A current PhD student in Molecular Plant Genetics who has a masters in Agrobiotechnology
Healing or therapeutic gardens - how love of nature is being used to cure serious illness
Getting affected with disease is inevitable for a person at some stage of life, however life expectancy of people has increased significantly worldwide due to groundbreaking discovering in the field of medical science. Horticultural therapy is an approach which has been integrated within modern medical science that exploits aesthetic beauty of nature in tackling serious illness such as dementia, Alzheimer's disease and schizophrenia. In this case, professional therapists guide and engage patients with plant and garden oriented activities in order to achieve specific therapeutic treatment result.
Horticultural therapy could be provided either via a healing or a therapeutic garden. A healing garden is often seen as a beneficial component in hospitals and similar establishments, which is used to create mental peace among patients, thereby trying to gain better outcome through the planned in-house treatment. In contrast, a therapeutic garden is constructed at exterior environment with an aim to satisfy the mental, bodily and communal necessity of patients, their kith and kin and caretakers.
Majority portion of such gardens are supposed to contain ornamental plants and grasses, annual and perennial plants, shrubs, non-poisonous plants which attract butterflies and birds. Sculptures are not recommended in such places, however water fountain and ponds are considered essential to enhance the scenic beauty of such a garden. Other important components in such a settings are benches, sun deck, walking paths and music playing facilities.
Closeness to the nature in the aforementioned garden assists the patients to maintain appropriate diurnal rhythm, minimize blood sugar and assimilate higher quantity of vitamin D. Besides, it also helps them to get over anxiety and distress away from the boredom of closed atmosphere of the hospital and achieve calmness, serenity and peacefulness. Likewise, they have better social interaction, as they become part of social engagement groups through gardening. Thus a sense of care for nature is nurtured within themselves as well, which increases their aspiration to live a long life.
Overall, the practice of horticultural therapy as an additional tool to conventional hospital based treatment has become popular in some of the industrial countries already and it is poised to expand further in future as a way to secure mental well-being of relevant patients.
Abstract: The French Alzheimer plan anticipates new specialized structures for cognitive rehabilitation and psycho-behavioural therapy of Alzheimer's patients: the cognitive-behavioural units as follow-care units, the units of reinforced hospitalization inside the long term care units and the adapted activities units. this plan indicates the need to make healing gardens integral parts of these units. The benefits of green space in urban environments has been demonstrated with regards to physical, psychological and sociological effects and similarly studies in hospitals have revealed objective and measurable improvements of patients well being. Although green spaces and gardens are available in many French care units, they are rarely specifically adapted to the needs of Alzheimer's patients. For the garden "art, memory and life" a specific concept guided by a neuropsychological approach was developed, complemented by an artistic vision based on cultural invariants. It is already used in the frame of non-pharmacological therapies to improve symptoms such as deambulation, sleep disorders, apathy and aggressive behaviors. Based on the literature, and our experience and research, recommendations for the design of such gardens dedicated to Alzheimer's patients can be proposed. Beyond taking into account obvious aspects relating to security, allowing for free access, a careful design of walk-ways and a conscious choice of plants is needed. A systematic analysis of the existing green spaces or garden must be conducted in order to pinpoint the weakness of the space and identify the potential for developing it into a real healing garden. Evaluation of adapted questionnaires for users and professionals allow to establish a list of requirements combining both user requests and therapeutic needs as basis for the design of the garden as well as to evaluate during the course of the project, whether the needs of the various stakeholders have been met or if adjustments are necessary.
Pub.: 28 Sep '12, Pinned: 29 Apr '17
Abstract: In 2008, the Taiwan Association for Care and Counseling for Loss organized a workshop about Horticultural Therapy, conducted as a participatory action research (PAR). Nineteen grief caregivers participated. Specific goals were designed according to a survey of participant expectations and focus-group discussions. The workshop content included lectures and interactive activities. Results demonstrated that most participants displayed an increased awareness of personal loss and meaning in grief, indicating that horticulture and nature appreciation might relieve individual grief and stress. The report introduces the rationale, evolution, execution, and results of the program development.
Pub.: 05 Mar '14, Pinned: 29 Apr '17
Abstract: Objectives were to review the literature on horticultural therapy and describe the Danderyd Hospital Horticultural Therapy Garden and its associated horticultural therapy programme.The literature review is based on the search words 'gardening', 'healing garden' and 'horticultural therapy'. The description is based on the second author's personal knowledge and popular-scientific articles initiated by her. The material has been integrated with acknowledged occupational therapy literature.The setting was the Danderyd Hospital Rehabilitation Clinic, Sweden, Horticultural Therapy Garden.Forty-six patients with brain damage participated in group horticultural therapy.Horticulture therapy included the following forms: imagining nature, viewing nature, visiting a hospital healing garden and, most important, actual gardening. It was expected to influence healing, alleviate stress, increase well-being and promote participation in social life and re-employment for people with mental or physical illness. The Horticultural Therapy Garden was described regarding the design of the outdoor environment, adaptations of garden tools, cultivation methods and plant material. This therapy programme for mediating mental healing, recreation, social interaction, sensory stimulation, cognitive re-organization and training of sensory motor function is outlined and pre-vocational skills and the teaching of ergonomical body positions are assessed.This study gives a broad historic survey and a systematic description of horticultural therapy with emphasis on its use in rehabilitation following brain damage. Horticulture therapy mediates emotional, cognitive and/or sensory motor functional improvement, increased social participation, health, well-being and life satisfaction. However, the effectiveness, especially of the interacting and acting forms, needs investigation.
Pub.: 30 Oct '04, Pinned: 29 Apr '17
Abstract: Since ancient times the relationship between mankind and plants occupies medicine and philosophy. From the first tablets of herbal medicine to Asclepius gardens, those of cloisters and bimaristans to cosmological gardens in Asia, from the largest public park to asylum institutions of the nineteenth century, the garden is proposed as a place of care, a promoter of restoration of the human being. If the advent of technology and drugs have for a time relegated it to the level of empirical care, results in neuroscience ultimately provide it on a scientific basis. The early evolutionary theories, the Savanah theory from Orians, the biophilia hypothesis from Wilson, are relayed by the famous Ulrich' study showing the positive influence of a view of nature through the window on the recovery of in patients. Mechanisms leading stress regulation, level of attention and organisation, focus and fascination, are recognized at the origin of restoration processes. Human capacities to respond to the recuperating function of a natural environment connect to grounded behaviour for adaptation to natural selection process and survival. The mechanisms of our immune system are essential to maintain our vitality. Phyto-resonance, felt or unconsciously perceived in appearance, according to Shepard is an emotion that structures well beyond the archaic behaviour. Recovery, in terms of phenomenological experience of the presence, is a philosophical demonstration of the environmental i.e. multisensory, spatial and temporal approach. Its emotional and affective experience connects to the vitality and creativity. The phyto-resonance hypothesis according to the Konrad Neuberger's point of view induces strategies catering to all levels of the organisation of the human being. It confirms the multidisciplinary nature of hortitherapy and places the mechanism of relationships between man and plant at the centre of discipline. It is also a source of inspiration and inexhaustible work for caregivers. The phenomenological approach of the therapeutic garden is an art of hospitality, human relationships and care. The garden opens the door to our interiority and prepares the interpersonal meeting. The experience of presence, mobilizing internal resources, is an opening to the possibilities of the living world, allows entry into a slow but promising time. The reintroduction and rehabilitation of the garden setting in residential care is necessary. These benefits are open to all for a better efficacy of care.
Pub.: 28 Jun '15, Pinned: 29 Apr '17
Abstract: Two-thirds of people with dementia reside in their own homes; however, support for community-dwelling people with dementia to continue to participate in everyday activities is often lacking, resulting in feelings of depression and isolation among people living with the condition. Engagement in outdoor activities such as gardening can potentially counteract these negative experiences by enabling people with dementia to interact with nature, helping to improve their physical and psychological well-being. Additionally, the collaborative nature of community gardening may encourage the development of a sense of community, thereby enhancing social integration. Despite increasing evidence supporting its therapeutic value for people with dementia in residential care, the benefits of horticultural therapy have yet to be transposed into a community setting. This paper will examine the theoretical support for the application of horticultural therapy in dementia care, before exploring the potential of horticultural therapy as a means of facilitating improved physical and psychological well-being and social integration for people living with dementia within the community.
Pub.: 25 Dec '15, Pinned: 23 Apr '17
Abstract: Called dotage in Korea, dementia is primarily characterized by cognitive impairments. Secondary manifestations include mental-emotional problems, including depression. This study was designed to examine the effects of an integrated dementia intervention for Korean older adults. The intervention is composed of cognitive stimulation training, exercise, music, art, and horticultural therapy. Participants included 38 older adults with mild dementia. Twenty were assigned to the experimental group and 18 to the control group. Participants in the experimental group attended 18 program sessions. Significant differences were found postintervention between the two groups in measures of cognitive function, depression levels, and mental-emotional health. The findings indicate that this integrated dementia intervention can be applied to help older adults with mild dementia.
Pub.: 09 Nov '10, Pinned: 23 Apr '17
Abstract: Psycho-oncological care, including spiritual care, is essential for cancer patients. Integrated medicine, a therapy combining modern western medicine with various kinds of complementary and alternative medicine, can be appropriate for the spiritual care of cancer because of the multidimensional characteristics of the spirituality. In particular, therapies that enable patients to establish a deeper contact with nature, inspire feelings of life and growth of plants, and involve meditation may be useful for spiritual care as well as related aspects such as emotion. The purpose of the present study was to examine the effect of spiritual care of cancer patients by integrated medicine in a green environment.The present study involved 22 cancer patients. Integrated medicine consisted of forest therapy, horticultural therapy, yoga meditation, and support group therapy, and sessions were conducted once a week for 12 weeks. The spirituality (the Functional Assessment of Chronic Illness Therapy-Spiritual well-being), quality of life (Short Form-36 Health Survey Questionnaire), fatigue (Cancer Fatigue Scale), psychological state (Profile of Mood States, short form, and State-Trait Anxiety Inventory) and natural killer cell activity were assessed before and after intervention.In Functional Assessment of Chronic Illness Therapy-Spiritual well-being, there were significant differences in functional well-being and spiritual well-being pre- and postintervention. This program improved quality of life and reduced cancer-associated fatigue. Furthermore, some aspects of psychological state were improved and natural killer cell activity was increased.It is indicated that integrated medicine performed in a green environment is potentially useful for the emotional and spiritual well-being of cancer patients.
Pub.: 05 Mar '13, Pinned: 23 Apr '17
Abstract: Distress is one of the most common clinical manifestations associated with dementia. Pharmacological intervention may be appropriate in managing distress in some people. However, best practice guidelines advocate non-pharmacological interventions as the preferred first-line treatment. The use of non-pharmacological interventions encourages healthcare professionals to be more person-centred in their approach, while considering the causes of distress. This article provides healthcare professionals with an overview of some of the non-pharmacological approaches that can assist in alleviating distress for people living with dementia including: reminiscence therapy, reality orientation, validation therapy, music therapy, horticultural therapy, doll therapy and pet therapy. It provides a summary of their use in clinical practice and links to the relevant literature.
Pub.: 26 Nov '15, Pinned: 23 Apr '17
Abstract: To summarize the evidence from randomized controlled trials (RCTs) on the effects of horticultural therapy (HT).Studies were eligible if they were RCTs. Studies included one treatment group in which HT was applied. We searched the following databases from 1990 up to August 20, 2013: MEDLINE via PubMed, CINAHL, Web of Science, Ichushi-Web, GHL, WPRIM, and PsyclNFO. We also searched all Cochrane Database and Campbell Systematic Reviews up to September 20, 2013.Four studies met all inclusion criteria. The language of all eligible publications was English and Korean. Target diseases and/or symptoms were dementia, severe mental illness such as schizophrenia, bipolar disorder, and major depression, frail elderly in nursing home, and hemiplegic patients after stroke. These studies showed significant effectiveness in one or more outcomes for mental health and behavior. However, our review especially detected omissions of the following descriptions: method used to generate randomization, concealment, blinding, and intention-to-treat analysis. In addition, the results of this study suggested that the RCTs conducted have been of relatively low quality.Although there was insufficient evidence in the studies of HT due to poor methodological and reporting quality and heterogeneity, HT may be an effective treatment for mental and behavioral disorders such as dementia, schizophrenia, depression, and terminal-care for cancer.
Pub.: 03 Dec '14, Pinned: 23 Apr '17
Abstract: This preliminary study examined the effect of horticultural therapy on psychosocial health in older nursing home residents. A combined quantitative and qualitative design was adopted. Convenience sampling was used to recruit 10 older residents from a nursing home in Taichung, Taiwan. Participants joined a 10-week indoor horticultural program once a week, with each session lasting for about 1.5 hours. A single-group design with multiple measurements was adopted for the quantitative component of this study. Interviews held 1-2 days before the intervention (T0) were used to collect baseline data. The two outcome variables of this study, depression and loneliness, were reassessed during the 5th (T1) and 10th (T2) weeks of the intervention. Generalized estimating equations were used to test the mean differences among T0, T1, and T2 measures. After the 10-week program, qualitative data were collected by asking participants to share their program participation experiences. The results of generalized estimating equation showed significant improvements in depression and loneliness. Four categories emerged from the qualitative data content analysis: social connection, anticipation and hope, sense of achievement, and companionship. Given the beneficial effects of the horticulture therapy, the inclusion of horticultural activities in nursing home activity programs is recommended.
Pub.: 24 Dec '14, Pinned: 23 Apr '17
Abstract: Aim To present a narrative review of the empirical literature on the use of horticultural therapy in dementia care. Method A comprehensive literature search, conducted in December 2014, resulted in the selection of 15 primary research articles for review. Of these, three used qualitative methods, five used quantitative methods and seven used mixed methodology. The articles were critically appraised, and the narrative synthesis used a thematic approach whereby prominent themes from the articles were grouped to form representative themes. Findings Three main themes emerged from the narrative synthesis: the emotional health of people living with dementia, their perceived self-identity and their levels of engagement. Conclusion Horticultural therapy can be beneficial. At a macro-level, it is an inexpensive therapy that does not require specialist training to deliver. At a micro-level, it enhances the wellbeing of people living with dementia. Recommendations are made to promote access to appropriate horticultural therapy for people living with dementia, and for further research in this area.
Pub.: 21 Jan '16, Pinned: 23 Apr '17
Abstract: Palliative care patients experienced a variety of needs and perceived their quality of life as being only fair. This study adopted a single group repeated-measure design to investigate the effect of horticultural therapy on the quality of life of palliative care patients using the Quality of Life Concern in End of Life Questionnaire. Significant differences in the domains of "existential distress" and "health care concern" were observed immediately post-intervention and at four weeks post-intervention, respectively. No other significant differences were seen in the other domains or in the total mean score of the outcome measure.
Pub.: 28 Jan '17, Pinned: 23 Apr '17
Abstract: There is increasing evidence that gardening provides substantial human health benefits. However, no formal statistical assessment has been conducted to test this assertion. Here, we present the results of a meta-analysis of research examining the effects of gardening, including horticultural therapy, on health. We performed a literature search to collect studies that compared health outcomes in control (before participating in gardening or non-gardeners) and treatment groups (after participating in gardening or gardeners) in January 2016. The mean difference in health outcomes between the two groups was calculated for each study, and then the weighted effect size determined both across all and sets of subgroup studies. 22 case studies (published after 2001) were included in the meta-analysis, which comprised 74 comparisons between control and treatment groups. Most studies came from the United States, followed by Europe, Asia, and the Middle East. Studies reported a wide range of health outcomes, such as reductions in depression, anxiety and body mass index, as well as increases in life satisfaction, quality of life and sense of community. Meta-analytic estimates showed a significant positive effect of gardening on the health outcomes both for all and sets of subgroup studies, whilst effect sizes differed among eight subgroups. Although Egger's test indicated the presence of publication bias, significant positive effects of gardening remained after adjusting for this using trim and fill analysis. This study has provided robust evidence for the positive effects of gardening on health. A regular dose of gardening can improve public health.
Pub.: 14 Nov '16, Pinned: 23 Apr '17
Abstract: Horticultural therapy is defined as the process of utilising fruits, vegetables, flowers and plants facilitated by a trained therapist or healthcare provider, to achieve specific treatment goals or to simply improve a person's well-being. It can be used for therapy or rehabilitation programs for cognitive, physical, social, emotional, and recreational benefits, thus improving the person's body, mind and spirit. Between 5% to 15% of people with schizophrenia continue to experience symptoms in spite of medication, and may also develop undesirable adverse effects, horticultural therapy may be of value for these people.To evaluate the effects of horticultural therapy for people with schizophrenia or schizophrenia-like illnesses compared with standard care or other additional psychosocial interventions.We searched the Cochrane Schizophrenia Group Trials Register (Janurary 2013) and supplemented this by contacting relevant study authors, and manually searching reference lists.We included one randomised controlled trial (RCT) comparing horticultural therapy plus standard care with standard care alone for people with schizophrenia.We reliably selected, quality assessed and extracted data. For continuous outcomes, we calculated a mean difference (MD) and for binary outcomes we calculated risk ratio (RR), both with 95% confidence intervals (CI). We assessed risk of bias and created a 'Summary of findings' table using the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach.We included one single blind study (total n = 24). The overall risk of bias in the study was considered to be unclear although the randomisation was adequate. It compared a package of horticultural therapy which consisted of one hour per day of horticultural activity plus standard care with standard care alone over two weeks (10 consecutive days) with no long-term follow-up. Only two people were lost to follow-up in the study, both in the horticultural therapy group (1 RCT n = 24,RR 5.00 95% CI 0.27 to 94.34, very low quality evidence). There was no clear evidence of a difference in Personal Wellbeing Index (PWI-C) change scores between groups, however confidence intervals were wide (1 RCT n = 22, MD -0.90 95% CI -10.35 to 8.55, very low quality evidence). At the end of treatment, the Depression Anxiety Stress Scale (DASS21) change scores in horticultural therapy group were greater than that in the control group (1 RCT n = 22, MD -23.70 CI -35.37 to - 12.03, very low quality evidence). The only included study did not report on adverse effects of interventions.Based on the current very low quality data, there is insufficient evidence to draw any conclusions on benefits or harms of horticultural therapy for people with schizophrenia. This therapy remains unproven and more and larger randomised trials are needed to increase high quality evidence in this area.
Pub.: 21 May '14, Pinned: 23 Apr '17