Therapeutic garden

A Therapeutic Garden is an outdoor garden space that has been specifically designed to meet the physical, psychological, social and spiritual needs of the people using the garden as well as their caregivers, family members and friends.

Therapeutic Gardens can be found in a variety of settings, including but not limited to hospitals, skilled nursing homes, assisted living residences, continuing care retirement communities, out-patient cancer centers, hospice residences, and other related healthcare and residential environments. The focus of the gardens is primarily on incorporating plants and friendly wildlife into the space. The settings can be designed to include active uses such as raised planters for horticultural therapy activities or programmed for passive uses such as quiet private sitting areas next to a small pond with a trickling waterfall.

Types of Therapeutic Gardens

 * Alzheimer’s Gardens: adult day care programs and dementia residences
 * Healing Gardens: acute care hospitals, skilled nursing facilities and other healthcare facilities
 * Rehabilitation Gardens: rehabilitation hospitals
 * Restorative Gardens: psychiatric hospitals
 * Senior Community Gardens: assisted living, continuing care retirement communities and other senior living residences
 * Cancer Gardens: chemotherapy facilities
 * Enabling Gardens: vocational schools, arboretum
 * Meditation Gardens: religious institutions and other faith based settings

Design
The design of a Therapeutic Garden is ideally a collaborative effort involving the people using and caring for the garden. The development of the garden is typically accomplished by a design team of landscape architects, garden designers, horticultural therapists, healthcare professionals, such as doctors, nurses, occupational therapists, recreational therapists, gerontologists and other staff members. Additional stakeholders involved may include, if appropriate, the patients or residents themselves and their respective family members and other caregivers. The design team is often led by a landscape architect or garden designer, specifically trained in the design and development of Therapeutic Gardens. It is strongly recommended horticultural therapists presence in the design process, since they are professionals specialized in the use of the gardens as a therapeutic tool, who know all the potentialities of a garden for this purpose, since it is their working tool with people with disabilities or illness.

The majority of elements in a Therapeutic Garden should be plant related, such as perennials that attract hummingbirds, shrubs that attract butterflies and water features for gold fish and Koi. Plants familiar to those using the Therapeutic Garden need to be non-toxic and non-injurious. Issues related to sustainability of the garden, such as using native plants and rain water harvesting, should also be considered in the overall design. Attracting nature, such as butterflies, gold finch and hummingbirds into the Therapeutic Garden, is important. Nature is referred to as a ‘positive distraction’ by Roger Ulrich, Ph.D. at Texas A&M University. Other considerations include providing ample shade, movable furniture, water features, smooth and level walking surfaces, and year round interest. Consideration should also be given to the maintenance and upkeep of the Therapeutic Garden as safety is an important consideration. An endowment fund can be set up for the perpetual maintenance of the Therapeutic Garden.

Elements
The elements of a Therapeutic Garden consist of the following:

Natural elements:
 * Familiar plantings
 * Plants that attract birds and butterflies
 * Ornamental trees, shrubs, perennials, and ornamental grasses
 * Non-toxic and non-injurious plantings
 * Vegetables
 * Annual plants
 * Soil
 * Sunlight and natural shade
 * Wind
 * Precipitation

Constructed garden elements:
 * Patio, courtyard
 * Paved walking pathways
 * Seating, such as tables, chairs and benches
 * Landscape lighting
 * Raised beds
 * Shade, such as gazebos, pergolas or umbrellas with tables
 * Fountain, water garden, or other water features
 * Hose bib or other water source
 * Electrical outdoor outlet; for music and related activities

Nature
Spending time outside in a garden has been shown to positively affect a person’s emotions and improve their sense of well-being. Access to nature balances circadian rhythms, lowers blood pressure, reduces stress and increases absorption of Vitamin D.  Nature has been shown to be beneficial for our overall health and well-being. We are all connected to nature and it is important to maintain this vital connection for our health and well-being, which is described in the work ‘The Biophilia Hypothesis’ by Edward O. Wilson.

Garden Programs
Healing gardens for hospitals have put a new emphasis on creating garden programs where patients can go. The programs are usually based on the discipline of Horticultural Therapy. This model takes the form of the Swedish Covenant Hospital system. Landscape artist David Kemp has a business on the East Coast of the United States designing healing gardens for hospitals.

Therapeutic Gardens in literature

 * Healing Gardens: Therapeutic Benefits and Design Recommendations
 * Healing Landscapes: Therapeutic Outdoor Environments
 * The Healing Landscape: Gardening for the Mind, Body, and Soul
 * Restorative Gardens: The Healing Landscape
 * Interaction by Design: Bringing People and Plants Together for Health and Well-Being
 * Design for Aging: Post-Occupancy Evaluations