Crafting Community/Creating Places of Healing

(USA) Daniel Winterbottom

1 Introduction

The use of gardens to improve users physiological and psychological health stems from a long,international history.From the monastery courtyards of Medieval Europe to therapeutic spas in Dalmatia and today in the ＂healing＂ gardens found in hospices,hospitals and nursing homes,nature has been,and is used,to alleviate a diversity of medical conditions.Stresses associated with everyday living,or health crises can reduce the body's ability to make antibodies and impair the immune system response to infection.Even modest access to green spaces lowers risk to fatal diseases[1].

Mental fatigue leads to decreased productivity and accuracy,impulsivity,anger,and careless behavior[2].One study found that levels of aggression are significantly lowered when nature is present.There were fewer reports of fear,incivility,violent behavior,and reported crimes within a Chicago housing project when trees were present[3].

Illustrated drawings from Persia,Japan,and Medieval Europe document that the benefits of therapeutic gardens have been understood for hundreds of years.Chinese scholar documented the restorative outcomes derived from traditional historic Chinese gardens,and in Tibetan Buddhism nature remains a foci and ritual devotion amongst its followers[4-5].Fredrick Law Olmsted,the ＂father＂of landscape architecture,wrote extensively about the essential healing properties of nature while designing the Central Park in the United States.The benefits of these earliest therapeutic gardens were perceived intuitively and only recently has technology and research generated the evidence that gardens do improve our health and reduce health compromising conditions including high stress,depression,anxiety,attention deficient disorder,rumination,aggression,and many others.Evidence-based data is crucial to validate the need for and opportunities within therapeutic garden design.However,this research is focused on the effects of nature exposure/engagement and the application of the theory remains the greatest challenge,and therein lies the need for sensitive,responsive,intentional design.As we move forward,we must use evidence to create culturally appropriate and responsive environments that meet the diverse needs of those seeking physical or cognitive rehabilitation,and physiological and sensory stimulation.

The following projects created by University of Washington landscape architecture design studios and address a range of specific therapeutic goals using a participatory community design model that informed the designers of their unique needs,aspirations,and challenges.This process was critical in creating a successful user responsive design.

2 Pete Gross House Healing Garden

In 2005 we partnered with Fred Hutchinson Cancer Center to create a garden for cancer patients in Seattle,Washington.The Pete Gross House provides accommodation for seventy outof-town patients receiving treatment for advance stage cancer.Patients are uprooted from familiar home environments for long periods,while they cope with exhausting and invasive treatments.Patients arrive with a companion to provide care and strength during the intensive treatments and the gardens are intended to serve both.Patient's energy level,mobility and comfort are severely impacted by the treatments and mobility limited to their rooms,hallways,and the garden.The side effects of treatments make many feel uncomfortable in public settings and care providers are often bored and exhausted from the stress.The garden becomes a place of respite,escape,and social interaction.The 1,500 Sq.ft.Pete Gross Healing Garden is located on the 7th floor roof top and accessible to patients,families,friends,and staff.The $30,000 USD budget for the garden was raised through donations.The garden was designed and constructed in 2006 by fourteen undergraduate students enrolled in the design/build capstone studio.The team devoted the first week to community engagement and discourse.Many students had never known anyone afflicted with cancer and were reserved in their initial interactions with the residents.This changed as they were drawn into the stories told by the younger residents who despite the severity of their situation displayed a deep inner strength,were bluntly direct and deeply moved when asked about their journeys and feelings.

During these brainstorming exercises many themes emerged including the need for a ＂home＂like environment,to ＂get away＂ and for many types of space to support intimacy and socializing.The youth desired a place to play games,socialize and ＂be away from adults＂.The adults wanted place that were quiet,contemplative,and rich with nature.

What youth would like to have in the garden:

· Game tables

· Places to eat

· Spaces to talk and socialize

· A telescope

· Place to watch the stars and moon

· Place to be away from adults

· Place to write

· Place to disappear

· Deck like my backyard

What adults would like to have in the garden:

· Place for meetings

· Ability to see the views and feel away

· Spaces to talk and socialize

· Place to be alone

· Place see the sky

· Place to be with nature

· Place like home

· Reclining chairs to sleep

· Relax in the sun

· Places to write letter

· Place to cry

The Design

After reviewing the input,the class developed a program and five schematic design proposals.In a participatory session with the advisory committee elements from each of the designs were chosen and a final preferred alternative was created.

A u-shaped planted pathway connects the three garden rooms,＂living room＂,＂porch＂and ＂study＂ to the main entry door.Emerging through the doorway,one is struck with the vibrant colors,the dramatic views and flow of the spaces.Entering a broad hallway,a deep blue painted wood,green metal fence and flowerpots with textural herbs leads one into the space and screens the expanse of unused roof,frames views to the city,and protects visitors from south winds which is important for the patients who have less control over the body temperatures due to repetitive treatments.The bright and contrasting colors,plant textures and geometric patterns offer an escape from the muted browns and beiges that define the interior spaces of the residences and lend a sense of joy and uplift for those facing the unrelenting stress of the illness (Fig.1).

The hallway opens on one side to the ＂living room＂.This central gathering space,offers comfort,enclosure and a sense of privacy defined by an arbor supporting vines above,cushioned chairs,and a reiteration of the blue wood screen on two sides.The mix of vines of akebia,passionflower,clematis and hops bloom and give shade from March to October.Raised planters hold familiar aromatic kitchen herbs,rosemary,oregano,parsley,and sage.This outdoor living room feels very homey,with its inward focus used by residents and staff for reading and homework,and for meetings and conversation.This central space,like a living room,is the heart of the garden,and as the first space visitors experience feels very domestic in scale,character,and use (Fig.2).

On the west side of the living room,low planters and two glass sculptures create a gateway into the ＂porch＂,the largest space,triangular,and open to the sky.This space has sweeping views of the Puget Sound and the Olympic Mountains to the west,the Space Needle and Lake Union to the north.Set against the south wall,a hedge of bamboo resonates softly as breezes activate the green canes that contrast with the red painted wall behind.Light weight lounge chairs can be arranged for rest,contemplation,visiting or for playing games.Responding to the young residents of the Pete Gross House,a telescope is mounted above the parapet wall to investigate the many boats plying the Puget Sound and lake.This is an outward looking space,connected to the water,wind and sky,where residents and visitors meet and mingle,share views,relax,and play games (Fig.3).

The third room,the ＂study＂,is accessed through a narrow pathway of pre-cast concrete pavers,flanked by woodlands plants,lily of the valley,ferns,Solomon's seal,bleeding hearts and violets under a canopy of styrax japonica and Japanese maples.Four wide ascending stairs lead visitors to the most private space,canopied with vines,and enclosed on three sides by the building and a wood screen dividing wall.The raised elevation of the room enhances views to the north of Lake Union and Gasworks Park.A glider offers a comforting motion for those escaping into the view beyond,or seeking solace in its privacy or to grieve (Fig.4).The screen,walls and arbor are all painted blue,a cool calming color,and the surrounding plantings soften the space.The bluestone stair risers are etched with poems by the children who stayed at Pete Gross House and wanted to leave something behind.At the end of the connecting walkway just below the raised platform is a series of 2＂ × 2＂ slate chalkboard squares salvaged from an old school,which are used by residents to leave notes,create poems,and draw pictures.

It is important that the rooms gracefully unfold,and a sense of journey and diversity of use and experience invites users to explore the gardens and spectacular views.

A series of walls and a screened pathway ensure that privacy is available when needed.A sense of graceful flow is achieved in the circulation in and around each room.The dialectic of open and closed is maintained through the full and partial views of the gardens through baffles,panels,and plantings.In the porch users arrange the movable furniture to meet their needs,regaining a sense of control most have lost during their treatments.In a similar fashion the living room can be used for group or individual activities while the study is less flexible,specifically designed for grieving individuals and couples seeking a solitary experience.

The casualness of the gardens,the range of textures,colors and scale of spaces seems to accommodate the needs of the diverse user groups.Children respond enthusiastically to the chalk board,the poetry,bright colors,and lounge in the ＂deck＂ area as they get to know and share experiences with their peers.The older users find the ＂living room＂ to be a comfortable space and often use this space for meetings,to call and update their families and frequently use this and the ＂deck＂ to complete paperwork and correspondence.Both groups enjoy the telescope,the views,the flowers,and meeting others who are using Pete Gross House for the same reasons.

3 Puget Sound VA Healing Garden

The completed Healing Garden at the Puget Sound Veterans Administration offers a verdant place for escape,contemplation,and respite,a calming oasis from the stress and anxiety common among veterans and exacerbated by the institutional hospital setting.Initiated through an extensive community participatory process,students worked with staff,patients,and administrators to understand their needs and desires.We engaged in focus-group discussions,visual preference exercises,and brainstorming sessions as we studied the site.Students then analyzed the feedback to inform their designs.Six schematic design proposals were created and presented to the community.Two were merged,and elements were borrowed from the others to compose the final design.

The Sky Room features a view of the sky framed by the buildings and offers a sense of escape and expansiveness in the courtyard garden.The seating arrangement fosters social interaction and is used for group therapy sessions.The Earth Room,at the other end of the L-shaped site,is contained on three sides by the building and prompts an inward focus.It is private and used for meditation and modest physical therapy.A fountain sits between the two ＂rooms＂ linking earth to the sky with running water.Respecting the veterans' wishes,native materials,plants,stones and red cedar wood infuse a sense of place and region.Images of mountains were cut into privacy screens and native plants ensure a lush,verdant natural environment where users can escape the monotony and harshness of medical wards and hallways (Fig.5 &6).

One of the great,unplanned benefits of that project were the stories exchanged between students and patients.Most students knew little about the military or the post-conflict effects upon those who served.Through this experience the walls of ignorance were dismantled,and students gained a deep,visceral understanding of life after war and its innate physical and mental challenges.They saw how gardens could help people cope,endure,and thrive.

4 Building Community at Rab Psychiatric Hospital

In 2012,hospital director Dr.Vesna Sendula Jengić embraced a partnership with the University of Washington design/build program to create a therapeutic campus master plan.In nine weeks,the team completed the master plan and with the patient's assistance designed and built the first garden the ＂Garden of Celebration＂.Over the next three years,2013-2015,additional University of Washington teams,created the ＂Garden of Wonder and Wandering＂ the ＂Cognitive Enhancement Garden＂ and the ＂Garden of the Senses＂ Each garden addressed the specific patients' needs that emerged through the participatory design process with staff,administrators and patients and their families.Dr.Sendula navigated the unfamiliar terrain of therapeutic gardens with curiosity and caution.Protective of her patients,she soon became supportive and an outspoken advocate for these therapeutic gardens.

4.1 Mental Health

The use of therapeutic gardens in mental hospitals is not a recent phenomenon.In Europe and North America in the late 19th century,hospitals for the ＂insane or lunatics＂ were moving away from punitive care into more humane and productive treatment regimens using nature-based therapies.Hospital grounds became pastoral landscapes,with working farms,green house programs and places for active gardening.Mental hospitals were among the first to incorporate horticultural and occupational therapy programs into their treatment protocols.

4.2 Restorative Nature

Prior to the garden implementation,patients rarely used much of the overgrown and un-programmed landscape that lacked site furnishings,pathways or maintained garden beds.The master plan identified that 60% of the campus open space was underused.The ＂Garden of Celebration＂ is the largest outdoor gathering space serving the hospital.It is used for individual retreat,group therapy,performances,and socializing.At the garden entry an accessible curved wooden ramp leads patients up to two seating pavilions on a terraced hillside with wind swept pines.One pavilion is covered,for rain.The other is draped with wisteria for shade during the hot Adriatic summers.The pavilions and their terraced stone retaining walls overlook a stone plaza.Performances can be held in the pavilions with the viewers seated on plaza benches or activities can be held on the plaza with the audience seated at the pavilions and on the terraces.During the participatory design meetings,staff and patients requested that dry stone walls be used because they are a feature of vernacular Adriatic landscapes,a familiar and identifiable icon for those displaced into the hospital.A water feature brings calming,melodic sounds and the plantings of ornamental grasses,flowering perennials and aromatic herbs stimulate the involuntary attention and soft fascination,which are conducive to both respite and re-energizing.

The spiral pattern of paving in the plaza invites meditative walking.Walking is a favorite pastime for many patients and prior to the establishment of the gardens they walked the service roads exclusively (Fig.7).Restorative walking is a commonly used strategy to relieve anxiety caused by both illness and/or medications.The ＂Garden of Celebration＂ links with two others to form loops of an extensive hospital walking circuit.The＂Garden of Wonder and Wandering＂ and ＂Cognitive Enhancement Garden＂ have a contiguous pathway that affords softer walking surfaces.Patients are removed from the roadway and immersed in a pine forest with understory plantings of perennials,herbs,and ornamental grasses.

In the ＂Garden of Wonder and Wandering＂,varying configurations of bench and chair seating accommodate groups,pairs and individuals,there are chez lounge chairs and serpentine benches for sleeping,resting,and observing,and a bench swing for calming gentle movement (Fig.8).The gestation for the design was the sea.A curved wooden pier juts out from the highest elevation and looks across a ＂sea＂ of wind activated ornamental grasses toward an abstracted wooden sculpture resembling a ship.The boat is the central feature of the garden and patients can sit and meditate in its chapel or cave-like space.Construction of curved glue-laminated wood,references ancient wooden boat building,a craft long revered on the island of Rab.This garden close to the forest and abundant with soft vegetation is a favored place for patients visiting with their families.

A crushed stone path leads to the adjacent＂Cognitive Enhancement Garden＂.Though available to all patients and not enclosed,this garden is adjacent to the dementia ward and many of the elements are designed specifically for its residents.Many face mobility challenges and need to be accompanied by a nurse as they use the garden.The cognitive play pavilion is a covered wood structure featuring upright vertical wood frames with cognitive games playable at wheelchair and upright standing heights.Wood elements are rotated on rods in the frames for memory and recognition exercises for patients with cognitive challenges.Games can be created to match the faces by form,color,or both.Some elements are painted with images,shells,boats,and flowers that can also be matched.Other frames have chimes on tension cables that can be strike with a mallet and other additional elements to make music.Seating lines two sides of the structure.Patients from the broader community meet at a table for drawing,horticultural or occupational therapies and shared meals.The use of the shelter by all patients is a staff-directed intention to integrate dementia patients into the social life of the hospital.

Across from the pavilion a serpentine reflexology path has railings on either side and meanders through ornamental grasses,lavender,and lantana (Fig.9).Dementia patients use this area for physical therapy and for maintaining balance skills.Further along the more primary path is a raised dog therapy deck and an exercise machine for more intensive recreation.

The sensory garden was our last project,and with it we completed the master plan for the hospital campus.This most formal of the four gardens overlooks the lavender fields used for occupational therapy and a vegetated hillside conservation area.A curved stone ramp enables mobility challenged patients to enter the garden safely.The garden is a series of concentric circular paths defined by planters both raised and at grade.The plantings of herbs,perennials and shrubs are lush aromatic,textured and colorful.At the entrance a series of seating stairs with cushions offer a restful place of transition for patients entering and leaving the garden.The focal point at the center of the garden is a shade arbor and olive tree,a sacred and beloved plant to many patients who grew up in the Adriatic (Fig.10).

These gardens work together as a therapeutic campus with a diverse range of experiences,activities and spatial configurations allowing the patients and caregivers to choose which best accommodates their needs.For the patients,this ability to choose restores a sense of environmental control and agency in a time and place where many decisions about their welfare are by necessity determined by others.Each garden aims to support a broad range of physical and psychologically positive engagements.The designers explore every opportunity to increase nature interactions associated with seating,pathways and gathering spaces resulting in a significant increase of feasible and spontaneous uses when compared to pregarden conditions.

4.3 Reflections

To have students working and living with mental patients is unusual and one may question what the purpose is,why do it.I can think of no alternative means that provides students with a visceral,intimate understanding of the realities of trauma,disabilities,and serious illnesses.Through their witnessing,they gain a deeper comprehension about the challenges faced and strength needed to endure obstacles to their healing including ostracization,alienation and isolation.Discussing these issues with students is important,but experiencing it,receiving the patients' stories and witnessing their daily struggle leads to a more responsive,sensitive and compassionate design proposal.We have worked with children diagnosed with HIV/AIDs,women serving 25 years to life in prison,those coping with terminal diagnosis's,families surviving by recycling plastic from a garbage dump,combat veterans and African Americans families transitioning from homelessness.In each project extraordinary individuals emerged and taught us about grace,acceptance and courage when facing unimaginable conditions.Can gardens change these entrenched societal challenges? Are students awakened and embrace design as a catalyst for social justice?Are these projects worth the enormous challenges,frustrations and time required? My personal hope is through their participation,the next generation of practitioners and educators will be strong voices for those least served and most in need of landscape architecture and better activists for social and environmental justice.

5 Participatory Design at Nikkei Manor

Nikkei Manor,an assisted living home for ninety elderly Japanese Americans offers a community-based living environment.The garden we created in 2012,＂Ichi-go-ichi-e＂ meaning ＂One time,one meeting＂,was designed to increase resident's access to green spaces so they could reap the therapeutic benefits of exposure to and contact with nature.Nikkei Manor asked that the garden be safe and secure,adaptable for group and individual activities that universal accessibility be provided to all areas of the site without disrupting the peaceful and tranquil qualities,The garden is used daily by many of the residents to increase mental,emotional,and spiritual wellbeing,socialization,physical exercise,for visits with family and friends and as a place of escape and respite.It used for staff facilitated group activities including arts and crafts,drum circles,games,and celebrations,horticultural,occupational,and pet therapy.

The average resident age is 87,90% are Japanese or Japanese American and several don't speak nor understand English.Many have early onset memory loss and 50% rely on walkers and wheel chairs for mobility.The students,in their early twenties had little experience working with or caring for an elderly family member.The studio ethic was that sensitive,responsive,meaningful design derives from an intimate,visceral understanding of,and empathy for,those coping with the physical,cognitive,and cultural challenges.Finding effective methods to cross the divides of age and culture was essential to the design process.The participatory process would offer strategies to increase familiarity,imbue the site with appropriate meaning and create an environment that offers psychological,physical,and emotional comfort.

In addition to hosting focus groups and engaging in storytelling and to understand their cultural and personal preferences we created simple visual preference games using colored stickers,red and green to be placed next to images of different elements such as paving,seating,planting,or styles such as formal,naturalistic,picturesque.We created a similar image card sorting game with two piles,one I like,the other I dislike.The images consisted of traditional Japanese and non-Japanese images.Physical models were brought in for residents to evaluate and rearrange.To bridge the divide of age,students participated in role playing exercises using wheelchairs,tying their feet together,navigating with blind folds,wearing glasses smeared with Vaseline,planting seedlings with oversized gloves to viscerally experience the effects of stroke,loss of sight,mobility limitations,arthritis,etc (Fig.11).

Many of the residents did not speak English or found focusing in active group settings with loud talking too distracting.The team developed a card game to understand their preferences.ln one-onone meetings,resident participants were given a deck of cards with garden images printed on them.Each was asked to sort the cards into two piles,one for likes and one for dislikes.The gamelike quality was appealing,and the directness of the exercise was compatible with variable levels of abilities and comprehension.Meeting oneon-one opened up the opportunity for a simple discussion between the participant and the design team member.Often this method clarified why the residents chose certain images.ln several cases very personal stories emerged that told of their past and of what they imagined the garden to be,things they might not have been comfortable sharing in a large-group activity.Many spoke fondly of the traditional Japanese rock and moss gardens of their childhood and felt they wanted this archetypal garden at Nikkei Manor.ln the card game,residents selected images of colorful gardens,with abundant seasonal bloom,lush,foliage,and texture.The design team and advisory committee discussed the expertise required to create a traditional garden that contained diverse religious symbolism and arrived at a Pacific Northwest interpretation of a Japanese garden.From discussion with staff,the design team learned that the transition from home to assisted living is disorienting for many older adults.Many residents experience apprehension,depression,confusion,and loneliness during the transition from independent living and productivity to a group living situation.Loss of independence,work,or avocation can mean loss of identity.The garden can ease this transition and remind residents of home.An informed written summary of the findings from these types of exercises,surveys,and meetings with participants is next presented to and discussed with the design advisory committee.The designers respond to all they learned about the community when they begin to design the garden,including cultural backgrounds,familiar place attachments,and specific health conditions.By working with an occupational therapist,designers have an increased awareness of health conditions and users' strengths and weaknesses.The summary lists programmatic activities,with some indication of how these will be apportioned among the various spaces from which users can choose (quiet and enclosed,active,and open).The designers use this information to choose elements,forms,and expressions users will respond to in the garden.To expand gardening capacities at Nikkei Manor,grant funding was later provided to design and install a vertical garden for the secondfloor balcony,located just off the dining room.Again,working as a team from the outset,the occupational therapist and landscape designer and several other staff and volunteers led 14 residents and staff members through a three-station activity.The entire participatory design process took place in the courtyard garden of the facility,which by then had been installed by a University of Washington landscape architecture design/build studio class.

One activity station had two card-sorts and an age-range identifier task;the purpose was to inform the garden's look and planting theme.Two other stations looked at four different anthropometric measures to determine the garden's specifications and dimensions for optimal usability by the widest range of users,as some of the resident's used canes or walkers to help with ambulation.All 40 participants completed the activities at the three stations.A second community meeting was held to get feedback on a half-scale model of the proposed vertical garden.The group of about 25 residents and day care attendees overwhelmingly approved it (and even got their hands dirty,potting up individual cells of the garden).From a seated or standing position,the garden was comfortable for all.

Design Development at Nikkei Manor

ln this last phase,a second ramp was added linking the plaza and the deck at the outer wall.ln the long perpendicular space between the ramps,designers detailed a poured concrete planter large enough for a redlined Japanese maple and mounds of red-and pink-flowering azaleas.

Corner benches of wood with curved steel arm supports bordered the planters on either side of both deck and plaza.Ramps were sloped at 1:20 and surfaced with plastic lumber with a skidresistant texture;the designers integrated kick rails and black metal handrails.At a generous five feet in width,the ramps appeared to flow from the plaza plane.The cohesive connection of the spaces was enhanced by echoing the tatami mat pattern of the concrete plaza in the orientation of the wood decking.The loop path would offer gentle exercise and a companionable journey,and planted seating areas would be readily available everywhere along the route.On the outer wall along the second ramp,shelving at different heights was fitted to the trellis structure;here,residents could seasonally display and care for their bonsai and other houseplants (Fig.12).A pattern of alternating steel planters and custom wood benches wrapped around the plaza.Plants were abundantly layered under the cherry tree and along the entire length of the retaining wall.Hydrangeas,camellias,and Leyland cypress screened the warehouse facade at the top of the wall.Between the planters at the base of the wall,just opposite the entry door.The water fountain was placed to become a wayfinding landmark.The steel-panel fountain,five and a half feet in height,was pierced with three slotted scuppers dropping water into three bowls filled with amber glass.At the fountain's head was a large-stylized lotus blossom with one of the scuppers at its base,so the stream of water resembled its stem.The sound of falling and splashing water would indeed be audible from the residence entry door (Fig.13).The design team focused on making the pavilion both a landmark and a destination that would be experienced as a semi-private retreat.For those seeking exercise,it is also the midpoint in a loop up and down the adjacent ramps (Fig.14).The pavilion connected to the trellis and was tied visually to all the wood-built.A katsura tree was planted at this corner of the site.Also at street side,along the whole length of the deck,the fence was softened and buffered by a 14-foot hedge of fargesia,a non-invasive bamboo.ln response to the design advisory committee,the team decided the entry gate should both further heighten the sense of passage for the visitor and mark the garden's presence in the neighborhood.From site corner to building corner,they created a sequence of fencing,gateway,and pergola,repeating the traditional Japanese design language of the deck structures.At the gate the visitor would enter,turning to their left between ornamental steel panels,first glimpsing the garden through one and then another of the panel's round cutouts.A crane motif animates the garden: The exterior entry features a sheltered bench and a threshold with a change in pavement-a visual and tactile alert for visitors to understand they are entering the garden.The Ichi-go-ichi-e sign is modeled on traditional forms found in structures,using the same bypass framing,similarly sized lumber,and a color scheme of red,black,and yellow.lt had the same detailing of rafter ends as the entry arbor,overall expressing a traditional Japanese approach to design.The pavilion was covered with polycarbonate panels,tinted a smoke color to reduce glare.Movable cushioned seating would be available year-round.A window opening in the pavilion wall was at the gate are a small crane with a fish and a larger crane with head tilted skyward;a third crane (elsewhere,near the emergency exit) is taking flight.ln the process of designing the entry for cultural celebration and identity,one of the designers suggested naming the garden.The name chosen,Ichi-go-ichi-e (＂one time,one meeting＂),was carved in a wood sign and hung over the entry gate to be seen from the street (Fig.15).To make the garden safe to use at night,a lighting plan was created.Up lights were used to illuminate the entry gate,water feature,cherry tree,Japanese maples,pavilion,Buddha,and emergency egress.Downlights were fitted along the ramps.

6 Conclusion

In each a community participatory process was used,and as these gardens illustrate,time spent engaging in a collaborative process offered insights that a formal site analysis process would not have revealed.Cultural values,needs related to specific conditions,ages,and abilities were revealed,and stories that informed our project narratives and built a sense of purpose and stewardship amongst the communities we worked with emerged.The result are gardens that are uniquely responsive to user and staff needs.In the process we were able to educate the staff and administrators about the project goals,functions,and the integrative potentials existing in their programs,and the long-term care requirements.

The community process also ensured that the gardens don't become generic and that we as designers don't become predictable and stale in our creativity.Each community is unique,and gardens should express that specialness as well.For many of these user's the garden becomes a significant part of their world.Limited mobility means less journeys outside of the facility;thus,the garden should have diversity of uses,activities and characters.A place of seasonality that reflects passages of time,attracts wildlife and converys a level of spiritual awakening,so important to those facing trauma,illness and/or end of life.Each of these projects exemplifies this in their own unique manner.