Maintaining the healing garden – An essential design element

Photo by Naomi Sachs

Higher maintenance. Photo by Naomi Sachs

There’s gardening, and then there’s maintenance. Things have been so busy this year, and for the first time in my life, my garden has felt like a chore. I don’t have time to be in it – relaxing or gardening – and I barely have time to maintain it. Maintenance isn’t the sexiest of garden topics, but it’s part of life, so let’s talk about it.

As a designer, especially one who loves plants and gardening and who knows about the myriad benefits thereof, I used to be so disapproving when clients wanted a “low-maintenance” landscape. How boring! Nevertheless, I would try to sympathize and design accordingly. A low-maintenance landscape can still be beautiful and rewarding. For example, one Santa Fe client had a sweet little backyard but was not a gardener and was away about half the time, traveling for work. When she was home, she didn’t want to worry about weeding and pruning and deadheading and mowing; she wanted to sit in her garden with a cup of tea, or meditate under her favorite tree, or hang out with friends. She was very happy with the design, a xeric, “zen-like” garden.

"Sanctuary garden" designed by Naomi Sachs. Photo by Lee Anne White,

"Sanctuary garden" by Naomi Sachs. Photo by Lee Anne White,

In presentations on restorative landscapes, I talk a lot about stress reduction, and I do touch on maintenance. If you’re not a gardener, or if you don’t have time to garden, or if your climate doesn’t allow for gardening (think Texas in the summer), or you don’t have the budget to pay a gardener, a high-maintenance garden is going to cause more stress than joy. You don’t want to look out your window and think about out all the work that needs doing, or be sad when your plants die because they are not being tended to. Where’s the pleasure in that?

For private home healing or sanctuary gardens, you have to know yourself and your limitations (preferences, time, funds). Whether you’re designing and planting for yourself or hiring a designer and installers, be honest with yourself, and only bite off what you can chew.

Photo by Naomi Sachs

A mailbox at a home for people with dementia is a wonderful long as the roses are kept pruned! Photo by Naomi Sachs

And the same thing goes for gardens in healthcare facilities and other public spaces. There’s a garden nearby that was so beautiful when it was installed a few years ago. A very interesting design, with a rich variety of native plants, around a really cool building. But the organization that owns that property lacks the funding and the volunteers to maintain the landscape. It needs more TLC than it gets, and is no longer the best reflection of the organization.

It doesn’t matter how beautiful the design is, or how successful it would be in an ideal world. If it’s not maintained, it doesn’t serve the facility or the users of the space – the patients, clients, the visitors, the staff. Maintenance should always be budgeted in from the start, and a plan should be provided to the facility so that things can be kept looking good and working well. Having a horticultural therapist on staff certainly helps, as they work with patients in the garden and can really keep an eye on things. A good designer will know and understand the limitations and the strengths of the facility and design with that in mind.

There’s no such thing as no maintenance (and believe me, I’ve had requests!). But there’s a big range in how much a landscape needs to stay healthy and beautiful. If you keep in mind the reality of what can and cannot be done, the garden – for yourself or for clients – has the best chance of being a true source of healing and inspiration.

Note: We’ve been having a good discussion ( on this topic in our Therapeutic Landscapes Network LinkedIn group. Come join us!

Wordless Wednesday, 8/3/11 – Black swallowtail butterfly

Black swallowtail on Echinacea purpurea (coneflower). Photo by Gary Wangler

Black swallowtail on Echinacea purpurea (coneflower). Photo by Gary Wangler

Gary Wangler, Horticulturist/Manager of Grounds Operations/Horticultural Therapist of the St. Louis Children’s Hospital took this photo at a State Park last week, where some of the hospital patients were enjoying a week-long summer camp. Thanks for the gorgeous image, Gary!

For another recent post about butterflies at the St. Louis Children’s Hospital, click on the following blog title:


“From Motown to Growtown!” – Documentary ‘Urban Roots’ on farms, community gardens, and food justice in Detroit, MI

Urban Roots poster by Shepard Fairy,

Urban Roots poster by Shepard Fairy

Last night I watched the excellent and inspiring documentary ‘Urban Roots‘ at the Horticultural Society of New York.  It’s a film about urban farmers, gardeners, and food and community activists who are taking over the hundreds (thousands?) of acres of vacant lots in Detroit, MI and making them into productive landscapes that address ecological and economic problems at the same time – in other words, healing Detroit by healing and cultivating the earth. Or as one young woman said, “turning Motown into Growtown!” And it’s happening elsewhere, too. For example, at the Healing Landscapes Sustainability Symposium in Cleveland, OH this past February, I learned of several similar projects in the Cleveland area, and even in my own city of Beacon, NY, we have the Green Teen program, which “empowers urban youth to be effective community change-agents by immersing them in the local food system” and the CSA (community-supported agriculture) Common Ground Farm.

What impressed me about the movement in Detroit is individuals working at a grass-roots level (no pun intended…) to solve deep economic, social, and environmental problems for themselves instead of waiting for someone to give them a hand and do it for them. In other words, self-determination.

Some of the projects and places in the film: Brother Nature Produce, D-Town Farms, Field of Dreams (FOOD), Grown in Detroit, Eastern Market, Farnsworth Community Garden, Elmhurst, and Earthworks Urban Farm.

At the Therapeutic Landscapes Network, we focus on gardens and landscapes in the healthcare setting and on research and evidence-based design, because no other organization is doing this kind of work on an interdisciplinary level. But our mission is to serve as a “knowledge base and gathering space about healing gardens, restorative landscapes, and other green spaces that promote health and well-being.” That means any landscape, wild or designed, urban or suburban or rural, large or small, that facilitates health. And preferably the health of not just humans but animals and the planet as a whole.

For information on these broader topics, visit our website’s Other Healing Landscapes section. We’re still adding to this, but right now we have pages on community gardens, gardens in prisons, and memorial gardens. Input and suggestions are always welcome.

Thanks to the Horticultural Society of New York for screening the film, to Mark McInnis for making the film, and most of all, to the people of Detroit for their inspiring work. Keep on growing!

Wordless Wednesday, 7/27/11 – Tomato from Hearthstone

Tomato, Hearthstone Alzheimer Care, Marlborough, MA. Photo by Naomi Sachs

Tomato, Hearthstone Alzheimer Care, Marlborough, MA. Photo by Naomi Sachs

A tomato, full of promise, from the one of the raised beds at Hearthstone Alzheimer Care in Marlborough, MA.

Here’s an interview with President and Co-founder John Zeisel about the garden at Hearthstone:

Life and renewal in the garden – a cancer survivor’s story

Raised vegetable bed. Photo by Donna Helmes

Raised vegetable bed. Photo by Donna Helmes

Donna Helmes signed up for the Therapeutic Landscapes Network newsletter last week, and in the optional “tell us a little about yourself” box, she said that she was a cancer survivor. I asked whether she would share her story for the TLN Blog, and here it is.

In 2008, during a routine mammogram, an eagle-eyed radiologist discovered my invasive ductal carcinoma breast cancer. A double mastectomy and 4 rounds of chemotherapy followed.  I thought my life was over before it ever really began.  I was filled with regret over all my past missed opportunities and I grieved for things I believed that I would never have, such as a child of my own.  I struggled to find the strength to face my disease and endure treatment.

Donna Helmes during treatment

Donna Helmes during treatment

During my recuperation from surgery, my mother bought me a pack of seeds and a pink gardening kit.  I was unimpressed.  I lived in an apartment and I had cancer.  I wasn’t in the mood to take on a new hobby, especially one that might involve bugs! My mom would not be deterred. She planted the seeds in a tray and placed it in my laundry room.  She left me strict instructions about watering, and when and how to repot the seedlings when the plants were large enough.

Donna Helmes flowers. Photo by Donna Helmes

Annuals on the deck. Photo by Donna Helmes

So as not to disappoint her, I half-heartedly followed her instructions. I watered the tray of seeds and placed them in a sunny location.  I checked on them every day. After a few weeks, a funny thing started to happen.  I found myself looking forward to watching the progression of my little flower seedlings.  I was happy and more than a little excited when the plants were big enough to be transplanted.  After a few more weeks, as I neared the end of my chemo treatments, the flowers began to bloom.  I realized that the flowers symbolized so much for me about life and renewal and health.  I was transfixed by the lovely profusions of colors and textures and smells.  I rejoiced in the blossoms as much as I rejoiced at the end of chemotherapy.

From then on, the strength and beauty found in something so delicate inspired me.  I discovered that I felt calmer and could forget about cancer when I tended to my flowers. Each day brought a new discovery about the plants. I discovered that I loved digging in the dirt and caring for my plants (bugs be damned!).  I enjoyed learning about the rhythms of life and how a little sun, some water and lots of love can produce something wondrous.  It felt good to feel the warmth of the sun on my bald head and my arms felt more flexible after a few rounds of weeding.

Bella. Photo by Donna Helmes.

Bella, laughing

Today, I have my own house with a little backyard. I grow flowers, organic vegetables and all sorts of plants.  This year I even I added strawberries.  My beautiful baby girl, whom I adopted last fall, enjoys being next to me outside while I weed, water and tend to my garden.   We take pleasure in nature and our souls benefit from all the beauty around us.  And my mom? She couldn’t be happier for her daughter, the gardener.

Thank you so much, Donna, for your story and pictures!

Do you have a story to tell? Please share it with us, either here as a comment or by contacting us.


Wordless Wednesday, 7/20/11 – Lotus

Lotus. Photo by Naomi Sachs

Lotus seedhead. Photo by Naomi Sachs


HEALTHCARE DESIGN.11 – Join the TLN in Nashville, TN!

HCD Conference logo Mag-Blue

For the second year in a row, the Therapeutic Landscapes Network will be attending HEALTHCARE DESIGN.11, taking place November 13 – 16 at the Gaylord Opryland in Nashville, TN. Just like last year, we’ll be reporting live from the conference.

HEALTHCARE DESIGN.11 is a four-day conference devoted to evidence-based design for healthcare buildings. Developed in collaboration with design professionals who are engaged in the day-to-day championing of higher quality healthcare environments, this annual, multi-track learning event examines the many ways evidence-based design strategies can positively impact the safety, operation, clinical outcomes and financial success of healthcare facilities now and in the future.

If you design, build and operate healthcare facilities, or are a researcher, student or educator involved in the healthcare design field, this is a great conference to attend.

Register by July 29th to save on registration! Click here to register.

Click here to view the complete agenda, and here for more information.


Garden = Life

Ulfelder Healing Garden, Massachusetts General Hospital, Boston, MA. Photo by Naomi Sachs

Ulfelder Healing Garden, Massachusetts General Hospital, Boston, MA. Photo by Naomi Sachs

On my visit to one of three healing gardens last week in Boston, I waited in the hospital lobby for someone from administration to meet me. A pajama-clad man, connected through various tubes to an IV pole, ambled slowly by, his expression a combination of concentration and resignation. Someone grimaced while maneuvering, with difficulty, a wheelchair bearing the profound weight of an obese middle-aged woman. Doctors and interns in their scrubs and stethoscopes whisked quickly through the space to whatever important task awaited them.

And it dawned on me (not that this hasn’t occurred to me before, but there was something different, perhaps more immediate or visceral, this time): As much as hospitals are places for birth and healing, they are also inherently places of pain, sickness, and death. Most people begin their lives and bring forth new life in the hospital, and that is a wonderful thing. But other than that, we don’t really want to be there. Hospitals are where sick and injured people go to be healed, sometimes successfully, sometimes not. Thus, they are places that elicit uncertainty, fear, and sadness.

And the environment itself, designed to be clean and efficient, is therefore sterile, intimidating, and alienating. It is so far from what most of us experience in our day-to-day lives.

And then there’s the garden. If you’re lucky, your hospital has a garden. And if it’s a good one, it’s an antidote, a life-affirming oasis, a desperately needed contrast to the strange machines, shiny surfaces, alien sounds, and assaulting smells. Gardens are about life. They contain green, living things; fresh air; birds; water. There is death in the garden, too, of course; plants don’t live forever. But somehow, even their death feels more natural, more just part of the cycle of life rather than a startling and traumatic interruption. And often even when plants look like they have died, we know that they have simply gone dormant: Autumn comes, leaves turn color and fall to the ground, and everything goes into hibernation. Then spring arrives and, as if by some miracle, green shoots emerge from the earth, from buds and branches. And the cycle begins again.

There is so much hope and promise in a garden. As Maude tells Harold in my all-time favorite movie, ‘Harold and Maude’:

“I like to watch things grow. They grow, and bloom, and fade, and die, and change into something else. Ah, life!”

Here’s a clip that includes that scene and the daisy scene, which comes right after:

The biologist E.O. Wilson termed our affinity to nature “biophilia” – an innate attraction to life and living things.

So that was my realization. Without going into a zillion caveats, which I’m usually wont to do: Hospital = pain and sickness, and sometimes death. Garden = respite and life and hope.

(Almost) Wordless Wednesday, 7/13/11 – Fountain ripples

Fountain at Ulfelder Healing Garden, Massachusetts General Hospital

Fountain at Ulfelder Healing Garden, Massachusetts General Hospital

I had the good fortune to be able to visit the Ulfelder Garden at Massachusetts General Hospital in Boston last week while attending the Design & Health World Congress. Stay tuned for a blog post with images and description of the garden. In the meantime, here’s an interesting article, from The Holistic Oncologist, about an evaluation of the garden based on guest book comments.

And here are some of the comments from the guest book on the day of my visit:

“Thank you to all the physicians that took care of my treatment this last day of treatment, 6/17 – this garden is ideal!”

“Thank you for this miracle garden.”

“Peace in the garden.”

“This is truly a healing garden.”



Renovation/Remodel Competition – Enter your outdoor space!

Interior courtyard at Wesley Woods, Atlanta, GA. Photo by Naomi Sachs

Interior courtyard at Wesley Woods, Atlanta, GA. Photo by Naomi Sachs

Designers of restorative outdoor (and green indoor) spaces in healthcare settings, this competition is for you! Read on, especially the bolded part, to find out why.

HealthcareDesign 2011 Remodel/Renovation Competition

Have you recently completed the renovation of an emergency department or a respite area within a healthcare facility? If so, this competition is for you.

The Remodel/Renovation competition is open to ALL HealthcareDesign readers including architects, landscape architects, interior designers, and facilities wishing to highlight their latest projects. Submissions will be accepted under two categories: Emergency Rooms or Respite Area, which includes indoor spaces such as atriums, chapels, meditation areas, and water features, and outdoor spaces such as courtyards, therapeutic/healing gardens, landscaped grounds, front porches, entry gardens, plazas, roof gardens and roof terraces.

A panel of experts appointed by The Center for Health Design will review and evaluate all submissions and narrow the projects down to the Top 5 in each category. Projects will then be posted online at for reader voting and comments. The projects with the most reader votes will be named “Best in Category,” and will be published, along with the four runners-up, in our December issue of HEALTHCARE DESIGN.

There are no entry or publication fees and submissions are due July 29.

Awards will be presented at our HEALTHCARE DESIGN.11 conference in Nashville this November.*

To request a submission kit, click here. For more information, please contact Libby Johnson at or call 216-373-1222.

*Stay tuned for a blog post about this conference