Healing Gardens Make Hospital Stays a Walk in the Park

By Paula Melton

What’s the first thing that comes to mind when you hear the word “hospital”? A lush, sun-dappled garden buzzing with hummingbirds, or a cold, institutional interior? For those of us who thought of the latter, the therapeutic landscaping movement is aiming for a change—and it’s finding more and more synergies with medical science, sustainable design, and the budgetary realities of the healthcare industry.

What makes a garden “therapeutic”?

Both controlled experiments and observational studies have proven that access to nature can relieve stress and pain and speed recovery (see "Biophilia in Practice," EBN July 2006). Even a landscape painting or a view out a window can contribute to well-being and measurably improve outcomes—but newer experiments show that healing and biophilia are much more strongly correlated when patients inhabit natural outdoor spaces, leading designers to look increasingly to “healing gardens.”

As healing gardens become more popular and hospitals begin marketing them as amenities, there is an important distinction to be made between conventional landscaping and a therapeutic garden, explains Robin Guenther, FAIA, sustainable healthcare design leader at Perkins+Will. A healing garden goes out of its way to “connect to that primal biophilia,” says Guenther, noting some of the key features that make this work:

Contrast —“People are trying to create a sense of contrast with the surrounding landscape,” says Guenther, but the garden itself should also contain a great variety of colors, textures, fragrances, and sounds to better mimic nature and to add elements of surprise and discovery.

Sensory experience —A healing garden also engages all five senses, explains Matt Maranzana, senior associate and landscape architect at HOK in St. Louis. The sound of running water or wind chimes and the ability to touch plants, dirt, and water (a garden feature often balanced against fears of spreading infection) also decrease stress.

Multiple functions —“You never know who’s going through which emotion,” Maranzana told EBN. Some people may be celebrating a birth while others are mourning a loved one. His colleague Michelle Ohle, associate at HOK Planning Group, notes that accommodating multiple uses can be a challenge—but a fun one. “You learn some of the little tricks. When you don’t have a lot of space, do vertical planting to create topographic changes.” Labyrinths are popular for defining a compact, contemplative space, she says, while an amphitheater creates a public multiuse area.

Distractions —“When they’re well done, they really allow people to be transported from their current experience,” says Guenther. Flowers that attract birds and butterflies (but not bees) can provide fodder for either quiet contemplation or conversations. Educational features like interpretive placards are also gaining popularity.

Movement —“You’re not just walking out the door and plunking yourself in a chair,” Guenther explains. A therapeutic landscape “encourages you to walk through it or push somebody in a wheelchair through it; the idea of a journey makes it a destination.” Gardens can also be used for physical therapy, notes Ohle.

Balancing healing with green building

Depending on the choice of plantings, watering may be needed. “If you’re trying to do native and drought-tolerant planting without irrigation, then you can’t really meet the expectation for diversity of experience easily,” Guenther concedes—but she has worked on projects that accomplished it.

Ohle adds that stormwater retention may also be a challenge. “We have very stringent guidelines because this is ADA-plus,” which may limit the options for permeable paving and other stormwater management strategies, she said. “The logistical needs have to come first,” Ohle notes, including accommodating IV poles and keeping opportunities for tripping to a minimum. Similarly, a highly ornamental garden is likely to require more intensive fertilizer. “What’s good for common sense is really good for healthcare settings,” Ohle told EBN. “Let’s rebuild the soil and not use crazy amounts of fertilizers and chemicals.”

Vegetated roof technology has made healing gardens possible for buildings without green space, says Guenther. “You’re seeing a lot of these therapeutic gardens on roofs,” she said.

Helping the bottom line

More and more hospitals are willing to commit to healing gardens not only because they benefit patients’ health but also because they’re a wise investment.

“Retention is much higher at facilities with exterior, occupiable space because the staff doesn’t get burnt out,” Ohle said. “Hospitals operationally can save a lot of money that way.” They can also save on maintenance: “It’s much easier to take care of beds rather than mow and water,” adds Maranzana. Also, mowing is loud and can increase stress, and mower exhaust can infiltrate patient rooms through air intakes.

Healing gardens have become a distinctive feature that hospitals market. Some facilities, Guenther said, have even started offering a private area in the garden as an end-of-life choice. “Everybody wants them,” said Ohle, adding that hospitals want their exterior spaces to reflect their high quality of care rather than feeling like a prison yard. According to Maranzana, hospital landscaping at its pinnacle begins in the parking area and aids visitors in wayfinding throughout the building and grounds, making the hospital experience quite different from what many of us are used to: “humane and personable.”

For more information:

Therapeutic Landscapes Network
www.healinglandscapes.org

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IMAGE CREDITS:
1. Rendering: AECOM, Perkins+Will/HGA

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