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A patient with dementia, who is normally in a state of agitation, finds a sense of calm in the simple act of digging up two vegetables in the Bickle Garden.
Such moments of therapy and peace were easy to spot over the past few months in the new garden at Toronto Rehab's Bickle Centre for Complex Continuing Care, says Amanda Beales, a Registered Dietitian at Bickle.
"It gave the patients something to connect with – a reminder of their own gardens," says Amanda. "The garden has offered so much positive patient interaction in its first year."
A home-grown effort
Planted this summer, the garden grew thanks to the Bickle Green Team, which received funding from
TD Friends of the Environment. It brought Bickle together with the Parkdale neighbourhood organization Greenest City to build a wheelchair accessible, inclusive gardening experience.
"This collaboration allowed us to build and enhance our relationships with the community," says Paula Cripps-McMartin, Clinical Director, Bickle Centre. "We were able to learn and grow together, and now the garden has become a source of comfort and therapy to our patients as well."
UHN's first wheelchair-accessible garden offered ingredients for patients honing their cooking skills, a practice terrain for those working on mobility, and a space reminiscent of patients' own yards at home.
"Our garden provided patients an opportunity to re-engage in a meaningful life activity that had been put on pause due to illness and/or hospitalization," says Susan Currie, Occupational Therapist (OT). "Anytime we can make therapy fun, it increases a patient's motivation and engagement ten-fold."
Susan, who is also the OT Professional Practice Leader for Complex Continuing Care Patient Programs at Bickle, integrated the garden in therapy with patients from the Low Tolerance Long Duration Rehab program and the Complex Continuing Care units.
"Given that OT works on helping people engage in activities that they find important, the garden was a perfect fit," she explains. "Instead of using a table and staring at a wall while working on standing, patients could do the same standing exercises in the garden, in a more interactive environment."
Beyond physical rehabilitation, Amanda says the garden was an excellent "ice breaker to connect with patients" and backdrop for education sessions and nutrition assessments.
"We would be walking around the garden, looking at the vegetables growing and all of a sudden a patient would open up to me about their diet struggles, or about how much they loved eating a certain vegetable. It helped me build a rapport with my patients."
Fruits of their labour
While some patients practiced walking in the garden and learned about nutrition, others harvested foods that they later used in their cooking program, says Deep Singh, Occupational Therapy Assistant at Bickle Centre.
Deep worked with patients who took part in the Kitchen Group - those practicing cooking skills for their return to an independent living space. From herbs to zucchini, the group harvested the garden's crops, and incorporated them into recipes.
"The garden enhanced our group and motivated them to cook," she says. "Harvesting also helps with fine motor skills – I gave them scissors to cut the leaves we'll need, for example."
Thanks to the variety of food grown in the garden, the Kitchen Group made colourful salads and healthy snacks such as zucchini and kale chips.
Staff who tended to the garden throughout the summer also had a chance to indulge in its harvest. They came together for a group lunch made with some foods from the garden, Amanda says.
"We enjoyed the benefits of the garden, just like the patients," she explains.
Home away from home
Much like the patient with dementia who found solace in picking vegetables, other patients have expressed the comfort the garden provides.
For both Susan and Deep, the best memories of the garden come from the joy they saw their patients experience.
"My favourite part of working in the garden was having patients reminisce about their own gardens at home," Susan says. "For some of our Complex Continuing Care patients, home is a very distant memory and thus our gardens brought a little bit of home to them."
Those memories of home, Deep says, encouraged patients in to work harder in Occupational Therapy.
"If they are able to garden, to cook, then they know they will be able to be independent at home, and they gain confidence," Deep explains.
Though the harvest is done for the year, the garden will blossom again next year – and Amanda, Deep and Susan all see potential for even more patient involvement in the years to come.
"It was definitely a success for our first year," Susan says, "I am hopeful that our garden project will continue to 'grow' with each year."