Yesterday I spent the day in the company of a group of hardy souls at a Derbyshire Care Farm. Despite the chilly weather I had an inspirational time. The members who come to the farm spent the day in useful activities such as caring for a multitude of animals, gardening and generally sharing ideas. Regular healthy refreshment breaks are taken which also give an opportunity to warm up, sing and discuss the progress on the farm. The facilities are a work in progress, somewhat basic but this seems to add to the general sense of being in the landscape and the activities of the day. Men seem to especially like the environment.
Of course there is a risk of providing an overly romantic account of my day. But the fantastic work of this place is that dementia becomes almost obscured by the working day. This is surely the key indicator that this model works.Farm workers and visitors focus on the task in hand in an unhurried way which subtly accommodate some of the challenges which being older bring. Pushing a wheelbarrow, by a chap who normally walks with a stick, provides a novel way of navigating the uneven ground littered with molehills. Similarly roaming across a field and soaking up the sun against the animal shed is not challenged but quietly noted by the others. Similarly a quick pee by the poly tunnel is encouraged as a way of restoring continence and getting on with the job of finding a bucket of scatter feed.
What makes this all work so well? The combination of being out in the open, regardless of the weather, provides opportunities for conversations way beyond the often task orientated question and answer dialogue. Relaxing into the rhythm of the day there is much pragmatic conversation about family members, nonsense poems, petting of animals, appreciating the vivid vapour lines in the sky, marriage and lastly having dementia. Dementia is mentioned by those with insight but as a passing declaration; “I have dementia and three of my family also have dementia”, followed by, ” I come here for the company…it’s friendly”.
Care Farms provide a venue for valued work in a supportive place where animals and people are patient. Working provides physical exercise, a sense of place, ongoing company and most of all a sense of purpose. People remember that the chickens, goats, horses, rabbits and alpacas all have to be fed in the morning. Then plants need watering and tending to. Each day these jobs change in subtle ways: feed has to be distributed evenly to all the hungry horses, the wind lifts the hay which has to then be collected up. Opening of gates involves working out the release mechanism and where to stand. These challenges stimulate decision making as the farm staff pause to allow a response. It’s slow farming.
Recently the farm was criticized for having only people with mild dementia. It seems a shame that we consider the severity of dementia as a reason to negate the valued work these places provide. My own observations were that the majority of people in the group had significant cognitive challenges and that in a less stimulative environment these individuals would probably spend their time in ennui, fingering items, foraging or wandering. The beauty of the care farm is that these behaviours are reduced because of the core ethos of providing meaningful work for all. Let’s not forget the whole day also provides respite for the carers who can choose how to spend their time knowing that the cost of £65 a day provides a high support ratio for their loved one to be fully engaged in the day.
We need more care farms to remind us all of what matters most to people with dementia and their carers. Care farms challenge our ideas about keeping older people indoors in risk free places; people with dementia are able to embrace the many challenges the outdoors provides. Perhaps we a service providers need to consider why we work so hard at risk mitigation with minimal regard for the rights of people with dementia.