By Jenna Grow, MS, OTR/L, BCG, LSVT Big Certified
Occupational Therapist
Pennsylvania Central 3

Most of us can relate to having patients who love to be outdoors — and many of them enjoy gardening. Some of them may still be gardening, while others may feel the activity became unattainable due to their physical deficits. In our role as clinicians, we have the unique ability to assess the person to identify any deficit areas and to thoroughly assess their environment. With the information we gather, we can use one of our most valuable tools — education! We can both educate the patient on the physical and mental benefits of gardening as well as techniques to garden safely. 

How Gardening Benefits Older Adults

Research has shown there are many therapeutic benefits to gardening. Every individual, regardless of age or ability, should have the opportunity to garden safely. As health professionals, it is important that we recognize and understand these benefits and encourage our interested patients to pursue gardening. 

Gardening can promote one’s physical and mental well-being. The physical benefits include promoting flexibility, strength, endurance, and even balance. When done outdoors, gardening increases Vitamin D levels. Working in a garden promotes grip strength and overall hand dexterity. It increases a person’s overall physical activity which is a vital component of successful aging, as physical inactivity is a leading cause of death. Patients can even reap the benefits of gardening during participation in other meaningful tasks!

The mental health benefits are just as significant as the physical benefits. Gardening can have a positive impact on one’s mental health with research showing it decreases stress, boredom, and anxiety and promotes overall happiness. Gardening can also help to promote relaxation and a positive mood while helping a person avoid negative thoughts. Social interaction is another benefit to gardening when completed with a friend or relative.

Safety Tips for Older Adults Who Garden

If you decide that gardening is an appropriate intervention for your patient, there are several considerations to take into account to help make it safer—depending on individual patient factors. 

1. Warm-Up. Prior to embarking on their gardening quest, recommend your patients take a moment to stretch and loosen up their joints! This will help to reduce any stiffness and improve overall mobility. 
2. Pick the Best Time to Garden. Older adults are more susceptible to sunburns and dehydration. Avoid being outside during the hottest times of the day. Gardening is best done in the early morning or early evening. It’s better for your patient and their plants.
3. Take Sun Protection Seriously. Remember to encourage older adults to wear sunscreen and even a large brimmed hat. Older adults are more susceptible to sunburns due to their skin thinning, which allows UV light to penetrate the skin more easily.   
4. Ensure You Have Proper Footwear. Proper footwear is a necessity as outdoor surfaces can increase the risk of falls. Clinicians play a vital role by making recommendations to help select the best footwear while also providing the research to back it up. Encourage older adults to avoid wearing flip-flops or shoes without backs. 
5. Spread Out Gardening Tasks. It’s so easy to get in the zone when gardening! However, spreading out gardening tasks can go a long way in protecting joints and muscles and also help to avoid heat exhaustion. Making a list of gardening tasks can help to decide what to prioritize and what can wait until later.
6. Keep Gardening Areas Easily Accessible. Make sure the path to the garden is accessible. Assess the outdoor environment and identify potential modifications that may help to make the area safer. For example, modifications may be warranted to accommodate an assistive device (e.g., a walker or wheelchair). Concrete walkways or large square stones made as smooth as possible are ideal.
7. Build Raised Beds. Raised garden beds may be a good alternative for patients who have trouble getting down to the ground. These can also be utilized to promote proper body mechanics and may even make gardening more enjoyable. You can also consider placing a bench nearby to sit on. 
8. Use Gardening Bed Alternatives. Window boxes, vertical gardens, retractable hanging baskets, and taller pots are other fun alternatives for someone who may have trouble getting to the ground or who doesn’t have access to a raised bed. Many of these alternatives can be placed on a porch or deck and will allow the person to get outdoors, but prevent them from having to walk in the grass, spend too much time in direct sunlight, or rely on an unsafe pathway. 
9. Find Appropriate Tools and Accessories. Update gardening tools to those that are easier to handle. There are a lot of tools that promote ergonomic positions and are modified to meet the needs of the individual (e.g., larger handles, lighter vs. weighted handles, lightweight hose). By identifying someone’s individual deficits, appropriate modifications can be made to make gardening possible. For example, consider a gardening apron to help the individual safely transport items from one area to the next. In the case of someone with low vision, they may benefit from painting the ends of the tools a bright color in an effort to help them locate them more easily when on the ground.
10. Add a Wagon to Make Transporting Materials Easier. A wagon is a very valuable gardening tool that can help someone safely transport tools and plants. A wagon is often easier to maneuver than a wheelbarrow, too.
11. Stay Hydrated. Like anyone of any age, it’s important that older adults stay hydrated, especially when working in the heat. Encourage your patients to carry water with them as they garden. It can either be transported in their gardening apron or in a wagon so it’s always in easy reach.  
12. Consider Indoor Gardening. Indoor gardening is a great idea if the person is unable to safely access the outdoors. From additional lighting and indoor gardening kits, to even growing plants hydroponically, the options are plentiful to allow someone to be a successful gardener from inside their home! 
13. Know Your Limitations. Educate, educate, educate! Go over any deficits identified with them and encourage them to ask for help, especially with tasks such as weeding, pruning, or getting on a ladder.
14. Avoid Power Tools. This is a perfect task for a family member or friend to assist the older adult with. Encourage the use of manual tools that promote safety and good body mechanics.
15. Garden with a Partner. Many older adults are intimidated by outdoor gardening. Doing it with a friend, family member, or caregiver is ideal in the event an accident does occur.
16. Inspect the Yard. It’s ideal to have a family member or friend assess the yard prior to gardening to identify any potential hazards (e.g., debris, roots, rocks, uneven walkway).
17. Carry a Cellphone. Always, always, always encourage older adults to carry a cellphone or emergency alert system with them when outdoors and gardening alone. In the event of a fall, a cellphone or alert button can assist in getting any necessary help faster and could potentially save a life.
18. Kneel Carefully. Be mindful that going from kneeling to standing can become more difficult as you age. Advise patients to avoid putting both of their knees on the ground. This makes getting up significantly harder. Instead, put one knee on a knee pad and leave the other knee bent in front of you.
19. Make Sure You Have Adequate Lighting. If the older adult prefers to garden in the evening hours, assess the area and provide education on the importance of adequate lighting. It’s vital that the walkway is illuminated to reduce the risk of falls.
20. Notice Changes in Elevation. Recommend avoiding hills, slopes, or banks as these can lead to falls. 

Older Adults Can Enjoy Gardening with the Right Accommodations

As the warmer months approach, keep in mind the mental and physical health benefits of gardening and determine if it is an appropriate intervention for your patients. Don’t hesitate to get them outdoors! Remember to educate them on the benefits and offer your expertise in assessing the environment and modifying the task to promote safety and independence!