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Therapeutic garden

Brief introduction about therapeutic gardens and some case studies.

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Therapeutic garden

  1. 1. Welcome Welcome 8787
  2. 2. Credit seminarCredit seminar Therapeutic GardenTherapeutic GardenTherapeutic GardenTherapeutic Garden SHAMANTH.M.GSHAMANTH.M.G AHM/14-07AHM/14-07 FLA DeptFLA Dept Dr.Y.S.R.Horticultural University.Dr.Y.S.R.Horticultural University. 2014-20162014-2016 8686
  3. 3.   Name Designation Department/ Major Field Chairman Dr.R.Nagaraju Assistant professor Horticulture Member Dr.K.Swarajya lakshmi Associate professor Horticulture Member Dr.B.Govindarajulu  Principal scientist       Pathology Member Dr.D.Srinivas reddy Assistant professor       Entomology
  4. 4. Case StudiesCase Studies Design GuidelinesDesign Guidelines Types of therapeutic gardensTypes of therapeutic gardens Therapeutic gardenTherapeutic garden Topic division History & IntroductionHistory & Introduction conclusionconclusion 8585
  5. 5. The World Health Organisation defines health as  complete physical, mental and social well-being.  8484
  6. 6. Healing:-  •Process  that  promotes  overall  well-being  (Cooper  Marcus  &  Barnes 1999).  •In particular, it is a process that the body restores or recovers  both  physically  or/and  mentally.  Moreover,  it  is  a  multidimensional  process  which  includes  physical,  mental,  spiritual, emotional and social aspects.  8383
  7. 7. Gardening  works  on  many  different levels which makes  it  a  powerful  and  flexible  medium  for  improving  health and quality of life.  8282
  8. 8. • 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 8181
  9. 9. For  a  patient,  visitor,  or  member  of  staff,  spending  long  hours  in  a  hospital  can  be  a  stressful experience.  Nearby access to natural landscape or a garden  can enhance people’s ability to deal with stress  and thus potentially improve health outcomes. 8080
  10. 10. A  therapeutic  garden  referred  to  different  garden  features  that  have  the  ability  to  foster  restoration  from stress and also have other positive effects on  patients  staffs  and  visitors.  and  “should  contain  prominent  amounts  of  real  nature  content  such  as  green vegetation, flowers, and water.”         Ulrich, 1984 7979
  11. 11. History • “The idea of healing garden is both ancient and modern”(Cooper  Marcus & Barnes, 1999).  • Historically, people have always used nature as a powerful healing  source and as a resource for recovery (Cooper Marcus and Barnes,  1999). • Persian garden, the Japanese Zen garden and the Monastic  Cloister gardens are some of examples of a healing environment  which appeared throughout history in different parts of the world.  • The Greeks created healing temples for their gods. The temple for  the god Aesclepius (god of healing) was built in pastoral settings  with mineral springs, bathing pools, gymnasiums, and healing  gardens. Here people would come to worship, lodge, recreate, and  heal. 7878
  12. 12. •In the 19th century, Dr. Benjamin Rush was first to document  the positive effect working in the garden had on individuals with  mental illness. •In US, horticultural therapy blossomed after World War II, with  homecoming soldiers in need of restorative therapy. •Since the mid-1980s, research has indicated that gardens, parks  and areas with natural greenery have beneficial effects on human  health, well-being and capacity (Kaplan,R and Kaplan, S.1989).   7777
  13. 13. • Friends Asylum - first known example of psychiatric hospitals  using gardening activities opening in 1813 in Philadelphia. • In 1972, foundation teamed with the Horticulture Department  at Kansas State University provided first horticultural therapy  curriculum in the U.S. • 1973 – NCTRH (National council for therapy and rehabilitation) • 1988 – AHTA (American Horticultural Therapy Association) 7676
  14. 14.  Medieval monastic cloister gardenMedieval monastic cloister garden  Early example of restorative outdoor space for sickEarly example of restorative outdoor space for sick patientspatients 7575
  15. 15. Raised BedsRaised Beds 7474
  16. 16. 16 INTRODUCTION “Quality of life,” “well-being,” and “healing” are  phrases  that  embody concepts being recognized  with increasing importance in the 21st-century. However, over the last 50 years with the rapid  growth   of  medical technology and economic  pressure,  this ancient concept has been neglected. Presently, Healthcare costs are climbing. Hence in  hospitals and healthcare institutions often keep  up extensive gardens and landscapes as an      important part  of healing.  7373
  17. 17. 17 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  thereupetic  gardens  is  primarily  on  incorporating plants and friendly wildlife into the space near  to  hospitals  and  healthcare  centers  for  the  better  health  outcomes of the peoples. 7272
  18. 18. 18 • The  Joint  Commission  for  the  Accreditation  of  Hospitals  Organization  (JCAHO)  has  stated,  “Patients  and  visitors  should  have  opportunities  to  connect  with  nature  through  outside  spaces,  plants,  indoor  atriums,  and  views  from  windows” (1999). • There  is  significant  evidence  indicating  that  environmental  exposures, such as contact with plants and animals, viewing   landscapes, and participating in wilderness experiences, may  have  positive  impact  on  mental  and  physical  health  (Frumkin, 2001, 2004), 7171
  19. 19. Table 1: Responses from 143 garden users at four San Francisco  Bay Area hospitals Healing Gardens in Hospitals Cooper Marcus and Barnes, 1995 7070
  20. 20. 206969
  21. 21. Benefits of therapeutic gardening • Psychological • Social  • Physical 6868
  22. 22. Facilitates  stress  reduction,  helps  body  reach  more  balanced state Helps  person  summon  up  own  inner  healing  resources Provide  a  setting  where  staff  can  conduct  physical  therapy, horticultural therapy, etc. with patients Helps patient  come  to terms with  incurable medical  condition Provide  a  relaxed  setting  for  patient-visitor  interaction away from the hospital interior. Provides needed retreat for staff from stress of work 6767
  23. 23. • Therapeutic landscape designed for people with vision loss, outside London, England. 6666
  24. 24. 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 6565
  25. 25. ElementsElements  Familiar plantings  Plants that attract birds and butterflies  Ornamental plants  Non-toxic and non-injurious plantings  Annuals  Soil  Sunlight and natural shade  Wind  Precipitation Natural elementsNatural elements 6464
  26. 26. Patio Paved walking  Seatings Landscape lighting Raised beds Shade Water features Electrical outdoor  outlet; for music and  related activities Constructed garden elementsConstructed garden elements 6363
  27. 27. POTENTIAL ACTIVITIES IN A THERAUPEUTIC GARDEN 6262
  28. 28. Views through a windowViews through a window 6161
  29. 29. Sitting outsideSitting outside Reading/Reading/ doing paper work outsidedoing paper work outside 6060
  30. 30. Walking &Walking & RehabilitationRehabilitation exercisesexercises 5959
  31. 31. Therapeutic garden characteristicsTherapeutic garden characteristics 1.Scheduled and programmed activities 2.Features modified to improve accessibility  3.Well defined perimeters 4.A profusion of plants and people interactions 5.Supportive conditions 6.Universal design  7.Recognizable place making                                                                                 AHTA, 2015 5858
  32. 32. Design Principles in Therapeutic Landscapes  Before starting the design process it is important to know the user groups.  In designing a healing garden the focus should be on the people who are going to use the garden.  Depending on user groups there should be a balance between the physical activities and just being and experiencing the garden passively (Stigsdotter & Grahn 2002). 5757
  33. 33. The key design principles • Sustainability • Orientation • Accessibility • Socialisation • Meaningful activity • Reminiscence • Sensory stimulation • Safety AHTA, 2012  5656
  34. 34. Sustainability  Understanding of its therapeutic value,  activity programs and maintenance regime  Garden’s success very much depends  upon the staff’s understanding of the design AHTA, 2012  5555
  35. 35. Orientation •Locate gardens where they can be easily viewed from inside the  building •Simple path system AHTA, 2012  5454
  36. 36. Accessibility Ensure garden accessible with people by removing the physical and  mental barriers   Ensure there is plenty of shade  Offer a range of garden beds at differing heights for ease of access AHTA, 2012  5353
  37. 37. Socialisation AHTA, 2012  •Enhance the quality of life •Include elements that encourage interaction  between  family members 5252
  38. 38. Meaningful activity AHTA, 2012  5151
  39. 39. •Reminiscence •Sensory stimulation •Safety  AHTA, 2012  5050
  40. 40. Plants used..Plants used.. 4949
  41. 41. Enhancing the sense of smell to relax Scented flowers Blue bottle (Centaurea cyanus L.)Stock (Mathiola incana L.) Lavendula angustifolia Rosa damascena 4848
  42. 42.  Scented Climbers  Star Jasmine  Rangoon creeper Bower vine Potato vineMadhvilataHoney suckle 4747
  43. 43. Glossy Abelia Cape Jasmine Kamini Arabian Jasmine Din ka Raja Night-blooming jasmine  Scented Shrubs 4646
  44. 44. Lavandula angustifolia Ocimum sanctum Passion flower (Passiflora sp.) Rosemarinus officinalis Balm mint (Melissa officinalis) Chamomile (Matricaria recutita) Anti-stress herbs 4545
  45. 45. Trees for shade (Tropical region) Indian devil tree (Alstonia scholaris) Indian Beech Tree (Pongamia pinnata) Neem (Azadirachta indica) 4444
  46. 46. Healing garden entrance with arbor at Cortesia’s Healing Sanctuary in Oregon. 4343
  47. 47. • View of raised beds and work tables 4242
  48. 48. Case studies..Case studies.. 4141
  49. 49. “EFFECT OF HEALING GARDEN USE ON STRESS EXPERIENCED BY PARENTS OF PATIENTS IN A PEDIATRIC HOSPITAL” Toone (2008) 4040
  50. 50. • Dell Children’s Medical Center in Austin. • To test the hospital healing garden had an effect on the on stress levels of parents of pediatric hospital patients. • 27 participants, equating 9 to group. • Data was collected in the form of surveys and behavioral observation. 3939
  51. 51. Dell Children’s Medical Center in Austin.Dell Children’s Medical Center in Austin. 3838
  52. 52. Table 1- All Pre/Post Total Symptom Score and Emotional Distress Summery Scores Table 1- All Pre/Post Total Symptom Score and Emotional Distress Summery Scores 3737
  53. 53. Total Symptom Score Setting N Range Minimum Maximum Mean Garden 9 22.83 -1.67 21.17 7.333 2 North 9 34.67 -28.17 6.50 -1.796 Surgery 8 8.83 -3.33 5.50 1.222 Emotional Distress Summery Score Setting N Range Minimum Maximum Mean Garden 9 30.75 -6.50 24.25 5.722 2 north 9 30.25 -24.00 6.25 -2.361 Surgery 8 10.50 -3.50 7.00 1.055 Table 2- Descriptive Statistics of Change Scores Within GroupsTable 2- Descriptive Statistics of Change Scores Within Groups 3636
  54. 54. Table 3- Wilcoxon Signed Ranks TestTable 3- Wilcoxon Signed Ranks Test Total symptom score P Emotional Distress Summery Score P Garden .015 Garden .214 2 North .678 2 North .953 Surgery .161 Surgery .514 3535
  55. 55. Conclusion participants experienced a greater decrease in stress when sitting in the Healing Garden Courtyard than when in either of the interior spaces. Conclusion participants experienced a greater decrease in stress when sitting in the Healing Garden Courtyard than when in either of the interior spaces. 3434
  56. 56. Healing at a Hospital Garden: Integration of Physical and Non-Physical Aspects Healing at a Hospital Garden: Integration of Physical and Non-Physical Aspects Asano, 2008 3333
  57. 57. Fig. 1. The garden design layout of the Kansai Rosai Hospital, Japan. 3232
  58. 58. Fig. 2. Minutes spent visiting the Kansai Rosai Hospital garden. Fig 3: Frequency of visits to the Kansai Rosai Hospital garden 3131
  59. 59. Fig. 4. Reported use of the Kansai Rosai Hospital garden by respondents of a survey (multiple answers). 3030
  60. 60. Table 1. Changes reported by patient visitors to a hospital garden. N=142 n Relaxed 43 Refreshed 24 Enjoyable 8 Healed 5 Other (feels like my own garden, let children play with peace, able to be private ) 3 Unaware 1 No change 3 No answer 59 2929
  61. 61. Fig 5: Frequency of visit and if the hospital staff ever recommended the garden responses by hospital staff 2828
  62. 62. Fig. 6. Kansai Rosai Hospital nurses response to the possibility of rehabilitation or therapeutic use of the hospital garden 2727
  63. 63. Fig 7: A model demonstrating the design elements, purpose, and programming of a healing landscape. Fig 7: A model demonstrating the design elements, purpose, and programming of a healing landscape. 2626
  64. 64. Landscape preference evaluation for hospital environmental design Petros and Georgi. 2011 2525
  65. 65.  The main goal of this study was to investigate user’s attitudes towards landscape design regarding the existing and future improvements to outdoor grounds and spaces,  The main goal of this study was to investigate user’s attitudes towards landscape design regarding the existing and future improvements to outdoor grounds and spaces, 2424
  66. 66. Table 1: How satisfied are you with the current outdoor space area of the hospital? (%) Table 1: How satisfied are you with the current outdoor space area of the hospital? (%) A lot A little Not at all Doctors 5 45 50 Nurses 12.5 75 12.5 Administrative staff 13.6 63.7 22.7 Medical students 8.3 75 16.7 Table 2: Which part of the outdoor space of the hospital would you wish to increase? (%)Table 2: Which part of the outdoor space of the hospital would you wish to increase? (%) Green areas Parking areas Rest areas Isolated areas Water formations Doctors 90 5 5 0 0 Nurses 50 4.2 37.5 8.3 0 Administrative staff 63.6 18.3 13.6 0 4.5 Medical students 52.8 13.9 25 8.3 0 2323
  67. 67. Table 3: Would you like a garden with trees and bushes in the outdoor space of the hospital to exist? (%) Table 3: Would you like a garden with trees and bushes in the outdoor space of the hospital to exist? (%) A lot A little Not at all Doctors 90 10 0 Nurses 70.8 29.2 0 Administrative staff 77.3 18.2 4.5 Medical students 80.6 16.6 2.8 Table 4: Do you believe that landscape design with green areas in the outdoor space of the hospital would positively affect your psychologic status? (%) Table 4: Do you believe that landscape design with green areas in the outdoor space of the hospital would positively affect your psychologic status? (%) Yes May be No Doctors 95 5 0 Nurses 79.2 20.8 0 Administrative staff 72.7 18.2 9.1 Medical students 91.7 8.3 0 2222
  68. 68. Table 5. Do you want to spend your rest time in a well-designed landscape surrounding the hospital? (%) Table 5. Do you want to spend your rest time in a well-designed landscape surrounding the hospital? (%) Yes No Doctors 85 15 Nurses 95.8 4.2 Administrative staff 81.8 18.2 Medical students 94.4 5.6 Table 6. What kind of vegetation would you like to be planted in the hospital’s garden? (%) Table 6. What kind of vegetation would you like to be planted in the hospital’s garden? (%) High trees Medium height trees Small trees Bushes Trees+bushes Doctors 5 15 15 15 50 Nurses 4.2 29.2 20.8 8.3 37.5 Administrative staff 9.2 45 13.6 0 72.7 Medical students 11.0 22.2 11.1 0 55.6 2121
  69. 69. Table 7. Do you wish for water features in the outdoor space of the hospital? (%) Table 7. Do you wish for water features in the outdoor space of the hospital? (%) Yes No Doctors 70 30 Nurses 91.7 8.3 Administrative staff 50 50 Medical students 80.6 19.4 Table 8. What combination of colors would you like to see prevailing in the hospital’s garden? (%) Table 8. What combination of colors would you like to see prevailing in the hospital’s garden? (%) Monochromatic Limited number of colors Variegation Doctors 10 50 40 Nurses 8.3 41.7 50 Administrative staff 4.5 63.7 31.8 Medical students 8.3 47.3 44.4 2020
  70. 70. Table 9. What kind of activities would you wish to exercise in the hospital’s garden? (%). Table 9. What kind of activities would you wish to exercise in the hospital’s garden? (%). Rest Landscape observation Picnic Avoidance of stressful environment Walking Doctors 50 10 10 30 0 Nurses 41.7 8.3 8.3 29.2 12.5 Administrative staff 36.4 9.1 22.7 31.8 0 Medical students 61.1 0 19.4 16.7 28 1919
  71. 71. 1818 Table 10. Do you believe a garden would help the patients to recover? (%).Table 10. Do you believe a garden would help the patients to recover? (%).
  72. 72. Conclusion All doctors responded to the survey gave a possibility of improving the physiologic status of the patients with outdoor gardens. The staff understood to a large extent, the importance of having a green landscape for improving the psychology and healing of patients. Conclusion All doctors responded to the survey gave a possibility of improving the physiologic status of the patients with outdoor gardens. The staff understood to a large extent, the importance of having a green landscape for improving the psychology and healing of patients. 1717
  73. 73. Impact of Gardening Activities on Special Children: a Case Study Impact of Gardening Activities on Special Children: a Case Study Riaz et al., 2012 1616
  74. 74. Table: 1- Distribution of children according to age, gender and living place. Table: 1- Distribution of children according to age, gender and living place. 1515
  75. 75. Figure: 1. Nature of impairment in special children. Figure: 1. Nature of impairment in special children. 1414
  76. 76. Figure: 2. Places to be used by children for gardening activities. Figure: 2. Places to be used by children for gardening activities. 1313
  77. 77. Figure: 3. Opinion of respondents about gardening as a means for a closer relationship between parents and children. Figure: 3. Opinion of respondents about gardening as a means for a closer relationship between parents and children. 1212
  78. 78. Figure: 4. Opinion of special children about having fountains around. Figure: 4. Opinion of special children about having fountains around. 1111
  79. 79. Figure: 5. Kinds of plants in which special children were interested at school and home. Figure: 5. Kinds of plants in which special children were interested at school and home. 1010
  80. 80. Figure: 6. Suggestion of respondents about gardening to be used as part of a school curriculum. Figure: 6. Suggestion of respondents about gardening to be used as part of a school curriculum. 99
  81. 81. Figure: 7. Teachers having discussion of gardening with students in class. Figure: 7. Teachers having discussion of gardening with students in class. 88
  82. 82. Figure: 8. Mode of involvement of children in garden activities. Figure: 8. Mode of involvement of children in garden activities. 77
  83. 83. Figure: 9. Satisfaction level of parents about gardening facilities at school. Figure: 9. Satisfaction level of parents about gardening facilities at school. 66
  84. 84. ConclusionConclusion The results of this study show the positive impacts of gardening for the children with special needs in respect to mental, social and all allied benefits and outcomes that are needed for their betterment. Teachers and parents of such children observed gardening as a very important activity for their physical and psychological health along with the other trainings and education at schools. The results of this study show the positive impacts of gardening for the children with special needs in respect to mental, social and all allied benefits and outcomes that are needed for their betterment. Teachers and parents of such children observed gardening as a very important activity for their physical and psychological health along with the other trainings and education at schools. 55
  85. 85. OrganizationsOrganizations American horticulture therapy association www.ahta.org Canadian horticultural therapy association www.chta.org City farm www.resourcecentrechicago.org Gardening leave www.gardeningleave.org Farming for health www.farmingforhealth.com Garden partners www.gardenpartners.org German association for horticulture and therapy Horticultural therapy institute www.htinstitute.org Human issues in horticulture- horticultural therapy, Hawaii Michigan horticultural therapy association www.michiganhta.org Thrive www.thrive.org.uk Trellis www.trellisscotland.org.uk Urban meadows www.urbanmeadows.org ASHA foundation trust www.ashafoundation.org 44
  86. 86. The therapeutic garden is a preceding concept, it is being revived in modern times because of the comprehensive therapeutic benefits. It is a natural method to reduce stress, tension, fatigue, pain, sadness, depression and anxiety. It increases positive mood, energy and feeling of calm and encourage human-nature interactions. The significance of the discipline and the contribution it can make to advancing health and well being has just begun to be understood. Continued research studies will help contribute to evidence based research and further implementation of best practices. The therapeutic garden is a preceding concept, it is being revived in modern times because of the comprehensive therapeutic benefits. It is a natural method to reduce stress, tension, fatigue, pain, sadness, depression and anxiety. It increases positive mood, energy and feeling of calm and encourage human-nature interactions. The significance of the discipline and the contribution it can make to advancing health and well being has just begun to be understood. Continued research studies will help contribute to evidence based research and further implementation of best practices. 33 Conclusion
  87. 87. 22 Doubts…???Doubts…???
  88. 88. “We are not ourselves when nature being oppressed, commands the mind to suffer with the body” Shakespeare 11

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