The physical environment of Green Care Farms and its relation to residents’ activity engagement

• Green Care Farms provide an environment rich in sensory stimulation by providing a variety of meaningful places and objects in- and outside • Nevertheless, residents with dementia exhibited great variation in their use of places on the Green Care Farm. While some visit a variety of places in- and outside during the day, a substantial group also spent their day more stationary • Residents of GCFs were still engaged in activity in 86 % of the day, mostly in recreational activities, looking around, social activities or eating and drinking. In 5.1 % of the time, they engaged in outside- and animal-related activities. • Being engaged in an activity triggered engagement in subsequent moments in time, showing the importance of activating residents with dementia. For people with dementia, being actively engaged in activity can slow down cognitive decline and increase quality of life. Green Care Farms (GCFs) integrate nature and animals into daily life aiming to encourage engagement in activity. This environment might trigger engagement, in the present moment, as well as during longer periods of time. This study explores the environmental design of GCFs in relation to residents’ use of the environment and engagement in activity, contributing to understanding the role of the built environment. Maps, floor plans and photos of four Dutch GCFs were compared. Ecological momentary assessments (n=5,436) were conducted including 151 residents. Observations noted residents’ place of stay, the activity, which they performed and whether they were actively engaged in it. Data was analyzed with descriptive analyses and a general linear model. GCFs highly varied in their spatial design; however, all provided an environment rich in sensory stimulation. On average, residents spent 10.1% of their day outdoors. The variety of places used strongly differed between residents. Nevertheless, engagement in activity was generally high (86.4%), particularly in outdoor and activity spaces. The activities in which residents engaged were mostly recreational activities, looking around, social activities or eating and drinking. Engagement triggered engagement in subsequent moments in time. This study showed that certain places within GCFs are meaningful in encouraging activity engagement. Considering different interests and dementia stages, it is important to create varied, meaningful opportunities for engagement both indoors and outdoors.