Reconnecting with the Wild

For the estimated 10 million new cases of dementia each year globally, life often becomes defined by loss and isolation. As symptoms progress, many people with dementia experience a phenomenon referred to as the "shrinking world," gradually losing the interest and confidence to engage with the outdoors.

A recent comprehensive metasynthesis examining 37 qualitative studies unpacks this challenge. The research affirms that while the benefits of nature connection are clear, many people with dementia live disconnected from nature, and addressing this requires a new, holistic approach to care.

The Hidden Barriers to the Outdoors

The study found that disconnection is caused by complex, intersecting personal and external conditions:

• Personal Challenges: Progressive declines in memory, cognition, and mobility limit a person's ability to access outdoor spaces. These changes are often compounded by increased confusion, anxiety, and fear.
  

• Caregiver Strain: Care-partners are crucial for facilitating outdoor activities. However, they often face significant constraints on time and transport , and have major concerns about safety risks like falls, which can lead to restricting outdoor engagement.
  

• Environmental Obstacles: External factors like unfavorable weather and long distances to natural venues act as barriers. Additionally, poorly designed built environments, such as those with uneven pathways or a lack of clear signage, can create a confusing and intimidating experience.

The Path to Reconnection: An Integrated Approach

The theoretical framework generated by the authors highlights that mitigating these barriers requires an integrated approach centered on the principles of relationality and enablement.

The core strategies to facilitate meaningful nature connection include:

• Inclusive and Individualized Activities: Activities must be intentionally inclusive, offering diverse participation opportunities to accommodate varied needs. Activities should also be tailored to an individual's unique history, interests, and preferences to boost confidence and motivation.

• Accessible and Enabling Environments: Outdoor spaces need careful planning to ensure safety and ease of navigation. This means providing clear, wheelchair-friendly pathways, adequate seating, and sheltered areas.

• Effective Communication and Education: It is crucial to build trusting relationships with individuals and provide ongoing support and encouragement. Education is also vital for care-partners, helping them understand how to guide personalized, nature-based activities.

Profound Outcomes for Well-being

Meaningful nature connection yields multiple, mutually reinforcing positive outcomes for both the person with dementia and their care-partner.

For the Person with Dementia:

• Mental & Emotional Health: Individuals experience reduced signs of agitation, depression, stress, and anxiety. Engagement with nature often evokes feelings of calm, happiness, and comfort.

• Cognitive Health: Natural environments can trigger reminiscence (happy memories of gardening or walks) and offer rich sensory stimulation that helps with concentration and orientation.

• Sense of Identity: Nature-based activities foster a sense of continuity with life before dementia, helping individuals regain a sense of self-worth and normalcy.

• Physical Health: Activities naturally involve physical movement and exposure to fresh air and sunlight, contributing to better appetite and better sleep quality.

For Care-Partners:
Care-partner well-being is a critical outcome. Care-partners can unwind and recharge while in nature and strengthen the caregiving bond through shared moments of joy.

In conclusion, this framework underscores the therapeutic potential of nature, advocating that policies and funding should be established to better integrate nature into dementia care design and community support efforts.

Source Cited:

Nguyen, H., Thomson, C., Sun, J., & Marsh, P. (2025). Growing closer: Addressing nature disconnection in dementia. Wellbeing, Space and Society, 9, 100291. https://doi.org/10.1016/j.wss.2025.100291