like skydiving. “People who have been pretty fearless in their lives, just because they have dementia doesn’t mean they shouldn’t be allowed to take those kinds of risks,” he says.

And amid a growing movement to recognize the human rights of people with dementia, access to outdoor activities is attracting more and more attention. Britain adopts social prescription, a practice where health workers refer patients to activities such as museum visits or nature experiences. These changes come as the number of people with dementia worldwide is increasing. And all over the world, initiatives are integrating nature into the delivery of care with promising results.

Spend time in urban forests supports feelings of self-worth in people with dementia, study finds. Search in on-farm care programs for people with dementia, most common in the Netherlands and Norway, found that largely outdoor services boosted social engagement and physical activity while providing relief to family carers. For people living in care facilities, spending time in the gardens was found to reduce agitation and promote calm.

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When the new Alzheimer Scotland outdoor dementia resource center opens in the Cairngorms National Park next month, it will be a 10-minute drive from this first gathering place near Loch Morlich. Housed in a refurbished building in Badaguish Outdoor Centerthe center is in a meadow lined with Scots pines and mountain vistas.

Five days a week, the center will be open without an appointment. Councill and Wright hope to offer wide-ranging programs such as bird watching, forest swimming, mountain biking and canoeing. A network of surrounding trails will be marked with clear orientation signs.

The center’s budget of approximately $1,100,000 has been met a larger grant, including a host of initiatives to use the national park to improve public health, says project leader David Clyne. Clyne’s own father suffered from vascular dementia, he recounted, and later in life spent much of his time sitting indoors watching television. Services at the new center will have a wider reach, he thinks, in part by helping loved ones whose lives are also shaped by dementia. “It’s not just one individual,” he said. “It’s a condition that impacts family, friends.”

Councill hopes the new center can also inspire others to think differently about the kinds of spaces and activities that are typically available for people with dementia. “When people get a diagnosis, sometimes they can feel like it’s all negative and the focus is on the loss and what you can’t do,” says Councill. “I guess he’s trying to turn things around a bit and focus on what people can still do.”

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