Senior Housing

Environments for Aging is just around the corner!

TX wildflowers. By Naomi Sachs

Texas bluebonnets and Indian blanket flower. Photo by Naomi Sachs

The fantastic Environments for Aging conference is just around the corner…chronologically (April 9-12) and for me, geographically–it’s in Austin, TX! What a beautiful, fun, vibrant city for a conference. Not sure if the bluebonnets will still be blooming, but I’m sure other wildflowers will be. In fact, if you can take an extra day and go see the Ladybird Johnson Wildflower Center, you will thank me.

I’ll be presenting with Susan Rodiek and Eric Bardenhagen on Sun, Apr 10 from 2:00 – 3:00 PM on “Planning, Designing, and Evaluating Outdoor Spaces to Optimize Usage” – see description below. And here are some other sessions I’m looking forward to attending. Hope to see you there!


Research Summary: “Investigating Walking Environments In and Around Assisted Living Facilities.”

Photo courtesy of Susan Rodiek

Walking is the most popular form of exercise for elderly people. Photo courtesy of Susan Rodiek.

Speaking of older adults (see our last post about Environments for Aging), a good article – “Investigating Walking Environments in and Around Assisted Living Facilities: A Facility Visit Study” by Zhipeng Lu – was published in the Summer 2010 issue of Health Environments Research & Design Journal (HERD). I wish I could provide a web link for you to access the free article, but alas, it’s only available to buy. So I’ll summarize the author’s points here.

At issue are the dueling needs of elderly people: The need for safety and the need for exercise and social connection. Lu states that “falls are the most frequent cause of injury-related morbidity and mortality among community-dwelling older people.” Falling is a true risk and needs to be avoided. But as he (and others he cites) argue, exercise and social connection are both critical for maintaining physical and emotional health. Careful consideration of location/neighborhood, as well as design of indoor and outdoor pathways, can both reduce risks and enable elderly people to live active, healthy lives.

Lu first makes a case for the benefits of exercise – in this case, walking – for elderly people (people 65 or older), and asserts that “the physical environment plays a role in promoting physical activity.” Since walking is the most preferred form of exercise among elderly people, it makes good sense to see what types of settings best promote frequent and safe walking.” The design of walkable ALF environments has become more important because frail older people are increasingly averse to nursing homes and seek a higher quality of life and greater independent living in an ALF.” An assisted living facility, or ALF, as defined by the Assisted Living Federation of America is “a long-term care option that combines housing, supportive services, and healthcare for mentally and physically frail individuals.”


Hurrah! ‘Access to Nature for Older Adults’ Wins ASLA Award

Access to Nature for Older Adults

Photo by Susan Rodiek

The 2010 ASLA (American Society of Landscape Architects) Awards have been announced, and one of the winners is the excellent new DVD series, “Access to Nature for Older Adults: Promoting Health Through Landscape Design.” Yea! We’ve blogged about this DVD series before, and we’re so pleased that ASLA agrees that it’s a valuable educational and design tool. Here’s what the jury had to say:

“Many of the features that were found beneficial, if included in all landscape design activity, would result in superior design and experience for us all. Improving our interactions with our world and better mental health all around! Talks about landscape design specific to an older population, proving a point of the importance of landscape architects. It sets up a design hypothesis that is in need of proving. Everything it applies to older population also applies to everyone. The research has a much broader application than just the elderly population.”
—2010 Professional Awards Jury

And to celebrate, TLN members get a 15% discount off any or all three Access to Nature DVDs. You don’t even need to be an official TLN member (though we’d love it if you were: Join online – it’s free!). If you are a designer, or an administrator, or a health and human service provider, or an educator, or a student, or someone with parents or grandparents (hm, that would be everybody), you should buy this award-winning DVD series.

To order your Access to Nature DVDs with the 15% discount, visit the Access to Nature website, ( and at the checkout, enter the promotional code TLNA2N. If for some reason that code doesn’t work, try TLNA2Na (same code but with a lower-case “a” at the end). The website is also chock-full of good information, so it’s a good one to bookmark.

Access to Nature DVDs

This is actually the fourth award for Access to Nature series: It received the 2009 Environment + Design Award from CEAL – The Center for Excellence in Assisted Living, and an early prototype of the Access to Nature program also won the Active Place Design Competition award in product design from EDRA, the Environmental Design Research Association, and a Viewer’s choice award from the Harvard School of Public Health.

Congratulations again to Susan Rodiek and her team at Texas A & M University; keep up the good work, and thanks for extending the discount to the Therapeutic Landscapes Network!

‘Re-Creating Neighborhoods for Successful Aging’ – Excellent New Book

This from a recent New York Times article:

“In two years, baby boomers will start to retire [if they haven’t been forced to already due to the recession!], and by 2030 the number of American’s elderly is expected to reach 72 million, more than double the number in 2000. Demographers expect the suburbs to age particularly quickly, as residents retire close to home, or as those who have already moved to the Sun Belt return to live near relatives as they grow frail.”*

Those are some pretty astonishing numbers. It’s what some people have referred to as “the baby-boomer tsunami,” and we as a culture need to start planning and designing now. Luckily, some people have been already.

Re-creating Neighborhoods for Successful Aging edited by Pauline S. Abbott, Nancy Carman, Jack Carman (who serves on the Therapeutic Landscapes Network’s Advisory Board), and Bob Scarfo, is a timely new book that addresses these issues and highlights interesting and creative solutions. Drawing from the fields of gerontology, health sciences, community planning, landscape architecture, and environmental design, the book provides an in-depth examination of current elder housing practices and strategies, alongside goals for the future.

Housing models, such as continuing care retirement communities (CCRCs), shared housing, and co-housing, are evaluated, and best practice recommendations are presented. Expert contributors also incisively explore interdisciplinary issues including

  • the causal relationship between health and the environment
  • challenges posed by America’s automobile-dependent suburban communities
  • elder-friendly design principles, including universal design and defensible space
  • restorative benefits of nature and green environments
  • assistive technology that can support older adults’ independence
  • retrofitting of naturally occurring retirement communities (NORCs)
The book closes with an inspiring look at opportunities for future collaboration of the health sciences and the planning and design professions for the realization of supportive, life-affirming communities that will result in healthy aging, active living, and continued social participation for older adults.

*”Suburbs See a Challenge as Residents Grow Old,”
New York Times ‘Metropolitan’ section, December 6, 2009, pp. 1 & 8.

A New Way to Improve Quality of Life for Seniors: Excellent DVD Series (with a discount for us!)

Five years ago, Susan Rodiek embarked on a project to create a series of DVDs about providing better access to nature for older adults. Rodiek, a professor at Texas A & M University’s Center for Health Systems & Design, specializes in senior populations, and access to nature has long been a focus for her research and teaching.

Those years of hard work have paid off. I received my “Access to Nature for Older Adults” DVDs last week and I’m truly impressed. The three-DVD series is not just instructional – it’s downright inspiring. With beautiful imagery, compelling research and interviews, easily digestible information, and a lot of real, practical solutions to common problems, it’s a must-watch and a must-have for architects, landscape architects, planners, educators, and any care provider who works with seniors in continuing care retirement communities, assisted living facilities, nursing homes, hospices, as well as acute care general hospitals.

Session One, The Value of Nature, describes how access to nature may benefit the health of seniors, from the perspective of experts and available research – addressing the role of programs, policies, and design issues.

Session Two, Improving Outdoor Access, explores how the layout of the building itself can either encourage or discourage outdoor access, and how specific areas – such as indoor-outdoor connections – can be successfully developed.

Session Three, Safe and Usable Outdoor Spaces, highlights the main outdoor features that are reported by residents to impact their outdoor usage, and how these can be improved. Seating, shade, and walkways are among the outdoor elements illustrated.

The Access to Nature website is also chock-full of good information. Some of it is accessible to everyone, and some of it is only accessible if you have the DVDs. So go ahead and buy them! You won’t be sorry.

Receive a 10% discount: Between now and the end of January 2010, Therapeutic Landscapes Network members and readers of this blog will receive a 10% a discount when you buy any or all of the Access to Nature DVDs. Just enter this promotional code in the checkout section on the Access to Nature website: TLNA2N.

Therapeutic Gardens Bloom in Senior Living Communities

Intergenerational gardening at Glacier Hills Retirement Community
Continuing our discussion on “aging in nature,” here’s a great article from Assisted Living Success. I’ve cut and pasted the first section here, but I strongly encourage readers to click on the link to read the full article. Full of all lots of good information and inspiration about gardens for seniors, including some great “how to” tips.

Therapeutic Gardens Bloom in Senior Living Communities

By Mona Del Sole

Drifting through the garden at sunset is the aroma of just-picked basil and tomatoes mixing with the perfume of lavender. My grandmother clanks down her garden tools brought from home, gathers her harvest and shuffles along the winding pathway. Pausing to remember her way, she’s guided by a specially designed walkway and soothed by whispers of a poetry reading nearby. She places one foot in front of the next toward what seems an uncertain destination. Soon her journey safely ends at the patio where she began, greeted by friends and iced tea.

Perhaps you’ve heard them called restorative, healing or memory gardens. Or maybe you’ve not heard about the therapeutic garden before now. Yet there is mounting research on the benefits of these specially designed gardens and an increase in their establishment within senior living communities.

Want to boost staff retention? Some say that you should consider the therapeutic garden. Reduced resident stress, improved satisfaction and better health outcomes are being reported for residents. And, for families who are dealing with the transition of a loved one from home to facility, the garden is an attractive feature. After all, it is likely that gardening was once a favorite hobby.

Meander through a therapeutic garden and you’ll find carefully selected flowering perennials, annuals, shrubs and trees. Containers and furniture are strategically placed to create spaces that are inviting and enjoyable. Discover sitting areas with specific themes such as a butterfly garden, sensory garden, vegetable garden, fragrant garden and shade garden. Safety, comfort and meeting the needs of the senior population are key elements of the design.
To read the rest of the article, click here. You can also order reprints from this site.

In the above photo, a resident of Glacier Hills Retirement Community in Ann Arbor, MI gardens with students from the Go Like the Wind Montessori School through a project called GRO – Generations Reaching Out. To learn more, visit the ElderTree Network. Many thanks to Suzanne for sending the image and links!

Therapeutic Outdoor Spaces in Senior Housing Communities

Image of aspens courtesy Henry Domke Fine Art

Here’s a letter that I received this week, along with my response. I’m posting our exchange partly to share some resources in this area of our field, and partly in hopes that you will have more ideas and information to add. Please leave comments! The more information that we can offer people on the Therapeutic Landscapes Network, the better, so please help us build our knowledge base.

Hi, I am an assistant social worker at a residential community for seniors in northern New Mexcio. We are looking to transform our courtyards and our outside acreage into a wonderful space for our elderly residents. One of the spaces needs to accommodate our physical therapies. I’m looking for designs and templates to guide our process

Thanks for your email. That’s wonderful that you’re looking to transform your courtyards and outside landscapes into healing gardens for elderly residents. Facilitating contact with nature is so important, and people benefit from it physically, mentally, and emotionally. Here are some excellent books:
  • Clare Cooper Marcus and Marni Barnes’ Healing Gardens: Therapeutic Benefits and Design Recommendations, especially the chapters 8 (Nursing Home Gardens, by Deborah L. McBride), 9 (Alzheimer’s Treatment Gardens, by John Zeisel and Martha M. Tyson, and 11 (Getting it Done, by Marni Barnes and Clare Cooper Marcus).
  • Martha Tyson’s The Healing Landscape: Therapeutic Outdoor Environments – this is the most “how-to” book that I know of, with nice drawings and helpful scenarios, mostly focusing on senior populations.
  • A new book that just came out, by Pauline S. Abbott, Nancy Carman, Jack Carman, and Bob Scarfo, Re-Creating Neighborhoods for Successful Aging, which has a lot of case studies and useful guidelines.
  • Joann Woy’s Accessible Gardening: Tips and Techniques for Seniors & the Disabled.
  • Diane Carsten’s Site Planning and Design for the Elderly: Issues, Guidelines, and Alternatives.
  • For more research-oriented study, I’d recommend Susan Rodiek and Benyamin Schwartz’ The Role of the Outdoors in Residential Environments for Aging.
I also urge you to seek out a horticultural therapist who could really link the physical therapy with using outdoor spaces and other aspects of nature. You could contact to see if they can put you in touch with a local HTR.

Best of luck, and keep in touch to let us know how it all turns out. We’re always looking to add good examples of therapeutic spaces to our list of gardens on the Therapeutic Landscapes Network’s site (

Forcing spring

Image from House Beautiful, 2008

It’s the third warm, sunny day here in the Hudson Valley, and it really feels like spring. Today I celebrated by cutting some stems from our giant forsythia hedge to force indoors. Even though forsythia and magnolia are three of the earliest spring-blooming shrubs (but later than witch hazel – see this post), we’ve still got a few weeks before they really burst into full glory. By taking cuttings and bringing them inside, you can trick trees and shrubs into thinking spring is further along, hence the term “forcing.” I actually could have done this weeks ago, but I always forget! You can force lots of other shrubs and trees, too, including azalea, flowering quince, pussywillow, witch hazel, serviceberry, redbud, rhododendron, beautybush, crabapple, and other fruit trees such as cherry, apricot, pear, and apple. To see some really gorgeous examples, check out this blog post from Habitually Chic: “Forcing Spring.” 

Forcing trees and shrubs is also a nice idea in the healthcare setting, particularly in long-term care facilities like nursing homes and hospices. Think how nice it would be in a place where residents have been cooped up indoors all winter, if the horticultural therapist or another health care worker or a family member took some cuttings and brought them indoors for a little spring preview. Or better yet, went with the residents on a “field trip” to prune a few branches on the grounds. Most long-term care facilities have flowering trees and shrubs, and as long as they are pruned carefully and not too overzealously, no one will miss a few branches here and there. If you are letting residents help, make sure to oversee the use of sharp tools, and of course no matter who’s doing the cutting, make sure to prune so that the actual tree or shrub isn’t harmed. Here’s a good article from, that tells you when and how: “Forcing Spring Flowering Trees and Shrubs.” A bouquet of twigs, then buds, then flowering branches becomes a great conversation piece and provides that joyful anticipation of spring’s arrival. 
Of course, people force bulbs, too. Paperwhites and hyacinths are the most popular two, but other spring bulbs work as well. Here’s a good article about that from “Forcing Flowering Bulbs for Winter Color.” 

Gardening for Health – another good article

Image courtesy Henry Domke Fine Art

Twitter can sometimes be a supreme distraction, but it can also send good articles my way, including this one, “Gardening for Health.” It’s old (2000), and repeats a lot of the same stuff I and others have been saying again and again, but there’s a personal component to this piece that – in my opinion – makes it worth sharing. I hope you agree!

Sorry to not be keeping up with the daily blog postings. Work with the web designer on our “new improved” website for the Therapeutic Landscapes Network is progressing, and it’s taking a lot of my attention these days as we make decisions about images, layout, features to add to the site that aren’t there now (like a search feature – progress at last!). If you have any thoughts on what you like about the existing site ( and what you would really like to see different with the new site, I’d love to hear from you. The TLN will continue to provide all of the same information (plus more!), but in a juicier, more accessible, easier-to-search format. Think organic peaches rather than bran cereal. Above is one of the images that will be in our homepage slideshow. We’re shooting to launch at the end of this month, so get your comments and ideas to me soon!

Thanks to twitterbo for “tweeting” this! 

Symposium on Healing Gardens in Senior Communities

Image courtesy Henry Domke Fine Art
Another symposium in the spring that looks great: “Healing Gardens: The Power and Practice of Nature in Senior Communities.” Thursday, April 23 at Medford Leas Continuing Care Retirement Community in Medford, New Jersey.

“Engaging older adults in horticultural activities, therapeutic gardens, and sensitively designed landscapes fosters a sense of well-being, promotes healing and adds value for residents. At this one-day workshop held on the Medford Campus, attendees will learn first-hand strategies for promoting the power of nature to advance wellness in senior communities.”

For more information and to register, click HERE to go to the Medford Leas website and then scroll down. Thanks, Jack Carman of Design for Generations for sending the announcement!