Dissertation On BAGULAMUKHI

Therapeutic COLLEGE OF
Landscaping ARCHITECTURE AND
PLANNING, BHOPAL
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
 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 Alzheimer‟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 Alzheimer‟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 Alzheimer‟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
 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).

 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.

 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 Different Concepts cited in various
scholars Research Papers

Objective 2

Literature Study Case Studies

Objective 3
Case Studies Research Papers
Understanding the Concept of
Therapeutic Landscape

 Various definitions given by Research scholars - Becke

Davis (2007), Clare Cooper-Marcus (2005), Elisabeth
Palka (1999), Diane Relf (2005)

 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 one‟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.

 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 A brain with How the two brains

disease. advanced compare.
Alzheimer's.
Case Studies
 William E. Carter School, Boston
Boston‟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, 61%
15% 53%
38% 36%
Patients,
26% 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