Horticultural Therapy: A Tool for Healing Outside the Walls of Traditional Medicine

As the baby boomer population in the United States gets older, more people are being admitted to nursing homes. These homes can be places of mental and physical stagnation, especially ones for adults with diseases such as dementia and Alzheimer’s Syndrome. In such cases, residents often outnumber the staff, making it difficult for the staff to engage residents. As a family member of mine sat in her chair watching sing-a-longs from the 1950s, this reality became clear to me; passing balls around a circle and the occasional craft project was not enough to keep her morale high. She isn’t the only one. Research shows that patients who reside at nursing homes are increasingly being diagnosed with depression. According to a study on depression in nursing homes, risk of mortality increased by 59 percent in the year following a diagnosis of depression. Could horticultural therapy help?

Horticultural therapy was introduced to the United States as a formal field of study in 1973. Since then, professionally certified horticultural therapists have been helping at-risk youth, mental health patients and the elderly boost their self-esteem, increase strength, flexibility and coordination, and even develop skills and creativity through common activities associated with gardening. Plants are carefully chosen with properties that stimulate the senses and engage both the mind and body.

Tailoring the garden to the patients as such is key. Mitchell Hewson, Canada’s first registered and practiced horticultural therapist, runs Homewood Health Centre, home to Canada’s first horticultural therapy program. The Centre carefully designs paths and raised beds to accommodate patients. Paths permit handicapped patients to use walkers or wheelchairs, allowing these normally restricted patients to participate in horticultural therapy and reap its benefits. For the elderly, kneeling and bending over plants on the ground can do more harm than good to backs and joints, especially knees. Raised beds (now common in most of therapy gardens), make it easier and more comfortable for adults to garden without placing too much physical stress on their bodies.

With accommodations set, patients stand to gain much from the physical activity and from being outdoors. Weeding and shoveling strengthen hands, and carrying fertilizer and pots strengthens the upper body. High levels of natural light promote vitamin D production in the body, a deficiency of which was linked to frailty in older individuals in a 2005 study. For the elderly, the level of light required for optimal sight and depth perception is three times greater than the required level for younger adults; this therapy helps.

It benefits patients psychologically and socially as well. Patients report less anger, and depression. Antisocial behavior decreases as they share conversations and their self-esteem increases. The use of seasonal plants helps the elderly validate the time of year, giving them a better sense of their environment. The plants used come in a wide array of sizes, shapes, colors, and textures, providing an excellent source of sensory stimuli for the patients to interact with. Succulents are easy to plant and care for, flowers are vibrantly colored and odorous, herbs smell strongly and also provide nutrition. Patients become more aware of their surroundings, a benefit particularly helpful for those struggling with dementia or Alzheimer’s disease. Responding to nature while simultaneously getting to know other residents in a nursing home setting especially helps patients with dementia or Alzheimer’s feel more comfortable and at home.

The Upshot for Therapists

Hewson developed models, such as charting methods for recording patient progress, procedures, and activities with set goals that have helped therapists implement the therapy. At his Centre, residents are physically evaluated before participating to ensure that they are not given tasks that are too challenging for them. Thanks to his pioneer work, patient activities in gardens are recorded, kept and updated by most therapy programs. Staff review effective activities and modify programs accordingly top optimize a patient’s therapy and recovery from illness.

Scientific research is constantly evolving in finding few ways horticultural therapy addresses particular health conditions. Not only was Henson able to establish protocols for the treatment of people suffering from Alzheimer’s, M.L. Verra et al. (2012) also examined whether horticultural therapy could be used to help decrease pain levels in people suffering from chronic musculoskeletal pain. The results showed that indeed, the programs benefited the patients and reduced their pain. In yet another instance, horticultural therapy was shown to benefit prison inmates. When asked about his participation in the program at the North Carolina Botanical Garden, a prisoner responded, “When I look at these flowers, I feel the stress going right out of me.”

Ultimately, horticultural therapy provides a connection with nature and helps alleviate the stress and the monotony of life characteristic of those living in nursing homes. It provides patients a non-invasive and effective method of physical healing, promotes their positive social interactions, and addresses many of their age-specific challenges and diseases. Through interactions with nature and other patients, horticultural therapy effectively improves the mental health of an individual and promotes a sense of community among participants.