Healing Gardens as Transformative Spaces

In the labyrinth with Air (one of the four sculptural elements) at Schneider Healing Garden at University Hospitals Seidman Cancer Center image: Brad Feinknopf

In the Schneider Healing Garden’s labyrinth at University Hospitals Seidman Cancer Center in Cleveland
image: Brad Feinknopf

Below is an excerpt from the article “‘It’s Somewhere Else Instead’: Healing Gardens as Transformative Spaces,” published in the Canadian Society of Landscape Architects’ LANDSCAPES | PAYSAGES magazine. To read the full article, visit CSLA’s website and see volume 16, number 2, pages 20-23.

Healing gardens are intentionally designed to provide a physical space that supports people who are dealing with disruptions in their lives that make the present confusing and the future uncertain. Whether a person with a challenging health issue, a loved one, or a caregiver, one is waiting in liminal space, suspended at the threshold of new experiences.

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Healing Labyrinth for Cancer Support

image: Thomas Baker

image: Thomas Baker

[The labyrinth] is…at once the cosmos, the world, the individual life, the temple, the town, man, the womb—or intestines of the Mother (earth), the convolutions of the brain, the consciousness, the heart, the pilgrimage, the journey, and the Way.
–Jill Purce, The Mystic Spiral

The Loran Smith Center for Cancer Support was built in 2000 as part of the Athens Regional Medical Center (ARMC). The Center serves the community of Athens, GA and the northeast region of the state. It is a welcoming “safe harbor” for anyone affected by cancer and provides resources, research, and access to social services, as well as a supportive therapeutic outdoor environment for patients and their families as they deal with the physical, social, and emotional impacts of cancer treatment. The Center and surrounding gardens also serves ARMC medical professionals and caregivers who care for these patients and their families.

Construction on the Loran Smith Center began in 1999. With therapeutic gardens and healing landscapes as her research area, Professor Marguerite Koepke saw this as a special opportunity to establish a dialogue with the hospital and Center. ARMC was very receptive to the collaboration and Koepke prepared the first master plan for their approximately two-acre site.

At that time, Koepke was also establishing a new semester-long course in therapeutic garden and healing landscapes design at the University of Georgia (UGA). She saw her relationship with the ARMC and the Center as an important opportunity to involve students in local service learning projects, especially those in medical settings, with real clients and real sites. Over the years, as the ARMC campus has grown and changed, her classes have been involved in multiple projects, including several revised master plans and small garden area designs. Design elements in these long-term master plans have typically included a grotto, a meditation/labyrinth garden, memorial garden and numerous naming opportunities, a wetland meadow with observation points for quiet meditation, woodland walking paths, small play areas for young users, and an area designated for a small greenhouse to support horticulture therapy and year-round use.

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Healing Gardens: Therapeutic by Design

Harrison Medical Center in Bremerton has a 3,000-square-foot rooftop garden that serves its oncology department.  image: Hafs Epstein Landscape Architecture

Harrison Medical Center in Bremerton has a 3,000 square-foot rooftop garden that serves its oncology department.
image: Hafs Epstein Landscape Architecture

Do you think all gardens are therapeutic? Can a “healing garden” be harmful?

Gardens with particular characteristics have been shown to have positive effects in health outcomes, primarily through the facilitation of stress reduction, but the answer is that many gardens are not therapeutic, and some gardens may actually increase stress levels in humans.

Stress can lead to several adverse health outcomes and should be ameliorated by design, so why do some (even award-winning) healing gardens fail? The article “Not all healing gardens deliver as advertised,” published on DJC.com, provides three general principles that are essential for gardens to provide positive results, and list several factors that limit the benefits gardens can provide.

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Landscape Architecture Awards for Healthcare Environments

image: Healthcare Vendome Media

image: Vendome Healthcare Media

Vendome Group, publisher of Healthcare Design, Environments for Aging, and Behavioral Healthcare, in conjunction with The Center for Health Design and The Society for the Advancement of Gerontological Environments, is launching their inaugural design awards program this fall. This is the first such awards program that is specifically for therapeutic landscape design, recognizing projects in three major categories: acute care, senior living, and behavioral health.

The significance of the new awards program lies in its focus on therapeutic landscapes and its sponsorship by The Center for Health Design, the leading voice in the healthcare design industry for architects, interior designers, and hospital administrators. These awards represent an important step toward the more integrated design of healthcare environments. Never before have landscape architects had the opportunity to be recognized specifically for their accomplishments in healthcare design.

I’d like to encourage everyone who has built work in this niche market of our profession to submit your projects and to showcase the great work that we do. If you believe that your work makes a meaningful difference in this industry, then please demonstrate that and share your best projects. We will all benefit from your success.

Entry forms are due September 20, and information on how to enter can be found on Healthcare Design’s website.

Good luck!

by Jerry Smith, FASLA

On ‘Designing for Access to Nature in Healthcare’

Mary Catherine bunting Center

Mary Catherine Bunting Center at Mercy Medical Center in Baltimore
image: Patrick Ross via Healthcare Design Magazine

Making the connection between health and nature would seem to be an obvious one, especially when we consider the emerging research on measuring health outcomes in nature or when simply viewing any variety of nature’s wonders.  And it would seem that our work as landscape architects in this field should be a no-brainer – particularly in healthcare design, right?

But there are other functions that enter into this transitioning equation which impact and influence how we bring nature into a sterile built environment.  Global issues like sustainability, aesthetics, social and cultural factors, or more specific issues like infection control.  How do we blend these synergies of influence from such disparate fields in ways that will help us to design positive interventions that will simply help people get through their good days and their bad?

The answers seem to be coming not only from the design studios but from a collection of sources and resources, like a broad ‘band of brothers’, focusing on human connections and place making.  Researchers, social scientists, strategic planners, landscape architects – like Angela Loder, University of Denver; Francis (Ming) Kuo, University of Illinois; Kathy Wolf, Washington University; Robert Ryan, UMASS Amherst; Len Hopper, FASLA, and Rodney Swink, FASLA, to name a few – all of whom are making a difference in how we collaborate and connect people with the benefits of nature through design.

I’ve had the privilege and pleasure of working with these ‘change makers’ on the Human Health and Well-being sub-committee of SITES and with Angela on developing the Living Architecture Performance Tool.  It is Angela’s research on living architecture that this article is focused around, aligned with my work on the Green Guide for Health Care and on the Environmental Standards Council of The Center for Health Design.  We hope this will be the first of several such articles to be published around these transdisciplinary efforts.

Designing for Access to Nature in HealthcareHealthcare Design, July 2013
Written by Angela Loder and Jerry Smith

by Jerry Smith, FASLA

Dementia Green Care Handbook

Dementia Green Care Handbook image: Garuth Chalfont

Dementia Green Care Handbook
image: Garuth Chalfont

As a contribution to the growing body of knowledge and expert guidance on the design and use of outdoor spaces for people with dementia, this handbook addresses the growing need for spaces to be actively used by residents and service users for therapeutic benefit. This handbook resulted from the ‘Therapeutic Dementia Care’ research and design project. In this project, particular attention was paid to the needs of people with dementia and distressed behavior. Hence, the focus is on care environments for nursing, residential, and enhanced day support.

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Expanding Horizons: The Life Enrichment Center

Flowers, herbs and fruit are grown in planters and plant beds to give participants the opportunity for cultivation and harvestimage: Dirtworks PC, photo by BBuck

Flowers, herbs and fruit are grown in planters and plant beds to give participants the opportunity for cultivation and harvest
image: Dirtworks PC, photo by BBuck

The Life Enrichment Center is located in the foothills of the North Carolina Mountains. It is a sustainable community-based Adult Day Care facility, serving adults of all ages with a range of physical and mental disabilities and neurological conditions. The Center’s philosophy is to do “whatever it takes” to help families keep adult loved ones at home and engaged in their community.

Enriching and supporting a dignified quality of life is never more poignant than when that life involves degenerative disease.  Complex neurological conditions, including Alzheimer’s disease, require concepts of treatment that incorporate both pharmacological as well as non-pharmacological approaches. Medications, the first and often last step in treatment, offer meager solace for people who live daily with these conditions. Like other chronic illnesses that require lifestyle changes such as diabetes, manic depression and AIDS, Alzheimer’s requires a paradigm of care beyond medication that emphasizes living with existing abilities. Key to realizing this necessity is understanding a recent finding in today’s neuroscience: that much remains active and vital in the brain of a person living with dementia and other neurological disorders.1

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