LANDSCAPE ARCHITECTURE

THE DESIGN GUIDELINES FOR THERAPEUTIC SENSORY GARDENS

Linda Balode
Latvia University of Agriculture
[email protected]

Abstract
The research topic is sensory, healing, rehabilitation and horticultural gardens, and the related discourses. The first
part of the paper describes the historic development of the rehabilitation and health gardens in Latvia. Then he
research paper takes a look at the main aspects which dominate in the rehabilitation and sensory visual and functional
garden sites in the world. The quest to create contemporary landscape sites for health reasons is still one of the main
subjects to explore and find definitions for. The methodology used in this paper is descriptive, from the perspective
of historical relaxation gardens and health sites. The aim of this research is to define the main development lines of
health sites in Latvia, trying to answer such questions as: How we can start developing sensory gardens and what
is needed for their development in the future? To achieve the goal, it is necessary to absorb the world experience
and exchange best practices, find innovative solutions, and adapt advanced rehabilitation center area landscapes
to individual needs. When creating the healing gardens, the aesthetic and functional criteria have to be applied.
Depending on the availability of the natural environment, health and satisfaction will be enhanced.
Key words: Horticultural therapy, Sensory gardens, Healing gardens, Rehabilitation, Sanatorium.

Introduction interest in human and environmental studies all over

The world experience shows that architecture the world, and the studies reveal many interesting facts
is closely linked with other fields of science, such proving that a person’s interaction with environment
as, biology, mathematics, philosophy, aesthetics, improves his or her mental and physical health. Most
psychology, physics and others. Professional and gardens give aesthetic pleasure, but sensory and
well-landscaped outdoor sites or well-designed indoor therapeutic gardens are created to functionally reveal
interiors can be both functionally effective and also all five of the human senses: vision, touch, smell, taste
strengthen and improve health processes – it is a new and hearing (Fig. 1.).
architectural trend, called ‘Design and health’ (Dilani, The sensory gardens are developed near the
2001). The study and analysis of how the environment kindergartens, hospitals, schools, as well as the care-
affects the human and vice versa, including also homes and other medical facilities. The surrounding
the relationships between individuals and different environment affects not only the way of thinking, but
groups, is called the environmental psychology. also the person’s intellectual development. Already
Both positive and negative lessons - learned from in 1810 in his book ‘Theory of Colours’ J.V. Goethe
environmental psychology - are useful not only to published the research on how optics affects human
the landscape architects, but also to designers, psyche. Unlike the physicist Newton, he emphasized
architects and urban planners. In the landscape the role of emotions and experience in how we perceive
architecture the design and positive health processes the colours (Goethe, 1810). The healing power of
are intertwined in the healing or health gardens nature, the sun and fresh air have already been used in
(Cooper and Barnes, 1999). There is an increased the previous centuries in planning and landscaping the

Source: graph created by the author (2013)

Figure 1. Examples of the five human senses.

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gardens near the medieval monasteries, infirmaries, Results and Discussion

19th century Pavilion type hospitals, 20th century International trends in developing rehabilitation and
shelters and sanatoriums. The plants, light, water and sensory gardens
other nature elements can cause in a person many In creating health gardens and parks it is important
different feelings. to take into account the fact that the outdoor site needs
In most of the medical institutions of Latvia, the to be a place where one can also have an aesthetic
green area is obsolescent and non-functional. Latvian pleasure and emotional feelings. The design of outdoor
landscaped sites need new and innovative ideas. site needs to be thought out, so the visitor has a strong
One of the solutions is the development of Latvian desire to explore the garden till its last trail and plant.
therapeutic gardens. And thus the research subject is: As every work of art, also the health garden’s value
Therapeutic and rehabilitation gardens. The present is its ‘open ending’ for further exploration of reality.
article discusses the landscape rehabilitation areas People tend to grasp a thing from all of its sides –
and their functional significance in Latvia and abroad. similarly, how a person relives the nature in its body.
The aim of the present research is to analyze and The same way, in a rehabilitation garden it cannot be
summarize the available historical papers, scientific said where nature ends and a person begins (Merleau
research literature, publications, documents, and – Ponty, 1967).
electronic resources on the Latvian health resort The rehabilitation garden’s space is traditionally
gardens, as well as the global experience of the divided into geometrical squares with trails and
medical treatment’s impact on people. On the basis a fountain in the central part of the garden. The
of the worldwide therapeutic gardens that are used in selection of rehabilitation garden’s plants includes
scientific research, the author surveyed and analyzed many plants that are daily used as herbal teas, spices,
the newly formed Latvian therapy gardens and food or flowers. In the mid-20th century in western
identified the most important features of rehabilitation countries the healing rehabilitation gardens slowly
and sensory gardens. The study provides a scientific disappeared from the medical institutions. It can be
research article on rehabilitation gardens in the world. explained with the rapid development of medical
It summarizes the historical and presently available and other technologies. The gardens located near
documents on the Latvian current rehabilitation the medical institutions were made smaller, to give
gardens. The author also looked into some further space to the car parks in their territory. Balconies and
opportunities to create the rehabilitation gardens in terraces were replaced with modernized ventilation
the landscape sites of Latvia. equipment. Due to the rapid industrial development
the medical institutions lost the beautiful sceneries
Materials and Methods that could be seen out of their window. The urban
The research paper is based on international landscape was booming and the nature, its healing
scientific studies on therapeutic gardens, as well as power was left forgotten. After the Second World War
on the analysis of Latvian therapeutic gardens. The the hospitals were designed as multi-story buildings,
literature on the Latvian health resort parks, healing not as Pavilion-type buildings. More emphasis was
gardens and sensory trails has been summarized put on the comfort of hospital’s staff, not patients
and analysed. The study has been conducted on (Gerlach –Spriggs et al., 1998). In the 21st century
the healing effect of the international therapeutic the medical institution gardens were made based on
gardens on humans. To complete the research tasks, technologically advanced equipment, ignoring the
the articles on the history of health resorts of Latvia, emotional needs of patients, their families and staff
scientific research literature, publications, documents to mentally recover in an outdoor site (Cooper and
and electronic media have been analysed. Using the Barnes, 1999).
gathered scientific information and analytical matrix, In the recent years there has been an increasing
the sensory garden guidelines for Latvia have been tendency to develop the sensory or therapeutic gardens
developed. The research is based on the current near the medical facilities. Discussions with the
development tendencies of the rehabilitation gardens, patients reveal their longings for the nature’s beauty,
but also taking into account the historical relaxation countryside’s peacefulness – bird songs, smell of soil
sites. The study analyzes the rehabilitation garden and flowers. Many of them are locked in the medical
literature of the period from 1800 to 2013. The study facilities or their homes without a chance to enjoy the
deals with two historical health resort rehabilitation things that for healthy people are self-evident. It is
gardens of this country that have already been closed, also important for people with various disabilities as
as well as four newly created gardens, that currently they get to explore the world through touch, hearing,
are the only existing ones in Latvia. taste and smell. Only in silence when enjoying the

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God’s given richness and mightiness of the nature, walls, relief and water. The water plays a key role in
and feeling the seasonal changes, a person can relax the healing gardens. In the summer it keeps the air
from the urban environment, find peace and spiritual nicely cool and moist, creating sounds and senses.
balance. The aesthetical and sensory enjoyment of A fountain can be in the garden as a landmark. It is
the rehabilitation and therapeutic gardens helps these recommended to have a separating wall or fences
people to return to social life. These kinds of projects in the healing garden or park. The walls secure the
are already known to other countries. The most patients’ physical and mental safety, reducing also
common types of therapeutic gardens are: Alzheimer’s, the risk of getting lost in the garden (Beckwith and
healing, rehabilitation, cancer patients’ and meditation Gilster, 1997). In Persia the walls in the gardens were
gardens etc. The rehabilitation gardens are specially used to keep the fragrances of roses (Rosa L.), jasmine
designed to intensify the particular senses that patients (Jasminum L.) and fruit trees (Hobhouse, 2003).
need. Many of these gardens have separated zones – In the sensory gardens you need to be careful with
for different age groups, treatment specifics or sensory plants that have strong fragrances, as well as flowers
stimulus. Those separated zones have different design that have a lot of pollen or flying seeds. To evade the
techniques, flowers, aromatic herbs, trees and bushes. hay fever or asthma, it is recommended to choose
In the ancient Rome it was popular to plant different plants that are pollinated by birds or insects and aren’t
medical plants near the soldier medical facilities. self-pollinating plants. The blind people can touch
Every plant had its own function and therapeutic everything in the garden, and with the help of Braille
effect. The fennel (Foeniculum vulgare L.) was used to learn about the sites or the plants. The garden offers
as a sedative, the garlic (Allium sativum L.) improved to smell and hear freely – it’s a possibility to relax.
the functions of the heart, the willows were used as Many international research papers have analysed
an antiseptic, but the sage (Salvia officinalis L.) who the positive effects of these gardens. The United
was less therapeutic had a religious meaning. In the States have many good examples of rehabilitation
Roman military hospitals the key role to recovery gardens that are overseen by the American Society
was given to the courtyard, fresh air and physical of Landscape Architects (ASLA). Since 1999 there
activity (Umbani, 2011). The sensory gardens should is also an online database of therapeutic landscapes
have benches, lighting and for physically disabled (Therapeutic Landscapes Network, 2013). American
people – heightened plant beds. The recommended studies have proven that gardens improve the relations
height for the heightened plant beds is 0.75 m, with between nurses and patients (Lappe, 1987). Similar
a place for the legs – 0.5 m. The plant beds should studies in Japan show that even in a relatively short
be accessible from all sides. The heightened plant time period (two months) the patients’ self-esteem and
beds, vertical plant walls, pots and containers will cognitive functions increase (Endo, 2003; Nomura
also help people in wheelchairs to participate in the and Hashimoto, 2006).
gardening – to sow, to weed and take care of plants.
Rehabilitation and sensory gardens in Latvia
For blind or visually impaired people it’s important
The sensory gardens that are located near the
to have the information on objects in Braille. The
rehabilitation facilities are called the healing or
sensory gardens have trails with different types of
therapeutic gardens. The landscaped environment
pavement. The recommended width for trails is for
of the therapeutic gardens is specially designed for
1 person – 1.40 m, and for two people – 1.90 m. If
people with physical or mental disabilities, for small
it’s not possible to have the recommended width, then
children to develop their feelings and senses, and for
after every 100-200 metres there should be a square
elderly, hospital patients, as well as for the visitors
of 1.80×2.0 m. The pavement should be non-slip,
and staff. The goal of the rehabilitation and healing
safe and with a normal slope. For the safety reasons
gardens is to improve person’s health and well-being,
there should be handrails with size of 0.70 and 0.90
to advance the recovery with the help of interaction
m. The New Zealand transport strategy (NZTS) has
with the nature. In the fast-paced and exhausting
defined the provisions for improving the standards and
day-to-day life, it is important to find time for the
design of the pedestrian sites. The strategy includes
relaxation and recuperation. Relaxation and treatment
world’s best practices in planning, designing and
in a site rich with natural healing resources shortens
maintaining the pedestrian infrastructure networks.
the time necessary for medical rehabilitation and
The trail infrastructure strategies have been developed
recuperation of the human body. The research and
also in Australia, the United States and in many other
written evidence dating back to the 15th century show
countries (Land Transport NZ, 2009).
that sulphur springs in Baldone health resort had many
Besides the high quality trails the other four
healing qualities that gathered patients from all over
most important elements in the garden are – the shed
the country. Baldone sulphur spring health resort was
(especially for Alzheimer’s patients), separating
located relatively high above the sea level, where the

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air is dry and rich with ozone. The area had many than 480 visually impaired and blind people, as well
hillocks that heart disease patients could use for the as the people with different kind of disabilities from
exercises. Since 1992 Baldone resort is closed and the Liepaja and 11 Kurzeme regions. The organization
use of mineral waters has stopped (Kūrorts, 2010). focuses on the rehabilitation, employment, education,
The Kemeri resort has also been closed since 1994. accessibility and other isues related to the persons
The Kemeri resort was opened in 1838. In 1801, in St. with disabilities and their social inclusion. In 2011,
Petersburg for the first time a chemical test was made in Ziemupe, Pavilosta region the construction works
for the Kemeri sanatorium sulphur springs. Soon began to develop the “Garden of Soul Relieve”.
after that the test results of Latvian-born chemist, In the farm ‘Laivenieki’ and its 6 ha territory, from
pharmaceutist and nature scientist David Hieronim which 1.3 ha is forest. It is planned to develop a site
Grindels were published. The health resort offered where people with special needs can relieve their soul,
mainly the hydrogen sulphide and mud baths, but also relax, meet and communicate with other people in a
the regimen and silence helped the patients to recover peaceful and harmonious countryside environment.
faster. In the territories of Latvian health resorts there The ‘Garden of Soul Relieve’ will be developed
also were landscaped parks for walking and relaxation based on patients’ senses (vision, hearing, smell,
that helped to recover faster (Sarma, 2008). taste, touch, proprioceptive senses). The specially
The Bruknas manor is located in Davini parish, developed landscape design and innovative ideas
Bauska region, by the shores of Iecava river. Since based on patients’ previous experiences and memories
2001 the historical building is a home for ‘Mount will help to fasten the recovery. It is planned to create
blessing community’ and the cultural centre ‘Bruknas a pond with sandy waterfront and a sauna, with places
manor’. ‘Mount blessing community’ is a mental and for swimming and fishing. A few kilometres from
physical rehabilitation site for people suffering from the farm there is the Baltic sea, giving an additional
addictions. In 2006 the community introduced a drama value. The garden will be a unique environment for
therapy method that relaxes the body and mind from people whom their disabilities have deprived of the
the tension. Using different exercises and creative possibility to enjoy the nature’s beauty (Dvēseles
tasks, drawing and writing, it is possible to analyse Veldzes Dārzs, 2012).
the persons’ feelings and determine what is depressing On May 27, 2012 the sensory trail ‘Juši’ was
them. The community is based on the drug addiction opened in Ligatne national park, Sigulda. In the
community ‘Senacolo’ model – this community is planning of this trail participated both experienced
located in Medjugorje, Bosnia and Herzogovina, and landscape artists and children, and youngsters from
its spiritual patronage is Mother Teresa from Calcutta. Sigulda region Creativity Centre in which a young
The main problem for the addicts is not the drugs, researchers team called ‘Juši’ has been created.
alcohol, gambling and other addictions, but rather Experts from the Nature Conservation Agency and
the lack of will to live. In 2007 the ‘Mount blessing Gauja National Park Foundation, as well as Sigulda
community’ in a project tender received the financing region Creativity Centre worked on the development
and in manor’s park developed a Renaissance-style of the sensory trail. The project was supported by
garden. The garden’s symmetrical squares are made the culture, environment and tourism agencies. The
from decorative vegetable and herbal plants. The main idea of ‘Juši’ project is to encourage children’s
crops are changed every year, thus symbolizing the interest and give them a possibility to explore this
changeability of the world. The idea of this kind of world through their feelings. The goal is to give
layout for the garden came from the Italian monastery the children and youngsters a chance to spend their
gardens from 15th and 16th century. In the 6.7 ha manor free time innovatively and creatively, and acquire
territory is located not only the landscaped park with knowledge that later might be useful in the study
Renaissance-style geometrical garden, but also ponds, process. In the modern technological world all that
6.9 ha of pastures, fruit and berry garden. The nature, children and adults need is accessible by computer
seasonal changes, liturgical rhythm of time, prayers, or mobile phone. Our cognition process ends there.
work in the garden, maintaining and renovating the But a person has also his senses that allow him to
Bruknas manor help people to purify and return back see, explore, understand and feel the world. To
to normal life. Through spiritual guidance and work maintain those senses they need to be trained. At
therapy people can find again the meaning in life and the beginning of the trail, behind the Sigulda New
get rid of various addictions (Ušča, 2008). Castle pond, you can see the ‘Juši’ trail map created
Rehabilitation gardens help to bring back the joy by the artist Iveta Īle. Through the entire route
of life not only for the people suffering from various there is guidance near the sensory objects and what
addictions, but also to severely and terminally ill kind of senses can be experienced near them. In the
patients. Liepaja Society of the Blind unites more near future it is planned to develop the trail further

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and introduce many new ideas and designs (Zālīte, that are outdated, non-functional, but may serve as a
2012). foundation for the development of new sensory and
In May 2013, in Valmiera the development works rehabilitation gardens (Fig. 2.)
will begin in the territory of Gauja steep coasts, where Psychological support is formed not only in the
the Olympic centre plans to create the ‘Gauja Steep social attitudes, but also in the environment in which the
Coast Sensory Park’. Valmiera Olympic centre has person lives. The visit to this garden develops not only
the management rights over 349 314 m² territory until feelings and senses of small children and teenagers,
December 31, 2017 – it includes 159 314 m² of ‘Steep but also enables residents of any age with various
coasts’ and 190 000 m² of ‘Recreation park’. Two trails disabilities to spend their free time interactively. The
are planned to develop in the park with the total length old school neighborhoods have become mentally and
of 3.3 km. The park will be for people of all ages, physically outdated landscape. Old manor parks are
starting from small children up to seniors. The ‘Gauja the cultural heritage of this country and an important
Steep Coast Sensory Park’ will offer a possibility to tourist sites, but without innovative ideas they are
experience nature with all of the five senses: hearing, stagnating. To continue the development of this kind of
vision, touch, smell and taste. In the ‘Senses trail’ it projects in Latvia, it is necessary to do a more detailed
will be possible to feel with bare feet different kind of research on the planning, designing and maintaining
natural material coverings (pine (Pinus sylvestris L.) of the rehabilitation and sensory gardens.
cones, needles, moss (Bryophyta L.), pebble stones,
sand, chestnuts (Castanea L.) etc.). It is planned to Conclusions
have in the park constructions that help to train the In the world and also in Latvia there is a growing
balance, as well as the ‘Educational trail’, in which the interest in the studies of people and environment that
visitors will be able to explore the local flora and fauna. show how the relations between these two factors
In cooperation with ornithologist Andris Klepers there improve the human health. The selection of the
will be developed an observation site for the martlets location plays an important role when creating the
(Apodiformes L.) – birds of the swallow (Hirundo rehabilitation garden. How can we start developing
rustica L.) family. The sensory park will also have the sensory gardens and what is needed for their creation
‘Nature school’ – it will be a green classroom both for in the future? To achieve the goal, it is necessary to
nature teachers and students to learn in an open air. The absorb the global experience and exchange the best
park is located next to the Sport Rehabilitation centre, practices, to find innovative solutions, and adapt the
where people can do sports, swim in the pool, relax advanced rehabilitation center area landscapes to
in the sauna and enjoy the healthy herbal teas (Gaujas individual needs. The garden will be more effective
Stāvo krastu Sajūtu parks, 2013). Latvia has many and beneficial if it is located near the sea, a river, or
natural countryside landscapes, forgotten traditional a healing source. Furthermore, the proximity of the
farms, manor parks, social care homes, kindergartens forest and fresh air is an integral part of rehabilitation
and Soviet period green territories near the schools garden ingredients. Latvia has natural landscapes,

Source: graph created by the author (2013)

Figure 2. Health gardens development opportunities for Latvia.

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many healing springs and mud deposits, countless well- been developed a rehabilitation garden with different
preserved traditional Latvian farms, historical manors garden areas to treat people in distress. Before
and parks that could be used for the development of building rehabilitation or sensory gardens in Latvia, it
sustainable rehabilitation and therapeutic gardens. is important to define the target audience. After finding
While doing the research on sensory gardens we have the appropriate location we have to identify the needs
to take into account this important factor – the climate of potential visitors. Whether they are small children,
of Latvia. Most of the existing gardens are located in hospital patients or seniors from care homes – every
the countries with warm climate. We have to search group has its landscape vision and viewing angle.
for appropriate plants, trails, square structures and For Latvia to have the development of rehabilitation
other elements that can be used in the local climate. gardens we must have an overseeing organization that
In the Baltic Sea region a good example can be found would gather and coordinate the newest tendencies
in Alnarp, Sweden, where in the territory of the and search for the funding.
Swedish University of Agriculture Sciences there has

References
1. Beckwith M.E., Gilster S.D. (1997) The paradise garden: A model garden design for those with Alzheimer’s
disease, Activities, Adaptation and Aging, New York: Haworth,Vol. 2, 22, (1-2), pp. 3-16.
2. Cooper M.C., Barnes M. (1999) Healing gardens: Therapeutic benefits and design recommendations. John
Wiley and Sons, New York, pp. 27-86.
3. Dilani A. (2001) Design and health – The therapeutic benefits of design. Stockholm: AB Svensk Byggtjänst,
pp. 31-38.
4. Dvēseles Veldzes Dārzs (Soul Refreshment Garden) (2012) Projekts. Liepājas neredzīgo biedrība (Liepaja
Association for the Blind). Available at: http://www.redzigaismu.lv/lat/jaunakie-projekti/projekts-
dveseles-veldzes-darzs/, 18 March 2013. (in Latvian).
5. Endo H. (2003) Change of dementia care management after implementation of long-term care insurance.
Clinical neurology, Rinsho Shinkeigaku, Japan, 43 (11), pp. 788-790.
6. Gaujas Stāvo krastu Sajūtu parks (Gauja steep coast senses park) (2013) Valmieras District Council.
Available at: http://www.valmiera.lv/zina/par-valmieru/veidos-gaujas-stavo-krastu-sajutu-parku-valmiera,
7 March 2013. (in Latvian).
7. Gerlach - Spriggs, Kaufman R., Warner Jr. (1998) Restorative Gardens: The Healing Landscape. New
Haven, Yale University Press, CT and London, 5 p.
8. Goethe J.W. (1810) Zur Farbenlehre (Theory of Colours). In: J. Naydler (ed.), Geothe on Science:
Anthology of Goethe’s scientific Writings (1996), Floris Books, Edinburg, 116 S. (in German).
9. Hobhouse P. (2004) Gardens of Persia. Carlsbad, Kales Press, California, 192 p.
10. Kūrorts (Resort) (2010) Baldone District Council. Available at: http://www.baldone.lv/Lapas/N_Kurorts.
htm, 10 April 2013. (in Latvian).
11. Land Transport NZ (2009) Pedestrian planning and design guide. NZ Transport Agency WOKA KOTAH,
188 p.
12. Lappe J.M. (1987) Reminiscing: The Life Review Therapy. Journal of Gerontological Nursing, 13 (4),
pp. 12-16.
13. Merleau - Ponty M. (1967) Signes, Gallimard, Paris, 234 p.
14. Nomura N., Hashimoto T. (2006) Group reminiscence therapy for Japanese elderly community. Shinrigaku
Kenkyu, Japan, 77, pp. 32-39.
15. Sarma I. (2009) Ķemeru kūrorta vēsture (Ķemeru resort history). Jūrmalas Kūrorta Ziņas (Jurmala Resort
Messages). Pavasaris – vasara, 4. lpp. (in Latvian).
16. Therapeutic Landscapes Network (2013) Available at: http://www.healinglandscapes.org/about/history.
html, 20 March 2013.
17. Umbani L.U. (2011) Preventive therapy in Complementary Medicine. Xlibris Corporation, USA, pp. 453-
455.
18. Ušča A. (2008) Bruknas muiža piedzīvo straujas pārmaiņas (Bruknas Manor is experiencing rapid change).
Available at: http://www.pilis.lv/c_zinas/zinja.php?id=2997, 3 April 2013. (in Latvian).
19. Zālīte R. (2012) Siguldas novada Jaunrades centrs ‘Juši’ (Sigulda Regional Innovation Centre ‘Jusi’).
Available at: http://old.vidzeme.com/i.php?v=lat&jid=2016, 2 May 2013. (in Latvian).

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