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People with dementia can work on farms in the Netherlands

On Dutch ‘care farms’, older people take care of livestock, harvest vegetables and make their own decisions.

Four days a week, Paula, the 81-year-old mother of Kees Oranje, gets up and goes to work on a farm in the nearby village of Brielle, just west of Rotterdam.

Depending on the day, Paula can feed the chickens, help with household chores or help prepare hot meals. The farm raises pigs for meat and grows pumpkins, beans, kale and more in a large vegetable garden. In many ways, Boerderij Op Aarde – ‘Farm On Earth’ – looks like a typical Dutch farm, but with one key difference: Paula and most of her fellow farm workers have dementia.

Boerderij Op Aarde is one of hundreds of Dutch ‘care farms’ run by people with a range of illnesses or challenges, physical or mental. They provide meaningful work in agricultural settings with a simple philosophy: rather than designing care around what people are no longer able to do, design it to leverage and emphasize what they can accomplish.

It’s an approach that research shows has many benefits. For people with dementia, who are often less physically active and more isolated, agricultural settings promote movement and social interaction. And care farms can also have emotional benefits, giving participants meaning and meaningful input.

“We don’t focus on what is missing, but on what remains”, says Arjan Monteny, co-founder of Boerderij Op Aarde, “what is still possible to develop in everyone”.

Care farming began to gain popularity in the Netherlands in the late 1990s. According to Jan Hassink, a researcher at Wageningen University, farms, under financial pressure as farming costs rose and food prices were falling, looking for ways to become more multifunctional. At the same time, a movement was emerging in the Netherlands to reduce reliance on institutions, as part of a growing recognition that people with disabilities had the right to be active in society.

A few decades later, care agriculture is well established in the Netherlands and interest in the model for people with all kinds of disabilities is growing in Europe, the United States and many other countries, says Hassink . As a dementia management option, it’s becoming more relevant every year. Dementia rates should more than double worldwide by 2050. Yet how best to care for these people remains a question that many countries are still grappling with.

“We don’t focus on what’s missing, but on what’s left –– what’s still possible to develop in everyone.”

In traditional dementia care settings, Hassink says, the focus tends to be on preventing risk. There is often a fixed schedule of simple activities, such as games or movies, and the only choice participants have is whether or not to participate. During his research, Hassink spoke to countless people with dementia. What many of them have in common is the desire not only to participate in society, but also to contribute to it.

At Boerderij Op Aarde, participants start each weekday morning discussing the day’s work. The tasks are not lacking: the goats and pigs must be fed, the gardens must be maintained, hot meals must be prepared. A weathered bench in the workshop could use some repainting. Workers can choose which tasks they will take on — this is important, Monteny says, because people with dementia don’t have many decision-making opportunities in their lives.

“It’s a small question,” he says, “but it has a big meaning for people.”

Even bigger and more consequential decisions are made with everyone’s input. Recently, attendees engaged in discussions about the impact of last year’s poor pumpkin harvest on planting plans in 2022. Almost everything the farm produces is used on the farm; lunches include vegetables from the farm’s gardens and pork sausages and ham.

According to Hassink, one of the benefits of care farms is that the participants work alongside the farmers, which creates a more equitable power dynamic than is found in many institutions. “They have joint responsibility for looking after the business on the farm, making it a relationship of equals,” he says.

Monteny co-founded the 16-hectare farm with his partner Ronald van de Vliet in 2012. Every day they work with two staff members from a local care institution, with which the farm partners, as well as four volunteers. Almost all of their 40 attendees – 18 come a day – have dementia and all are of advanced age. They chose to focus on this group, Monteny says, because at the time, most dementia care they encountered tended to be “one size fits all,” without much physical and mental stimulation.

It changes quickly. Today, there are around 1,350 care farms in the Netherlands, serving a wide range of people, according to Maarten Fischer, director of the Federation of Agriculture and Care. About 400 of those farms provide care for seniors with dementia, he said, many in settings that also include participants with other needs.

“They focus on what needs to be done that day, which gets them out of their current disease process,” says Fischer.

The model is confirmed by research. Studies in Norway and the Netherlands found that people with dementia in care farms tended to move more and participate in more strenuous activities than those in traditional care, which may help with mobility in daily life and positively impact health. cognition. Dementia is often linked to social isolation, and care farms have been found to strengthen social involvement, especially among those who would not opt ​​for traditional support options. Spending time outdoors in nature, often as part of a day at a care farm, can also improve well-being among people with dementia. Farms aren’t just good for individuals. Their families also benefit from: studies find that caregivers feel less guilt when their loved ones are supported by services they view as nurturing and fulfilling.

Hassink says even institutional care facilities could replicate some of these benefits by incorporating elements common to care farms into their programs. Instead of a fitness class, for example, they might offer more productive activities that incorporate movement. Institutions could also give their participants more opportunities to decide what activities they would like to do.

“I think the realization that people still enjoy doing meaningful things, meaningful work, being valued and contributing is really important,” he says.

Before Kees Oranje’s mother started coming to Boerderij Op Aarde in 2018, she was largely isolated, he says, living alone on the family farm a few kilometers from the nearest village. Oranje remarked that she seemed to be “bounce back” after starting on the farm at the age of 77. joy, surprise, even anger.

“What the person needs is not just care,” says Oranje. “A person also needs emotions.”

At other farms, people with dementia are grouped with people of other ages who have different conditions. This is the case at non-profit care farm launched by Ronald de Vré in Badhoeve, near Amsterdam. Six days a week, the farm hosts groups that mix children and adults of all ages with a range of different conditions, some dealing with substance abuse issues and others with conditions like Parkinson’s disease or dementia. They take care of the gardens and the animals, including ponies, donkeys, swans, sheep and around 60 chickens. With conditions like dementia, he says, “Your world gets smaller, but here you feel like your life is still in the real world.”

The model has its challenges, and it’s not for everyone. Care farms are generally not suitable for people with advanced dementia, whose condition makes it difficult to attend. As a small organization, Monteny said, it can be difficult to keep up with health regulations designed for larger institutions, and funding, which the farm receives from the municipality and a regional health care institute, is tight. Agricultural environments also have the potential for injury. Monteny acknowledges that accidents do happen, although they’ve only ever had minor incidents, like a hammer falling on a toe.

“We make it as safe as possible,” he says, “but risk is part of life. It is one of our mottos. »

Oranje says he is not worried about such risks at Boerderij Op Aarde. As her mother’s dementia progressed, she lost the ability to tell her at the end of the day what she did on the farm. But she continues to live independently in her own home, which Oranje says is possible because her work on the farm keeps her active.

“She has to be alert all day, and that’s the best environment. She can maintain the best possible mental state in her situation now,” he says. “And that’s very, very, very, very important because it gives him a reason to live.”

This story was originally posted by Reasons to be happy and appears here as is part of the SoJo Exchange of the Solutions Journalism networka nonprofit organization dedicated to rigorous reporting on responses to social issues.

Elizabeth Hewitt is a freelance journalist based in the Netherlands. She is interested in the impact of policy-making on life and enjoys writing about local solutions to big problems.