Dissertation On Therapeutic Landscaping Submitted by Ifrah Tanweer 0549AR151018 In the partial fulfillment of the degree of Bachelor of Architecture Session 2018-2019 Guide: Ar. Neha Pranav Kolhe Coordinator: Ar. Vinita Verma Paikra
BAGULAMUKHI COLLEGE OF ARCHITECTURE AND PLANNING, BHOPAL
ABSTRACT This study establishes a set of elements and principles to be used for designing a therapeutic garden for people experiencing stress and stress related diseases such as Dementia and Alzheimerâ€&#x;s. To understand how a garden may provide benefit, the literature on therapeutic gardens and healing gardens are reviewed. The history of gardens in hospital settings and other healthcare institutions is examined. In addition, published work on the effects of nature on stress and health outcomes and theories as to why nature is restorative is included in the review of the literature. Because the focus of the study is outdoor environments for people experiencing stress, published works on therapeutic landscapes, stress, dementia, neurodisability and Alzheimerâ€&#x;s are reviewed as well. The nature of stress, its characteristics, and its consequences are studied to determine the strengths, deficits, and needs of the Dementia or Alzheimerâ€&#x;s patients as well as current treatment methodologies in use today including whether these treatments would lend themselves to an outdoor environment. Published case studies are studied to formulate the designing elements. Based on the extensive literature review, and case studies, design guidelines are established for setting up a therapeutic garden for people experiencing stress and stress related diseases.
Introduction 1.1
Overview
The therapeutic landscapes concept was first posited in 1992 by Wilbert Gesler as a vehicle for exploring why certain environments seem to contribute to a „healing sense of place‟ (Gesler, 2003).
Such environments were defined as therapeutic landscapes, „where the physical and built environments, social conditions and human perceptions combine to produce an atmosphere which is conducive to healing‟ (Gesler, 1996).
“A therapeutic landscape is a plant-dominated environment purposefully designed to facilitate interaction with the healing elements of nature.” (AHTA)
Introduction 1.1
Overview
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An important area of mental health that therapeutic landscapes can improve or heal is the care and treatment of patients suffering from stress related diseases. What leads to the development of stress-related diseases includes long-term increase of circulation cortisol and elevated blood pressure. Cardiovascular, metabolic, immunological and neuronal pathology are result of those physiological changes (Dahlgern, 2009).
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Accordingly, the rates of stress and stress-related diseases have significantly increased (Shahrad, 2012). Therapeutic landscapes with natural setting might be one of the answers to deal with stress.
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This research addresses the study of patients suffering from stress related diseases and dementia and explores how the power of plants can improve their lives. The contribution that plants can make to therapeutic efforts is examined, along with the extent to which outdoor spaces can be designed as ideal therapeutic environments to affect medical outcomes. To expand the subject beyond just plants, the relationships between senses and experiences as well as people and natural elements are briefly explored in this dissertation.
Aim & Objectives Aim To study the therapeutic / healing property of nature and its impact on patients suffering from stress or stress related diseases. Objectives: To understand the concept of Therapeutic Landscaping To identify the interrelation between Disease and Therapeutic Landscaping To formulate the major elements to be used for designing a therapeutic landscape
Methodology Objective 1 Definitions by different Research scholars
Different Concepts cited in various Research Papers
Objective 2 Literature Study
Case Studies
Objective 3 Case Studies
Research Papers
Understanding the Concept of Therapeutic Landscape ď‚›
Various definitions given by Research scholars - Becke Davis (2007), Clare Cooper-Marcus (2005), Elisabeth Palka (1999), Diane Relf (2005)
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The therapeutic landscape by distinction has an intentional, purposeful and measurable means to bring about health and well-being, often designed to meet the needs of specific patient populations. The therapeutic landscape is a space designed for a therapeutic treatment to bring about a certain measurable outcome. It can be thought of as similar to a medication taken for a specific disease or illness.
The Importance of a Therapeutic Landscape Physical Health Benefits Viewing and being in nature has been found to positively influence cardiovascular functioning; reduce the magnitude of physiological responses to stress; and enhance the ability to cope with, and recover from, stressful episodes. Viewing nature has also been found to reduce heart rate, release muscle tension, lower blood pressure, and improve skin conductance.
Mental Health Benefits The experience of nature in a neurological sense can help strengthen the activities of the brain‟s right hemisphere and restore harmony to its functions as a whole. This is perhaps a technical explanation of the process that occurs when people „clear their head‟ by going for a walk in a park. Contact with nature has been found to improve concentration, remedy mental fatigue, and positively affect mood state.
The Importance of a Therapeutic Landscape Social Health Benefits Interacting with nature in oneâ€&#x;s local neighbourhood has been found to promote a sense of community, foster a sense of belonging or sense of place, and enhance social ties/ relationships. Knowing that nature was nearby was found to improve the quality of life and neighbourhood satisfaction of residents. ď‚›
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Economic Health Benefits Spin-offs for economic health arising from nature contact include the capacity for parks and natural features to improve the productivity of workers; to improve recovery rates of patients in hospital; and to decrease the incidence of illness reported by individuals incarcerated in detention centres.
Interrelation between diseases and Therapeutic Landscapes
According to the Attention Restoration Theory, intentional fatigue is one of the results of stress. “Any prolonged mental effort leads to directed attention fatigue” (Kaplan 1995 p.170). Soft fascination which is one of characteristics of natural settings gives opportunity for recovery from directed attention fatigue.
In order to know what their needs are we should know what are their problems and according to the needs, what kind of intervention is needed. Intervention may lead the design to fulfill the needs of participants. Intervention and design should support each other.
Interrelation between diseases and Therapeutic Landscapes Types of Diseases and Various Healing Processes through Therapeutical Landscaping are discussed in dissertation
STFR (Stress Triggered Fatigue Reaction), Burnout Syndrome, Hepatitis C, Skeletal Injuries, Respiratory Illness, History of Problematic Drug Misuse (including heroin, party drugs, cannabis, inhalants and alcohol) Trauma relating to Childhood History of Physical or Sexual Abuse History of Suicide Attempts or Deliberate Self Harm Fear of relationships, meeting new people, trust, assertiveness, feeling safe in social settings Autistic Children Students Prisoners Gall Bladder Patients
Understanding the people experiencing Stress
The concept of stress is referred to a set of biological reactions” (Dahlgren, 2006) Stress is a result of reactions of body to any kind of demand. It is a physiological reaction of the body to a dangerous situation or a threat, which cause physiological changes. These kinds of changes in body prepare us to fight or flight (Shahrad, 2012). Dementia is a broad category of brain diseases that cause a long-term and often gradual decrease in the ability to think and remember that is great enough to affect a person's daily functioning. The most common type of dementia is Alzheimer's disease, which makes up 50% to 70% of cases. Occasional forgetfulness and confusion are normal occurrences, but Dementia is a medical condition (Zeisel and Tyson, 1999). Not all memory loss is caused by Alzheimer’s.
Stages of Alzheimer’s and its effect on brain
A brain without the disease.
A brain with advanced Alzheimer's.
How the two brains compare.
Case Studies ď‚›
William E. Carter School, Boston Bostonâ€&#x;s William E. Carter School is a public school for children (up to age seven years 11 months) with profound developmental delays. Its 0.4-acre sensory garden .
Case Studies
Healing Gardens In Hospitals
Reference:- “healing gardens in hospitals the necessity of nature” by Clare Cooper Marcus 94% 73% 73% 68%
Visitors, 15%
Patients, 26%
61%
53% 38% 36%
Staff, 59%
12% 11%
Elements and Principles for designing a Therapeutic Landscape
Elements and Principles for Designing Therapeutic Landscapes cited in various Research Papers “What are the design principles of Healing Gardens for people who are suffering from stress-related diseases?” ~ Azadeh Shahrad, 2012 “The Design Guidelines For Therapeutic Sensory Gardens” ~ Linda Balode, 2013 “Healing Gardens: Creating Places for Restoration, Meditation, and Sanctuary” ~ Annalisa Gartman Vapaa, 2002 “Garden Design to Reduce Stress” ~ Dr. Leonard P. Perry, 2018 “Therapeutic Gardening” ~ Phyllis Turner, 2013 “Accessible Gardening for Therapeutic Horticulture” ~Jean Larson, Anne Hancheck, Paula Vollmar, 2008
Elements and Principles for designing a Therapeutic Landscape
Elements and Principles for Designing Therapeutic Landscapes cited in various Research Papers “Gardening for health – starting” ~ Horticultural Therapy Association of Victoria “Landscapes with Healing in Mind” ~ Jean M. Larson “Therapeutic Garden Characteristics” ~ Adapted from American Horticultural Therapy Association Board of Directors, April 30, 1995 “The Design Principles of Therapeutic Gardens” ~ Ahmet Tuğrul Polat, Sertaç Güngör, Metin Demir “What Makes a Garden a Healing Garden?” ~ Ulrika A. Stigsdotter and Patrick Grahn “Healing Gardens’ Design” ~ Dr. Hesham El Barmelgy
Formulating Elements and Principles for Designing Therapeutic Landscapes
Secure and Safe environment Color theory in designing Plant arrangements Paved Pathways Softscape to Hardscape ratio – 7:3 Wheelchair accessible paths and areas Different rooms for 8 characteristics Synchronization of Interior and exterior Design Hierarchy in arrangement of vegetation Order and Maintenance Pots, Containers, etc. for encouraging gardening accessible at all heights
Formulating Elements and Principles for Designing Therapeutic Landscapes
Wildlife Water Features Open to sky spaces Some shaded or covered spaces The design should motivate the user to follow the trail till the end Seating for solo person in some areas Spaces for group seating to encourage communications or interactions Art and Sculpture that promote healing and Positivity Know the user and his mental power Adapt the garden site
Conclusion
Through my study of different research papers, journals, articles, etc. I came across varied landscape types but found that most of the elements and principles used for designing a therapeutic landscape are similar. therapeutic gardens should not be limited to just hospitals and healthcare facilities. Therapeutic gardens can be designed into a wider variety of spaces where people who are not confined to a hospital or healthcare facility can go and benefit from the healing qualities of these gardens. By including healing gardens in other facilities as well as residential and places of business such as yoga centers, a wider audience can benefit from these gardens. I believe that a therapeutic landscape is about perception as well as activity. the architect or designer should know the user very well and design according to the demand of the user. The architect should also be aware of the mental power of the user. The elements formulated are set as the basic elements and principles to be used while designing a therapeutic landscape for people experiencing stress and stress related diseases. One can use more elements while designing a therapeutic landscape as cited in other research papers. A therapeutic landscape should have interactive spaces promoting communication, socialization, independence, awareness, security, serenity, etc.
Bibliography Various articles and research papers were studied to carry out this research. Some of them are mentioned below along with the name of their authors.
What are the Design Principles of Healing gardens for people who are suffering from stress related diseases?, by Azadeh Shahrad, 2012; Healing Gardens: Creating Places for Restoration, Meditation, and Sanctuary - What are the defining characteristics that make a healing garden? by Annalisa Gartman Vapaa Planting Design And Its Impact on Efficacy in Therapeutic Garden Design for Dementia Patients in Long-term Care Facilities in North Texas by Cuiyan Mei Design Guidelines Of A Therapeutic Garden For Autistic Children, by Bonnie B. Hebert Therapeutic Landscapes: A Critical Analysis, by Ariane Kachatourians The Design Guidelines for Therapeutic Sensory Gardens, by Linda Balode; Healing Gardens‟ Design, by Hesham M. El-Barmelgy; Therapeutic Gardens- Deficiencies & Potentials, by Andreas Niepel; Design of evidence-based gardens and garden therapy for neurodisability in Scandinavia: data from 14 sites, by Josephine Anne Spring “What Makes a Garden a Healing Garden?”, by Ulrika A. Stigsdotter and Patrick Grahn