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The Future of Green Care Communities: Fostering Reciprocity



Imagine for a moment living in a residential care community that does not value your daily access to Fresh Air as paramount for your health and wellbeing.


People of all ages who can access Nature without support spend less time interacting with the natural world than previous generations.


Meaningful moments outdoors have been shown to prevent loneliness, boost quality of life and wellbeing, and have numerous positive impacts on physiological, psychological, social, spiritual, economic, and environmental health, often simultaneously—for all ages, including those providing care to others!

Older adults living in residential care communities, individuals living with dementia or mobility impairments, and those who live independently with in-home care and support, accessing the outdoors and Nature can be challenging, primarily when their ability to do so depends on others.

All Ages need Nature, yet when accessing Nature is not a valued form of care

nature-deprivation becomes normalized.


The Case for Care Outdoors


My mind wanders as I sit nestled near a babbling brook, breathing in the fresh smell of damp tree trunks. Watching the water flow over the stones, a memory of a woman I once knew becomes clear. 



Irene lived most of her life in the Louisiana Bayou country. Catching catfish was her favorite pastime, and she was more comfortable on the water than on land.


Around the age of 78, her husband died, and needing personal care assistance; she moved to an assisted living near her daughter in California.


I was working as the Director of Activities when I met Irene.


She was timid and was not interested in participating in community activities. I often visited her in her room, and she lit up when sharing stories of life on the bayou. 


Listening to her stories, I could see her eyes glisten with unshed tears. Life was no longer meaningful for Irene, and her new home did not have access to a lake, pond, or even a view of the natural world she loved.


Irene continued to isolate herself in her room as the months passed, her health deteriorating with each passing day. I have met many Irenes working in assisted living and memory care communities, and maybe you have, too.


Care Outdoors: A Unique Approach to Care


To be valued is a human need that does not go away with a dementia diagnosis, mobility impairment, or when we are receiving care. 


To have opportunities to continue making contributions to our world, however large or small, is a human need. 


To feel as though your life has meaning, is a human need from the moment we are born until we take our last breath. 


In Care Outdoors, reciprocity, interdependence, and caring with are paramount for health and wellbeing.


When our care philosophy is focused wholly on 'giving care', we miss out on the extraordinary power of a 'reciprocal care relationship


The Ageism Barrier


As Tracy Gendron, PhD shares from her research study

"Ageism can result in people feeling their needs being ignored or dismissed due to their age or feeling a self-imposed sense of isolation from a world that does not recognize or value their contributions. Findings from this study further amplify the importance of recognizing and understanding this life-or-death impact of ageism"

–Tracy Gendron, PhD


Reciprocal-Shared Care offers everyone the opportunity to make meaningful contributions, feel valued, and receive the mental, physical,

and social benefits of sharing care.


With Reciprocal-Shared Care, we nurture Nature as Our Care Ally and we become Nature's Care Ally, a mutually beneficial and interdependent care partnership is key.


How does Reciprocal-Shared Care Differ from Person-Centered Care?


In Reciprocal-Shared Care, individuality, values, preferences, emotional and social needs of the individual are foundational for the care relationship, person-centered care


Reciprocal-Shared Care expands Person-Centered Care to include the needs of the carer, community, and natural environment while nurturing contribution, regeneration, and healthy ecosystems for all; care giver, care receiver, whole communities, and ecosystems. 


How can we care for and with each other if we are not caring for and with the ecosystems that sustain us? 


For most of human history, we have lived in close connection with the land, relying on Nature for our basic survival needs, health, pleasure, physical and spiritual activity. Indigenous communities have long-held perspectives that view Nature, or Mother Earth, as inseparable from people, culture, spiritual identity and an essential determinant of Indigenous health.


For example, the Okanagan Native Americans, whose ancestral territory extends from northern British Columbia to Washington State, believe that the human body is the Earth; the land, soil, water, air, and all other life forms are part of who we are and what makes us human. 


Their perspective emphasizes the interconnectedness of all living beings and the importance of maintaining reciprocal and harmonious relationships with the natural world–giving and receiving. 


We Are Nature 

When we are immersed in care tasks, the natural world is often as near as the other side of our window panes and often far from our sensory awareness or thoughts. 


The changing clouds, the way the trees move with the breeze, and the sounds of birds often go unnoticed. 


While the therapeutic benefits of Nature on human health are widely recognized, from bolstering the immune system to fostering inner tranquility, there are seldom any adverse effects associated with embracing Nature as our greatest care ally


The key to unearthing the full benefits lies in nurturing a symbiotic relationship with Nature. We cultivate a reciprocal partnership with the natural world by caring in, with, and for Nature. This approach not only aids in restoring Nature's wellbeing but also promotes human health and wellbeing. 


Diverse and robust ecosystems are pivotal in generating clean air, water, and soil—essential elements for maintaining a healthy and vibrant life. 


Our health and Nature's health are 100% interconnected. 

Nurturing Biodiverse-Rich Outdoor Spaces =

Grows Reciprocal-Shared Care


📣 Hot of the press research: 


Why are Biodiverse Outdoor Environments Important?


  • Biodiversity loss poses a threat to humanity's existence, impacting mental wellbeing along with environmental health.


  • Research suggests that environments with high natural diversity, including various plants, animals, and landscapes, offer greater mental health benefits compared to those with low diversity.


  • Daily interactions with biodiverse Nature, even brief ones, can contribute to improved mental wellbeing.


  • Biodiverse environments stimulate the senses, improve concentration, reduce mental fatigue, promote physical activity and social interaction, and mitigate stress, emphasizing the importance of biodiversity for human mental health and the need to prioritize it in urban planning.

"The results of our study suggest that the benefits of Nature for mental wellbeing can maximised by protecting and promoting biodiversity in our natural environments. This means moving away from heavily curated pockets of greenery – such as landscaped gardens and parks of mown grass, which are typically associated with low biodiversity – towards spaces such as wild meadows and waterways which provide a more attractive habitat for a range of plants and animals." (Hammond et al., 2024). 

Reciprocal-Shared Care Movement Exercise:

Enjoy a few moments to engage in this simple exercise and embody the essence of reciprocal-shared care:


Step 1: Gently tap your chest with your palms and say aloud, "Giving Care."

Step 2: Hold your palms face up in front of you and say aloud, "Receiving Care."

Step 3: With your hands still in front of you, alternate between saying "Giving Care" and gently tapping your chest with your palms, saying "Receiving Care."

Step 4: Finally, bring your palms to your sides and gently sway side to side, saying "Sharing Care."


This movement exercise emphasizes that all care is relational, and the care relationship is a continuous flow of weaving in and out of giving and receiving care to each other and the land. 


Therapeutic Green Care Communities 


Since the 13th century, Geel, a small town in northern Belgium, has been a place of pilgrimage for healing illness. It is known as one of the earliest therapeutic communities, where local families and residents cared for distressed pilgrims primarily through farm work activities and reciprocal caring.


Therapeutic communities provide community-based care where patients live, learn, and work alongside community members. The ability to maintain societal connections through work and meaningful contribution is paramount. 


For over 700 years, foster families in Geel have opened their homes and farms to people living with mental illness, removing the stigma and internalized shame associated with their condition.


Therapeutic Green Care Communities have the potential to benefit people of all ages, including those living with dementia, physical and learning disabilities, at-risk youth, neurodivergent individuals, chronically unemployed, those suffering from PTSD....


Occupation is central to therapeutic green care communities, and work is valued as a form of care. Working outdoors promotes healing, builds self-esteem, gives life meaning, and provides opportunities to make meaningful contributions, be valued, and experience the joy of accomplishment. 


Nature work offers the additional benefits of sunlight, fresh air, and caring for plants and animals provides connection and solace. 


Therapeutic Green Care communities embrace the philosophy that care receivers are active agents of care. 


Healing is viewed as a transformative process that requires the active participation of the individual and their community. 


Living, working, and learning in a green care community enables people of all ages and abilities, to develop authentic relationships with each other and the natural world. 

"Nature's story is one of relationships. Nature should not have a 'part-time role' in our wellbeing. A full-time relationship is needed for a sustainable future and optimal wellness" –Miles Richardson

By engaging in meaningful outdoor activities, such as gardening, farming, or caring with animals, individuals can experience a sense of purpose and connection often lacking in traditional care settings.


Got Green Care?


Simply being outdoors is not considered Green Care. 


Green care is conscious and active contact with Nature 

to produce an effect.


Green Care is a valuable phrase summarizing a wide range

of both self-care and therapy programs and Includes:



Green Exercise is a Green Care Approach


Green Exercise is the:

"Synergistic benefit in adopting physical activities whilst being directly exposed to nature" (Pretty et al., 2007)

The fresh air, sunlight, trees, and birds,

 it's all just so invigorating!


Research has shown that physical activity in natural landscapes is measurably more effective than exercise alone for improving cardiovascular health, blood pressure, 

and self-esteem. 


Interestingly, the most significant impact on self-esteem and mood happens in the first five minutes of green exercise!


Nature-enhanced physical activity produces almost immediate psychological benefits and relief!  


Yes and, evidence suggests that exercise feels more effortless and less demanding in natural environments. People tend to walk faster outdoors than indoors and report a lower rating of perceived exertion (Gladwell et al., 2013).


📣 Hot of the press research: 


  • Nature-based physical activity (PA) has demonstrated significant potential in preventing non-communicable diseases (NCDs) at a population scale.


  • This prevention leads to substantial monetary savings in healthcare and productivity.


  • Accessible natural spaces supporting PA offer specific health-economic benefits, particularly important given the rising prevalence of NCDs.


  • Sustainable increase in these benefits requires simultaneous protection and improvement of natural environments


(Grellier, J. et al., 2024).


The Future of a Green Care Movement 


Think for a moment about the people you know, including yourself, who live or work in a care community, adult day or with in-home care. 


How often do residents, staff, volunteers, and carers engage outdoors? 


How often do you engage outdoors? 


How often do your children and grandchildren engage outdoors?


It's concerning that care is primarily practiced indoors, especially considering that the average American spends over 93% of their time indoors. Children today spend up to 44 hours per week on their digital devices and less than 10 minutes a day playing outdoors. 


Indoor environments are often rife with pollutants and synthetic materials that can negatively impact our health.


The decline in human-nature interactions poses a significant threat to both human and environmental health. As urbanization continues to rise, we are increasingly disconnected from the natural world, leading to biodiversity loss and adverse effects on physical, mental, social, and spiritual health.

Eco Gerontology emphasizes the importance of the natural environment in supporting all domains of livability and advocates for nature-inspired and community-based solutions to our most pressing social and environmental challenges. 

By rekindling our connection with Nature, embracing Eco Gerontology, Growing Reciprocal-Shared Care and Green Care Communities, caring for each other and the ecosystems that sustain us, we can co-create a healthier and more sustainable future for current and future generations.


The quest for positive change remains my focal point as I direct my efforts toward collaborations with organizations that cherish expertise and insights, seeking to prioritize the greater good. 


If your organization and community share this vision and is committed to driving positive change, I eagerly await the opportunity to connect and explore avenues for collaboration. 


Let us join forces in pursuit of a brighter future for current and future generations =

Greening Care from Soil to Soul!


References:


Berget, B., Braastad, B., Burls, A., Elings, M., Hadden, Y., Haigh, R., ... & Haubenhofer, D. K. (2010). Green Care: a Conceptual Framework. A Report of the Working Group on the Health Benefits of Green Care (No. 866). Loughborough University.


Breed, M. F., Cross, A. T., Wallace, K., Bradby, K., Flies, E., Goodwin, N., ... & Aronson, J. (2021). Ecosystem restoration: a public health intervention. EcoHealth, 18(3), 269-271.


Hammoud, R., Tognin, S., Smythe, M., Gibbons, J., Davidson, N., Bakolis, I., & Mechelli, A. (2024). Smartphone-based ecological momentary assessment reveals an incremental association between natural diversity and mental wellbeing. Scientific Reports14(1), 7051.


Gendron, T., Camp, A., Amateau, G., & Iwanaga, K. (2024). Internalized ageism as a risk factor for suicidal ideation in later life. Aging & Mental Health28(4), 701-705.


Grellier, J. et al., (2024). Valuing the health benefits of nature-based recreational physical activity in England. Environment International, 108667.


Moriggi, A., Soini, K., Bock, B. B., & Roep, D. (2020). Caring in, for, and with nature: An integrative framework to understand green care practices. Sustainability, 12(8), 3361.


Sánchez González, D. (2018). Natural landscape and environmental gerontology. Environmental Analysis & Ecology Studies.






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