Promoting Freedom and Autonomy in Residential Dementia Care - Lessons from Green Care Farms

Sep 28, 2026

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Environmental factors shape functional capacities, well-being, and autonomy for older adults, especially those living with dementia. Traditional nursing homes often trade control and safety for restrictive environments, limiting remaining abilities. Green Care Farms (GCFs) offer an alternative by integrating physical, social, and organizational dimensions that differ from conventional care. This qualitative study (two Dutch settings) examines how residential environments can be redesigned to support freedom and capacities for people with dementia.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Study focus and rationale

GCFs as an alternative care model

Methods and settings

Participant observation and interviews

Comparison with a regular nursing home

Findings and implications

Alignment of physical and organizational aspects

Risk acceptance and implementation challenges

Innovation in Aging, 2025, Vol. 9, No. S2 897 Abstract citation ID: igaf122.3035 PROMOTING FREEDOM AND AUTONOMY IN RESIDENTIAL DEMENTIA CARE: LESSONS FROM GREEN CARE FARMS Gijs Steinmann, Maud Hamers, and Hilde Verbeek, Maastricht University, Maastricht, Limburg, Netherlands 898 Innovation in Aging, 2025, Vol. 9, No. S2 Environmental factors play a crucial role in promoting the functional capacities, well-being, and autonomy of older adults, particularly those with dementia. However, by prioritizing safety and control, traditional nursing homes often create restrictive environments. Green Care Farms (GCFs) are increasingly recognized as a promising alternative, integrating physical, social, and organizational aspects that differ radically from traditional settings. This study examines how residential care environments can be (re)designed to structurally promote the freedom and remaining capacities of people with dementia. Specifically, we identify the environmental aspects through which GCFs foster autonomy and explore their potential implementation in other settings. Our findings are based on qualitative research at two Dutch care settings: a GCF and a regular nursing home (RNH) . At the GCF, we combined participant observation with semi-structured interviews to immerse ourselves in residents’everyday surroundings and identify aspects that enhanced or constrained freedom and autonomy. At the RNH, we conducted participant observation as active members of a project team in which staff sought to integrate GCF elements into their traditional setting. Our analysis reveals that the GCF environment promotes freedom and autonomy through a consistent alignment of physical and organizational aspects. This generates environmental presses that stimulate physical activity to maintain physical functioning, and it enables the acceptance of risks to enhance freedom. In principle, each of these aspects could be implemented in other settings. However, this would require profound organizational changes in RNHs, as staff would need to adopt values and practices that directly oppose traditional ways of working.

FAQs

Why do traditional nursing homes may limit autonomy for people with dementia?

They often prioritize safety and control, which can create restrictive environments that constrain freedom and remaining capacities.

How does the Green Care Farms environment promote freedom and autonomy?

It aligns physical and organizational aspects consistently, creating environmental presses that stimulate physical activity and enabling acceptance of risks to enhance freedom.

What would be required to implement GCF elements in regular nursing homes?

It would require profound organizational change, including adopting values and practices that directly oppose traditional ways of working.

Sep 28, 2026

Uploaded by Blitz