Essential Design Elements for Therapeutic Gardens

Hulda B. and Maurice L. Rothschild Garden, Evanston, IL

On the the first day of the ASLA Conference in Chicago this year, I went on a Field Session where we toured three therapeutic gardens in three different locations. It was a great day, and I’ll be blogging more about that soon.

But in the meantime, I’ve been thinking a lot about essential design elements for therapeutic gardens. Much research has been done about features that are important in healing gardens, such as the presence of lush vegetation, movable seating, sensory stimulation, and so on. But before we even get to that, there are a few really important rules for creating successful and safe therapeutic gardens in the healthcare setting. I’m talking less about other Landscapes for Health like parks or private gardens or nature preserves, and more specifically about gardens in hospitals, nursing homes, treatment centers, hospices, and other places where people go to either get well or die gracefully in good, loving, capable hands.

So, here goes:

1. Design for the client (the “user”).
Cookie-cutter doesn’t cut it. Who will be using the garden? In a general hospital, sure, you have to design for lots of different people. But for a children’s garden, or a retirement community, or a cancer center, your clients’ needs will be very different and the garden must address those specific needs. Listen and pay close attention to those clients and to the staff (including horticultural or other types of therapists – they are your absolute allies). Do the research to find out what types of gardens and what design elements are most important for a particular population. Hire a consultant who is an expert in this area. Design for the client.

2. Design for comfort.
You’re designing an environment for people who are extremely vulnerable. Patients are sick or are awaiting diagnosis or treatment; family members and friends are worried and may have their own issues with hospitals and other health care facilities; staff and caregivers are under extreme pressure. So make the garden comfortable! Physically and emotionally. I’m all for modernist, avant garde, cutting-edge design in the right context. But in a therapeutic garden, you want to design for physical and emotional comfort. Remember the basics from site planning 101 about temperature, sun and shade, protection from wind and noise, etc.. Here again, knowing who your client is will enable you to really design for that specific population. Design for comfort.

3. Design for safety.
When talking about design for therapeutic gardens, Roger Ulrich likes to quote part of the Hippocratic Oath, “to do no harm.” This is the physician’s #1 priority, and it must be the designer’s as well. So make sure your pathways are smooth and easy to navigate (but also slip-resistant). Make sure you’re not using poisonous or prickly plants, especially in gardens for children and the developmentally disabled. Make sure benches are easy to get in and out of. Make sure the door leading to the garden is easy and safe to get in and out of! Design for safety.

4. Design for maintenance.
There’s no point in designing an amazing garden that looks great in the first year for the magazine photos and then looks terrible – or even worse, is dangerous – because it can’t be maintained. Again, this is about designing for the user. Talk to the administrators, find out who will be maintaining the garden, what sort of budget is alloted, who will be coordinating. This is not the fun stuff that we designers went to school for, but it is an essential component of what we do. Design for maintenance.

So when designing a garden for palliative care, we should ask these questions every step of the way: Is the space being designed for the people who will use it? Is the space comfortable, both physically and emotionally? Is the space safe? Can the space be maintained over many years? If yes, yes, yes, and yes, we’re well on our way to creating a successful healing garden.

The new website has lots of good information on Evidence-Based Design (EBD) in the Resources section, and we’ll be adding more soon in the EBD area.

As always, I welcome your comments and feedback. Have another essential element? Leave a comment for me and our other readers.