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Apprenez à jardiner dans le respect de votre environnement, un site de la SNHF

Agapanthus 'Blue Heaven' (La plante du mois)

Jardine avec Bottine et ses amis. de 3 à 11 ans

Jardins pour malades d'Alzheimer

Pitié Salpétrière (Q.Massot)Chaque malade est différent et possède sa propre histoire. La meilleure façon de l’aider est de s’en souvenir. Ceux qui aident ou soignent ont tout intérêt à développer un sens aigu de l’observation et de l’analyse. Finalement, on se rend compte que contrer les risques liés à la déambulation peut contribuer au maintien d’une certaine autonomie. La réponse à apporter se situe au niveau de stimulation des sens par le végétal et la mise en espace, et de comment le patient/résident se meut et vit dans cet espace. Il n’y a pas de réponses paysagères toutes faites mais des réponses contextualisées, en fonction des sites, des paysages, des milieux, de l’histoire locale…

Il y a néanmoins un élément en commun : comment faire disparaître la notion d’enfermement et de privation de liberté, liés à la maladie et ses syndromes. C’est bien toute la problématique du traitement paysager des jardins thérapeutiques liés aux maisons de retraite et plus particulièrement les unités Alzheimer.

Quelques recommandations à tester

- Du calme, de l’espace… Il faut aménager autant que possible une zone peu bruyante, bien éclairée (mais pas trop), bien signalée et sécurisée (ranger les tapis, les fils téléphoniques, les objets qui encombrent les passages, sécuriser les cuisinières à gaz par des systèmes coupe circuit). À la maison, on fermera la porte d’entrée et on protègera les escaliers. En institution, les nouveaux projets tendent à privilégier des systèmes anti-fugues très peu contraignants (bracelets alarme silencieuse à déclenchement magnétique lors d’un passage de porte).

- Il ou elle veut marcher ? Et bien marchons un peu avec la personne et profitons-en pour l’aider à s’orienter. Des promenades dirigées dans la maison, le jardin ou même le quartier, proposées très régulièrement, suffisent souvent à répondre à un vrai besoin et à détendre l’atmosphère.

- Ne pas obliger à rester assis et surtout éviter la contention : plus on l’empêche, plus on exacerbe le besoin de se déplacer.

- Rythmer les journées : lever, toilette, repas, activités.

- Proposer des activités ludiques ou artistiques, occuper avec des tâches ménagères (plier du linge, débarrasser la table), lutter contre l’ennui.

- Traiter l’anxiété et la dépression, qui sont à l’origine de bon nombre de troubles du comportement. Il n’y a pas de médicament contre la déambulation et tout ce qui « calme » augmente les risques de somnolence et donc de chutes !

- Maintenir ou retrouver le rythme veille/sommeil (activités toniques le matin, relaxation en fin d’après midi).

Les altérations sont variables selon les individus, les effets de la maladie sont variables selon les cas.

- Rapport à l’espace :
Des lignes sombres pouvant stopper un patient, qui y verra une ligne infranchissable. Un cheminement en pente permettra de « ramener » un patient à son point de départ.

La réponse du paysagiste

La réponse paysagère est indissociable de la réponse spatiale. Les plantes et le jardin ne font partie que d’un ensemble spatial global, en association avec les bâtiments, les voies, les limites du terrain…. Humanisation de maison de retraite et de lieux d’hospitalisation.

La réponse spatiale

- une réponse spatiale simple pour ne pas brouiller la lecture de l’espace par le patient.
- un espace sans équivoque, ne présentant pas de lieux soumis à interprétation pour des personnes dont la vision est altérée. Il y a risque d’interprétation, de formes « anxiogènes », se mêlant avec les ombres (le cabinet du Dr Caligari, Robert Wiene, expressionnisme et déformation de la réalité).
- la question de la déambulation. Le traitement des sols, avec relief, avec aspérités, mais sans danger de chute, et alternance de matières (gravier résiné, sol souple, métal, pavés, béton…)
- la nécessité d’une clôture sécuritaire. Hauteur de 2 m pour empêcher toute « sortie », qui peut se révéler dangereuse, voire mortelle. La question de la liberté, et de la dissimulation de ces panneaux rigides disgracieux.
- notions de géobiologie. Relation de l’humain avec son environnement, et notamment les ondes, et vibration entre les éléments. Détection de la présence de cours d’eau souterrains, ayant une influence négative sur le bien-être général. Ce type d’étude commence à se pratiquer pour le bâtiment, mais aussi pour l’implantation de végétaux.

La réponse végétale
Appel à toutes les ressources de la plante, qu’elles soient esthétiques, pratiques… La palette botanique devient une véritable boîte à outils pour créer des effets stimulants.

- apporter des repères spatiaux et temporels par le végétal. Troncs (érable « peau de serpent », bouleaux, cerisiers rouges…), feuillage…
- créer des paysages particuliers

Jeu sur la plante et thématisation des espaces dans des contextes de jardins prenant souvent place sur des espaces de petite taille et clos, des patios.
couleur (rouge, jaune, bleu, mauve, pourpre, blanc, orange…) au niveau des feuillages, floraisons, branchage… (cornouiller rouge, cornouiller mâle, jaune, sanguin…)
écorce des arbres (érables « peau de serpent », bouleaux…)
branchage torsadé (noisetiers, saules torsadés, hêtres nains…)
jardin de grandes feuilles (bananier, cannas, palmiers…)

- repères des saisons

- stimulation des sens (ouïe, odorat, vue, toucher, goût).
Exercices avec les végétaux, odeurs, visions couleurs, formes, toucher, goûter (contourner la réglementation de consommation d’aliments produits sur place).

- les plantes qui « font du bien »
Les fleurs de (Edward) Bach (réponse aux déséquilibres émotionnels agissant sur notre santé). 38 essences différentes créées à partir de fleurs et de plantes correspondant à 38 états psychiques : peur, solitude, désespoir, doute…)

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Fabien Charlot
Conférence dans le cadre de la journée à thème "Jardins, environnement et santé"  Bordeaux 2010.

acheter les actes du colloque Quand les plantes se parlent