Growing closer: Addressing nature disconnection in dementia

• Nature connection supports dementia wellbeing in multifarious ways • Complex intersecting conditions influence individuals’ connection with nature • A relational and enablement approach mitigates barriers and meets needs • Pronounced impacts are of great value and significance for individuals and society • An evidence-based theoretical framework is provided to guide nature connection While the benefits of nature connection for people with dementia are well known, many with the condition live physically and emotionally disconnected from nature. This metasynthesis aims to explicate the process of building and sustaining nature connection while experiencing the challenges of dementia, in order to offer evidence-based solutions and a pathway to positive change. We analysed and synthesized qualitative findings from 37 studies to develop a theoretical framework that illuminates the central phenomenon of (dis)connection with nature while experiencing dementia. This theoretical framework explicates the influencing factors as well as outcomes of this phenomenon. The framework demonstrates that building and sustaining connection with nature is hindered by intersecting personal and external factors, including physical, cognitive, and emotional changes; availability of resources and support; and environmental barriers. Solutions include facilitating strategies, such as inclusive and individualised nature-based activities, accessible and enabling environments, and effective communication, education, and coordination. Critical positive outcomes from meaningful nature connection include improved physical, cognitive, mental, and emotional health, enhanced social connection, meaningful participation, and caregiver well-being. This theoretical framework has potential to guide policy and inspire support efforts, identifying starting points and avenues for more effective and enabling ways to ensure people with dementia are living well. This paper identifies areas for future investigation into the influencing factors and impacts of nature connection for people with dementia across settings.