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Dementia: Out of the waiting room, into the trees

04 October 2019

The power of nature is being used to heal young people and those with dementia. Rebecca Paveley finds out more

Nature is the therapist for Instinctively Wild clients with dementia, who attend eco-sessions alongside a carer, supported by NHS staff

Nature is the therapist for Instinctively Wild clients with dementia, who attend eco-sessions alongside a carer, supported by NHS staff

JOHN MUIR, the 19th-century Scottish conservationist whose activism led to the founding of the national parks in the United States, once said: “Everybody needs beauty as well as bread, places to play and to pray in, where nature may heal and give strength to body and soul.”

Muir is little known in England, though well-known in the US and Scotland, where he is the inspiration for an eco-therapy project which is doing groundbreaking work with people who have early onset dementia, and those who struggle with their mental health.

The project Instinctively Wild is a social enterprise that operates in the Borders area of Scotland, and was set up by Pete Carthy, a teacher and a Third Order Franciscan.

The project offers forest-school activities for schools and youth groups, and for corporate team-building, and also appears each year at the Greenbelt and Solas festivals. But its core work focuses on providing opportunities for those with health conditions to connect with nature.

One of the programmes that it offers, Branching Out, is funded by the Scottish government in Dumfries & Galloway. Clients are prescribed the programme by their GP, and then attend for 12 weeks, taking part in activities such as bird surveys and forest school, but in a way that encourages mindfulness and meditation.

The health benefits of being outside in a natural environment are well-publicised. A recent study by researchers at the University of Exeter’s Medical School found that spending just two hours a week in a natural environment had a significant impact on health and well-being — including reducing the risk of type 2 diabetes, cardiovascular disease, and high blood pressure.

“Just being outside improves people’s mood. Nature has many, many facets and opportunities, if one knows how to use them,” Mr Carthy says.

The evaluation of the Branching Out programme has shown measurable improvements in people’s sense of self-confidence and well-being after the sessions, and the team have collected anecdotal evidence, too.

“One of our clients, who went on to volunteer with us, said that she was able to pass her driving test because she felt the Branching Out programme had given her more confidence,” he said.


THE most innovative project by Instinctively Wild involves working with people with early-onset dementia.

This programme has been running for seven years, working with staff from NHS Borders, who select people whom they think will most benefit. The NHS originally funded the programme, and is keen for it to continue, but, owing to pressure on budgets, it has been unable to keep up the funding. The project has most recently been funded through grants, but these are coming to an end, and Mr Carthy is grant-hunting again to keep the project going, as the benefits have been so great for clients.

Clients often come to the project shattered by a dementia diagnosis, he says. “Many have lost a lot of confidence, but, through the programme, they meet other people with dementia and their carers, and it raises their self-confidence. One hadn’t played the guitar for years, but he brought it along to a session and played it — his partner was amazed.

“For us, nature is the therapist. We facilitate that experience by using nature’s sensory modalities, but also by working very closely with NHS staff and carers.”

Sensory modalities are the trigger points for our senses, what is perceived after a stimulus: the basic sensory modalities include light, sound, taste, temperature, pressure, and smell.

The Instinctively Wild team work with nature to rekindle memories in clients using hand tools or music, or lighting a fire, or using clay to stimulate touch, or foraging for herbs to drink as tea. The smell of a fire in the woods might trigger memories of a childhood playing outside, or perhaps going camping, as might the sound of chopping wood.

Clients each attend with a carer — often a partner — and NHS staff attend each of the eight sessions.

At the beginning of each session, people are encouraged to pick up a stone with an expression on it that reflects how they are feeling, and to repeat the exercise at the end.

“We find that people are feeling happier each session. We also look for ‘golden moments’: either comments from clients about reminiscing experiences, or from carers or NHS staff regarding the particular person they are working with.”

Comments that the team have collected include: “This week, he talked about cherry trees, and pointed them out during the walk. Also, his partner told us that, in between sessions, at home when he has been on walks, he collected wild flowers.”

The wife of another client said that, since the previous session, he had “been talking about the lemon balm plant of his own accord, and that he had ‘loved the plant very much’, which stimulated his memory.”

One important aspect of the programme is that each session operates in the present: there is no attempt to encourage people to remember what happened at a previous session, or to talk about a future one. Early experiments to encourage group singing proved too stressful, as many struggled to remember words.

There is also no conscious attempt to awaken participants’ spirituality. “We are not consciously trying to awaken spirituality, but to encourage a deep experience with nature. John Muir is very inspirational for us. He said: ‘For every walk with nature one receives far more than he seeks.’

“We care about people, and, ultimately, we want to make a difference for them. That’s why we all get out of bed in the morning; that’s why we all do what we do.”

Mr Carthy says that when the project was first set up, it “so happened” that all those involved were Christian. But, as the project has evolved, that is no longer the case, and those of other faiths and spiritualities are involved.

He quotes the saying attributed to St Francis: “Preach the gospel at all times. When necessary, use words.” “That’s what I am trying to do,” he says. “At times, it is difficult, and goodness knows how many times I’ve nearly given up. But, somehow, with a lot of prayer and support along the way, I’m still doing it, still pushing forward, still trying to make the world that little bit better.”

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