Healthcare Design - May 2014 - 72

AL REP
O

A view of nature, as seen at
the Hulda B. and Maurice L.
Rothschild Enabling Garden at
Levy Senior Center in Evanston,
Ill., designed by Garth Wemmer,
Ted Wolff, and Joanne Westphall,
can provide a restorative
experience for those inside.

ARCH

Although people with dementia lose short-term
memory and may forget what they did an hour ago,
they often retain long-term memory, and the part of
the brain that registers emotion remains viable long
after other parts have declined. Designing gardens
for those with dementia therefore calls for places to
enjoy simple pleasures: gardening, watching birds at
a feeder, and sitting in a beautiful setting which may
include plants, flowers, and cultural artifacts reminiscent of earlier years.
Mental and behavioral health
Garden design for mental and behavioral health
patients is a challenge because of the wide demographic range, type of disorder, and course of
treatment. As with the frail elderly and people with
dementia, safety and security-both actual and
perceived-is paramount. Design must address the
possibility of attempted escape and harm of self or
others. At the same time, the space and elements
within the space (plants, seating, paving) should create a homelike, noninstitutional environment that offers a sense of freedom and control for the patients/
residents.
Shaded areas within the garden are essential,
since many psychotropic medications make people
more susceptible to glare and UV exposure. Social
support between staff and patients is an important
component of inpatient and outpatient treatment,
and the garden should provide spaces for one-onone and group interaction. Much research has linked
exercise-even mild exercise for short periods of
time-with reduced stress, depression, anxiety, and
aggression. A garden that provides walking paths

HCDmagazine.com 06.14

and open areas for group exercise offers great physical and emotional benefits. Separate outdoor spaces
for staff are encouraged for any healthcare facility, but
are even more important in settings where patients
may be dangerous. For facilities where patients or
residents spend more than a few days and may be
unable to venture outdoors, views of greenery and/
or indoor planting still allow people to connect with
nature.
The research on the health benefits of nature
contact that began more than 30 years ago has
grown and has, fortunately, become accepted by
many healthcare design practitioners and administrators. The reduced demand for "proof" that nature is
important allows us to focus on what specific design
elements best serve specific populations. The more
these elements are taken into account, the more gardens can serve as essential adjuncts to medical care,
resulting in increased staff and patient satisfaction,
shorter hospital stays for inpatients, better sleep patterns, decreased drug expenses, and fewer demands
on staff in all types of healthcare facilities, for all types
of patients and residents. HCD
Clare Cooper Marcus is professor emerita in the departments of architecture and landscape architecture at
the University of California, Berkeley. Naomi A. Sachs is
founding director of the Therapeutic Landscapes Network (www.healinglandscapes.org) and a PhD student
in architecture at Texas A&M University, focusing on
access to nature in healthcare through the Center for
Health Systems and Design. They are the authors of
Therapeutic Landscapes: An Evidence-Based Approach
to Designing Healing Gardens and Restorative Outdoor
Spaces (John Wiley and Sons, 2013).

NAOMI SACHS

LAND

URE

http://www.healinglandscapes.org http://www.HCDmagazine.com

Healthcare Design - May 2014

Table of Contents for the Digital Edition of Healthcare Design - May 2014