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Paula and most of her fellow farm workers have dementia. Boerderij Op Aarde is one of hundreds of Dutch “care farms” operated by people facing an array of illnesses or challenges, either physical or mental. They provide meaningful work in agricultural settings with a simple philosophy: rather than design care around what people are no longer able to do, design it to leverage and emphasize what they can accomplish.

For people with dementia, who are often less physically active and more isolated, farm settings promote movement and social interaction. And care farms can have emotional benefits, too, giving participants a sense of purpose and of making a meaningful contribution.

Studies in Norway and the Netherlands found that people with dementia at care farms tended to move more and participate in higher-intensity activities than those in traditional care, which can help with mobility in daily life and have a positive impact on cognition. Dementia is often linked to social isolation, and care farms were found to boost social involvement, especially among those who wouldn’t opt for traditional assistance options. Spending time outdoors in nature, often part of a day on a care farm, can also improve well-being among people with dementia. Farms are not only good for individuals. Their families also benefit: studies find caregivers experience less guilt when their loved ones are supported by services they consider to be nurturing and fulfilling.