Under the Glass: News from the Greenhouse

LD

This fall we launched a research study on the effects of therapeutic horticulture for Parkinson’s Disease (PD) care partners. Thanks to Siang’s leadership in putting together the grant proposal, we received funding for a year-long project from the Parkinson’s Foundation. We are wrapping up our first semester of the study and we will continue it with a new group in January.

Our research aims to determine whether participation in a structured therapeutic horticulture program can reduce caregiver burden. Florida is a state with higher incidences of PD and Alachua County reports higher-than-average incidences. The Norman Fixel Institute for Neurological Diseases at UF Health reported that the current number of their patients with PD exceeds 1000.

Caregiver burden is a complex, multi-dimensional concept that can be defined as the strain or load borne by a person who cares for a disabled, elderly, or chronically ill family member. This responsibility can adversely affect the care partner’s physical and mental health, such as causing weight loss/gain, injuries as a result of caregiving, anxiety, depression, and stress. Because of their caregiving responsibilities, many care partners also find themselves socially isolated and worried about having little time for self-care. Additionally, care partners of people with PD reported a need for more psychological and emotional support including but not limited to coping with lifestyle changes and wellness strategies.

Caregiver burden is related to the well-being of both the individual and caregiver and studies have revealed that experiencing caregiver burden without adequate support or resources can lead to a reduction in the quality of care they provide.

In the therapeutic horticulture program at Wilmot Botanical Gardens, we intentionally use the term care partner rather than caregiver. The traditional use of the term caregiver implies a one-way relationship where the carer gives, and recipient passively receives. A partnership is defined as mutual cooperation and shared responsibility and even if those responsibilities are not equally balanced, defining the relationship in this way can affect the sense of agency that each partner feels. It is important to state that a partnership perspective does not diminish the essential role that the care partner plays but to remind us that both should be afforded support.

In the TH program, both care partners and those with PD participate and we emphasize partnership through cooperation, mutual purpose, and common goals within our activities. During each session, participants engage in a horticulture activity designed to learn plant care and propagation while exploring different aspects of wellness. By providing structured opportunities to explore wellness using horticulture activities in a group setting, we aim to introduce concepts of personal wellbeing through plants and nature, increase confidence in nurturing plants, promote interpersonal relationships through meaningful interactions with plants and other participants, and offer support to carry on affordable and manageable horticulture activities at home.

Following their informed consent, participants in the program filled out a demographic and quality of life survey before starting the program and then again after eight sessions. A new group of participants will do the same during the spring semester and then we will analyze the results to determine if the TH program had a positive effect on both care partners and those with PD.

Ching Wu, one of our horticultural therapy interns, took a lead role in planning, delivering, and evaluating activities. We had a small yet wonderful group of participants this fall and have all learned a lot from each other, not just about plants, but also life. We anticipate having a larger group next semester and trying out some new horticulture-related activities as well. If you know someone with PD and/or a care partner of someone with PD, send them our way!

Happy holidays from the greenhouse crew!

Bastawrous M. Caregiver burden – A critical discussion (2013). International Journal of Nursing Studies, 50:431–441. doi: 10.1016/j.ijnurstu.2012.10.005

Lageman, S. K., Mickens, M. N., & Cash, T. V. (2015). Caregiver-identified needs and barriers to care in Parkinson’s disease. Geriatric Nursing36(3), 197–201. https://doi.org/10.1016/j.gerinurse.2015.01.002

Liu, Z., Heffernan, C., & Tan, J. (2020). Caregiver burden: A concept analysis. International Journal of Nursing Sciences7(4), 438–445. https://doi.org/10.1016/j.ijnss.2020.07.012

Willis, A. W., Roberts, E., Beck, J. C., Fiske, B., Ross, W., Savica, R., Van Den Eeden, S. K., Tanner, C. M., Marras, C., & Parkinson’s Foundation P4 Group (2022). Incidence of Parkinson disease in North America. NPJ Parkinson’s Disease8(1), 170. https://doi.org/10.1038/s41531-022-00410-y