Garden and Nature-based Occupations as Psychosocial Interventions for People with Life-Limiting Illness: Implications for Occupational Therapy Practice

Abstract

Gardening and nature-based occupations have been proven to be beneficial to the health and wellbeing of those who participate in them, however there is limited of how gardening and nature benefit those from the perspective of people living with life-limiting illness. This literature review investigates the views of people with a range of life-limiting diagnoses to establish the psychosocial benefits of garden and nature based occupations, and the potential implications of this for occupational therapy practice. Chapter one reviews the current gardening and nature-based research using Kitwood's framework of the psychosocial needs of Identity, Inclusion, Occupation, Attachment and Comfort, as well as the additional domain of Agency proposed by Kaufmann and Engel. Chapter two examines the phenomenon of acceptance within the literature, establishing the role of gardening and nature in enabling participants' acceptance of illness and preparation for death. Acceptance is proposed as a further useful addition to Kitwood's framework in the context of life-limiting illness. Chapter three utilises this adapted framework, with the additional domains of Agency and Acceptance, to explore the discourse on palliative care within the occupational therapy literature. Given the benefits of valued occupations such as gardening to fulfill psychosocial needs, it is suggested that occupational therapists have a more holistic role in facilitating acceptance for people nearing the end of life.