Using an Eco Art Activity Program to Improve Well-Being for Family Caregivers

Unpaid family caregivers worldwide encounter stress, anxiety, and mental health issues related to reduced attention to personal well-being [1-3]. Koltz and Koltz [4] introduced an eco-art therapy approach for counselors to work with older adults using a series of outdoor environmental experiences to improve mental health. Utilizing concepts from the eco-art therapy approach, a program was developed to focus on caregivers learning sustainable self-care practices to improve mental health and well-being. This report will focus on a conceptual model using one eco-art activity from a state wide caregiver respite program to connect self-care and personal well-being. To promote improved well-being in caregivers, the framework for the program uses Kolb’s Experiential Learning Cycle Theory [5] to establish a process for a group to institute eco-art as part of a daily routine. Experiencing the natural environment through art outdoors or indoors for older adults with mobility issues is beneficial for an improved outlook on life and well-being [4]. 

According to Nakamoto et al., [2], older adults are experiencing a more significant burden associated with caregiving, given that the Covid pandemic has shut people in their homes for an extended time. Particularly caregivers attending to people with health issues that could be negatively affected by an infection of Covid. Stress and anxiety were also reported as higher for caregivers than for people who were not caregiving [2]. To attend to the issue, increasing art and ecological activity can decrease stress and anxiety [6]. Older caregivers often neglect their well-being and rarely find time for themselves, and connecting to eco-art is an excellent approach to work on themselves [7]. 

The benefits of nature and art for the caregiver 

An inexpensive approach to health and wellness intervention is using the natural environment [7]. The benefits of nature are therapeutic and include increased well-being and stress reduction [6]. Van Heezik et al., found that home gardens play an integral role in reaching older adults because of their decreased mobility and inability to enter natural environments. In addition, all forms of gardening will improve the quality of life in older adults in many demographic groups, including caregivers [8]. Engagement in outdoor activity, improved mental health, and social engagement enhances personal well-being and health [9]. 

For some older adults and caregivers’ it becomes difficult to engage with the outdoors in natural environments, and they need more experience in outdoor activities to improve self-care [9]. Sia & Diehl [10] reported higher levels of well-being and a positive mindset when older adults engage with the outdoors and take time to notice their surroundings. Another benefit of engaging with the outdoors is having a positive outlook and attitude about life moving forward through the challenges that caregivers face [10]. Connecting our cognition with our senses of our eco-environment is equally effective, whether inside or out in nature [7]. Wolf and Housley [9] shared that viewing nature through a window or from the inside of a home also has the same effect on cognitive health and stress reduction. Moreover, using creativity and cognitive skills to garden inside a residential community provides the same valuable benefits to personal well-being as walking outdoors [9]. Therefore, exploring nature using eco-art activities will allow unpaid caregivers to engage their creative nature and the outdoors within the context they can manage [11]. 

When combining eco-art activities and programs for older adults, it is vital to understand, from this perspective, that nature has the power to heal. Art interventions are typically an hour long to meet the individual's ability and hold their attention. Wang and Glicksman [8] noted the many benefits of art on personal well-being. The therapeutic benefits of art include social engagement, increased self-expression, enhanced self-esteem, and promotes exercise and physical/mental stimulation. Bagan (n.d) [12] shared how the aging brain connects well with art, and the ability of older people does not deteriorate with age. Engaging with creativity is essential to stimulating the different hemispheres of the brain to promote brain health [12]. Older adults who experience an eco-art activity will engage their brains to cognitively engage and promote personal well-being and sustained self-care practices [11].

Theory framework for experiential learning 

Kolb’s experiential learning cycle has four stages that people learn through. The central concept is that when people experience a hands-on experiential activity, they are more likely to incorporate it into their daily routine. The four constructs of the theory move people through four primary stages. The first stage is experiencing a concrete activity, the second is reflecting observation, the third is abstract conceptualization, and the fourth is planning active experimentation. Moving through Kolb’s experiential learning cycle can effectively incorporate newly learned practices into everyday routines.

The concrete experience 

The goal of using Kolb's learning cycle is to use an effective framework to improve the well-being of unpaid caregivers by incorporating activities to aid in decreasing stress, anxiety and overall low well-being. We provide activity in an environment that promotes respite from the everyday caregiving routine. The first stage includes a concrete or experiential activity. We engage caregivers by helping them first move through the stages using their senses of smell, touch, sight, sound and breathing. Using the senses engages the caregiver at the moment and allows them to relax and engage with the experience. This exercise aims to help support caregivers by offering a tangible way to help reduce stress and focus on their daily self-care. In these circumstances, caregivers are happy to be working on self-care and recognize that the experience is suitable for their well-being. With many demands, caregivers often sacrifice their health and well-being to care for a loved one [1]. This activity may be helpful for caregivers to reflect on how tending to their needs can benefit themselves and their loved ones [13]. 

Reflective observation 

After the activity is completed, the facilitator guides the participants to reflect on their experiences. Reflective observation is how someone engages with and feels about their concrete experience. During the reflective observation, the facilitator discusses how tuning into bodily senses can reduce anxiety from a busy mind. Being in touch with their feelings, emotions, and the benefits the activity promotes allows for a connection to begin on why it is essential to continue doing the activity for their well-being [3]. Asking specific questions: Where in your body do you feel relaxed? What part of this activity do you resonate with most? Does this activity feel like you are connected to nature? Connected to yourself and what you may need moving forward? These and any other questions that focus on well-being in connection with the activity are appropriate. Creating a link to conceptualizing how to improve the personal well-being of a caregiver. 

Abstract conceptualization 

The next stage in the process of learning a new activity to improve well-being is abstract conceptualization. Abstract conceptualization focuses on how to set time aside for the learned activity and why it is vital for caregiver self-care. Caregivers, in most circumstances, do not set aside time for themselves and often experience a decrease in personal well-being [7]. At this moment in the cycle, caregivers are provided a five-minute activity guideline to continue with the experience or an opportunity to conceptualize a similar activity to accomplish the same goal. Seeing how the activity plays an integral role in their future is critical to incorporate the changes into their everyday routines.

Planning active experimentation 

Now that the caregiver has envisioned how to use the activity or an alternate and why it is essential for their self-care, planning for the next time is an instrumental piece of the experiential cycle. Writing down a specific day and time is helpful in this planning step. When putting together a program for caregivers, small time allotments are good because of the time constraints often placed on the individual themselves. Finding five minutes is a start, and moving toward finding an hour or two is most beneficial to decrease stress and anxiety and improve their well-being [8]. 

Setting up your own eco-art activity group experience 

An eco-art educational program for caregivers should attend to removing barriers to participation in a day of respite and learning methods to improve personal well-being. The number of group members attending is variable; however, no more than fifteen to twenty is recommended to keep attention focused on each caregiver. Removing barriers may include assisting caregivers in finding a respite caregiver for a family member or providing onsite caregiving. Attracting a caregiver to take time for themselves is challenging because often they feel as if they are the only person to manage the care, much less leave them attended by a stranger. We recommend offering scholarships to help cover costs or provide on sight care workers for the one-hour retreat. Motivating a caregiver to attend an activity for themselves is challenging but worth the investment of time. 

Arrival and Introductions 

When caregivers first arrive for an experiential wellness day, they should be welcomed and cared for. Offering complimentary beverages and snacks is an approach to foster socializing with the other participants and opens the door to conversation. The social aspect of the group is as important as the activity. Social connections open the door to a relaxing time away from everyday challenges. Before beginning the activity, please share with the group about yourself to help build the trust needed to receive what you are exploring with them in the activity. Give time for each person to share their name and experience (make it optional) to show that the group cares about each caregiver. The final component of the introduction is to share the activity they will be working on and the group’s goals. Be specific that this is a five-minute activity to promote wellness and self-care. They use their senses of touch, smell, sight, and breathing to take time for themselves. 

The concrete experience 

This concrete experience was used in the current caregiver respite program and focused on using plants, explicitly making a lucky bamboo garden. Any plant can be substituted; however, the lucky bamboo plant works best for this experiential application because it can thrive in pebbles and does not need soil to live and grow. The components of the garden include small pebbles, a jar or vase, and lucky bamboo. Begin by lining up all the products on a table in the front of the room and show them the components for the activity. It is recommended to hand out the materials after the demonstration on how to assemble the garden. Demonstrate placing the luck bamboo plant in the container and selecting the appropriate number of plants. Take time to explain the meaning behind the number of plants in the garden listed in table 1. 

Table 1: Lucky bamboo meaning. 

The activity materials used for the lucky bamboo garden are pebbles or small stones, a glass container and the lucky bamboo plant (or an alternative plant that can be rooted in water). These three components are easy and relatively inexpensive to accumulate. Each material is from the environment. Being descriptive and engaging with personal well-being and the outside environment is easy to incorporate into the experience. Begin by explaining that we need to focus on our well-being, even for five minutes a day. Five minutes can change our outlook and put a quick focus on ourselves. Each material is transformed to fit within the five-minute practice of connecting with our environment, either outside or what we experience in our homes and jobs as caregivers. 

Start by explaining the glass in the container is made from sand. The sand is heated to a temperature that changes it to be malleable and clear and is poured into a mold to create the glass container. We, too, can be changed to fit our schedules to be molded around our responsibilities. Taking time to sit with our lucky bamboo garden provides a quick break and change we may need at the moment to redirect our challenges throughout the day. The pebbles are smooth, and many were molded or changed by nature as water moved across them or tumbled from an original state of roughness. Have them feel the stones and how smooth they are. Ask them to reflect on what they are feeling. Continue by connecting these thoughts to a memory related to stones. Often, we have memories about skipping rocks in bodies of water, stones we may have used in a fish pond, or any other positive experience we have engaged with through memory. 

Additionally, the stones can represent what is going smoothly in their life through the challenges of caregiving. Processing positive thoughts will be beneficial later when using the garden for five-minute self-care moving forward. The next step is to take the bamboo plant and reflect on the smooth texture of the stem. Connect it to the smooth feeling of the rocks and the same experience. Look at the plant’s brilliant color and connect thoughts about what the green may represent. Often the experience connects people to the bright color representing hope and growth. Caregivers can experience the thought of how they can grow as individuals as they take a daily break from their caregiving responsibilities to focus on themselves. They can hope through difficult circumstances by feeling whole and restored by this simple reflection. The last step in the process is to combine all the components, place the plant into the container, and gently place the stones around the stems to about three-quarters or most of the way to the top. They are adding water to complete the garden. 

The last reflection made with caregivers through the eco experience is to discuss the benefits of water intake for themselves and the lucky bamboo garden they are entrusted to care for. Water is necessary to cool and care for our bodies. Taking a break to sit next to our lucky bamboo garden is a reminder to water the plant and ourselves daily or as needed. When we sit with the bamboo garden, we take a quick break, relax and take a moment to breathe. Placing the garden in a sunny location provides an opportunity to take in the sun for our well-being and the needed connection with the environment. The activity is usually completed with groups of caregivers to engage not only in your well-being but the social engagement that often eludes caregivers who spend the vast majority of their time caring for others (Figure 1). 

 Figure 1: Lucky bamboo (Plant) garden. 

Reflective observation 

Asking specific questions: Where in your body do you feel relaxed? What part of this activity do you resonate with most? Does this activity feel like you are connected to nature? Connected to yourself and what you may need moving forward? These and any other questions that focus on well-being in connection with the activity are appropriate. All are linked to a conceptualization of how to improve the personal well-being of a caregiver. 

Abstract conceptualization 

Caregivers or older adults must visualize when they can perform this five-minute activity. Is it in the morning when they start their day? Is it in the afternoon when their roles as a caregiver become overwhelming? Alternatively, is it in the evening when everything else is completed and they feel they can take time then? Explain to your caregivers in the group planning is essential to have the same relaxed and good feeling they are currently experiencing. 

Reflective observation 

Not all caregivers in your group can envision how this activity may be incorporated into taking five minutes for themselves. However, they may have a different idea of incorporating the outside environment into a daily routine. Brainstorm with participants how this may look different or what other types of activities can be an alternative. We often discuss taking walks down the road. They should not focus on “to-do’s” but on what they are visualizing, taking deep breaths, engaging with their sense of smell, their sight, and how they feel when they stretch their legs during the walk. Engaging in how their body feels and knowing the importance of engaging with their environment can improve their well-being and mental health. 

Planning active experimentation 

We provide a planner or guide for the caregiver to engage with the activity. Setting time aside is an essential component of planning for the next experience. We will ask each caregiver to explain when they will use this experience again. Forming a commitment that is verbal and in writing. Engaging with the environment is good for our overall mental health and well-being, reinforcing the conceptual eco-activities described as eco-art. Improving mental health through nature is beneficial and cost-neutral to improve sustainable self-care habits. 

Other eco-art activities for caregivers 

Many forms of eco-art activities can be used to engage caregivers or other older adult groups for sustainable self-care practices. These activities include photography, painting, journaling sights and sounds; art using sticks, stones, and leaves. Natural eco-art is a beneficial method to improve the health and well-being of older adults. Creating the eco-art activity experience within the experiential learning cycle is a proven method that creates lasting engagement well beyond the one-our group experience. When a caregiver feels and experiences the benefits of taking care of themselves, they are more likely to engage with the same or a similar activity moving forward because they want to improve life satisfaction. For more information about the benefits of creating an eco-art activity program, seek out information regarding sustainable self-care curriculum for older adults or contact the author.

There are no funding sources connected to this manuscript.

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