Healthcare and Therapeutic Design

PPN Zoom Book Club: Schools That Heal

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by Amy Wagenfeld, PhD, OTR/L, SCEM, FAOTA, Affil. ASLA

Schools That Heal: Schools That Heal: Design with Mental Health in Mind by Claire Latané, FASLA / image: Claire Latané

The ASLA Children’s Outdoor Environments Professional Practice Network (PPN) is pleased to share a recap of the PPN’s second Zoom book club meeting. Hosted on May 9, 2023, 32 attendees eagerly welcomed Claire Latané, FASLA, MLA, SITES AP, author of Schools That Heal: Design with Mental Health in Mind, published in 2021 by Island Press. Written with an exquisite balance of evidence, sensitivity, and compassion, the book is intended for architects, engineers, and interior designers as well as landscape architects. We are grateful that Professor Latané was able to speak with us about the book and her ongoing advocacy work. Before recapping the book club meeting, a bit more about the author of this month’s PPN book selection:

Associate Professor and Chair of Landscape Architecture at California State Polytechnic University – Pomona, Professor Latané became a Fellow of ASLA in 2022 and was a Landscape Architecture Foundation (LAF) Fellow for Innovation and Leadership for 2017-2018. Her fellowship focused on high schools and high schoolers, an age when most mental health disorders get diagnosed (if they even get diagnosed). It is a tough time because by age 12, youth are no longer eligible for after school care, and are often left to their own devices. On top of it all, parents are less welcomed to participate in high schools. This period in development was, in Professor Latané’s mind, a bit of a missing piece, and very light on research focused on the mental health benefits of nature in a learning environment.

Beyond her academic role, Professor Latané’s advocacy and commitment to bettering the lives of children is evident in her work as Founder of the Collaborative for Health and Inclusive Learning Environments (CHILE—rhymes with “while”) and as Founder of the Emergency Schoolyard Design Volunteers program for the National COVID-19 Outdoor Learning Initiative. With mental health challenges amongst children and youth on the rise and compounded by the COVID-19 pandemic, never has connecting children with nature been more important. So too is acknowledging that learning environments need to be nature-based places of healing and must be front and center thinking in every school district, everywhere. We need more Professor Latané’s in the world to be the voice for children and youth all of whom must have opportunities to experience the mental health promoting benefits of nature.

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The Approachable Green: Integrating Living Walls in Biophilic Interior Spaces, Part 2

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by Shan Jiang, Ph.D.

Duolingo Headquarter Office at East Liberty in Pittsburgh, PA, features a living wall near the entrance area, installed by Urban Blooms. / image: courtesy of Urban Blooms

While part 2 below covers a few case studies, please see part 1 of this post, published last week, for more on the scientific underpinnings of living walls. 

Living Walls in Workplaces

For corporate workplaces where people spend a significant amount of time inside, living walls could vitalize the working environment, add aesthetic pleasure, and play important roles in positively impacting people’s health. According to a scientific report published by Nature, urbanization in Western cities has resulted in a lack of exposure to environmental microbes due to the increased level of hygiene, loss of biodiversity, and irregular contact with soil, which has been linked to many immune mediated diseases. Indoor green walls in urban offices can affect health-associated commensal skin microbiota and enhance immune regulation among  employees [1]. Indoor plants in the workplace were found to correlate with less sick leave, better task performance, and quicker restoration from mental fatigue [2-3].

Workplaces are embracing the idea of bringing nature inside through living walls that maximize space utilization and provide numerous biophilic features. Living walls help to achieve many goals as required by the WELL Building Standard—Air, Water, Nourishment, Light, Fitness, Comfort, & Mind [4]. Duolingo, a leading tech company in the language education industry, has recently integrated several green walls that have become new attractions in their Pittsburgh, Pennsylvania headquarters.

Recent technology development makes living wall structures more flexible and designable beyond “just a green wall.” GBBN Architects’ Cincinnati office experimented with digital fabrication and augmented reality (AR) technology in their living wall design and installation. According to an interview with the living wall designers Mandy Woltjer and Troy Malmstrom, the design concept was to encourage plants to grow out of an irregular trellis that increases multi-dimensional volumes. Therefore, the plants were installed first in an AR space where the designer could precisely locate the plants in the designated position.

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The Approachable Green: Integrating Living Walls in Biophilic Interior Spaces

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by Shan Jiang, Ph.D.

Looking to Tomorrow symbolizes a brighter, more sustainable, and equitable future. Project partners: ArtWorks, Urban Blooms, and the Walnut Hills Redevelopment Foundation. Designer: April Sunami and Urban Blooms. Location: 1037 East McMillan Street, Cincinnati, OH. / image: Google Maps Street View

Biophilia and Biophilic Design

The term biophilia was coined by German psychologist Erich Fromm to describe the physiological tendency towards all living-beings—the “passionate love of life and of all that is alive” [1]. Later, E.O. Wilson and Stephen Kellert’s groundbreaking introduction of the Biophilia Hypothesis to the design disciplines helped reveal the mechanism of humans’ inherent inclination to nature and other lifelike processes from the biologistic and evolutionary perspectives [2]. It is widely encouraged to have direct contact with nature in outdoor settings, such as roaming in the woods, gardening, or simply watching nature from a park bench. A recent scientific study found that visiting nature more than once a week was significantly associated with better health and higher quality of life [3]. Unfortunately, most of the world’s population now lives in urban environments, with up to 95% of their lives spent on indoor activities [4]. Luckily, there are ways to establish nature connectedness from interior spaces, such as via indoor plants and nature views [5].

The Multifaceted Benefits of Living Walls

According to Stephen Kellert and colleagues’ biophilic design framework, the integration of daylight, natural materials, and vegetation are the fundamental applications that reconnect people to nature. While incorporating a courtyard could be constrained by spatial programming or financial limitations, a vertical greening system could be a great substitute [6]. A vertical greening system, also known as a vertical garden, a living wall, or simply a green wall, provides numerous benefits to the indoor occupants and the environment at large.

As outlined by Green Roofs for Healthy Cities (GRHC), there are different types of living wall systems. Green facades support climbing vines or cascading ground covers that are rooted in soil beds at the bottom or different levels of the structure. Living walls are pre-vegetated modules that are affixed to a vertical structure that support a much lusher mixture of plant species. Living walls can be broadly classified into three systems—the panel system, felt system, and container and/or trellis system [7].

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Healthcare & Therapeutic Gardens Interview Series: Dr. Garuth Chalfont

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by Afrouz Rahmati, Assoc. ASLA

images: courtesy of Dr. Garuth Chalfont

The Healthcare and Therapeutic Design Professional Practice Network (PPN) is pleased to share a new installment in their ongoing Healthcare & Therapeutic Gardens Interview Series: a conversation with Dr. Garuth Chalfont.

Dr. Chalfont is a leading practitioner in the art and science of healing gardens, therapeutic spaces, and dementia gardens that incorporate the natural world into the healing process. He designs and builds engaging outdoor spaces in dementia care environments and leads hands-on training workshops to facilitate their active and enjoyable use by residents, staff, and families. In his research, he explores the benefits of the natural world for holistic health (mind, body, and soul), in particular how nature contributes to prevention of (and healing from) dementia.

What inspires you to do work in the therapeutic landscape?

When I first got into it, I felt that the healing qualities of nature were hugely undervalued and underused in landscape architecture and garden design. The emphasis was on visual qualities rather than a person’s lived experience of spending time outdoors and actually using the space. In care environments, that was predominantly the case. Over the years, I have witnessed and experienced positive changes in the mental and emotional health of a wide range of people through engagement with nature and the outdoors. There is an ethical imperative, that people have a birth-right to receive healing from nature and not be deprived of it.

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Creating a Space to Reflect, Heal, and Remember

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by Valerie Bassett, ASLA

Park visitors using musical instruments
image: Valerie Bassett

The Quinterra Legacy Garden

Seven years after five university students were killed at a house party in Calgary, Alberta, a memorial park designed to honor them opened recently in the local South Glenmore Park. The design of the area, now known as the Quinterra Legacy Garden, was informed by sensitivities surrounding the planning process and shaped by the steps taken to support the families’ design vision for the creation of the park.

The tragedy happened in April 2014 on “Bermuda Shorts Day,” a time which used to be a celebration of the end of the university school year. After several years of mourning, in 2019, we were contacted by the Quinterra Group, set up by family and friends of those lost, to meet with them to understand their aspirations.

In short, the Group’s vision was for a peaceful, contemplative, and vibrant outdoor community space for people to be inspired, to heal, and to connect with nature. They also wanted it to be a special place to celebrate the students’ lives and bring a positive light to the tragedy. With each of the students being known for their love of music, art, and the community, this had to be at the core of the legacy garden.

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Icons of Healthcare & Therapeutic Garden Design Interview Series: Daniel Winterbottom, FASLA

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by Shan Jiang, PhD, International ASLA, and Melody Tapia

Children's garden play space
The Seattle Children’s PlayGarden / image: courtesy of Daniel Winterbottom

An Interview with Daniel Winterbottom, RLA, FASLA, Professor of Landscape Architecture at the University of Washington and Founder of Winterbottom Design Inc., Seattle, WA

The Healthcare and Therapeutic Design Professional Practice Network (PPN) is honored to present this interview with Daniel Winterbottom, RLA, FASLA, one of the most respected educators, designers, and influencers in the field of therapeutic gardens and participatory design-build. He has been published widely in Northwest Public Health, Places, the New York Times, Seattle Times, and Landscape Architecture Magazine. He is the author of two books—Wood in the Landscape (2000) and Design-Build (2020)—and he has also co-authored the award-winning book Therapeutic Gardens: Design for Healing Spaces.

When did you start your work in the field of therapeutic landscapes and what inspires you to do this type of work?

I guess what inspired me goes back to 1991, and a little before that. I was a bit challenged, in hindsight, with depression, and did not know it at the time, and, unfortunately, began to self-medicate. To come out of that, I spent a lot of time in nature; it was something that helped me evolve and come back from where I was. But more significant was the diagnosis of my mother with ovarian cancer. I spent a lot of time in hospitals, and it was at the time almost identical to Roger’s study (Roger Ulrich, 1986) that we were in the room when she pointed at a tree. She talked a lot about the tree; it was the only tree and was the only piece of nature in the view. I realized that she just clung to it—a totem of reality that you can attach to because the rest of reality was so oppressive. Almost at the same time, I entered into the landscape architecture profession. And because of the social convictions stemming back to the 60s and 70s, it all came together with me that there was an opportunity to explore this area, so I sought out working with marginalized populations.

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An Interview with David Kamp, FASLA: The Els for Autism Sensory Arts Garden

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by Amy Wagenfeld, PhD, OTR/L, SCEM, FAOTA, Affil. ASLA

Els for Autism Sensory Arts Garden
Els for Autism Sensory Arts Garden. A spacious curved trellis serves as a welcoming transition from the elementary school to the garden. The adjacent activity space, an oval “lawn” of resilient paving, features a variety of fixed and movable seating choices. / image: Robin Hill (c)

An Interview with David Kamp, FASLA, LF, NA, Founding Partner of Dirtworks Landscape Architecture, PC

The Children’s Outdoor Environments Professional Practice Network (PPN) is honored to share the second part of my interview with David Kamp, FASLA, whose influential work is held in the highest esteem in the design, planning, and environmental psychology community. (Please see the first installment, covering what shaped David’s design philosophy, here.)

Representative Projects

Your portfolio of projects is amazing. Could you share your thoughts about several that provided you the foundation to design the Els for Autism Sensory Arts Garden?

I realize that much of what I have shared with you deals with health. Building health through a stronger connection with nature, which strengthens connections to ourselves, our communities, and the larger world, is the foundation to all our projects. That includes our work with children—whether it is designing a universal access trail system for an environmental education center, dealing with the trauma of neo-natal intensive care for parents and well siblings, a public garden that engages everyone regardless of age or condition, or an international campus that welcomes children from a dozen different cultures. All of these perspectives deal with celebrating the wonder and delight of nature and using that resonating “connectiveness” to open up new worlds for kids to explore. Receiving the commission for the Els for Autism Sensory Arts Garden, we had a rich and nuanced perspective to draw upon for the collaboration.

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An Interview with David Kamp, FASLA

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by Amy Wagenfeld, PhD, OTR/L, SCEM, FAOTA, Affil. ASLA

Sensory Arts Garden
Within a lush and safe setting, the Sensory Arts Garden fosters curiosity and meaningful interactions and is welcoming to all regardless of ability. / image: Robin Hill (c)

An Interview with David Kamp, FASLA, LF, NA, Founding Partner of Dirtworks Landscape Architecture, PC

I am delighted to share the first of a two-part interview I had with landscape architect David Kamp, FASLA. Having followed his innovative and influential work with great interest for many years, I was fortunate to have worked with David and his team at Dirtworks to design the Els for Autism Sensory Arts Garden, located in Jupiter, Florida. It remains one of my favorite and most meaningful projects, one that truly meets the needs of children and adults with autism. We will talk about the Els for Autism Sensory Arts Garden in the second part of the interview, to be published here on The Field next week. For now, please enjoy learning about what shaped David’s design philosophy.

Personal History

Please tell us about your firm, when it was founded, and what your vision was.

Early in my career, as one of the designers for Australia’s Parliament House, I saw how design could express a sense of identity both personal and national—and do it at vastly different scales. Working for landscape architect Peter Rolland, FASLA, and a design team headed by Mitchell Giurgola Thorp Architects, the design for Parliament House drew upon an important historic concept whereby the city used its natural topography as a major organizing device. The design made little distinction between architecture and landscape. It is a triumph of the planner’s art, merging built form with landform in a way that is at once natural and monumental, seeking a balance with the existing landscape and morphology of the city.

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An Interview with Virginia Burt, FCSLA, FASLA

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by Siyi He, Associate ASLA, and Lisa Bailey, ASLA

Virginia Burt on site at a residential project by Virginia Burt Designs in Shaker Heights, OH. / image: © 2015 Richard Mandelkorn

Virginia Burt, FCSLA, FASLA, creates landscapes and gardens of meaning for residential clients, healthcare facilities, and academic and governmental organizations. For more than 30 years, Virginia’s design philosophy has reflected these roots, enabling her to create gardens and landscapes that reveal their natural context and sensitively reflect and support those who use them.

Virginia’s international work has been widely recognized. These awards include CSLA National Awards in 2015, 2016, 2017 (two), 2018, and 2019; awards from the Ohio Chapter of ASLA in 2006, 2012, 2015, 2016, 2017, 2018, and 2019; a National ASLA Award of Merit in 1999; and a Palladio Award in 2014. Virginia is one of seven women in the world honored to be designated a Fellow of both the Canadian Society of Landscape Architects and the American Society of Landscape Architects.

The following interview with Virginia Burt was conducted and edited by Lisa Bailey, ASLA, and Siyi He, Associate ASLA.

ASLA’s Healthcare & Therapeutic Design Professional Practice Network (PPN) also invites you to continue this conversation with Virginia on Thursday, July 16, 2:00-3:00 p.m. (Eastern). (The recording is now available.)

What inspires you to do this work?

I grew up on an apple farm, and being this close to nature literally wove and wrote it into my DNA. It is such a blessing.

I learned something from having watched plants blossom, literally blossom to fruit, and then being able to eat that fruit. You realize that something out there is greater than we are. So for me there is a richness, and I would say a spirituality, that infuses my world.

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Healing from Harvest: Community Gardens as Healing Gardens

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by Siyi He, Associate ASLA

Harvest celery, rainbow chard, and ginger. / image: Siyi He

Every spring in early April, some residents who live in the South End neighborhood of Boston go to Berkeley Garden to sow seeds on a plot they rent. They expect to harvest some greens, such as peas, broccoli, yin tsai, taro, or bitter melon, in the later days of summer. As one of the largest community gardens in the city, this forty-year-old garden, as well as so many other community gardens in the city, brings the joy and healing of harvest to people.

Living in an urban area isolates people from nature. We rarely get to smell or touch the texture of the soil. Getting vegetables from the grocery store is the easiest and most convenient way for us, leading to city dwellers who would never know where those vegetables come from or when would be the best time to plant certain vegetables. Not to mention, every city has food deserts. Vulnerable people, such as lower income residents, might have a difficult time obtaining healthy foods grown without pesticides. A community garden could help people to add organic vegetables to their diet in an affordable way.

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Therapeutic Garden Design in Chile

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by Kat Shiffler, Student ASLA

Watercolor sketch of a hospital's therapeutic garden
The Jacarandá Garden at San Borja Arriarán, a public hospital in Santiago. / image: Kat Shiffler

I was drawn to landscape architecture out of a specific desire to create healthcare environments that help people heal. As I finish my second year of graduate school at the University of Michigan, I find myself working from an improvised home office instead of the design studio. My desk looks out upon a modest park, where I see record numbers of people walking, running, and sitting—absorbing the benefits of urban greenspace in these anxious times. Today, the universal importance of therapeutic design is thrown into high relief as the whole world is transformed into one big waiting room.

In December, I traveled to Chile to check out some inspirational healthcare gardens and meet with staff from Fundación Cosmos, a Santiago-based NGO that focuses on the ecological and socially sustainable development of parks. I interviewed the foundation’s principals on their work, philosophy, and the state of the landscape architecture profession in Chile, and am sharing the conversation, with my translation into English, here on The Field.

What inspires you to do this work?

We are inspired to live in harmony with the environment, conscious of our interdependence with all living beings and our responsibility for the protection of ecological integrity which sustains life on earth. This is our vision as a foundation.

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Icons of Healthcare & Therapeutic Garden Design: Julie Moir Messervy, Part 2

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by Lisa Bailey, ASLA

The Toronto Music Garden
The Toronto Music Garden / image: Virginia Weiler

Healthcare & Therapeutic Garden Design Interview Series: Julie Moir Messervy

The first part of this interview with Julie Moir Messervy, owner of Julie Moir Messervy Design Studio (JMMDS), covered inspiration and the creative process. This week in part 2, the conversation continues with questions on marketing, post-occupancy research, maintenance, and challenges encountered.

How do you market your firm?

We don’t market except through our blogs and newsletters. I used to do a lot of lecturing, and I still do some, but I’ve been very busy lately. I learned from a marketing course that all of my books are marketing devices, but I never did them for that reason; I did them because I had something to say.

We’re lucky to have great projects come to us through word of mouth. The American Public Gardens Association has been a wonderful source of botanical garden work. We love designing for cemeteries, which are very spiritual and the most important healing gardens of all. You really have to get the details right there. When somebody you love dies, you grasp how important that work is. To make a place that feels comfortable, and yet a little bit transcendent—it’s one of my favorite challenges.

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Icons of Healthcare & Therapeutic Garden Design: Julie Moir Messervy, Part 1

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by Lisa Bailey, ASLA

Edinburgh residence garden
Edinburgh residence by JMMDS / image: photograph by Angus Bremner©

Healthcare & Therapeutic Garden Design Interview Series: Julie Moir Messervy

Julie Moir Messervy, owner of Julie Moir Messervy Design Studio (JMMDS), inspired me when I first heard her speak 20 years ago. Her unique way of thinking about design, her deep grasp of psychology, emotions and the invisible realm of spirit, and the subconscious impact of landscape archetypes on us resonated with me. I admire the contributions she has made through her books (Contemplative Garden, The Inward Garden, The Magic Land, Outside the Not So Big House, Home Outside, Landscaping Ideas that Work), lectures, projects, and now with the Home Outside app her firm has created. She has designed meaningful places for healing and for getting in touch with heart and spirit in cemeteries, memorials, arboretums, parks, schools, and homes. Landscape designs that do that are healthcare settings!

The following is an edited interview with Julie Moir Messervy, landscape designer, author, and speaker based in Bellows Falls, VT. The interview was conducted this spring by Lisa Bailey, ASLA, sole proprietor of BayLeaf Studio in Berkeley, CA, and a consultant with Schwartz and Associates, a landscape design firm in Mill Valley, CA.

What inspires you to do this work?

I was inspired by being a child playing in nature. I am one of seven children and found some away time, as well as solace and delight, in the fields, woods, and orchards around our house. Exploring nature has always been an important part of my life.

My favorite question that I’ve always asked my clients is, “Where did you go as a child for daydreaming, reverie, and reflection?” Not only do most people recall their love of nature, but they recognize their deep love and longing for the places in nature they played in. It’s not always an outdoor space; it could be a city library, under the piano, or in their bed. People want a place like that, not necessarily literally similar, but that recreates the feelings of security, wonder, and creativity. Having a contemplative place in your life—a place to remember and reconnect with the spirit—is a real source of healing.

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Healing Landscapes Design Practice

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Master plan for Hengqin Hospital Healing Garden, Zhuhai, China
Master plan for Hengqin Hospital Healing Garden, Zhuhai, China / image: Adam E. Anderson

Healthcare & Therapeutic Garden Design Interview Series: Adam E. Anderson

Adam E. Anderson, ASLA, was one of the speakers for the 2018 Healthcare and Therapeutic Design Professional Practice Network (PPN) Meeting at the ASLA Annual Meeting and EXPO. He is a registered landscape architect and the Founder/Director of Design Under Sky. He also runs the Landscape Architecture Department at Payette Architects. His projects are incredibly diverse, including but not limited to hospital healing gardens, residential gardens, master planning, campus plazas, rooftop gardens, and urban parks, as well as commissioned public art works.

His work interacts with the ever-changing landscape by ascertaining the unique phenomenological qualities and cultural influences inherent in a site, and then deploying interventions to embrace, reveal, and often embellish these qualities. “Nature” is abstracted in his projects, and he engages technological and ecological aspects of a site to create a celebration of nature and a sense of wonder.

Adam is currently working on projects at Lafayette College in Pennsylvania and the 43-acre site of 5th Xiangya Hospital in China. He recently received a Rhode Island Council of the Arts Project Grant and has been appointed to the Rhode Island Scenic Roadways Board by the Governor of Rhode Island. He has taught at RISD since 2014 and has been a visiting critic at the Harvard Graduate School of Design, Ohio State University, Northeastern University, and the Boston Architectural College.

The following interview was conducted by Siyi He, Associate ASLA, Chair of the Healthcare and Therapeutic Design Professional Practice Network (PPN).

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Nature, Healing, and Creativity

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by Siyi He, Associate ASLA

The 2018 ASLA Healthcare and Therapeutic Design PPN Meeting
The 2018 ASLA Healthcare and Therapeutic Design PPN Meeting / image: Siyi He

Therapeutic Landscape Design Practice in the United States and Overseas: A Recap of the 2018 ASLA Annual Meeting’s Healthcare and Therapeutic Design PPN Meeting

Landscape architects and designers know that nature has powerful potential to heal people’s bodies, minds, and spirits. Therapeutic garden design in healthcare facilities is creating functional spaces where people can access the healing power of nature in hospitals. The 2018 ASLA Annual Meeting’s Healthcare and Therapeutic Design Professional Practice Network (PPN) Meeting was held in Philadelphia on October 20 to discuss the topic of nature, healing, and creativity in healing garden design. The meeting was hosted by PPN Co-Chair Siyi He, Associate ASLA, and began with a description of PPN’s mission and the introduction of two invited landscape architect speakers, Geoff Anderson, ASLA, and Adam E. Anderson, ASLA. PPN Officer and Past Co-Chair Melody Tapia, Student ASLA, made the closing statement for the meeting. Melody and Siyi enthusiastically introduced the PPN leadership team and encouraged attendees to join our PPN. (Four of the attendees signed up for the leadership team right there! All ASLA members are welcome to get involved.)

The panelists, along with 40 attendees, discussed landscape design and features in healing gardens and the different restrictions for therapeutic design in the United States and overseas.

Our panelists were:

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Therapeutic Gardening for an Adult Inpatient Psychiatric Unit

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by Nancy Wicks, OTR/L

image: Nancy Wicks

Two days before the start of the 2017 ASLA Annual Meeting and EXPO, Nancy Wicks, OTR/L, an occupational therapist at the Resnick Neuropsychiatric Hospital at the University of California Los Angeles, hosted Amy Wagenfeld, PhD, OTR/L, SCEM, FAOTA, Affiliate ASLA, and Melody Tapia, Student ASLA, then a landscape architect student at the University of Massachusetts Amherst. The goal of the visit: to participate in a therapeutic garden group with patients on the adult inpatient unit.

The therapeutic garden group takes place each week on the adult inpatient psychiatric unit. It is an integral part of programming for acutely ill patients in recovery from a range of psychiatric diagnoses including schizophrenia, depression, bipolar disorder, and anxiety.

The program was started as a quality improvement project through the 4 East Unit Practice Council, which is multidisciplinary (Nurses, Occupational Therapists, Social Workers) using a quality improvement methodology called A4 Lean, which is one of the quality improvement tools used at UCLA. This methodology gives clinicians a structure to assess the current state of service provision and then implement changes.

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Icons of Healthcare & Therapeutic Garden Design: Clare Cooper Marcus

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by Lisa Bailey, ASLA

A healing garden should be: visible and easily accessed from the main foyer, predominantly green, and should have a path that tempts you to explore and semi-private seating niches off to the side. St Joseph Memorial Hospital, Santa Rosa, CA / image: Clare Cooper Marcus

Healthcare & Therapeutic Garden Design Interview Series: Clare Cooper Marcus

Clare Cooper Marcus, Professor Emerita at the University of California, Berkeley, in the College of Environmental Design’s Departments of Architecture and Landscape Architecture, has studied and been the grand champion for healthcare and therapeutic gardens since the time of her retirement from UC Berkeley in the 1990s. She taught for 24 years and authored several books, including Healing Gardens: Therapeutic Benefits and Design Recommendations, co-authored with Marni Barnes in 1999, and Therapeutic Landscapes: An Evidence-Based Approach to Designing Healing Gardens and Restorative Outdoor Spaces, co-authored with Naomi Sachs, ASLA, in 2013. Though not a landscape architect, Clare’s interest is in the social aspect of design and in what the people who are using designed spaces think and feel about them. She combines this background with her passion for gardening in her own backyard.

The following interview was conducted at Clare’s home and garden in Berkeley by Lisa Bailey, ASLA, sole proprietor of BayLeaf Studio and a consultant with Schwartz and Associates, a landscape design-build firm in Mill Valley, CA.

How did you become THE person who studied healing gardens?

Well, of course the person who started it all was Roger Ulrich with his famous study, “View through a window may influence recovery from surgery.” Roger is a good friend and colleague and I was inspired by his work. Then Marni Barnes and I conducted the first (I think) post-occupancy evaluations (POEs) of hospital gardens.

I was further motivated when, a few months after retirement, I was diagnosed with cancer. I was treated at the Kaiser Permanente Walnut Creek Medical Center where there is a green space in the center with three ancient 150-year-old Valley Oak trees protected by law. That became an oasis for me during treatment. When people came to visit me, we would walk through the green space on balmy evenings in the summer. It was doubly important to me to have green space when dealing with the stress of a life-threatening illness. It had a very personal meaning.

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The Children’s Outdoor Environments and Healthcare & Therapeutic Design Meeting in Review

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Joanne Hiromura, ASLA, presents during the joint meeting of the Children’s Outdoor Environments and Healthcare & Therapeutic Design PPNs that took place during the ASLA Annual Meeting and EXPO in Los Angeles last month. / image: Alexandra Hay

The 2017 ASLA Children’s Outdoor Environments Professional Practice Network (COE PPN) meeting took place with a new twist this year. Recognizing a synergy between PPNs, we held a joint meeting with our colleagues from the Healthcare & Therapeutic Design (HTD) PPN on Saturday afternoon during the ASLA Annual Meeting and EXPO in Los Angeles last month. If attendance is an indicator, this new direction was a positive one—an unofficial count of 73 makes it the biggest PPN meeting of the conference. For those of you who attended in person, we thank you for coming!

The meeting began with short summaries of the past year from leadership of both the COE and HTD PPNs. Amy Wagenfeld, Affiliate ASLA, PhD, OTR/L, SCEM, FAOTA, transitioned from current to past co-chair, with Ken Hurst, PhD, MLA, RLA, ASLA, CLARB, CPSI, stepping into the co-chair role with Brenna Castro, PLA, ASLA, CPSI. Amy, along with Chad Kennedy, PLA, ASLA, CPSI, LEED AP BD+C, will be serving as communications co-directors for the PPN. Over the past year, we have continued to be busy. The COE PPN logged nine blog posts for The Field, hosted three Online Learning webinars (one jointly with the HTD PPN), and have averaged three new posts per month for the PPN LinkedIn group. And, Ken Hurst was a mentor for one of the Student & Emerging Professionals SPOTLIGHT presentations that took place this summer.

While we are busily organizing several great webinars and Field posts for the upcoming year, we extend an open invitation for you to consider sharing your knowledge by presenting a webinar or writing a blog post (or several!).

Following these PPN updates, Joanne Hiromura, ASLA, RLA, Director of Landscape and Outdoor Playspace Design at studioMLA Architects in Brookline, MA, and Naomi Sachs, PhD, ASLA, EDAC, Postdoctoral Associate in the Department of Design and Environmental Analysis in the College of Human Ecology at Cornell University, provided keynote presentations.

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The Healing Garden at Piedmont Regional Medical Center

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The Labyrinth / image: Marguerite Koepke

Healthcare & Therapeutic Garden Design Interview Series: Joel Siebentritt, Director of the Loran Smith Center for Cancer Support, part of Piedmont Athens Regional Medical Center, Athens, GA

The need for cancer support and patient services was first envisioned by a very special group of nurses, caregivers, and cancer survivors in the mid- to late 1990s. They used their understanding of not only medicine but also complementary therapies to begin planning a physical facility to serve these needs. At first, the Loran Smith Center for Cancer Support was conceived mainly as a building but soon the planning grew into a more holistic idea of not only a structure but a building surrounded by nature and naturalistic gardens. Since its inception, the Center has grown from an idea and an unused piece of property on the edge of the hospital campus into a vital center of support for patients, caregivers, and family member. The healing garden is an important and integral part of the Center’s mission and is designed to serve the hospital, its caregivers, patients and their families, as well as the broader Athens community.

Joel Siebentritt, the Center’s director, is a passionate supporter of the garden and driving force behind getting the garden built, funded, and perhaps most importantly, programmed for important uses and functions. He loves nature and every day can see from his office window people who are using, enjoying, and benefiting from their interactions there. The following is an interview with Joel that delves more deeply into his connections to the garden and the garden’s history and purpose.

The following interview with Joel Siebentritt, Director of the Loran Smith Center for Cancer Support, was conducted by Marguerite Koepke, RLA, ASLA, professor emeritus, College of Environment + Design, University of Georgia.

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Icons of Healthcare & Therapeutic Garden Design: Leah Diehl

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The Greenhouse at Wilmot Gardens, which houses the Therapeutic Horticulture Program image: Leah Diehl
The Greenhouse at Wilmot Gardens, which houses the Therapeutic Horticulture Program
image: Leah Diehl

Healthcare & Therapeutic Garden Design Interview Series: Elizabeth “Leah” Diehl, RLA, HTM

Our second in the series of interviews takes us to the College of Medicine Healing Gardens and Teaching Laboratory at the University of Florida Medical School. Leah Diehl is a landscape architect and registered horticultural therapist who is responsible for building an amazing series of programs at Wilmot Gardens at the University of Florida.

Wilmot Gardens, on the University of Florida campus, is located in the heart of the Southeast’s largest academic health center. The gardens are dedicated to advancing patient care, research, and service through its vibrant and growing therapeutic horticulture program. The Therapeutic Horticulture Program at Wilmot Gardens resides at the core of the garden’s mission to improve lives through gardening.

As a side note, the gardens are open to the public year-round and boast an unrivaled collection of camellias in North Central Florida. Wilmot Gardens is named for Royal James Wilmot, who was a horticulturist with the Agricultural Experiment Station at UF in the 1940s. He founded the American Camellia Society in Gainesville.

Throughout these interviews, we are reaching out to landscape architects who have been instrumental in leading the design and development of Healthcare and Therapeutic Gardens. We would like people to know more about the leaders in the field of Healthcare and Therapeutic Garden design in order to illustrate the greater relevance of this field.

The following interview with Leah was conducted by Jack Carman, FASLA, past chair and current officer of the Healthcare & Therapeutic Design Professional Practice Network (PPN). Leah was reached by phone between therapeutic horticulture sessions.

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Icons of Healthcare & Therapeutic Garden Design

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Anne's Garden, Northeast Georgia Medical Center, Gainesville, Georgia image: © The Fockele Garden Company / courtesy of Naomi Sachs
Anne’s Garden, Northeast Georgia Medical Center, Gainesville, Georgia
image: © The Fockele Garden Company / courtesy of Naomi Sachs

Healthcare & Therapeutic Garden Design Interview Series: Naomi Sachs, ASLA

In starting this series, we are reaching out to landscape architects who have been instrumental in leading the design and development of Healthcare and Therapeutic Gardens. We want readers to get to know the leaders in this field, and also see the relevance of therapeutic design and its connections to other practice areas. The aim of this interview series is to tell the story, through firsthand accounts from key individuals, of recent developments and innovations in healthcare and therapeutic design. With input from a range of professionals, we hope to create a better picture of what landscape architects in therapeutic design are working on, and also get to know the people behind the projects that are being done.

One of the first people we have spoken with is Naomi Sachs, ASLA. Naomi has her Masters from UC Berkeley in Landscape Architecture and is currently pursuing her PhD in Architecture at Texas A&M University in College Station, TX. She has been a tireless advocate for the recognition of the importance of our connection to nature and the benefits that are derived from this interaction. Naomi may be most widely known from her work in developing the Therapeutic Landscapes Network, a tremendous resource for information related to the field of healthcare gardens and landscapes for health. Naomi’s most recent venture has been the publication of the book Therapeutic Landscapes: An Evidence-Based Approach to Designing Healing Gardens and Restorative Outdoor Spaces with Clare Cooper Marcus. (Further information on Naomi’s background can be found at www.naomisachsdesign.com).

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Your Brain on Water

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Reflection on water at the Chicago Botanic Garden image: Jack Carman
Reflection on water at the Chicago Botanic Garden
image: Jack Carman

Blue Mind: The Surprising Science That Shows How Being Near, In, On, or Under Water Can Make You Happier, Healthier, More Connected, and Better at What You Do
Wallace J. Nichols
2015

When I heard writer and sea turtle expert Wallace J. Nichols speak in Sausalito last summer, I was delighted by how much of what he said resembled the science behind why nature is good for our health and well-being. He quoted much of the same research we landscape architects do when promoting healthcare and therapeutic gardens. I knew I had to read his book, and I was amazed by the range of information that he brings together as both a scientist and an unabashed ocean lover in his book Blue Mind.

Blue Mind is an enjoyable read about the numinous experience of water, coupled with an urgent message to wake up to what is ‘hidden in plain sight’ in the hopes that we humans can transform the way we treat our planet’s resources. Nichols shares a strong emotional connection to this liquid element, as do many people who are willing to pay a lot of money to travel to beautiful beaches for vacations and spend top dollar for the house with a view of the water. For those of us who are curious to know what’s up with that from a scientific evidence point of view, this book explains the psychology and physiology of why we want and need the benefits associated with spending time in the presence of water.

In Blue Mind, Nichols makes an appeal to a broad range of people who might not feel convinced that emotion alone is a serious enough reason to cherish and protect this basic resource. He demonstrates the phenomenon of how people are attracted to water with cultural data, and how we are physically wired to benefit from the symbolism, physicality, color, sound, and essence of water as we encounter it in the environment, citing recent neuroscience studies and plenty of footnotes to point the reader to explore the topic further. Be prepared to dive deep from the comfort of your reading chair.

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Healthcare & Therapeutic Design in Chicago

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The Crown Sky Garden, at the Ann & Robert H. Lurie Children's Hospital of Chicago, designed by Mikyoung Kim Design image: Marni Barnes
The Crown Sky Garden, at the Ann & Robert H. Lurie Children’s Hospital of Chicago, designed by Mikyoung Kim Design
image: Marni Barnes

If you are considering attending the 2015 ASLA Annual Meeting and EXPO in Chicago this November, you have until June 19 to register at the early bird rate. You know you want to go, so register now so you don’t have to pay more money (like I did last year :-/ ).

Here are a few sessions on topics that might influence your decision:

Chicago’s Therapeutic Healing Spaces
Friday, November 6, 8:30 AM – 12:30 PM

Urban Green Space and Mental Well-being: Evidence-Based Design
Friday, November 6, 10:30 AM – 12:00 PM

Designing Incentives for Health
Saturday, November 7, 11:00 AM – 12:30 PM

Evidence-based Design: Sensory Play Gardens and Children with Developmental Disorders
Sunday, November 8, 11:00 AM – 12:30 PM

Healthcare and Therapeutic Design PPN Meeting
Sunday, November 8, 12:45 PM – 2:15 PM

An Integrated Interdisciplinary Approach to Therapeutic Design
Monday, November 9, 3:30 PM – 5:00 PM

Fortunately, these sessions were scheduled with no overlaps, so you could attend them all! Unfortunately, there are other related topics that also look enticing, some of which do overlap, that you may want to consider.

I’ve listed several sessions of interest, as well as more information on the above sessions, below, complete with times, descriptions, and speakers. See the Annual Meeting website for more information on the more than 130 education sessions, field sessions, workshops, and general sessions that will be offered throughout the meeting.

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The Future of Aging

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Russian River and Ocean 12x4 image: Annette Heacox
Russian River and Ocean 12×4
image: Annette Heacox

“The young and even the middle-aged can’t truly appreciate what it is to be old.” (-) “The sheer aloneness and inescapability of it. A different shore. You have gone somewhere and you aren’t coming back.” 

Why do we run away from aging in our current society? Aging is an unavoidable reality. Regardless of what we do to our bodies and minds, we age. But can racing against aging become embracing our golden years?

In this admittedly non-academic post, I share hopes and fears and also my research on the topic of aging. A few years ago, I wrote a questionnaire targeting the elderly population. Aging should concern us all, and we urgently need new attitudes and answers.

I want to challenge that vision of running away from aging. I’ll brainstorm some answers and propose new ideas partially based on the questionnaire I addressed to seniors. We are tomorrow’s elderly; there is always hope.

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Healing Gardens as Transformative Spaces

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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

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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

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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

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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’

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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 Healthcare – Healthcare Design, July 2013
Written by Angela Loder and Jerry Smith

by Jerry Smith, FASLA

Dementia Green Care Handbook

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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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