Finding the Third Space through Gardening: Strengthening Relationship Mutuality and Lowering Stress in the Caregiver and Care Recipient who has a Disabling Injury or Illness through Gardening1

There is strong evidence that illustrates the health benefits of gardening. However, gardening to improve mutuality and caregiver strain and health has not been studied. Mutuality is defined as shared, reciprocal experience that strengthens dyadic relationships aiming to achieve optimal health, mitigate adverse effects, and improve psychological and over-all well-being. The purpose of this study was to evaluate the relationship between gardening and mutuality in care recipients (CR) with a sudden disabling condition, and mutuality, caregiver health and strain in caregivers (CG) for CR-CG dyads after discharge from inpatient rehabilitation. A mixed methods, quasi-experimental study of 90-day duration (n=63 dyads) received the intervention of 1) gardening evaluation 2) teaching adaptive skills, and 3) providing take-home adaptive gardening equipment and supplies, and 4) six visits from a Master Gardener after discharge to home. The pre-post quantitative results revealed 1) CR mutuality decreased, though was higher than a published benchmark, 2) CG mutuality was higher than the published comparison, 3) the CR reported higher mutuality than the caregivers, 4) caregiver strain was 14% lower (favorable) compared to the 2023 annualized facility 90-day follow up data (historical comparison) 5) CG health decreased, though study participants reported 16% better health than the historical comparison, 6) study participants reported 6% better physical health than the historical comparison, and 7) study participants reported 20% better mental health than the historical comparison. The qualitative themes revealed that 1) gardening activities created a sense of CR/CG mutuality, 2) assisted progress in recovery and provided motivation, 3) allowed growing/eating healthy food, and 4) adaptive tools contributed to success. Gardening provided a positive impact on persons with sudden disabling events and their caregivers.