Seniors « Therapeutic Landscapes Network

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

December 14, 2009 | by Naomi Sachs

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!)

December 10, 2009 | by Naomi Sachs

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.

Upcoming Conferences on Environments for Aging

December 3, 2009 | by Naomi Sachs

Image courtesy of Henry Domke

Though they’re about 4,000 miles away from each other, both of these upcoming conferences look really good. If you’re looking to learn more about this subject, connect with others in this field, or earn CEUs, here are two excellent opportunities.

Elderly Care By Design International Symposium and Workshop

London, England, Feb 18, 2010

“Examining how investment in the design of environments for older people, from hospitals to residential facilities, nursing homes and facilities for the end of life, can support independent living, health and wellbeing, the event will be attended by an interdisciplinary mix of researchers and practitioners from government, academia, health and social care providers, and private industry.”

Environments for Aging .10

San Diego, CA, March 21-23, 2010

Founded and produced by Long-Term Living magazine and the Center for Health Design.

“Environments for Aging is a comprehensive, three-day experience to explore new ideas for creating appealing and supportive places for people as they age. The program will enable you to share common goals, innovations and best practices, and to gain inspiration through a gathering of like-minded individuals who have a vision for the future and who will be instrumental in shaping it.”

If you register by 12/31, you save $440.www.efa10.com.

Know of other good conferences that our members would want to know about? Leave a comment, or contact us through the TLN website.

Therapeutic Gardens Bloom in Senior Living Communities

December 2, 2009 | by Naomi Sachs

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!

Aging in Nature – It’s Never Too Late to Play Outdoors!

November 21, 2009 | by Naomi Sachs

“Mac” in his garden in Santa Fe, NM

In my next few posts, I’m going to focus on the over 60 set, as there’s a lot of great research and design about therapeutic landscapes for seniors. This is such an important area of our field. Having access to and being active in the outdoors is good for everyone, but I would venture to say (backed up by research) that it’s especially critical for the youngest and oldest generations.

Young kids need fresh air, sunlight (remember rickets? It’s coming back because kids aren’t getting enough Vitamin D!), exercise, and the sense of discovery that only the natural world can provide; it’s essential for physical, mental, and emotional development.

And much later in life, as getting out and about becomes more difficult, interaction with nature becomes all the more important – perhaps even more so than in between youth and old age. Exercise maintains health by stimulating blood flow, keeping muscles strong and ligaments flexible, and by maintaining bone density and strength. Staying interested in the outdoors provides continued sensory stimulation, which keeps the mind as well as the body active and strong. Getting outside also facilitates social interaction, a critical factor in maintaining well-being. More specifics on all of this, and mentions of good resources, in the next few posts.

In the meantime, a personal story: Above is a picture of Mac. He was my neighbor in Santa Fe, before I moved to the Hudson Valley, and he hired me to design a garden for him and his wife. They both had loved to garden in their younger years, but due to her very limited mobility and his near-blindness (that’s black tape over his glasses lens, before he got an eye patch), they had stopped. Their back yard was a wasteland of weeds and gravel that was impossible to navigate. We worked on a plan that would provide a smooth walking surface (colored concrete) with several places to stop along the way, as well as destinations to move toward; plants that provided shade, seasonal interest, sensory stimulation, and that attracted wildlife; and a design that they could also see and enjoy from inside the house, and that would entice them outside (in sight = in mind).

And we were pretty successful. The week that the garden was finished, Kay – who had not been in her back yard for years, and who hardly went outside period – ventured out with her walker, with Mac by her side. After that, they walked through the garden every day, several times a day. In good weather (which in Santa Fe is most of the time) they walked to “their” apple tree (they had planted it as a sapling decades ago), the farthest place from the door, and sat side by side in its shade, gazing out, commenting on the darting hummingbirds, or what was blooming, or how much water the mossrock boulders had collected in the afternoon’s rainstorm. After a few months, I started to see them walking up and down the sidewalk on the street as well – Kay had gotten strong enough to venture out of their small back yard garden and take on the more challenging slope of our street. This was especially encouraging because it meant that she had the opportunity to interact with neighbors, thereby broadening a social circle that had gotten pretty darn narrow.

So, this is but one of many, many examples of the power of one healing garden to change and improve someone’s quality of life. It’s never too late to play outdoors, and it’s up to us to help make that happen. Do you have a good example that you’d like to share? Please leave a comment! I would love to start gathering more of these stories, because as convincing as the quantitative research is and as much as we need it, I think it’s the personal stories that resonate and motive individuals. If you can share images, too, all the better.

Photograph by Lee Anne White

Edible Gardens are Healing Gardens

August 30, 2009 | by Naomi Sachs

Image courtesy of Anne Dailey

I can’t believe summer’s almost over. It flew by this year. Depending on where you are in this country, or in the world, your growing season is coming to a close (or just beginning, if you’re in the Southern Hemisphere – lucky you!). Here in the Hudson Valley, we’ve got a couple of months left before a hard frost hits, with end-of-the-summer treats like corn, tomatoes (though many fewer this year due to the blight), peppers, and melons. In my own tiny raised bed garden, I’ve got tomatoes, chard, arugula, and lots of herbs.

I’ve been thinking a lot about edible gardens as healing landscapes. After all, food is life. What could be more nurturing than good, healthy food? And not just nutritionally, though most of us know by now that the closer our food source is, the more nutrients (and flavor) it has to offer. On top of all that, there is something nurturing to the spirit about growing and eating your own food. Whether you have a few pots of herbs and tomatoes on the deck or fire escape, or an acre of land to tend, or a plot in a community garden or CSA (community-supported agriculture), an edible garden is a healing garden for body and soul.

Alice Waters, Deborah Madison, Michael Pollan, Barbara Kingsolver, and even Martha Stewart, to name just a few, are some of the more well-known advocates of eating locally, slowly, and sustainably. The locavore/backyard (and front yard!) farmer/victory garden movement has exploded, and lots of individuals, families, schools, communities, the New York Botanical Garden – heck, even the first family – are getting in on the grow-and-eat-your-own action. And there’s a plethora of information out there. On twitter alone, I’m following over two dozen people and organizations devoted to small-scale/local farming and agriculture and edible gardens. Not sure when to plant radishes? Debating about sowing a cover crop? Thinking of saving seeds from your heirloom squash? Just google it. A great example low-tech analog and high-tech digital living happily ever after.

And what a great learning experience for children, to know not only what real zucchini or blueberries or carrots taste like, but how they grow (vine, bush, in the ground below those frilly green tops).

Image courtesy of Allison Vallin and A Tasteful Garden

This New York Times “One in 8 Million” piece on Buster English in Brooklyn’s Fort Greene neighborhood really touched me, and hits on several of the ideas in this post.

To really get the most out of your edible garden as healing garden, here are some suggestions:

1. Grow organic: Avoid pesticides and herbicides. After all, a big part of growing your own food is creating a healthier alternative for you, your family and friends, and your neighbors. The people and the soil and the creatures who live in and around it will thank you.

2. Start small: If you’ve never “farmed” before, don’t take on too much at once. Plant what (or maybe even less than) you think you’ll need or that you have time to tend. Nothing puts a damper on your enjoyment of a garden like feeling overwhelmed, guilty, or inept. You can always do more next year.

3. Grow stuff you really like, or that you can’t get enough of locally (for example, even if I wanted to buy sorrel, it just isn’t available around here; and the first thing I’d plant if I had more space would be a fig tree); or that’s expensive to buy at the store/market (another example: I don’t grow potatoes or onions because I can get them cheap. Arugula, on the other hand…).

4. Teach the children: Put your kids to work! Or better yet, set aside a part of the garden that’s just for them. Radishes, carrots, tomatoes, zucchini, peas, and many herbs are easy to grow, even from seed. Here’s an article on the “top ten” kid-friendly veggies (and fruit) and another on the ones that might be a bit more of a challenge. What magic, to put a tiny radish seed into the ground, to water and care for it, to see a tiny shoot emerge, to tend it some more, and then pull it out of the ground and savor its bright pink, spicy peppery crispness. And what joy to be a part of that discovery and delight.

5. Include your elders. Maybe it’s your parents, or your grandparents, or other relatives, or the elderly couple that lives down the street. Maybe it’s residents of a nearby senior center. Many people from earlier generations grew up farming, or at least tending a kitchen garden, and they have knowledge and stories to share. In return, you can share some of your bounty with them. If I had my druthers, intergenerational gardening would be the next big thing.

6. And speaking of which: Share! If for no other reason than to impress your neighbors with your farming acumen, give some of your harvest away. What a truly generous gift.

7. And last but not least: Enjoy. Every time I bite into one of my home-grown tomatoes, I’m blown away not just by the taste; I also feel a deep sense of wonder and gratitude. Such beauty, such flavor, such nourishment. To me, that’s about as healing as it gets.

Image courtesy of Claire Brown and Plant Passion

Therapeutic Outdoor Spaces in Senior Housing Communities

August 27, 2009 | by Naomi Sachs

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 http://www.ahta.org 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 (http://www.healinglandscapes.org/sites.html).

More on scent and memory – Guest post by Wendy Meyer

May 31, 2009 | by Naomi Sachs

Image courtesy Henry Domke, http://henrydomke.com

Photo by Henry Domke, www.henrydomke.com

Wendy Meyer, a recent MLA graduate of the University of Texas at Arlington left such an informative comment on the last blog post, on scent as an emotional memory trigger, that I thought it was worth printing in its entirety, especially since she provides a link to her thesis, “Persistence of Memory: Scent Gardens for Therapeutic Life Review in Communities for the Elderly.”

Aha, I finally figured out how to post a comment! I wrote my master’s thesis in landscape architecture on this subject–specifically, on using fragrant plants in gardens for elderly people to help conduct reminiscence therapy. There is a ton of new brain science being done on the links between smells, emotions and memories. It turns out that early, emotional autobiographical memories are strongly related to smells, because of the way the brain evolved. I looked at how reminiscence helps older people come to terms with their lives, historic use of scent in gardens as well as history of therapeutic gardens. I also interviewed a group of practitioners for their advice and insights on using scent for therapy in gardens. I got different perspectives from landscape architects who design therapeutic gardens, nurses/therapists who work with elderly populations and horticultural therapists who work in all kinds of settings. One of the recurring themes was the need for everyone involved to work together in creating these gardens–not just garden designers and hospital/nursing home administrators, but the therapy staff, families, patients and (not to be forgotten!) the maintenance staff. I spent two and a half years reading and could have spent lots longer (but I needed to graduate)! You can see the thesis at this link:
http://dspace.uta.edu/bitstream/10106/550/1/umi-uta-1697.pdf. Or if that doesn’t work, I’m sending a PDF to the Therapeutic Landscapes Network website.

When I asked Wendy for permission to post this, and mentioned I might use a rose for the image, here’s what she had to say:

“Roses were probably the flower that came up the most–particularly rugosas, because the hips have a distinctive scent–but also lavender, gardenias, rosemary and lilac. People mentioned a lot of scents outside the garden as well–firs in the Northwest, sagebrush after a thunderstorm in the Southwest, crabapple blossoms in Wisconsin. I have a bunch of plant lists in the appendices–that was one of the fun parts to put together!”

Thanks so much, Wendy!

Scent as emotional memory trigger in the healing garden

May 14, 2009 | by Naomi Sachs

Lilac image courtesy What Do I Know? blog http://whatdoiknow.typepad.com/photos/flowers/lilacs.html

Image courtesy What Do I Know? www.whatdoiknow.typepad.com/photos/flowers/lilacs.html

Lilacs. Roses. Jasmine. Gardenia. Freshly mown grass. Chaparral. Depending on where you grew up, these scents probably conjure up some pretty powerful emotions and memories. In fact, of the five, our olfactory sense is the strongest emotional memory trigger. According to a June ’09 issue of Organic Gardening, “That’s because the part of our brain responsible for basic memory evolved out of the tissue that makes up the olfactory cortex.” For a slightly more detailed explanation, see this article on the psychology of scent, “Whisking up a memory with a whiff: Rachel Herz explores the psychology of scent.“) And here’s another good one, from Science & Tech: “Can you really smell memories? How childhood scents get ‘etched’ on the brain.” See also our next blog post, a guest post by Wendy Meyer that includes a link to her thesis “Persistence of Memory: Scent Gardens for Therapeutic Life Review in Communities for the Elderly.”

Fragrance in the healing garden

For this reason, using plants with fragrant flowers and foliage is an important part of designing the healing garden.* Especially in nursing homes, dementia gardens, and other landscapes for people with memory loss, scent can be very powerful. Consider this story, from Martha M. Tyson’s wonderful book The Healing Landscape: Therapeutic Outdoor Environments, about our colleague Vince Healy:

Vince’s grandmother was in her nineties. For quite some time she had not recognized Vince and was not really fully aware of what was going on around her. Since it was Easter time, Vince decided to pay her a visit. During his drive there, Vince came upon a roadside stand that advertised lilacs for sale. In southern California, lilacs do not grow well. This stand, however, had great quantities of them, and they were cheap. So Vince brought an enormous number of the lilacs and put them in the back of his van…By the time Vince arrived at the nursing home, the lilacs were looking very sad. When Vince walked into his grandmother’s room, she looked at him as always, blankly, and then she looked at the flowers. “They’re wilted! Throw them away!” After all this effort Vince was not about to throw them away, so he moved the lilacs closer, right under her nose. She drew in the fragrance with a deep breath and a sigh and said, “Lilacs….” Then she looked up at Vince and said, “Vinnie, how are you?”

Designing with fragrance as an emotional memory trigger

But even with less miraculous results, scents that elderly people remember fondly – “old-fashioned” flowers like lilacs, honeysuckle, gardenia, mock orange, roses – can evoke positive feelings and often facilitate conversations, thus providing something important but often lacking in places like nursing homes: Personal connection. Because our sense of smell often decreases as we age, strongly scented plants have a better chance of triggering a reaction than something subtle. I highly recommend Tyson’s book for more information, and Clare Cooper Marcus and Marni Barnes’ book Healing Gardens: Therapeutic Benefits and Design Recommendations is also valuable, especially the Chapter 8 on nursing home gardens and Chapter 9 on Alzheimer’s treatment gardens. Several other books have been published on gardens for the elderly, including Jack Carman et al’s new book Recreating Neighborhoods for Successful Aging. If you know of books that specifically address this issue of scent as a memory trigger in healing gardens, I’ll add it to our list!

*One caveat: In some cases, such as with gardens for cancer patients undergoing chemotherapy, even a good scent may be too overwhelming, and even nauseating. I don’t know of any specific research on what to steer clear of – if anyone reading this knows, please pass the information my way and I’ll list it on the Therapeutic Landscapes Network’s website.

Alzheimer’s Awareness Perennial Garden

March 25, 2009 | by Naomi Sachs

Better Homes & Gardens has teamed up with the Alzheimer’s Association to offer an exclusive Alzheimer Awareness Perennial Garden to help champion Alzheimer’s research and programs.

The collection of five perennials (echinacea, aster, salvia, phlox, and sedum) in whites and blues creates a beautiful, fragrant display that also attracts butterflies, all while raising awareness about and funding for Alzheimer’s disease.

The Alzheimer’s Association receives 10% of the gross sales from all Alzheimer’s Awareness Perennial Gardens (which sell for $99.95) to support research and services in communities nationwide for people touched by Alzheimer’s and related types of dementia. Recipients get a personalized gift card, planting instructions, and a planting plan.

Nice idea, right? Thanks to Jasmine’s Blog for blogging about this first! As she so eloquently put it, “Not only does the garden raise funds for the fight against Alzheimer’s, but part of the beauty of the concept is the stress-reduction offered by the pastime of gardening. The Alzheimer’s Association hopes that some of the 10 million unpaid caregivers in America will find relaxation through gardening. The kit also makes a beautiful tribute to a loved one.”