Can nature-based therapy help hospital patients recover?

Lance Alexander (0:01)

Best of Live Well ft. Lance Alexander.

Good morning Singapore. For older patients, a hospital stay can be particularly difficult apart from dealing with illness. Some may experience anxiety, low mood, confusion, especially when they're away from familiar surroundings. To help with recovery, Changi General Hospital is trying a different approach to patient care by bringing nature into the picture. This is Singapore's first program of its kind in an acute hospital. Called Nature-Based Therapy, it's part of inpatient care for selected geriatric and rehab patients.

To speak with us, we have adjunct associate professor Lim Si Ching, senior consultant, Department of Geriatric Medicine, and principal investigator of the Nature-Based Therapy program at CGH. She has a bit of a cough because of the haze, I reckon. Prof?

Lim Si Ching (1:03)

Thank you. Thank you, Lance, for the kind introduction.

Lance Alexander (1:06)

My pleasure. We've all been to a hospital. We know it can be functional, it can be stressful, it can even be a cold setting. You go in, you want to get well, and you want to leave as quickly as you can.

So it's wonderful news that CGH is introducing this nature-based therapy as part of inpatient care. What made the hospital decide to do something different, something quite holistic?

Lim Si Ching (1:33)

Yeah, thanks, Lance, for the question and the introduction. Well, currently, our Singapore population is aging. So if you go to any hospital, like CGH, for example, more than 60% of our patients are over the age of 65

What's so special about the seniors, they come in to the hospital, they are likely to stay longer than the younger people. They are also more likely to have complications during their stay. If we're not lucky, they might fall, they might get more confused, they might lose weight because they don't eat very well, and because they spend most of their days in bed, all these are no good for them. So in my effort to make the elderly a little bit more better in terms of their physical health as well as the mental health, I thought we should do something a bit more different than the traditional approach, like medications, treatment for example. So if you look at an elderly patient, when they come in to the hospital, they are unwell, and if they have dementia or delirium or cognitive issue, they can become very, very anxious and more confused than before. Because the environment is different, there's recent changes in the day-to-day routine, the caregivers are not familiar, their familiar family members or their helpers may not be in the hospital with them, and instead they have unfamiliar people like doctors, nurses, taking care of them, and then they have never seen us before. And in the midst of taking care of them, we also do nasty, painful things to them, like taking bloods, like doing procedures. So all these add on to the discomfort, the stress, the anxiety, the sleep problem, etc. So how do we do this?

In terms of medical things, we can explain to them very well. But in terms of psychological, social, discomfort, we don't really do very well in the hospital setting. So I thought several years ago, maybe we should try a bit of green therapy, contact with nature. Because I realized that people do become more relaxed if they're outdoors. You know, they get the sunshine, they listen to nature's sound, they look at the greens, they look at the flowers. It actually do help calm them down.

And we realized that they also eat better, their appetite improve. And in the midst of conducting garden therapy, as a pilot quite a few years ago now, we have started, they get to interact with other patients, get to interact with our staff. So everybody benefited actually, much, very much to my surprise.

Lance Alexander (4:14)

Tell us what actually they'll be experiencing when there is a therapy session. What do they come into contact with? What sights, what sounds, what smells?

Lim Si Ching (4:26)

So the principle goes by multi-sensory stimulation. Dementia affects our memory. It affects our language faculty. It affects our ability to plan and do things that we take for granted, like getting dressed, like toileting, etc. But it doesn't take away our senses. It doesn't also take away our sense of humor.

We can still appreciate music. We can still appreciate sound. Our senses are intact, so we use those. So in terms of sight, we have plants of different shapes, colors.

We got flowers. We got leaves of different texture that they can touch. And we got smell. We got aromatics in our garden, like the familiar pandan leaf, lemongrass. All these are familiar herbs and aromatics for our local people. And we also have sounds, like wind chimes, like water flowing. We have water features.