Healthcare Design - May 2014 - 68

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Acute care hospitals
In acute care hospitals, the patient population is
incredibly varied, including people who may also be
treated at more specialized facilities. Thus, design
must accommodate a wide range of users, with the
needs of the most vulnerable patients coming first.
Patients using the garden could include a person
awaiting minor surgery; someone recovering from
a hip replacement who is urged to walk and seeks
smooth pathways with frequent places to stop and
rest; a person who has received outpatient chemotherapy and needs to recuperate-in the shade-
before driving home; or a sick child being wheeled
through a garden as respite from frightening medical
procedures.
Overarching considerations for gardens in all
healthcare facilities include safety, security, and
privacy, visual and physical accessibility to and within
the garden, physical and emotional comfort, and
proper maintenance. It should go without saying that
gardens must feel like gardens, with a high ratio of
greenery to hardscape and a great variety of vegetation appealing to all the senses. Other important
design elements include plenty of choices as to
where to walk, sit, or look at a view; places to sit with
a family group, and places to be alone; ample shade
for those who need to stay out of the sun; and walking paths of varying lengths. All of these requirements
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also apply to visitors and staff using the garden, the
latter often being the largest group present. Unless
the designer takes into account these pragmatic
needs, and avoids the temptation to push the envelope with flashy design statements, the garden may
fail to meet the needs of those it could help most.
Frail elderly
When we turn to the needs of the elderly in, say,
assisted living or skilled nursing facilities or in a
retirement community, other needs come into
play. All of the basic needs mentioned above are
relevant, but in addition, there are requirements
that pertain particularly to those whose bodies
are becoming more frail-diminished eyesight and
hearing, changing posture and gait, brittle bones,
and more. Older people are at greater risk of falling,
and many venture out less often because they're
unsteady (especially if they have already fallen).
Therefore, pathways must be smooth while at the
same time offering good traction, and must be very
well maintained, avoiding expansion joints between
concrete pavers that are wider than 1/8-inch (which
could catch a cane, crutch, or walker). As we age,
we start to lose energy, which means that places to
rest along a walking route must be located every
20 feet or so-the first one being clearly visible
from the garden entry.

A garden at memory care
facility Serenades by Sonata
in Longwood, Fla., designed
by Baker Barrios, is easily
accessible from several
different segments of the
campus.

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Healthcare Design - May 2014

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