A Positive Distraction

The connection between nature and healing has been known for more than a thousand years.

A hospital garden can have healing properties.

Asian cultures were the first to recognize how lush gardens could induce tranquility and healing. Later, in the Middle Ages, European monasteries featured elaborate gardens to comfort and provide solitude to people under the monks’ care.

And even until the late 1800s, U.S. and European hospitals, too, tended private gardens, where patients could sit closer to nature to expedite the natural healing process.

By the early 1900s, however, the focus of hospitals shifted to a more science-oriented approach. Advances in medicine created an awareness of infections, and the need for sanitary conditions prevailed. The inside space in hospitals became the focus, and hospital designers sought more space in buildings for medical and lab equipment.

Soon, hospitals began to look and feel more like institutions--cold, sterile, and stark. By century’s end, an even newer trend emerged: managed healthcare. One by one, small community hospitals gave way to networks of corporate-managed facilities. In search of higher profits, cost-cutting and consolidation prevailed.

The Pendulum Swings Back

But the pendulum has begun to swing back, giving nature-based care a second look.

With antibiotics and modern drugs able to control infections, hospital designers have re-discovered the benefits of quiet hospital gardens. With competition growing for patient care, administrators are taking a patient-centered approach to boost patient satisfaction rates, a determining factor for repeat business.

Geoff Roehll, a landscape architect with Hitchcock Design Group, based in Naperville, Ill., well understands how hospital gardens have come full-circle. With more than two dozen Midwest hospital and healthcare healing-garden designs to his credit, he recently spoke on this topic to a group of 40 nurses at an Illinois Nurses Association-sponsored forum.

“It’s no surprise that a patient who heals faster saves money for everyone,” observes Roehll, a senior vice president for the firm.

“Healing gardens have been shown to improve medical outcomes by reducing a patient’s stress.”

His garden designs include the Wings of Hope Angel Garden at Edward Hospital in suburban Chicago. The garden was inspired by four local moms who had lost babies during childbirth.

Historically, grieving mothers were instructed to “forget about it” and get on with their lives, but these four women sought something different: They wanted a special place where they could reflect and mourn.

They inspired Roehll to create a special garden for them at the hospital.

A garden's peaceful atmosphere can soothe stressed patients and staff.

Unveiled last summer, the Wings of Hope Angel Garden has become a favorite place for hospital patients, their families, and the nursing staff. Modeled after a quiet English manor garden, its features include cedar pergolas in a brick-column frame, along with fountains and a pool. Accent lighting illuminates the garden for evening visits.

The response to this “healing” garden has been overwhelming.

“This dedicated space fosters restoration, and promotes healing from the devastating loss of a baby,” says Lisa Hill, MSN, RNC, an Edward Hospital labor-and-delivery instructor.

“To me, there is validity to the theory that a healing garden can be an integral part of a patient’s healing process.”

Hidden Benefit For Nursing Staff

Along with hospital administrators, Roehll has seen an unexpected benefit from hospital healing gardens. Primarily designed for patients and their families, nurses and other hospital staff have discovered the tranquility that a healing garden can offer. In warmer weather, many bring a bag lunch to the garden to relax.

This is only logical, Roehll contends. Nurses are tremendously stressed, and a hospital garden offers a quiet resolve from the daily routine. Like firefighters and police, nurses work on rotating shifts, which are known to disrupt sleep and eating patterns, and are factors in stress.

But the real benefit to hospital administrators is a reduction in nursing-staff turnover, which translates into higher operating costs to properly train new staff. If visits to a healing garden can reduce turnover, then it’s a “win-win” for all.

Labyrinth And Enabling Gardens Also Special

Of all of Roehll’s hospital garden designs, one stands out as the most unusual and picturesque. At Marianjoy Rehabilitation Hospital in Wheaton, Ill., he designed a garden around a large labyrinth, an ancient pattern familiar to nearly all world religions. The pattern has been found on pottery, coins and tablets up to 4,000 years old.

Borrowing from the famous Chartes Cathedral labyrinth in France, Roehll designed a similar labyrinth garden for Marianjoy. Designed within a sunken, circular plaza, the 1,520 square-foot garden has been a delight to the hospital’s Franciscan sisters. Before, they would unroll a labyrinth-patterned mat indoors each day as part of a tradition of walking and reflection. This was everything they wanted in a garden … and more.

According to Roehll, symbolism is threaded throughout the Marianjoy garden. Like the 800-year-old cathedral labyrinth, this one uses “sacred geometry” to dictate the number of plantings, site furniture, and hardscape elements. Part mystical, part sacred geometry, Roehll explains, the numbers 3, 4, 7, and 12 are used to base all design decisions. The Chartres design is a classical, 11-circuit labyrinth (11 concentric circles), with the twelfth being in the center of the labyrinth.

“Visitors enter the labyrinth facing east with a view of an unordered landscape,” he says, noting the randomness of the elements. “As they exit west, the view is of three ordered trees, which reflects their spiritual journey.”

At the same time, Roehll also shaped plans for another type of garden on Marianjoy’s 65-acre property. This one was an “enabling garden” for patient rehabilitation.

Unlike his other garden designs, which are more passive in nature, this garden offered a practical and interactive approach for patients. The use of small stairs and different walking surfaces with varying slopes, ramps, and handrails, “enable” patients to regain physical skills at their own pace.

A planting area off to the side, for instance, invites them to fill planters with soil to regain hand strength and dexterity. An interactive water feature provides both visual interest and a soothing background sound.

Achieving local notoriety for its work, Hitchcock Design Group was approached by a local high school to design a garden as a tribute to a series of tragic student deaths over a short time period. The idea of an “honor garden” began to emerge.

Located in a quiet courtyard, today the garden offers students at Naperville Central High School a sense of remembrance and tranquility for their fallen colleagues.

The Elements That Make Up A Garden

Whether you call it a “healing garden,” “memory garden,” “enabling garden,” or “honor garden,” the common denominator in each is lush plantings, Roehll says. This element provides visitors with a sense of access to nature and water.

An understanding of Midwest flowers and blooming cycles, the Purdue University graduate adds, also helps.

Gardens such as these should offer a healthy mix of spaces, patterns, and textures, says Roehll, who also serves on the Chicago Botanic Garden faculty committee.

“The key is to create a sense of mystery and discovery,” he says.

An ideal garden offers a balance of social-to-private areas, and sunny-to-shady areas. Paving materials, like decorative bricks, pathways, and stepping stones, can be helpful for rehabilitation. To invite socialization, Roehll likes to have benches and chairs face each other.

“While a plant may have a beautiful bloom for one month of the year,” he explains, “you should consider what it does the other 11 months.”

One should identify the plants that bloom at different times of the year, and plant accordingly so there is constant color and something blooming throughout the growing season.

In a healing garden, Roehl relates, visual elements can enhance the experience by providing a “positive distraction.” But sometimes this type of distraction can become a negative. The secret, he adds, is to design elements that don’t make you think.

“People who are ill interpret things differently than those who are healthy,” he explains.

He recalls a particular healing garden that featured a large abstract sculpture. To casual observers, the sculpture depicted a whale diving into the ocean. But ill patients saw the artwork much differently. They interpreted the diving whale as a sign of dying or death. The sculpture, he says, was eventually removed.

As a landscape architect in the Midwest, Roehll agrees that the biggest drawback is the seasonal nature of these gardens. In Chicago, for example, optimal garden conditions are available only six months out of the year.

But that doesn’t seem to deter most visitors.

That’s why he says that a healing garden’s elements should be coordinated not only with summer in mind, but for the other months, as well.

“You have to remember,” he says with a smile, “that people aren’t only sick when the weather is nice.”

Joe White is a freelance writer from Des Plaines, Ill. He can be reached via e-mail at jwhite@silbarpr.com.