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

Abstract

Horticultural therapy (HT) has been proposed to be an effective intervention for improving the psychosocial well-being of people with dementia (PWD) 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 PWD and their caregivers.

Using a hydroponic indoor growing system, this pilot study aimed to examine the feasibility and preliminary effects of a technology-enhanced home-based HT for PWD and their caregivers.

A single-group pre-post design was adopted. Thirty-eight dyads of PWD and their caregivers participated in three weekly face-to-face sessions, followed by eight weeks of home-based horticultural activities. Outcomes were measured at baseline and post-intervention (at week 11), including feasibility outcomes, cognitive function, neuropsychiatric symptoms, and happiness levels of PWD. Caregivers’ outcomes included positive aspects of caregiving, perceived stress levels, depressive symptoms, caregiver distress and happiness levels. Semi-structured focus group interviews were conducted with the caregivers to further explore their horticultural experience.

Intervention feasibility was established with a completion rate of 83% and an attrition rate of 3.33% (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 PWD and caregivers, enhanced the relationships between caregivers and PWD, expanded the caregivers' social networks, and enhanced the autobiographical memory of PWD.

This pilot study provides evidence on the feasibility of using a hydroponic indoor grower to conduct home-based HT for PWD and their caregivers. The findings suggest positive effects on the psychological well-being of both PWD and their caregivers. Caregivers reported potential positive effects of HT on the autobiographical memory retrieval of PWD. 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.

ClinicalTrials.gov NCT05577975; Registered on October 13, 2022