Making a case for therapeutic gardens

22 Aug

Jack Carman, FASLA Therapeutic Gardens 0 0

By: Eric Herr, For the Courier-Post 2:21 p.m. EDT August 19, 2016

(Photo: Jose F. Moreno/Staff Photographer)

When Jack Carman of Medford started his own business, Designs for Generations, more than 15 years ago, he did so with the intention of helping the healthcare community.

Before becoming an entrepreneur, Carman, a landscape architect, worked for a local municipal engineering consulting firm. There, he realized he might make a difference by designing therapy gardens for people in hospital settings, as well as those living in assisted-living communities and even at home.

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“As part of my job at the consulting firm, I would often review overall site plans for various healthcare environments and I noticed that in numerous instances, the primary focus was on the internal building design, with outdoor environments being virtually ignored,” Carman explains.

Seeing a void in environmental aesthetics — and with encouragement from his wife, Nancy, a geriatric care manager, Jack began to look more closely at therapeutic gardens and how they might positively affect mental behavior, especially among those suffering from dementia, Alzheimer’s and other degenerative disorders.

Carman discovered research conducted between 1972 and 1981, by an award-winning professor of architecture, Dr. Roger S. Ulrich, that supported his assumptions. Ulrich’s findings, which appeared in the April 1984 edition of The American Association for the Advancement of Science Journal, revealed some fascinating insights.

Twenty-three patients in a suburban Philadelphia hospital who were recovering from gallbladder surgery were assigned rooms with windows looking out on a natural scene.

These 23 patients exposed to nature had shorter post-operative hospital stays, received fewer negative evaluative comments in nurses’ notes and took fewer pain-relieving medications than did 23 patients in similar rooms with windows facing a brick building wall.

Encouraged by Ulrich’s study, Carman has since become a leading authority in his own right, conducting seminars, writing articles and doing a wide range of both commercial and residential landscape consulting.

A meditation garden is at the Virtua Hospital in Camden.The garden was designed by Jack Carman to comfort and support Alzheimer’s patients. (Photo: Jose F. Moreno/Staff Photographer)

In an article “What Is The Evidence To Support the Use of Therapeutic Gardens for the Elderly,” published in the September 2012 issue of the Journal of the Korean Neuropsychiatric Association, Carman along with other leading experts asserted that horticulture therapy not only improved attitudes and the overall quality of life — especially among aging populations — but could also, by extension, be linked to cost savings.

“Good therapy for patients and their families notwithstanding, therapy gardens also provide a welcome change of pace for doctors, nurses and other caregivers, whose jobs are both demanding and often very stressful,” observes Carman.

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Perhaps no one understands that aspect better than Amy Quick, director of Virtua Health, Camden CASTLE Program.

CASTLE, or Children Achieving Success through Therapeutic Life Experiences, is a Medicaid-funded initiative that provides assistance and support to children ages 3 to 15 who have behavioral and emotional issues affecting their lives at home or at school.

Staffers began discussing a garden in 2013, “recognizing the need to take care of themselves, first, as a means of providing and maintaining optimum care for all our patients, whether they be in CASTLE or other departments within our healthcare center,” explains Quick.

A once-neglected and overgrown 3,000-square-foot courtyard area was subsequently transformed into a vibrant natural habitat that incorporates a variety of plants and shrubs, a space for growing herbs and vegetables, plus yoga and meditation areas, walking paths constructed of recycled rubber, shaded alcoves and more.

According to Quick, the initial design was simply to have the garden only for viewing, but it soon became apparent access for patient activities, family time and even staff meetings would benefit everyone.

“The garden offers a soothing environment for patients and their families to enjoy and is a great stress-free place for our staff to relax and unwind,” notes Quick.

Another perk is that children in the CASTLE programlearn about horticulture by actively working in and maintaining the garden.

In an annual event, butterfly larvae, raised by the children, hatch and mature into butterflies that are taken out into the meditation garden and released.

The final phase of another therapy garden project that Carman designed for Virtua’s Voorhees location was completed last year.

Like Quick and her colleagues at Virtua Health, Lisa Heinkel, director of health services at Medford Leas Continuing Care Retirement Community, along with on-site horticulturalist Debbie Lux, use their recently completed garden for multiple purposes.

“This space has literally come alive since we opened it this spring for our residents and staff,” says Heinkel, adding it’s the perfect staging area for a variety of ongoing programs and activities.

Lux points out the area, which opened in May, incorporates many native plants, shrubs and trees as well asa water feature that attracts numerous birds and butterflies.

“The best part,” observes Lux, “is that when the weather gets too cold to go outside, our residents can still enjoy the view of the garden from the adjoining dining area.”

Michelle Bieszczad is director of Aging Services for Sisters of Mercy of the Americas Mid-Atlantic Community, a religious order serving Pennsylvania, New Jersey and parts of New York, with administrative offices in Merion, Pennsylvania.

She met Carman at a long-term care conference in Los Angeles back in the late 1990s.

“Jack and his wife Nancy were conducting a workshop on creating natural outside therapeutic environments for seniors and I was immediately fascinated by the whole idea,” recalls Bieszczad, who lives in Voorhees.

Bieszczad hired Carman to develop and design gardens for a nursing community in Northeast Philadelphia, where she then worked in a similar administrative capacity.

Their longstanding relationship has continued, with discussions underway about a new garden at the Merion location and elsewhere to benefit those suffering from Alzheimer’s and related memory challenges.

By most accounts, the size of the garden may not be as important as the design and configuration elements for practical use.

“The total sensory experience is always key in designing any therapeutic garden,” explains Carman. “The scent of fresh basil, rosemary and mint, along with the wonderful fragrances of various flowers, together with the tranquil sound of wind chimes and water features, for example, can evoke fond memories for those of all ages.”

Non-toxic plants, shaded areas, smooth level paths, seating and the many aspects of direct and indirect lighting are all equally important design basics to consider.

If the intrinsic beauty and overall positive effect of the gardens isn’t enough incentive, there’s always the all-important bottom line.

“Lets face it, budgets are tight everywhere and sometimes aesthetics such as gardens get cut,” observes Carman.

“But, what’s important to understand and what research proves is that when a calm, relaxing and pleasing natural environment is created, there are significantly improved overall health outcomes, for patients and their caregivers alike. That, in turn, can translate into huge cost savings at many levels across the board.”