Therapeutic and healing gardens are being implemented in various healthcare settings to the benefit of patients.
Hospital design in particular has taken a patient-centered approach of late, utilising the power of nature to improve health outcomes and helps decrease the length of in-patient stays.
A 2012 study on Therapeutic Gardens by Sara Holowitz, PhD found that “therapeutic and healing gardens represent an aesthetically pleasing, stress-reducing, cost effective CAM (complimentary and alternative medicine) modality.”
The idea that nature has a restorative effect on humans is a not a new concept. Psychoanalyst Erich Fromm coined the theory behind the biophilia hypothesis – a theory that suggests there is an innate bond between humans and nature, and the concept was later popularised by Edward O. Wilson in his book, Biophilia (1984), in which Wilson defined the theory as “the urge to affiliate with other forms of life”.
In a healthcare setting, healing gardens are generally considered a sub category to therapeutic gardens, but can differ slightly in terms of execution.
Healing gardens are designed to be passive and offer an environment that supports everyone, including patients, staff and visitors. The design primarily features green vegetation and water elements but is generally free of sculptures or man-made structures in order to be as calming as possible.
Therapeutic gardens on the other hand are targeted toward specific patient conditions that engage individuals and support recovery through definite landscape design. This could include spaces through which people can engage in activities such as walking or gardening on raised garden beds or the design could call for a purely passive environment.
This type of garden is generally found in a variety of healthcare settings such as hospitals, rehabilitation centres, senior villages or chemotherapy facilities.
Both garden forms can offer an array of psychological, social and physical benefits by positively distracting patients outside their hospital rooms.
A 2010 report entitled Beyond Blue To Green: The benefits of contact with nature for mental health and well-being by Deakin University Australia cited research by Clare Cooper-Marcus and Marni Barnes (1999), who said such gardens “are defined as natural spaces where opportunities are provided for relief from physical symptoms, for stress reduction, and for improvements in one’s sense of well-being through activities such as observation, listening, strolling, sitting and exploring the natural space.”
According to Dr. Roger S. Ulrich of Texas A&M University, laboratory research revealed that "visual exposure to settings with trees has produced significant recovery from stress within five minutes, as indicated by changes in blood pressure and muscle tension."
When it comes to designing a healing garden there are multiple considerations to consider beyond “greening” the environment. Appropriate way finding is essential for patients along with ample wheelchair access, suitable seating and non-obtrusive navigation.
Healing gardens can be structured or unstructured, but vegetation should be at the core of the design and “hard-landscaping” should be avoided wherever possible. In the case of fauna birdbaths, water features that provide the soothing sound of water or flowers and plants that attract birds or butterflies are also therapeutic for patients.
Therapeutic gardens will offer similar landscape design to their healing counterparts, but may also have more defined perimeters. Spaces are generally designed for specific patient conditions and can include scheduled activities such as horticultural therapy (humans engaged in plant-based activities such as gardening).
For example, Dementia Care Australia participates in horticultural therapy utilising raised garden beds, light hand tools and activities such as potting and planting for patients.
Horticultural therapy has also been found to beneficial for the ageing population and patients suffering mental illness due to its ability to provide sensory simulation.
When designing either type of garden in an urban healthcare setting, location is essential to minimise noise such as the sound of air conditioners, surrounding noise or traffic.
Finally, it’s all about the colour green. In colour therapy, green is seen as a healing colour as it reflects many elements in nature and earth. It has both energising and calming effects that directly contribute to the well-being of those in its presence.
In Australia, many hospitals are recognising gardens for their healing benefits and implementing vegetation where possible in design that puts patients first.
The award-winning Melbourne’s Royal Children’s Hospital (RCH) building, which opened in 2011, features many gardens, playgrounds and landscaped areas.
Designed by Billard Leece and Bates Smart architects, the gardens were inspired by the hospitals parkland setting as the architects set out to create outdoor spaces that offered engagement, seating and “sweeping lawn areas.”
Other redevelopment projects across Australia, including Epworth HealthCare Hospital in Melbourne and the new Royal Adelaide Hospital, have also placed gardens and open spaces at the forefront of their design in a bid to provide spaces that assist in patient treatment and rehabilitation while offering a “break” for patients.
While this back to nature approach in healthcare is not a new concept, it is receiving increased attention as the world increasingly focuses on sustainable design and reconnecting nature and humanity, particularly in dense urban settings.