A dementia-friendly Helsingborg “The garden of memories and knowledge”
A scent from a Lilac and suddenly you remember how you ran barefoot in your garden as a child. A special song and you start thinking about your grandfather and how he used to sit next to the radio in the kitchen drumming his fingers on the table. Our surroundings influence our senses and can make us remember things we barely knew we had left inside us.
The Garden of Memories and Knowledge is a sensory garden where memories are brought back to life and new memories are created.
Local
Sweden
{Empty}
Mainly urban
It refers to a physical transformation of the built environment (hard investment)
No
No
Yes
2022-05-30
As a representative of an organization, in partnership with other organisations
Name of the organisation(s): Stadsbyggnadsförvaltningen Helsingborg stad Type of organisation: Public authority (European/national/regional/local) First name of representative: Paulina Last name of representative: Svenstrup Gender: Female Nationality: Sweden Function: Landscape architect Address (country of permanent residence for individuals or address of the organisation)<br/>Street and number: Järnvägsgatan 22 Town: Helsingborg Postal code: 251 89 Country: Sweden Direct Tel:+46 70 864 59 45 E-mail:paulina.svenstrup@helsingborg.se
Name of the organisation(s): Vård- och omsorgsförvaltningen Helsingborg stad Type of organisation: Public authority (European/national/regional/local) First name of representative: Maria Last name of representative: Rosendahl Gender: Female Nationality: Sweden Function: Project leader Address (country of permanent residence for individuals or address of the organisation)<br/>Street and number: Carl Westmans allé 5 Town: Helsingborg Postal code: 25189 Country: Sweden Direct Tel:+46 42 10 36 19 E-mail:Maria.Rosendahl@helsingborg.se
Name of the organisation(s): Lunds universitet Type of organisation: University or another research institution First name of representative: Lisa Last name of representative: Ekstam Gender: Female Nationality: Sweden Function: Leg occupational therapist, Docent, University lecturer Address (country of permanent residence for individuals or address of the organisation)<br/>Street and number: Box 157, Baravägen 3 Town: Lund Postal code: 221 00 Country: Sweden Direct Tel:+46 72 561 80 24 E-mail:lisa.ekstam@med.lu.se
Name of the organisation(s): Stadsledningsförvaltningen Helsingborg Type of organisation: Public authority (European/national/regional/local) First name of representative: Sanna Last name of representative: Melling Gender: Female Nationality: Sweden Function: Research and development manager Address (country of permanent residence for individuals or address of the organisation)<br/>Street and number: Drottninggatan 14 Town: Helsingborg Postal code: 252 21 Country: Sweden Direct Tel:+46 72 211 33 18 E-mail:sanna.melling@helsingborg.se Website:http://fou.helsingborg.se/
Name of the organisation(s): Vård- och omsrogsförvaltningen Type of organisation: Public authority (European/national/regional/local) First name of representative: Karin Last name of representative: Nilsson Gender: Female Nationality: Sweden Function: Silviasyster (*nurse with a special education in dementia) Address (country of permanent residence for individuals or address of the organisation)<br/>Street and number: Myndigheten Town: Helsingborg Postal code: 251 89 Country: Sweden Direct Tel:+46732-315534 E-mail:karin.nilsson6@helsingborg.se
Name of the organisation(s): Socialhögskolan Lunds universitet Type of organisation: University or another research institution First name of representative: Yvonne Last name of representative: Johansson Gender: Female Nationality: Sweden Function: Docent, University lecturer Address (country of permanent residence for individuals or address of the organisation)<br/>Street and number: Box 157, Baravägen 3 Town: Lund Postal code: 221 00 Country: Sweden Direct Tel:+46 46 222 12 97 E-mail:yvonne.johansson@soch.lu.se
The Garden of Memories and Knowledge is a sensory garden and a part of the initiative ‘Dementia Friendly Helsingborg’. An initiative which was born out of the municipal research and development team (FoU Helsingborg)’s idea that in order to make a real change a wide range of municipal departments and services ought to collaborate and involve those we wish to make a difference for.
The process started with a hypothesis: By starting from a person's everyday situations and creating dementia-friendly activities, environments and meetings, we increase the quality of life of for people living with dementia and their relatives. A hypothesis, which has permeated the project from start to finish and has provided us with a twofold approach in creating create a dementia-friendly city: sharing knowledge about cognitive disorders and creating dementia-friendly environments in the public space.
The garden is a recreational place where focus has been on creating a dementia-friendly, beautiful and accessible sensory park. At the same time, the dissemination of knowledge have had a major focus during the project. Here, visitors can get information on where to turn for support and to learn more about dementia. It is a garden of knowledge about dementia.
The Garden of Memories and Knowledge have become a success! During the warmer days of the year, the garden is always full of people. Early on in the project, we had the vision that elderly people were dancing to the music installations in the garden. This vision has become a reality witnessed by many. We even received information that tourists visited the garden to learn more about dementia.
Her Majesty Queen Siliva of Sweden is an Honorary Ambassador of Alzheimer’s Disease International (ADI) and at the opening of the Garden of Memories and Knowledge, we had the honour to personally receive her blessing for the garden!
Garden of knowledge
dementia-friendly
sensory garden
accessibility
universal design
In Sweden, we are fortunate to have many green areas in our cities, which play a crucial role in our climate actions. However, many of them are monocultures with low biodiversity. Hence, we do not have to make extensive structural investments but we do have to add value. One goal was to increase the green and recreational values in the garden. For example, by adding water as an element and choosing plants that provide flowers and pollen for most of the year, thereby increasing the biological diversity.
The aim was to create a beautiful place that will stand the passing of time and ages gracefully. For example, we adjusted the design to the local context and focused on enhancing existing values. This meant that we were determined to save all of the trees in the park and to let the trees define the new design of the park. We have used material that will age beautifully, like natural stone, bricks and steel constructions made by a local blacksmith. We also chose to renovate some of the original equipment instead of buying new.
Although we have largely focused on people living with dementia and elderly throughout the project, we have also wanted to create places and activities that would attract all kinds of people. We wanted people to meet in order to increase the sense of belonging but also to spread the knowledge about dementia.
Research shows that the earlier you can get a diagnosis of dementia, the better you can slow down the disease and maintain independence. Research shows that spending time outside are an important parameter for slowing down the course of the disease. By creating a dementia-friendly environment in a public park, we wanted to draw attention to the subject and make people ask themselves the question if they themselves are affected, have a relative who is affected and made them understand how to act if you meet a person with dementia. We view the transformation of the garden as a preventative measure for people living with dementia.
The goal has been to create a place where memories can be brought back to life and where new memories can be created. Our goal has been to create a recreational environment together with the local dementia community. We have let the wishes from people with dementia guide the design in the garden.
Research tells us that stimulation of the senses is a powerful tool for people with dementia and how this kind of interaction improves their well-being as well as supports their memory. We wanted to work with sensory stimulation and the concept of a sensory garden in a new way. In our conversations with the local dementia community, they often spoke about their own gardens that they had had as young adults, which for the majority of those we met was in the 60s. It was also during that decade the dwellings around the park began to spring up. We knew that it was important to have "home like" environments and that people with dementia can more easily remember things from the past but have more difficulty remembering episodes that happened more recently.
With this in mind, we found inspiration in a wallpaper from the 60s which led us to the playful concept "the happy 60s". A concept that we wanted to apply in a recreational environment where sensory experiences were the focus. It did not become the traditional garden of the senses, but a sensory garden with a concept that evokes both humour and recognition in a recreational environment.
In the garden, we chose to work with organic shapes so that the place will be perceived as safe, friendly and inviting, from an environmental psychological perspective. To create a recognisable environment in the garden, we have created a living room with seating area with characteristics from the 60s.
The local dementia day care centre is placed 500 meters from the garden. In addition, to working with the garden, we also had a desire to create a route from the centre to the garden that was easy to identify and orient oneself by.
Both the UN convention on Rights for People with Disabilities and the UN Convention on the Rights of the Child are statutory law in Sweden. Sweden also have a law called the Planning and Building Act (PBL), a law that regulates various planning facilities and regulations that all municipalities are obliged to establish. PBL has regulations on how to build to make it accessible to everyone. These laws have been the minimum benchmark when it comes to the design of the garden. The most important aim has been to create a universal design that can be used by a wide range of people, but where people with dementia have had the greatest focus. Accessibility has permeated the entire project.
A goal we set early in the project was to create a dementia-friendly environment in a public park. The reason for this was partly to make people open their eyes to a disorder with a lot of stigma, and to make information about the subject more available. Another goal we have worked towards is to help people affected by dementia to get an earlier diagnosis. By creating this type of garden in a public park, our hypothesis is that we can work preventively and achieve proactive health care. In addition, it costs nothing to visit the garden, it is open and accessible to everyone.
In the garden there is a sign where you can learn about the ideas behind and the process of the project but also information about dementia and what early signs you should look out for as well as where you can get more information and support. The sign is in Swedish and there is a QR code that provide the same information in different languages with just a push of a button. On the sign there is also a QR code that takes you to an digital application (app) called Guide Helsingborg. It is an app where you can access a guided tour of the park and the project via your mobile phone.
Involving people with dementia has received positive attention from residents and businesses in the local area and from other municipalities. We believe that by drawing attention to dementia, more people can receive a diagnosis earlier, which will contribute to independence for longer in life.
During the project, we wanted to work in co-creation with people living with dementia. We have included the local dementia community in a range of different ways. During the process it become clear how much the local dementia community enjoy seeing each other and us, and how the different workshops really gave them joy and a recreationally time. Today the local dementia community visit the garden more often.
By creating an accessible sensory garden, we have open doors to more people having the opportunity to use the park. Today some visitors from the local dementia group dare to walk along the path all the way to the garden without support from staff. The health care staff also report that they feel proud of the park and of their knowledge of how they can use the garden. The local dementia community see the garden as their own place in the park.
Children at the nursery schools in the area have also been involved and participated in workshops together with the local dementia group. The children requested a place of their own in the garden. We therefore created a stone table with hollowed out bowls and a stone were given the shape of a face. A playful and tactile detail for them to explore. When we met the children in the garden, it was clear that they felt pride in their participation and that they enjoy interacting with the elderly. During the inauguration of the garden where both the local dementia community and the children from the local nursery schools sang together on stage. Theysang especially for Her Majesty Queen Siliva of Sweden who was there to declare the Garden of Memories and Knowledge open. A big occasion to say the least, it was an emotional moment!
The budget a Dementia Friendly Helsingborg is a joint effort from different departments of the City of Helsingborg. The Urban Planning Department, Health- and Social Care Department, and the Research Unit of Helsingborg and the University of Lund. This collaboration has led to an increased budget overall in the project, contributed to a large knowledge field and also contributed to new innovative methods and ways of working together.
We have above all worked together with the local dementia community. Their wishes about the coming design, details and activities in the garden have all been created. The garden would not be what it is today without this collaboration. For example, if it weren’t for the stories the local dementia community told us about the choice of concept would have been different.
The staff from the dementia day care have also assisted us in making the connections in order to involve people with dementia. They have contributed with considerations, wishes and ideas. Thanks to their knowledge and involvement with the garden, they have now created daily routines and activities around the garden. The day care center has gained more members since the garden was completed. In addition, the staff informs their new members and relatives about the garden. Consequently, they visit the garden even when they not are visiting the dementia day care center.
By involving all the nursery schools we have created a feeling of inclusion in the partnership between the elderly and the children. The children are aware of their own participation in the project and proud of that. The children and the elderly have also continue to meet each other. We were hoping for this during the project process and now this is something that happens spontaneous and by their own initiative.
During the project the working group has extended its network and established contact with a number of partners both regional and national organizations such as the Swedish Dementia Centre, Silviahemmet and Region Skåne's learning hub and knowledge center for cognitive disorders. Further, we have run a bi-monthly learning forum (a forum where we invited various lecturers and experts in the field to present their work and to discuss our findings etc.). Through these learning forums, the working group has established contact with several other areas of expertise and actors who constitutes contact points for spreading knowledge about the project providing opportunities to scale up the project and take ideas and advancements forward in new settings
Silviahemmet is a Swedish non-profit foundation with the mission to spread knowledge about (dementia) through various educational initiatives. Silviahemmet offered a certification in dementia knowledge to care and care units. Through Silviahemmet, you can certify yourself as Silvia's sister. A certification that is recognized both national and internationally. Her Majesty the Queen Silvia initiated the dementia care training program and the foundation Stiftelsen Silviahemmet. The Queen has a personal experience of Alzheimer's and is an Honorary Ambassador of Alzheimer's Disease International (ADI).
Different areas of knowledge has been entwined in the working group. The collaboration has been successful, especially the combination of a landscape architect and two certified Silvia sisters. They have worked closely together throughout the process to come up with the best design for people with dementia. Two professors also formed part of the working group. Conducting research into the working group's learning process as well as contributing with current research on the subject of dementia. They have observed our methods resulting in concrete proposals for changes to gain a different solidity of our work.
The city of Helsingborg has received a lot of positive reactions from residents and surprisingly it is mainly from people who do not have a connection to dementia. Proving that when your aim is to create something beautiful together with a specific group with the goal to create accessibility -you are creating universal design for all.
We have observed the park being used to a greater extent than prior to the project. Visitors include children, youth, and of course elderly people. We also know that visitors from outside the city visit the garden in connection with their relative underwent a dementia investigation, in order to gain more knowledge about dementia.
According to the staff at the day care center the garden has already had a positive impact. For example visitors to the dementia day care center have become more physically active and their independence have increased. Several people are now able to recognize the route and can walk by themselves to the garden. The numbers of clients to the dementia day care center has also increased and the center has become more attractive.
The understanding of people living with dementia has generally improved in the area and there is now a willingness to meet and to share the garden. The local dementia community says that overall, the knowledge of dementia seems to be more well-known among the public and people dare to ask questions as well as talk about this subject.
The invitational scope of this project is the cross-sectional work together with social scientists and the result of this collaboration. But also the co-creation with the local dementia community – a group we had never included before, and the landscape architect together with two Silvia sisters* (*health care nurses that have education about dementia) during the design process.
Designing a place for a limited audience and an audience that has a lot of stigma attached to it has been innovative and something we have not seen before. Traditionally, dementia gardens are fenced off and in the vicinity of a dementia home. We have turned this on its head by wanting the garden to become an exclamation point in the city. We wanted people to meet and start conversations about dementia to contribute to increased acceptance and understanding of the disease.
During the project, we have worked with different innovative methods. All of which we have carried out together with people living with dementia. A close cooperation we have understood to be unique. The collaborative meetings and methods became the guideline for the coming design and resulted in The Garden of Memories and Knowledge.
Instead of starting with a place in need of restoration, we started with the target group, people living with dementia. We wanted to improve their everyday life by creating a dementia-friendly environment and sharing knowledge about dementia. Hence, our starting point was dependent on where we could find people with dementia and we found the local dementia group and started to search for a possible site in the surroundings.
With the local dementia community, we held workshops, they received a design probe and we conducted different physical sensory exercises. At the first meeting, the aim was to map their needs and what qualities and existing shortcomings along the path and in the park. One of the outcomes was that we realized the importance of seating. Due to this, we planned an exercise where, with the help of chairs, we explored how and where the group wanted to sit. We also conducted a sensory workshop. We had prepared different plates, each plate represented an element of the mind. Conversations were held about how these sensory elements were experienced and what would be considered as desirable elements in the planned garden.
The project group also tested a design probe method. All participants received a box that we called the "sensory box". This box contained a range of things that would stimulate their senses. The box also contained a diary and the participants were asked to write down memories they had of gardens and what they think about in relation to senses and memories. The participants much appreciated being involved in work and it was clear that they enjoyed being able to test the elements of the senses and to meet regularly. The participants got to discuss what they wanted to do in the future garden. What type of activity was desired and what did you want the garden to look like?
All of the collaborative meetings and methods became the guideline for the coming design and resulted in The Garden of Memories and Knowledge.
Designing a place in a public park based on a specific target group and spreading information about a stigmatized subject has been incredibly positive for the sharing of knowledge and for creating universal design. We have learnt that it is possible to create a place based on a different theme/group in a public space to achieve awareness and inclusion.
There was a concern that it might not be possible to bring about a dialogue and co-creation with people with dementia. We learnt that it is about developing methods at the right level based on the target group. It is about having knowledge and understanding of the target group before starting this type of co-creative process. It have been incredibly educational and rewarding to work with people with dementia and working with them has led to a design that would never have become what it is without them. For example, the importance of using tactile materials to aid the understanding of how it affects us.
Research shows that incredibly few articles and research studies are conducted with people living with dementia. Our project has shown that it is possible and incredibly instructive to create with people living with dementia, but it requires time and, above all, knowledge and understanding for their needs and how they work to make is successful.
Given the scope of the project is has received a lot of attention and has contributed to raising awareness about a stigmatized subject. We believe it has fulfilled a great need of a group in society that is rarely prioritized and we see a clear value being created for this group by working in this way. What has been surprising is how incredibly appreciated the place is not only by people with dementia but by everyone else as well. It shows how important it is to create universal design in public places to attract a wide group of people. It creates togetherness, safety and community.
The demographic trend shows that the proportion of elderly people in our society is increasing. Globally, one person develops dementia every three seconds. Between 130,000-150,000 people in Sweden live with a dementia disease, and 2100 residents in Helsingborg are affected. In order to meet these people’s needs for good health, well-being and security, it is necessary to drive the city's development in the direction of becoming a more dementia-friendly society. It means a society with knowledge about dementia disorders that is adapted and facilitates those with cognitive problems. To succeed in meeting this challenge, collaboration across administrative boundaries, with academia and a close partnership with the residents, people with dementia and their relatives is required.
The need for a dementia-friendly society is well known and is included in the national strategic plan for the care of people with dementia. Of those affected, a large majority still lives at home, while at the same time research shows that people with dementia benefit from getting out of their homes. The benefit is, among other things, linked to the importance of social cohesion and increasing independence. The stigma surrounding dementia is great worldwide.
The inclusive, cross-sectional work has led to a better understanding across the entire residential area, where people with dementia feel that they are received better today. Creating dementia-friendly environments has improved the health and independence of people living with dementia. We have not found anything in our joint horizon scanning that, in a similar way to our initiative explores the developing and producing dementia-friendly environments in a public place together with people living dementia.
We hope that our work will make it easier for those affected by dementia and their relatives, partly through better adapted outdoor environments but also through spreading knowledge about dementia.
