[Chris Garcia]

Hello Naomi. I love the TLN and reference it all the time. Keep up the great work!

As someone who’s visited therapeutic landscapes at over two dozen healthcare facilities across the country (someday I’ll catch-up to Clare (0:), I can positively say that the demand and interest in healing environments has grown “profusely” in the last ten years. The legacy health system in Portland is the Mecca of healing gardens. I give Teresia Hazen, Brian Bainnson, Annie Kirk, and Hoichi Kurisu tremendous credit for educating that entire medical community on the benefits of horticultural therapy and outdoor spaces specific to the patient group and medical protocol. I remember sitting in on a meeting between the Samaritan Lebanon Hospital Board of Directors, Hoichi Kurisu, ASLA and a horticultural therapist trained by Teresia Hazen as they proposed monthly horticultural therapy sessions. The recognition, positive comments, increased donations and marketing that the healing garden generated over just two years influenced the the 22-member board to vote unanimously in favor. Woot Woot!

Bonner Healing Garden at Bonner Hospice in Sandpoint, Idaho is my personal “pilgrimage site” and I know that it has a profound emotional affect on many who have lost a loved one in that community. The garden includes a distinct chapel, tea house, water wall, profuse plantings and a scenic natural context along Sand Creek. The idea for this garden started with the hospice director and hospital CEO visiting a healing garden at Sacred Heart Medical Center in Spokane. A “Garden of Life” committee was set-up and the planning process took place over a year and a half span. Guess what book they referenced? Healing Gardens edited by Clare Cooper Marcus and Marni Barnes.

There are many more incredible examples I’ve encountered of how ideas have spread on Healing Environments and become actual places. There are many incredibly horrid examples as well. A recently completed hospital in Murray, Utah incorporates many features that we might consider “therapeutic” such as a labyrinth and fountains. But they were designed in-house by the architect with no thought given to integrating the program of care, thermal comfort, and providing profuse plantings. The worst is that there are brochures and maps that hype-up the “healing environment.” There are even signs at some of these outdoor spaces labeled “Healing Garden.” But all you see is a ramp or single hardscaped fountain with mass plantings and uncomfortable, if any, seating. Yikes! This is the worry. That the “healing garden” or “healing environment” with certain features is being marketed by the architect/ landscape architect/ healthcare facility without any actual places for active therapy or at least a profusely planted restorative setting. Evidence-based design, including post-occupancy evaluations, must always be referenced when designing any space deemed therapeutic or healing (The TLN and Informe Design, HELLO!).

Alright, here’s where my story comes in. After my fellowship, I moved to Florida specifically to distribute research and promote therapeutic landscape design among nursing homes, assisted-living, and cancer centers. My family is afflicted by cancer and dementia, among other things, so this move had personal meaning. In four months of marketing, articles, calls, site visits, and website redesign (joining the TLN….first thing) we gained three nursing home clients (about 5% response). All three of these nursing homes were in the same city! Evidently an assisted-living facility in that region already had a healing garden (very well-designed) and prospective clients were gravitating toward it. On top of that, nursing homes have an “institutional” reputation and are trying to catch-up with assisted -living in providing a home-like environment. Many of the ones I visited also had low health inspection ratings for their facility environment. Each administrator was very enthusiastic about the prospect of improving their outdoor spaces. But they were all for-profit, meaning that they couldn’t obtain donations over time for landscape projects and had to go to their healthcare affiliate to plan it into an annual budget (slow process). I hoped that the schematic design would be funded immediately to begin collaborating with staff and patients in the planning process. But inspections, slow responses, and sticker shock for already low design service fees delayed the process. Even for non-profit nursing homes, it can take years to fund projects over time, even without a grueling recession.

…Good professional experience….Back to California though. OK, all hope is not lost. As soon as I got back home, I began sending out articles, calling administrators, working with the ASLA, and utilizing a book with photos from my fellowship. I got only one response but it was for renovations at six family-owned nursing homes under an ownership that believes in Culture Change. The corporate design team hired me the first day I toured the campuses and my first design, “The Flower Meadow,” will be planted in October with the help of a contractor/landscape architect from the ASLA. I was just at this nursing home today and at least fifteen residents asked me about the flower meadow (I hung the design board in the entry lobby). How much does it mean to them? Consider the eldest resident who dozes in her wheelchair in front of a sun-scorched opaque fence that currently blocks the view of the landscape and street life. She makes sure to hunt me down when the administrator informs the residents that I’ll be coming by and tells me to make sure to tear down that fence! Today, I noticed some colorful artificial flowers that someone “planted” in the courtyard. All I could think about was how they looked like cemetery plots and I worried about a negative emotional reaction. But the residents loved the color and view from the rooms. It reminded them of Disneyland. No one knew they were artificial, probably for the best. But they also want to watch the birds and I have a bet with one of the residents on whether we’ll start seeing the Swallowtail butterflies after the planting…so much to look forward to. After I finished the water color design board, I went to their Cinco de Mayo barbecue and made sure to show it to all the residents, staff, and families and get their approval.

Wow. Quite a journey! But the lesson is that yes it’s a struggle to educate, market, design, and build truly therapeutic landscapes. I don’t recommend trying to establish a firm solely on the foundation of evidence-based design or therapeutic landscape design. Incorporate it into an overall range of projects. Passion, research, outreach,and timing mean everything in educating prospective clients and marketing therapeutic landscape design. Market to healthcare affiliates, architects, and administrators and have the research to back-up your design. The design must always start with the patient and program of care in mind!

I’ll have to post more on the TLN, Naomi! There’s so many unique healing gardens out there. I’ll try to be more prudent about sharing my studies and work on your blog (I post a lot of it for clients at http://growingwithcare.blogspot.com/)

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