Healthcare Design - May 2014 - 70

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Movable seating is important for all age and patient groups, to give people (albeit subconsciously)
a sense of control. For the frail elderly, such seating
must have a back and arms for comfort, be light
enough to move, but also be firm enough to remain
stable when a person presses the arms to get up.
The Adirondack chair, popular in many gardens
settings, is unsuitable for the seating posture of an
older person and can be hard to get out of. Features that reflect light, such as untinted concrete
and white or aluminum garden furniture, should be
avoided since aging eyes have trouble adapting
to glare. Additionally, to allow people to adjust to
changes in light, and to enable people to be outside even in bad weather or when they are weak,
the garden entry should be covered or offer filtered
shade as well as places to sit. Since many older
people develop cataracts, plants with flowers that
have deeply saturated blooms (red, yellow, orange,
white) should be selected rather than those in the
blue-mauve-purple range (which will appear to be
gray). Very elderly people move slowly and may
have developed a slightly stooped posture, so it's
important to provide a variety of planting-in terms
of color, texture, and visual detail-at or below eye
level. No one wants to take a walk at a slow pace
staring down at the edges of a lawn.
Dementia patients
The onset of Alzheimer's disease and other forms
of dementia makes a person particularly vulnerable to an environment that hasn't been designed
for his or her specific needs. All of the design
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HCDmagazine.com 06.14

requirements of a garden for the frail elderly pertain
to this group, plus a few others. As spatial cognition
declines, people lose the ability to retain a "mental
map" of even a familiar environment. There needs
to be one entry to the garden and a simple looped
or figure-eight path circling the garden, which leads
people back to the entry. A fork in the path or a
junction that requires the garden user to turn left
or right can bring about an agony of indecision,
or even agitation and anger. In late stages of the
disease, people can regress to putting inappropriate things into their mouths, such as the leaves or
flowers of plants. All plant material therefore must
be nontoxic. It's remarkable how many commonly
used plants-such as azaleas, oleander, wisteria,
daffodils, bleeding hearts, and hydrangea-have
toxic elements.

Top: Comfortable, movable
furniture allows people to
choose where to sit, what to
look at, and whether to be in
the sun or the shade at Don
Allen Memorial Garden at Sharp
Mesa Vista Hospital in San
Diego, designed by Schmidt
Design Group. Above: An
attractive garden that offers a
variety of places to walk and sit
encourages patients to exercise
and spend time outdoors at
The Graham Garden at Saanich
Community Hospital in Victoria,
British Columbia, Canada,
designed by Deborah Lefrank
and Associates.

NAOMI SACHS (GRAHAM GARDEN); CLARE COOPER MARCUS (DON ALLEN)

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Healthcare Design - May 2014

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