Garden activities have been shown to reduce stress and anxiety, improve social interaction, give a sense of purpose, and improve cognitive functioning (Park, 2008; Gurski, 2004; Mackenzie, 2000). Programs can be adjusted to accommodate various populations, and activities can be tailored to meet identified goals set by stakeholders in patient care. HT programs integrate well with other facility treatment services, and follow similar guidelines to occupational and recreational therapy programs. In addition to improving the well-being of patients and staff, garden environments are rich in symbolic meaning and aesthetic value.

A good reference, and where I recieved training;

Horticultural Therapy Institute;  http://www.htinstitute.org/

                    HORTICULTURAL THERAPY RESEARCH 

1.  The cognitive benefits of interacting with nature.
      This study attempted to show nature’s ability to restore human attention.  This study
conducted by one of the leading researchers in people-plant connections, Stephen Kaplan, was based on the Attention Recovery Theory (A.R.T.) established in 1995 by Kaplan.  According to this theory, our voluntary attention (vs. involuntary attention) can be fatigued and needs to be restored; not just by sleep, but in waking hours.  Involuntary engagement with nature was theorized to restore cognition in this study.
     Using established test methods for cognition, 38 participants were given tasks that fatigued their voluntary attention, and then randomly assigned to walk through a city-scape or an arboretum.  The participants who walked in the arboretum had scores that were significantly higher.  Trials using different methodologies reflected similar results.

 2. Stress recovery during exposure to natural and urban environments.
     This study was based on the psycho-evolutionary theory, and hypothesized that
stress reducing influences of nature could be demonstrated.  120 subjects first viewed a stressful movie, and then were exposed to color/sound videotapes of one of six different natural and urban settings.  Verbal self-ratings converged with multiple physiological tests to indicate that recovery was faster and more complete when subjects were exposed to natural rather than urban environments.

3.  Horticultural Therapy in a Nursing Home in Japan
     The use of HT in a nursing home in  Kanagawa Japan found benefits for 3 different groups of elders.  Twenty residents participated in weekly sessions conducted by volunteers.  Three different groups were established; Group 1; Self-sufficient, no dementia; Group 2; With aphasia or paralysis resulting from stroke, with out dementia, and Group 3; with dementia.  Sufficient volunteers were available to assist participants when needed.
      Noteworthy is the result of group 3 which showed a significant increase in motivation and feeling.   Considering the different baseline skills and motivations, all groups showed improvement in communication, attention span, and self-confidence. The study emphasizes how important it is to design treatment plans that establish realistic goals for individual needs.
 

4.  Elders with dementia using the buddy system during HT activities.
     This research investigates the influence of HT (applied with the buddy system), on interpersonal relations of elders with dementia.  Participants were paired up during horticultural activities and the resulting interactions were documented.  Note the title that uses the outdated term ‘demented elders’, even though the research is dated 2008.
     The psychological condition of the patients improved compared to the group without an activity partner.  Also, the paired elders had a more positive, active attitude.  Pairs of opposite sex participants had more effective results and communicated better.  The researchers feel the buddy system could be the most important factor in therapeutic horticultural activities.

5.  Effect of HT on the Community Consciousness and Life  Satisfaction of Elderly Individuals.
     This study involved  elderly persons with a history of living alone, and are now living in a facility for the elderly.  These 8 buddhist individuals located in Korea, participated in 23 sessions from April to September, and were scored on a variety of QoL issues.
 All items scored were improved, including participation, interest and assistance, self-concept and identity, need-drive adaptation, cognition, and problem-solving.  The primary focus though, was how HT might effect the residents community consciousness and life satisfaction.  All aspects of psycho-social functioning seem to have been improved in this study, which adds to the compelling evidence for HT.

SUMMARY AND DISCUSSION
   

  These studies were chosen to indicate the inter-dependent relations of the physical, emotional, cognitive and social health of elders.  It is my intent to combine this research with current theory and shift the dominant bio-medical framework towards a more holistic framework that I feel is better suited to accommodate innovative treatment plans for elders.  Carol Estes (2003) in ‘The Need for Theory’ warns of  “the bio-medicalization of old age” and that our role as critical gerontologists is “. . .  to provide alternative theoretical frameworks, a scientific epistemology, and emancipatory knowledge...” (p. 237).
     One example is the problem of over-prescribing of medications for elders; even though Oregon statutes emphasize ‘alternative therapies‘ be used, and medicating should be the last resort, it is well known that medications are often the first ‘therapy‘ for psycho-social (and other)  dysfunction amongst elders (Thomas, 2004),  The lack of (psycho-social) awareness and training in these ‘alternative’  frameworks, will play a crucial role in the well-being of elders, and our society as a whole.    
     Building on earlier research and (evolutionary) theory regarding our natural affinity for plants, these studies give further evidence of the important role that horticulture and nature activities play, in the  health  of older persons. The World Health Organization (WHO) has identified 4 major QoL areas; physical health, psychological health, social networks, and environment.  Any one of these areas that is missing (like the environmental factors) will likely have a negative impact on the others (Kane, 2004).  Our physical health is tied directly to psychological and ecological health.  Collaboration between these disciplines is essential if we are to synthesize effective treatment plans for elders.
     We cannot underestimate the importance of environmental psychology in health care.  Depth psychologist James Hillman, author of ‘The force of Character’, emphasizes how the psyche of elders is not so literal in perceiving the world, and that we also need to be aware of the importance of symbolic meanings, for the aging brain.   Andy Fisher in Radical Ecopsychology argues that “. . .genuine sanity is grounded in the reality of the natural world”, and that we must work to   “. . . relocate the human psyche within the wider natural world” (Fisher, 2002, p. xvii).  The natural world is rich in literal and symbolic meaning, and plays an important role in the health of elders.
      Future theory and research depends on pioneers in many areas, like critical gerontology and ecopsychology.  Carol Estes (1992) asserts, “academic gerontology is in danger of ‘selling its soul’ to mindless, theory-less positivism without retaining or regenerating the reflexivity that is essential to the gerontological imagination” (p. 60).  Clearly, it will take time for ‘hard science’ to quantify and fully validate the role of nature in the nuances of the psyche of aging persons, especially those with dementia, but this is precisely what is called for if we are to truly meet the whole-person needs of this  complex population.  We are the pioneers of a new framework that sees the connection of people and the natural world.

 

                                                 REFERENCES

1.  Berman, M.G., Jonides, J., & Kaplan, S. (2008). The cognitive benefits of interacting with nature. Psychological Science, 19, 1207-1212

3.  Zushi, T. (2008) A Practical Report of Horticultural Therapy in a Nursing Home in Japan Zushi, T. “A Practical Report of Horticultural Therapy in a Nursing Home in Japan.” Acta Horticulture 790 (2008): 121-28. Print.

4.  Han, K. H., S. M. Lee, H. S. Kim, and J. K. Suh. “A Study on Interpersonal Relations of  Demented Elders through Therapeutic Horticultural Activities of Buddy System.” Acta
 Horticulture 790 (2008): 133-38.

5.  Kim, H. -Y., M. -K. Cho, I. -J. Han, and J. -S. Kim. “Effect of Horticultural Therapy on the Community Consciousness and Life  Satisfaction of Elderly Individuals.” Acta Horticulture 639 (2004): 159-65.

Summary and Discussion References

Fisher, A.  (2002).  Radical Ecopsychology; Psychology in the service of life.  State University of New York Press, Albany, NY.

Hillman, J. (1999).  The force of character; and the lasting life. New York: Random House.

Kane, R L, Bershadsky, B, Kane, RA, Degenholtz, HB, Liu, J, Giles, K, and Kling, KC. (2004).  Using resident reports of quality of life to distinguish among nursing homes.  The Gerontologist. 44: 624-632.

Thomas, B.  (2004).  What are old people for: How elders will save the world.  Acton, MA: VanderWyk and Burnham.

Walsh et al., (2001).  Number of older siblings of individuals diagnosed with schizophrenia.  Schizophrenia Research, Volume 47, March Issue 2, pp. 275-280.  Retrieved from http://www.schres-journal.com/article/S0920-9964(00)00134-1/abstract

                                                          *********************************************************

                                       The Ecological Needs of Elders
                                                              by

                                                 Stephen Pettengill

     LIke most populations within society, elders are a diverse and complex group.  Two distinctions stand out; 1) the growing number of elders in the world (and the corresponding implications), and 2) elders have the accumulated life experiences, adaptations, and social capital of our communities that come with a long life.  

     Given the counter-productive outcomes that often come with traditional one-size-fits-all approaches to such complex multi-dimensional issues, it is important to note  emerging criticism, and “. . . the bio-medicalization of old age” (Estes, 1992).  Care must also be taken to avoid the myopic disciplinarian-ism that shapes our normative beliefs and policy-making.  A successful therapeutic program demands that we re-evaluate fragmented mind-sets and synthesize a more holistic framework.  Therefore, before we go rushing to assumptions about what ecological needs elders have, we must attempt to avoid the pitfalls inherent in dominant economic paradigms.   

     Critical perspectives warn of “. . . reproducing specific Western concepts of the person at the level of scientific theories”  (Kempen, 1996; Sampson,1988, p. 130).  Ruth Ray (2003) explains that “. . . the primary task for critical gerontology is the search for emancipation from oppressive forces, in and out of academe (emphasis added), which dictate how we should think, research, write about, teach, and otherwise construct knowledge regarding age, aging, and age relations” (p. 37).

     When advocating to optimize ecological supports for older persons, we must not forget the subjective perceptual nuances that inhabit the psyche of older persons.  It is only from here that a truly person-centered needs assessment can be made.   Estes (1992) asserts; “academic gerontology is in danger of ‘selling its soul’ to mindless, theory-less positivism without retaining or regenerating the reflexivity that is essential to the gerontological imagination” (p. 60).  Current policy approaches, e.g., are largely pre-occupied with economics, liability issues, institutional norms, outdated social constructs, and profit making.
   
     The goal for critical perspectives on aging and social policy, writes Estes (2003) in ‘The Need for Theory’ “. . . is to provide alternative theoretical frameworks, a scientific epistemology, and emancipatory knowledge. . .” (p. 237) that will contribute to a deeper understanding of the complex psyche of older persons. Intra-personal processes have everything to do with how elders experience current social constructs, care-giving, environments, and other ecological components.  My aim is to introduce ‘alternative’ perspectives on the ecological needs of of older persons, that go beyond traditional medical frameworks and fragmented disciplinary approaches

    In order to better understand the ecological needs of elders, we must draw from those who are willing to synthesize ‘emancipatory knowledge’, using trans-disciplinary methodologies blending anthropology, psychology, economics, biology, etc.  We can then establish ecological needs more accurately by examining current literature that reflects a wider spectrum of quality of life (QOL) indicators.
   
      There is a growing recognition of the holistic ecological elements required to support the QOL of elders.   E.g., Kane (2000) points out that “it is sadly narrow to define quality as the absence of negative outcomes. . . these are hardly evidence of good quality of life“ (p. 294).  These 11 QOL indicators are: sense of safety, security, and order; physical comfort, enjoyment, relationships, meaningful activity, functional competence; and four domains of dignity; privacy, individuality, autonomy/choice, and spiritual well-being.  

     Even the World Health Organization’s (WHO) QOL indicators, while less specific,
encompass emotional and social factors in their assessment of well-being.   An  
environment rich in (universal) symbolic references that also satisfy necessary physical and social functioning, is more likely to enrich a wider and more diverse range of human needs.  Many of these indicators will be problematic for conventional models of evaluation.  Alternative ‘world views’ should be considered in behavioral sciences and environmental gerontology (Wahl & Weisman, 2003).

     Edward Wilson, professor of comparative zoology at Harvard University, first used the term Biophilia in 1984 to describe humans’ innate attraction to other forms of life.  Our affinity for nature is intrinsically linked to our own human nature because our species developed over the course of hundreds of thousands of years within nature.  In short, “the brain evolved in a biocentric world, not a machine-regulated world,” writes Wilson (1984) in ‘The Biophilia Hypothesis’.  From this premise, it follows that we humans may not be able to achieve our full potential—physically, intellectually, or spiritually—if we become too isolated from the natural world.

     In other biophilia research, the preference for the specific topophilia (macro-
environment familiarity) domain of ecodiversity is associated with high QOL. The         
population sampled for a study identified preferences for water bodies, flowers, and
spatial familiarity restoration.  The results provide insight into specific aspects of        
ecosystems and artificial landscapes that are more likely to support restoration and      
the enhancement of QOL”  (Ogunseitan, 2008).

     Given this biophilia, and updated QOL indicators, an ecological needs assessment will be more accurate.  Interestingly, these QOL elements improve the social capital in the broader community, and improve the environment for staff and other caregivers too.  Ideally, the ecological needs include caregivers who are enriched by the environment they work in.  It is clear that given these indicators for QOL, legislation must be addressed, mental health regulations must be re-evaluated, and policy makers will have to be educated to better advocate for holistic person-centered care.

       Unavoidably, the medical-industrial-complex that dominates the caregiving professions, will have to change radically.  The quantity and quality of geriatric practitioners, e.g., is a serious problem; the traditional economic power structures are firmly entrenched, and needed changes will likely take time.  Not a great prognosis, but we must advocate for effective health care alternatives, like HT.
        
 Useful HT techniques (and why)

     In design theory, we need to answer the ‘why’ of a project, which allows the ‘how’ to be more naturally revealed.  Assuming we are fortunate enough to find willing collaborators, there are a few primary goals that should guide us; increase social interaction, reduce boredom, increase exposure to ‘meaningful’ activities, exercise, fresh air, sunshine, and exposure to other natural elements rich in symbolic meaning and psychic connection (Fisher, 2002).

     Many studies have shown that human beings are ‘phytotropic’ (plant oriented), and that scientists in various countries are finding signs of [mental health] breakdown where humans lack contact with nature (Kuo & Miller, 2008; Simson & Straus, 1998).  Positivists may disagree, but in many instances, biology follows the mind.  E.g., placebos are consistently demonstrated to reduce depression symptoms 50%-75% (Howland, 2008). If an elder is medicated, they may be less likely to do activities that are necessary to optimize physical and mental health.  One result of an ecological alternative that the Eden Alternative model demonstrated is a reduction in medication, among other benefits (Angelelli, 2006).  HT activities that can reduce depression (and medication) have multiple benefits for elders.

     A horticultural therapist may have trouble at first getting a group to participate in another activity; often these activities are just ‘busy work’ with little meaning to residents.  An horticultural therapist may have to overcome some ambivalence  at the onset of a new program.  The most important thing in HT, is the authentic passion one consistently models regarding horticulture and nature.

      Initially, I would plan something easy, meaningful, and accessible.  There are many ways to re-stimulate a human connection to nature/plants.  First, I would use art, including sounds and movies, that reminds us of our innate bond with the natural world, and include cultural familiarity themes.  Second, having indoor plants around is accessible, and gives an opportunity for  residents to care for plants.  Flower arranging is an obvious activity, and gives multiple rewards afterward.  Growing cut flowers would then follow, if possible. Finally, there is nothing like a tour of a garden, if possible, for stimulating interest, and a sense of discovery and enchantment.  Eventually, I would include elders in their own program development, to help them find personal meaning in activities, by using different leadership styles.

      MY work in HT will likely be to design/build environments best suited for therapeutic activities and/or as restorative gardens.  Working in or with nature taps into our psyche; the conscious use of symbols and primal elements like fire and water are useful tools I would use (indoors and out) to stimulate the instinctual connection, and a sense of the sacred (Armstrong, 2005).

      Gardens have always been built for contemplation, respite from the world, ritual activities, and leisure of all kinds (Simson & Straus, 1998, p. 35).  The staging of events, the ‘set’, plays into the overall effect of all activities. Ritualized activities use mythical language and symbols to illustrate the significance of life changes, and can help point the way for initiates to enact their new role in the community.  While these stage sets are not deterministic of behavior, they have a strong influence on the behavior and holistic well-being of its inhabitants. Closeness to elements of nature like pools, plants and trees makes people more relaxed, states Baum, et al, (1978).
 
     As we age, we want to work less for pleasures like entertainment, cultural exchange; social capital is built-into the environment.  “The stage is set for consciousness and celebration” Glass (2003) states, “the vacation atmosphere is there, there is enchantment, mythological undertones, and imagination needed to foster our purpose as elders”.  Along this line,I might consider using a rich Asian theme, and Bonsai to illustrate these mythological undertones.

     James Hillman, depth psychologist, himself an elder, has written extensively on the psycho-spiritual, artistic, and civic qualities of older persons.  In The Force of Character and the Lasting Life, Hillman explores subtle aspects of old age, even  debilitating ones, “have purposes and values organized by the psyche;  . . . aging makes metaphors of biology” (Hillman, 1999) and leads us away from the literal and  obvious interpretations of human experience (he attributes to youth) into more creative and generative interpretations.  The use of metaphor is an important facet of HT with elders, and I would intentionally organize materials and spaces in this way.                                   
                     
                                            REFERENCES

Angelelli, J.  (2006).  Promising models for transforming long-term care. Vol. 46, no. 4; pp. 426-428.  The Gerontologist.  Wash. D.C.; Gerontological Society of America.

Armstrong, K.  (2005).  A short history of myth. Canongate, NY.

Baum A, Singer J E and Valins S (Eds).  (1978).  Advances in Environmental                        Psychology: Vol I - The Urban Environment: John Wiley & Sons, Inc.; New York.

Bender, M.  (2002).  Explorations in dementia: Theoretical and research studies into             the experience of remediable and enduring cognitive losses.  Kingsley Publishers;           London, UK.

Estes, C.  (2003).  Theoretical perspectives of old age policy: A critique and a proposal.  Biggs, S, Lowenstein, A., Hendricks, J. (Eds).  The need for theory: Critical                      approaches to social gerontology.  Amityville, NY. Baywood Publishing Company.

Fisher,A. (2002). Radical Ecopsychology; psychology in the service of life . Albany, NY; Suny Press

Glass, T. A. & Balfour, J. L.  (2003).  Neighborhoods, aging, and functional limitations.  In I Kawachi & L. F. Berchman (Eds.) Neighborhoods and Health.  Oxford: Oxford University Press, pp. 301-331.

Hillman, J.  (1999).  The force of character, and the lasting life.  Ballantine Books, NY.

Howland, R.   (2008). Psychopharmacology; Understanding the Placebo Effect.  Part 2: Psychological and Neurobiological Processes.  Journal of Psychosocial Nursing and Mental Health Services; Vol. 46 No. 6, June 2008.          

Kane, R.  (2001).  Long term care  and a good quality of life: bringing them closer                 together. The Gerontologist, 41, 293-304.

Kuo, F., & Miller, E.,  (2008).  Vitamin G for healthy human habitat.  In Implications,               Febuary InformeDesign www.informedesign.umn.edu

Ogunseitan, O.  (2008).Topophilia and the QOL.   Environmental Health Perspectives          Vol. 116.  no. 1.

Ray, R. (2004).  The perils and possibilities of theory. In Biggs, S, Lowenstein, A.,                 Hendricks, J. (Eds). (2003)  The need for theory: Critical approaches to social                  gerontology.  Amityville, NY; Baywood Publishing Company.

Simson, S. & Straus, M., Eds. (1998).  Horticulture as therapy; Principles and practice. Haworth Press, Binghapton, NY.

Thomas, W.  (2004).  What are old people for; How elders will save the world.  VanderWyk and Burnham, Acton, Mass.

Wahl, H. W., Weisman, G.  (2003).  Environmental gerontology at the beginning of                the new millenium: Reflections on its historical, empirical, and theoretical                         development. The Gerontologist,  Vol. 43, No. 5, pp. 616-627.

Wilson, E. O. (1984). Biophilia.  Cambridge, MA: Harvard University Press

Wolf, M., Sasich D., Lurje, P. (2005).  Worst Pills, Best Pills: A consumer’s guide to avoiding drug induced death and illness. Simon & Schuster; NY.

When talking about issues concerning community solidarity and cohesion, researchers in the
social sciences frequently use the term ‘social capital’
 
The term social capital describes,
 
Important social processes and relationships – informal social support networks,
friendship, neighbourhood generosity, interpersonal trust and volunteering activity – but
also aspects of local community development, public-private-voluntary partnerships and
civic spirit...Social capital draws on processes which are crucial in community
development and the functioning of a democratic, inclusive and cohesive society.  
Likewise, community development helps generate higher levels of trust and social
participation...[and if]... properly applied and developed, it can play a role of leverage
in linking to public agencies, bridging across to other disadvantaged groups and
bonding in terms of developing crucial community level supports and mutual care at
local level. 

Social capital is one resource, among others, which can be used in support
of community development and social inclusion.  There are a number of inter-related
and overlapping key dimensions: community engagement; community efficacy (a shared
sense of empowerment and capacity to effect change at the community level);
volunteering; political participation; informal social support networks (e.g. who knows
who);informal sociability (speaking, visiting, writing, emailing);norms of trust and
reciprocity; and trust in various institutions (public, corporate, voluntary).
       (Forum Report, 2003:v-3).
 
Probably the most well-known definition comes from Robert Putnam who defines ‘social
capital’ as “networks together with shared norms, values and understandings that facilitate co-
operation within or among groups” (1995a:66).  Putnam’s definition focuses on one form of
social capital known as civic engagement: “people’s connections with the life of their
community” (1995b:665) (Ferlander, 2002:2).  Ferlander states that “Barry Wellman (2001)
also stresses the importance of community in his description of social capital in that he adds an
element of community attachment to the term” (2002:2).  Borrowing from Ferlander which
draws from definitions from Putnam and Wellman, social capital for this paper is defined as
“the existence of social networks, support, trust and community solidarity”(2002:2).
 
More social capital will not necessarily always lead to better outcomes (PRI, 2003b: 5).
 forms of social capital are the “norms, rules, and expectations that exist in a
neighborhood, community, or society” (Warschauer, 2003:8).  For example, understanding and
following the laws that society has implemented (ie. with regards to road safety), protects the
individual and others within that society.  Warschauer further states, “...the types of bonds and
bridges that exist between individuals, the types of groups and organizations that people belong
to, and the way that these groups express the needs and desires of a community all affect, and
are affected by, the norms and expectations of a society” (2003:8).  As stated earlier, “an
important source of social capital is the personal relations that people have in their family and
community. 

These relations can provide information, influence, social credentials, and
reinforcement” (Lin, 2001)” (Warcshauer, 2003:7).   For example, providing health care
information, how to contact government agencies, aiding in job searches, or finding support
groups.   These benefits can be shared through two different types of social capital: bonding
social capital and bridging social capital (Burt,1992; Putnam,2000) (Warschaurer, 2003:7):  
 
 Although space restraints prevent me from addressing the negative aspects of social capital in an
extensive manner, it should be noted that the literature also identifies a range of possible downsides to
social capital.  These include such things as: “1.Fostering behaviour that worsens rather than improves
economic performance; 2. Acting as a barrier to social inclusion and social mobility and; 3. Dividing
rather than uniting communities or societies”, to list a few (Performance and Innovation Unit, 2002:31-
33). Please see this discussion paper for more details pertaining to this topic.
 
Bonding social capital refers to the strong ties that are shared among dense, inward-
looking social networks, such as among family members, close friends, church groups,
or ethnic fraternal organizations...Bonding social capital plays a dual role: it brings the
strength of social solidarity, but sometimes at the cost of antagonism with, or distance
from, other groups...In contrast, bridging social capital refers to the ties that are formed
with those from other social circles.  Since it provides important links to new sources of
information and support, bridging social capital is considered especially important for
economic and social development.
(Warschauer, 2003:7-8).   
                          

                               ***********************************************

Although researchers have long been interested in the nature and

importance of social relationships, thinking of such relationships

as a form of capital is relatively new.

Viewing networks of social ties as a form of capital asset provides a lens for examining
how these ties can be invested in and drawn upon in ways that complement other capital assets

available to individuals and communities. Recognition of the potential benefits of social capital may,

in turn, have implications for the development of public policy and programs.

Access to, and the ability to make use of, valuable social connections are often necessary to

achieve desired outcomes. For individuals and organizations, who one knows can matter for

“getting by” or “getting ahead.” The central idea is that one’s network of social contacts may

represent another form of capital resource, beyond physical, financial, and human capital,

with important potential returns on investment.

Different types of social connections may lend themselves to different benefits. The close
ties to family and friends typical of “bonding” social capital may be particularly helpful for

individuals who need intensive, daily support. The social ties of “bridging” social capital are

often weaker, but they may offer a greater diversity of resources that can be potentially

leveraged to provide new opportunities.

There is already a well-established field of social network analysis that predates current interest in
social capital by several decades. The consideration of social networks as social capital, however,
provides a qualitatively new approach to a disparate field of mostly atheoretical investigation that has
been largely divorced from public policy development.By considering how social networks constitute

an important social capital resource, new relevance and sense can be brought to social network research.

The concept of social capital allows for a consideration of social networks in instrumental terms.
Most people do not think of the social ties they form as instrumental investments, in the way they
may do with their savings and education (although there are some exceptions, such as those engaged
in certain professions based on networking). But whether or not social relationships are invested in
consciously and instrumentally, public policy researchers may nevertheless benefit from under-
standing how and why people and organizations do or do not invest their time and energy in social
ties, when and how they attempt to draw benefits from them, and whether this makes a difference

to desired outcomes.

In instrumental terms, the potential value of an individual or organization’s social capital depends
on the benefits they may be able to draw from their social connections. The same is true of human
capital: the instrumental value of one’s education or training depends on the flow of benefits it produces.
The range of potential benefits that may flow from a person or group’s network of social ties includes
material goods and services, information, emotional support, reinforcement of positive behaviours,
and service brokerage. Knowing that such support is available in an emergency, even if never called
upon, may offer a healthy sense of predictability and security.

This is not to suggest that social capital represents some entirely unrecognized new resource to cure
all that ails social policy. Often, it may only explain a moderate amount of variance in key outcomes,
with several other factors being much more important. Moreover, more social capital does not always
lead to better outcomes. As White, Spence, and Maxim argue in this volume, one’s social ties may,
through reinforcement and sanctions, promote successful educational attainment, but they can also
have quite the opposite effect: in tightly knit families or communities where parents and other members
have low educational attainment and aspirations,social ties may demote the pursuit of education.

Nevertheless, social capital may often have a significant role to play for individuals and organizations,
although it must be considered in relation to a number of other resources and factors that may
make a difference in achieving particular goals and objectives.

http://www.policyresearch.gc.ca/doclib/SC_Thematic_E.pdf
 
Results show that households with an elderly member are over two and a half times as likely to have

high social capital (AOR=2.68 [1.22, 5.87], Po0:01) than are non-elderly households, after controlling

for socioeconomic status.

Having a household member who participates in a social or civic organization is also significantly

associated with having higher levels of social capital. Social capital, particularly in terms of reciprocity

among neighbors, contributes to household food security. Households may have similarly limited

financial or food resources, but households with higher levels of social capital are less likely to experience hunger.
http://www.jhsph.edu/clf/PDF%20Files/Social_Capital_Hunger_Risk.pdf

...elders were able to do what experts view is crucial to successful aging

in place; reshape the place one is aging by engaging is creating new meaning

as circumstances change (Leith, p. 330, Journal of Aging Studies)

from Kane, LTC, 2001 article

Subverssive ideas, also known as fresh thinking, should be encouraged....

including changing professional roles, breaking down boundaries of

organizations, and re-considering delegation of nursing roles (p. 301, Kane)

Without agreement about what is meant by quality, including the PLACE of

qulaity of life, strident disagreement will persist on how good or bad LTC quality is (p. 297)

excessive expecationsregarding health and safety, are often accompanied

by low expectations and excessive compromise regarding QOL (p.29f

     This study at the Margeret Morris Center in Colorado, determined that indoor gardening had a significant effect on sleep disturbances of elders..  23 institutionalized dementia patients with sleep disorders and/or agitation, participated in a five week study; 1 week of baseline assesments, and 4 weeks with indoor gardening activites.

Sleep patterns, agitation, and cognition were evaluated using a sleep diary, Modified Cohen-Mansfield Agitation Inventory and revised Hasegawa Dementia Scale respectively.   While there were significant improvements in agitation and cognition, sleep onset, wake up time and total sleep time did not change after the indoor garden program was implemented.  More controlled studies with larger groups are needed to reinforce this pilot study with dementia patients.

 Park, S. Y., K. Yamane, Y. Yamaki, and S. Takahashi. “Effects of Horticulture Activities on  Activities of Daily Living to Participation and Cooperation in Cases of Dementia.” Acta Horticulture 775 (2008): 41-46.

• Significant beneficial effects on activities of daily life

• Cooperation was signifi cantly increased and maintained

• Patients’ desire to join activities also increased

Horticultural Therapy: Roles in Nursing Homes Study of the effects of horticulture
activities on improvement of Activities of Daily Living

                               *********************************************************

 Midden, K. S., and T. Barnicle. “Evaluating the Effects of a Horticulture Program on the Psychological Well-Being of Older Persons in a Long-Term Care Facility.” Acta Horticulture 639 (2004): 167-70. Print.

• The gardening group had a signifi cant increase in psychological well-being, whereas the control group

had a slight decrease in psychological well-being

• Horticultural activities may be shown to have a benefi cial effect on the current psychological well-being

of older persons in a long-term care facility.
The effects of indoor horticultural activities on the psychological well-being of older persons in two

long-term care facilities

Kaplan, S. (1995). The restorative benefits of nature: Toward an integrative framework. Journal of Environmental Psychology, 15, 169-182.

Kaplan, R.  1992.  Urban Forestry and the Workplace.  In P. H. Gobster (editor),  Managing Urban and High-Use
Recreation Settings.  USDA Forest Service, General Technical Report NC-163.  Chicago, IL: North Central
Forest Experiment Station.

Kaplan, R. & S. Kaplan.  1989.  The Experience of Nature:  A Psychological Perspective.  Cambridge:  Cambridge
University Press.

Researchers are finding that older people are many times happier than their younger counterparts. Life experience, passage of time and emotional stability appear to be driving factors.

By Shari Roan, Los Angeles Times Staff Writer

October 15, 2007
For centuries, sages have alluded to a richness in life's later years that is lost on the young. But only in the last decade have researchers begun to measure happiness across the life span and, in doing so, try to understand why older people tend to be so content.

The explanation doesn't appear to be biological -- some chemical in the brain that mellows us just when all those plump neurons needed for thinking and memory are shriveling up. Rather, most scientists now think that experience and the mere passage of time gradually motivate people to approach life differently. The blazing-to-freezing range of emotions experienced by the young blends into something more lukewarm by later life, numerous studies show. Older people are less likely to be caught up in their emotions and more likely to focus on the positive, ignoring the negative.

"When you have that disaster at 10 in the morning, you can deal with it better when you're older," says Stacey Wood, a neuropsychologist and associate professor at Scripps College in Claremont. "With people in their 20s, it throws them off. They experience more emotion, and it's more intense emotion."

In a study published in September in Psychological Science, Wood and her collaborator, neuroscientist Michael Kisley of the University of Colorado, recorded the brain activity of 63 adults, ranging in age, who were shown a series of negative and positive images, such as dead animals or a bowl of ice cream. Older adults were about 30% less reactive to the negative images compared with the younger adults.

Other studies have found similar results -- that older people experience negative emotion less often and recover from it more quickly. The insult that has your blood boiling for three days at age 20 may not even register a spike in blood pressure at age 60. And despite -- or perhaps because of -- the fact that anyone with gray hair has likely experienced his or her fair share of suffering, older folks are also adept at transcending bad memories.

"What we see is a real difference in how negative information is processed by the brain," Wood says. "When we talk about maturity or wisdom, we're talking about that ability to integrate negative emotion or cognitive information; being able to weigh it and not find it so disruptive."

Why people regulate their emotions better as they age may be due in part to school-of-hard-knocks experience. Eventually they learn the world will not end when the car breaks down or the child gets strep throat. The later stages of life also offer more opportunities to actively avoid those parts that are stressful or upsetting, Wood says.

"You can surround yourself with less negative people and events," she says. "At a certain point, you're established in your career. You don't have to put up with that annoying boss any more. You can structure your life the way you want to."

Influence of time

One of the first researchers to discover that older people tend to be happier thinks there's another reason for this greater emotional control. It's linked to a person's sense of time. Older people are aware that life doesn't last forever -- and, with a finite amount of time ahead, they think it should be well spent.

In a study at Stanford University's Center on Longevity, psychologist Laura Carstensen showed that people who perceived their future time as limited had goals that were emotionally meaningful. People who perceived their futures as open-ended had goals that tended to be knowledge-related. Carstensen concluded that, as people age, they encounter "shrinking time horizons." With less time left, people tend to focus on the now. The 2002 study was published in the journal Psychology and Aging.

"As people come to appreciate the fragility of life, they tend to put more value on it," she says.

Younger people may anticipate that the older years will be bleak because the body fails and the mind is aware that time is running out. But older people typically aren't depressed by that.

"The paradox of aging is that there is this decline in physical well-being and cognitive status and yet an increase in psychological well-being," Carstensen says. "We [colleagues in her laboratory] don't think of that as a paradox, of course, because it's the decline that reminds people that life will not go on forever."

With an eye on the clock, older people are more selective about their activities and relationships, Wood says. The happiest find ways to feel useful, giving them a sense of purpose and making their time feel meaningful. The happiest tend to say they enjoy serving others in some capacity.

"I think of old age as the richest form of emotional satisfaction that is possible," Carstensen says. "There are still positive emotions, but there is also an understanding and appreciation that there is an ending around the corner."

An appreciation of remaining time leads older people to be more grateful for what they have, Carstensen and other researchers say. And being thankful is great for mental health. Studies by Robert A. Emmons, a psychology professor at UC Davis, show that people who focus on what they are grateful for have better emotional well-being, especially a positive mood, compared with people who focus on the negative or neutral information.

"When you focus on gratefulness, you see that other people are providing you with support and value you," says Emmons, author of the book "Thanks! How the New Science of Gratitude Can Make You Happier." "You see that good stuff doesn't just happen randomly. It helps you make sense out of life. Grateful people see their lives as gifts."

Being able to forgive is the flip side, he adds. "It helps reduce negative emotions like anger and resentment."

That's why neurotics, who get stuck on life's hurts, may be among the few personality types that don't mellow with age, Carstensen says. Neurotics are people who "keep going back to the same negative relationships and the same negative thoughts. They don't change," she says.

In fact, individual temperament is still the best predictor of happiness overall, Wood says. A child who is always smiling will likely be joyful decades later. The grumpy 30-year-old will likely be a grumpy, if slightly less so, 70-year-old.

A pleasant surprise

Why does the idea of being most happy in old age come as a shock to young and old alike? Psychological science has a reason for that too. We humans are terrible at predicting what will make us happy.

Younger people tend to think that happiness is getting what you want: a fabulous body, great job, true love, a nice place to live and a good ride. No one should dismiss the hopeful dreams of the young, but it's just not that simple, Wood says.

"We try to make decisions that make us happy, but we're not good at doing that," she says.

Well-known research shows that a sudden increase in wealth doesn't correlate to long-term gains in happiness, and people who become paralyzed due to accidents return from despair to their previous levels of happiness. Parents assume they will be bereft when the kids leave home, but happiness and marital satisfaction typically improve.

Aging too falls into that puzzling category in which reality often defies expectations.

"Why is it that when we think of age, we think about all the bad things that will happen?" says Dr. Peter Ubel, director of the Center for Behavioral and Decision Sciences in Medicine at the University of Michigan, who has studied happiness among ill and older people. "That is one of the reasons we don't anticipate happiness in aging very well."

Until recently, psychological study focused almost solely on life's negatives: bad behavior, troubled relationships, depression and stress. Today, researchers are also studying so-called positive psychology -- those factors that help people thrive mentally and emotionally.

The study of elder happiness has been a fruitful foray in positive psychology, experts say, showing that older people are happier if they stay socially connected, pursue new experiences and do things that make them feel useful.

Young can benefit too

Such research offers lessons for younger people as well. Teaching adolescents and young adults about the joys of volunteer work and community service may pry them from the self-centeredness that contemporary society reinforces, Emmons says.

"We live in a culture where people expect certain entitlements; 'I'm owed these things,' or 'I deserve these things,' " Emmons says. "It goes against the spirit of having a sense of purpose and being useful."

Similarly, teaching a child to count his or her blessings might place that child on an elevated happiness trajectory that persists throughout life, he suggests.

The rare younger people who experience the rich happiness common to their elders may be those who have recovered from life-threatening illness or addiction, Carstensen says. She cites research that shows people often feel differently about their lives after surviving a serious illness. They have come face-to-face with the "shrinking time horizon" that older people routinely live with.

"As people come to appreciate the fragility of life, they tend to put more value on it," she says. "There is something about recognizing our own mortality."

Combining the mental shrewdness of youth with the ability to savor life might be a successful recipe for contented living -- whatever one's age.

"If only younger people could step out of themselves and focus on the positive and realize life is fragile and life is valuable," Carstensen says. "And if older people could think about the future and worry a little bit more, that's probably good."

For example, elderly people may be too trusting. They are the most likely to be victims of financial scams, and they may make bad healthcare or financial decisions because they fail to think critically through the pros and cons of a situation.

Freedom to grow old

Elders will probably always have the last laugh, Carstensen says. Young people typically don't have the freedom to be as choosy about their activities and relationships. They have to show deference to the professor, please the boss, network with business acquaintances, discipline the toddler and beg the banker for a mortgage.

"That is what goes on in youth," she says. "Younger people have to prepare for a long, nebulous future. That is anxiety-producing. I'm not sure it would be adaptive for young people to say, 'I'm not going to worry about the future,' because you do have to worry about the future.'

"

As people age, they are gradually relieved of the burden of planning for the future, she notes.

In the words of the psychologically astute British poet Robert Browning: "

Grow old along with me! The best is yet to be, The last of life, for which the first was made.

"


http://www.latimes.com/features/health/la-he-happiness15oct15,1,4196893.story?coll=la-headlines-health&ctrack=2&cset=true
__._,_.___

Emotionally, the best may be yet to come




Researchers are finding that older people are many times happier than their younger counterparts. Life experience, passage of time and emotional stability appear to be driving factors.

By Shari Roan, Los Angeles Times Staff Writer

October 15, 2007
For centuries, sages have alluded to a richness in life's later years that is lost on the young. But only in the last decade have researchers begun to measure happiness across the life span and, in doing so, try to understand why older people tend to be so content.

The explanation doesn't appear to be biological -- some chemical in the brain that mellows us just when all those plump neurons needed for thinking and memory are shriveling up. Rather, most scientists now think that experience and the mere passage of time gradually motivate people to approach life differently. The blazing-to-freezing range of emotions experienced by the young blends into something more lukewarm by later life, numerous studies show.

Older people are less likely to be caught up in their emotions and more likely to focus on the positive, ignoring the negative.

"When you have that disaster at 10 in the morning, you can deal with it better when you're older," says Stacey Wood, a neuropsychologist and associate professor at Scripps College in Claremont. "With people in their 20s, it throws them off. They experience more emotion, and it's more intense emotion."

In a study published in September in Psychological Science, Wood and her collaborator, neuroscientist Michael Kisley of the University of Colorado, recorded the brain activity of 63 adults, ranging in age, who were shown a series of negative and positive images, such as dead animals or a bowl of ice cream.

Older adults were about 30% less reactive to the negative images compared with the younger adults.

Other studies have found similar results -- that older people experience negative emotion less often and recover from it more quickly. The insult that has your blood boiling for three days at age 20 may not even register a spike in blood pressure at age 60. And despite -- or perhaps because of -- the fact that anyone with gray hair has likely experienced his or her fair share of suffering, older folks are also adept at transcending bad memories.

"What we see is a real difference in how negative information is processed by the brain," Wood says.

"When we talk about maturity or wisdom, we're talking about that ability to integrate negative emotion or cognitive information; being able to weigh it and not find it so disruptive."

Why people regulate their emotions better as they age may be due in part to school-of-hard-knocks experience. Eventually they learn the world will not end when the car breaks down or the child gets strep throat. The later stages of life also offer more opportunities to actively avoid those parts that are stressful or upsetting, Wood says.

"You can surround yourself with less negative people and events," she says. "At a certain point, you're established in your career. You don't have to put up with that annoying boss any more. You can structure your life the way you want to."

Influence of time

One of the first researchers to discover that older people tend to be happier thinks there's another reason for this greater emotional control. It's linked to a person's sense of time.

Older people are aware that life doesn't last forever -- and, with a finite amount of time ahead, they think it should be well spent.

In a study at Stanford University's Center on Longevity, psychologist Laura Carstensen showed that people who perceived their future time as limited had goals that were emotionally meaningful. People who perceived their futures as open-ended had goals that tended to be knowledge-related. Carstensen concluded that, as people age, they encounter "shrinking time horizons." With less time left, people tend to focus on the now. The 2002 study was published in the journal Psychology and Aging.

"As people come to appreciate the fragility of life, they tend to put more value on it," she says.

Younger people may anticipate that the older years will be bleak because the body fails and the mind is aware that time is running out.

But older people typically aren't depressed by that.

"The paradox of aging is that there is this decline in physical well-being and cognitive status and yet an increase in psychological well-being," Carstensen says. "We [colleagues in her laboratory] don't think of that as a paradox, of course, because it's the decline that reminds people that life will not go on forever."

With an eye on the clock, older people are more selective about their activities and relationships, Wood says. The happiest find ways to feel useful, giving them a sense of purpose and making their time feel meaningful. The happiest tend to say they enjoy serving others in some capacity.

"I think of old age as the richest form of emotional satisfaction that is possible," Carstensen says. "There are still positive emotions, but there is also an understanding and appreciation that there is an ending around the corner."



An appreciation of remaining time leads older people to be more grateful for what they have, Carstensen and other researchers say. And being thankful is great for mental health. Studies by Robert A. Emmons, a psychology professor at UC Davis, show that people who focus on what they are grateful for have better emotional well-being, especially a positive mood, compared with people who focus on the negative or neutral information.

"When you focus on gratefulness, you see that other people are providing you with support and value you," says Emmons, author of the book "Thanks!

How the New Science of Gratitude Can Make You Happier." "You see that good stuff doesn't just happen randomly. It helps you make sense out of life. Grateful people see their lives as gifts."

Being able to forgive is the flip side, he adds. "It helps reduce negative emotions like anger and resentment."

That's why neurotics, who get stuck on life's hurts, may be among the few personality types that don't mellow with age, Carstensen says. Neurotics are people who "keep going back to the same negative relationships and the same negative thoughts. They don't change," she says.

In fact, individual temperament is still the best predictor of happiness overall, Wood says. A child who is always smiling will likely be joyful decades later. The grumpy 30-year-old will likely be a grumpy, if slightly less so, 70-year-old.

A pleasant surprise

Why does the idea of being most happy in old age come as a shock to young and old alike?

Psychological science has a reason for that too. We humans are terrible at predicting what will make us happy.

Younger people tend to think that happiness is getting what you want: a fabulous body, great job, true love, a nice place to live and a good ride. No one should dismiss the hopeful dreams of the young, but it's just not that simple, Wood says.

"We try to make decisions that make us happy, but we're not good at doing that," she says.

Well-known research shows that a sudden increase in wealth doesn't correlate to long-term gains in happiness, and people who become paralyzed due to accidents return from despair to their previous levels of happiness.

Parents assume they will be bereft when the kids leave home, but happiness and marital satisfaction typically improve.

Aging too falls into that puzzling category in which reality often defies expectations.

"Why is it that when we think of age, we think about all the bad things that will happen?" says Dr. Peter Ubel, director of the Center for Behavioral and Decision Sciences in Medicine at the University of Michigan, who has studied happiness among ill and older people. "That is one of the reasons we don't anticipate happiness in aging very well."

Until recently, psychological study focused almost solely on life's negatives: bad behavior, troubled relationships, depression and stress.

Today, researchers are also studying so-called positive psychology -- those factors that help people thrive mentally and emotionally.

The study of elder happiness has been a fruitful foray in positive psychology, experts say, showing that older people are happier if they stay socially connected, pursue new experiences and do things that make them feel useful.

Young can benefit too

Such research offers lessons for younger people as well. Teaching adolescents and young adults about the joys of volunteer work and community service may pry them from the self-centeredness that contemporary society reinforces, Emmons says.

"We live in a culture where people expect certain entitlements; 'I'm owed these things,' or 'I deserve these things,' " Emmons says. "It goes against the spirit of having a sense of purpose and being useful."

Similarly, teaching a child to count his or her blessings might place that child on an elevated happiness trajectory that persists throughout life, he suggests.



The rare younger people who experience the rich happiness common to their elders may be those who have recovered from life-threatening illness or addiction, Carstensen says. She cites research that shows people often feel differently about their lives after surviving a serious illness. They have come face-to-face with the "shrinking time horizon" that older people routinely live with.

"As people come to appreciate the fragility of life, they tend to put more value on it," she says. "There is something about recognizing our own mortality.

"

Combining the mental shrewdness of youth with the ability to savor life might be a successful recipe for contented living -- whatever one's age.

"If only younger people could step out of themselves and focus on the positive and realize life is fragile and life is valuable," Carstensen says. "And if older people could think about the future and worry a little bit more, that's probably good."

For example, elderly people may be too trusting. They are the most likely to be victims of financial scams, and they may make bad healthcare or financial decisions because they fail to think critically through the pros and cons of a situation.

Freedom to grow old

Elders will probably always have the last laugh, Carstensen says. Young people typically don't have the freedom to be as choosy about their activities and relationships. They have to show deference to the professor, please the boss, network with business acquaintances, discipline the toddler and beg the banker for a mortgage.

"That is what goes on in youth," she says.

"Younger people have to prepare for a long, nebulous future. That is anxiety-producing. I'm not sure it would be adaptive for young people to say, 'I'm not going to worry about the future,' because you do have to worry about the future.'

"

As people age, they are gradually relieved of the burden of planning for the future, she notes.

In the words of the psychologically astute British poet Robert Browning: "

Grow old along with me! The best is yet to be, The last of life, for which the first was made.

"


http://www.latimes.com/features/health/la-he-happiness15oct15,1,4196893.story?coll=la-headlines-health&ctrack=2&cset=true
__._,_.___