Therapeutic Benefits
Horticultural therapy and the THERAPEUTIC BENEFITS of garden environments have been documented since ancient times. In the 1940's and 1950's the work done with hospitalized war veterans significantly expanded the practice. Today it is widely used in assisting participants in learning new skills or regaining those that are lost.
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Average Client
Eric comments that Kirk mentioned that his AVERAGE CLIENT is an elderly person, maybe someone with health impairments but there are benefits for younger people as well. Correct? Kirk thinks gardening is very appropriate for adolescents and children. Getting them introduced to and involved with the garden often times helps them work on their activity level, it’s helpful in combating obesity and gets them away from video games.
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The Color Green
As a lifelong gardener Eric certainly knows anecdotally about the sense of stress release and peace that he gets when walking into a beautiful conservatory or walking through a garden. But from a medical standpoint what is it that is actually happening to us? Why do we feel that way around plants? Kirk explains, our brains are hardwired to respond to THE COLOR GREEN. Being in a lush, green environment allows us to relax, to recover from stress, and all of that factors into the healing process. So when one is exposed to plant materials, like in the greenhouse we’re visiting, your heart rate starts to lower, your respiration rate starts to lower, your galvanic response, the electrical impulses across your skin start to slow down a little and all of this factors into feeling better.
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Different Kinds Of Tasks
So, if working with issues related to depression, boosting that activity level is important. But also, working on something, perhaps with other people, can boost one's self-esteem, self-worth, self-value, all of these benefit all of us. From a physiological standpoint there's a little bit of physical extraneousness that goes into gardening. Importantly one can take it at their own pace. Regardless of where folks are, there are all these DIFFERENT KINDS OF TASKS that can be assigned to someone so that they can also rebuild certain muscles.
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Pinpoint A Task
So as a horticultural therapist, after assessing those needs, one can PINPOINT A TASK. Something very simple like plant propagation, which involves taking cuttings and working with potting soil, works well. Kirk makes those task determinations dependent on one’s cognitive abilities or physical abilities, Kirk is able to break those down into single step tasks.
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An Average Session
Eric and Kirk talked a bit about the psychological and the physiological benefits of horticultural therapy. Eric would now like to dive into the nuts and bolts of what AN AVERAGE SESSION with Kirk might look like. Well, again it is highly tailored to the individual so it is hard to have an average session. But once needs are determined then Kirk will design a task that meets the needs of the patient. It’s helpful to divide it into categories.
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Garden Design
Good GARDEN DESIGN certainly takes into account the utilization of space. How are people going to experience it here? Is it different from garden to garden? A.G Rhodes is a unique situation. Eric would like for Kirk to talk about the garden design here and what had to be taken into consideration when putting this together. Good horticultural therapy or therapeutic garden design is population specific. Whom does the garden serve? In this particular setting its serving the geriatric population and directed towards sub acute rehabilitation. This garden was designed primarily for mobility, working on walking skills, range of motion and strengthening and endurance.
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Raised Beds
Eric has noticed a lot of RAISED BEDS, even some really interesting ones that are up on legs. He's assuming that’s for a client that may be in a wheelchair. Correct, for raised access and also for standing endurance.
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Aesthetically Beautiful
Eric comments that they have also put a lot of focus on this being an AESTHETICALLY BEAUTIFUL garden. There is a lot of color here, it’s not just a functional, utilitarian place, its also very peaceful and beautiful. Well, Kirk feels, pretty counts.
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Patio
Eric notices the PATIO here and wonders - Our viewers might have a small patio that they want to convert into an area where they can take part in horticultural therapy or maybe someone who has an existing garden and they would like to know how they can creatively start integrating these principles and these kind of designs into their space.
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The Right Tool For The Job
A very important component of Kirk’s job is making gardening accessible to people that might have a limited range of motion. These folks may very well not be as strong as other gardeners. Something super important on that front is selecting the RIGHT TOOL FOR THE JOB. And that is part of the assessment process. Kirk must determine how and where a patient needs assistance and if adapted equipment is needed. Fortunately these days, gardening equipment is made specifically to meet those needs.
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Ergonomics Of Tools
And there is a lot of focus, of late, that is being put into the ERGONOMICS OF TOOLS. These are designed to take some of the impact out of the joints which makes it more comfortable to garden. The guys show us a few great examples of ergonomic tools. Instead of straight handles these have really nice, curved handles that utilize all the strength in your hand.
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As gardeners we know all about the therapeutic impact of working with plants. In this episode GardenSMART takes an in-depth look at the science behind why gardening is so good for us both emotionally and physically and how that information can then be applied to those in need.
Horticultural therapy and the THERAPEUTIC BENEFITS of garden environments have been documented since ancient times. In the 1940's and 1950's the work done with hospitalized war veterans significantly expanded the practice. Today it is widely used in assisting participants in learning new skills or regaining those that are lost. Horticultural therapy helps to improve memory, cognitive ability and socialization as well as strengthening muscles, improving coordination, balance and endurance. In this Episode GardenSMART visits A. G. Rhodes in Atlanta, Georgia. A. G. Rhodes is one of Atlanta's oldest non profits, a top nursing home provider of senior rehab services and long-term care. It has set the gold standard for therapy and rehabilitation services. The staff is comprised of season professionals who are experts in a wide range of therapy disciplines. One of their brightest is Kirk Hines. Kirk has been practicing horticultural therapy for 24 years. He was initially captivated by the art of gardening in containers and leaned first hand the incredible therapeutic value of time in the garden with plants. When he went off to Berry College he knew he wanted to pursue a blend of horticulture and psychology. Kirk has never looked back and today he heads up the horticultural therapy program on the beautiful campus at A. G. Rhodes. Kirk will share with us his decades of experience in this fascinating and cutting edge field of health and gardening.
Eric welcomes Kirk to the show. Thanks so much for joining us. Kirk returns the thanks and welcomes Eric and the GardenSMART audience to A. G. Rhodes. Eric mentions that Kirk has one of these really unusual occupations. In fact this is the first show that we have ever produced devoted entirely to horticultural therapy. And Eric would love to know how Kirk found himself in this occupation. It is something he was exposed to at Berry College. He started off in psychology, his love of bonsai is what led him closer to horticulture and wanted to pursue horticulture as his major. He was exposed to the field of horticultural therapy by his professors, they and Berry fortunately allowed them to sculpt and craft his curriculum so that it matched other university degrees in horticultural therapy. From there he did his internship, finished that up, came to Atlanta and started practicing.
Eric wonders - If he walked in the front door and said Kirk I want to be involved in horticultural therapy what would that look like? What would he be signing up for? Kirk explains, he would grab Eric and drag him into the greenhouse and quickly have him start propagating plants. Kirk works with patients on a daily basis, in groups, or as individuals. He works with them in the greenhouse, they work at tables, at the bedside, all dependent on the patients needs. Once the needs are assessed, he then develops some type of horticultural task that will address and meet those needs.
Eric comments that Kirk mentioned that his AVERAGE CLIENT is an elderly person, maybe someone with health impairments but there are benefits for younger people as well. Correct? Kirk thinks gardening is very appropriate for adolescents and children. Getting them introduced to and involved with the garden often times helps them work on their activity level, it’s helpful in combating obesity and gets them away from video games. If you have children growing vegetables the children are then more likely to taste them and this will lead to improving their nutrition. With younger adults gardening can also be helpful in addressing activity levels and stress reduction. As well, when dealing with a medical diagnosis involving a younger adult in the hospital regaining function after an injury or an illness can be very important and gardening can offer significant benefits.
Most of Kirk's clients are geriatric patients, so older adults. At A. G. Rhodes they have individuals who live in long term care but they also have people who come in for rehab after an accident, injury, stroke or heart surgery. Eric wants to know, if one were wanting to find an organization or facility that offers these services where should they look? Kirk thinks one of the best national organizations or associations would be the American Horticultural Therapy Association website. They would be able to help one locate services and horticulture therapists in your area. This group is a little spread out. There are probably fewer than three hundred in the country, A. G. Rhodes is rather unique and right here in Atlanta.
As a lifelong gardener Eric certainly knows anecdotally about the sense of stress release and peace that he gets when walking into a beautiful conservatory or walking through a garden. But from a medical standpoint what is it that is actually happening to us? Why do we feel that way around plants? Kirk explains, our brains are hardwired to respond to THE COLOR GREEN. Being in a lush, green environment allows us to relax, to recover from stress, and all of that factors into the healing process. So when one is exposed to plant materials, like in the greenhouse we’re visiting, your heart rate starts to lower, your respiration rate starts to lower, your galvanic response, the electrical impulses across your skin start to slow down a little and all of this factors into feeling better. Beyond that, there is also the act of gardening itself. One of Eric's favorite things to do is just loose himself in pruning or cultivating a new bed. There is something positive that comes from those activities. Absolutely, it is non-threatening and it is something that is familiar for most people.
A lot of people have gardened, even if it was just keeping a violet on a windowsill. So, when you break it down one can look at the physical movements. When gardening one is standing, reaching, you’re doing all of these things. And they can all be translated into rehabilitation goals. As well the thought process is involved - planning, naming, sequencing, all of those things. There is also a psychological impact. Eric knows when he has spent all of that time on a section of the garden or a specific bonsai plant, then seeing their maturation, that is something that really provides a great sense of accomplishment. Gardening improves and boosts ones self-esteem.
So, if working with issues related to depression, boosting that activity level is important. But also, working on something, perhaps with other people, can boost one's self-esteem, self-worth, self-value, all of these benefit all of us. From a physiological standpoint there's a little bit of physical extraneousness that goes into gardening. Importantly one can take it at their own pace. Regardless of where folks are, there are all these DIFFERENT KINDS OF TASKS that can be assigned to someone so that they can also rebuild certain muscles.
So as a horticultural therapist, after assessing those needs, one can PINPOINT A TASK. Something very simple like plant propagation, which involves taking cuttings and working with potting soil, works well. Kirk makes those task determinations dependent on one’s cognitive abilities or physical abilities, Kirk is able to break those down into single step tasks. For example, one can take one scoop of soil and fill up one pot, that’s one step. Then take the cutting and place it in the soil, that's another. Eric is interested in some of the plants that Kirk likes to work with as well as the ones that he finds to be most impactful with this kind of therapy. Kirk thinks about the ones that are most successful with his patients. Not everyone is going to be a horticulturalist, not everyone's going to have a greenhouse so it’s important to take into consideration what will be best for each individual's living situation. Thus they must determine if they have sun or shade or a windowsill or an outdoor garden. One possibility would be to propagate begonias. They propagate all types of tropicals like the philodendron, even bonsai materials or tropical trees. But mostly it’s finding something that they are going to be comfortable and successful with.
Eric and Kirk talked a bit about the psychological and the physiological benefits of horticultural therapy. Eric would now like to dive into the nuts and bolts of what AN AVERAGE SESSION with Kirk might look like. Well, again it is highly tailored to the individual so it is hard to have an average session. But once needs are determined then Kirk will design a task that meets the needs of the patient. It’s helpful to divide it into categories. If working with a patient that is perhaps dealing with depression or feelings of isolation he would work with others in a group setting, working with plant materials that increase activity level, increase the patient involvement, perhaps reintegrate them into a past leisure interest if they've been ill or injured. Perhaps they have given up things that they’ve enjoyed, missing those opportunities can lead to depression. Another patient might perhaps be dealing with a hip fracture, thus working on standing, strengthening or mobility. Working at raised beds or walking through a garden is something that accomplishes that. So horticultural therapy can cover an entire range of different types of gardening activities whether it be pruning, planting, even aspects of design. It could and can be adapted to meet those needs the same way a garden space is adapted. So for a patient that is working on mobility there are steps that can be taken. Perhaps when they are discharged and going home, they will then have three steps they must navigate in order to enter their home. Here they can practice steps/stairs while they are gardening. They have handrails, they have seating, there are areas with shade, even things like tinting on the walkway helps to decrease glare because if you have glaucoma or cataracts the glare from concrete can be uncomfortable. As they are moving through the garden there are things that distract patients from pain, things that help draw them through the garden. For example, blueberries that they can taste. Even the challenge of "hey let’s go look around the bend,& anything that causes one to walk just a little farther and that walk ends up increasing strength and endurance. All with the objective of helping patients to get better and go home.
Eric wonders, does that change much throughout the seasons? Certainly the type of activity would. Correct? It can and does but most often they can work throughout the year. Perhaps if its too cold or raining out in the courtyard areas or the garden areas they can then go to the horticultural therapy greenhouse. Or if addressing, perhaps, more reintegration into leisure interests or increasing socialization they will work at a table or work together taking cuttings, propagation, working on plant materials for sensory stimulation. Or if working with someone with alzheimer's disease, or someone severely cognitively impaired even smelling or touching helps them to engage. One of the amazing things about gardening is there's an incredible range of diversity of activities. Eric is positive that Kirk’s patients will never get bored. Kirk certainly hopes not, he tries not to be boring.
There is something to do every season and there is always a way to highlight plants with seasonal interest. This is another way to connect and to feel oriented to the time of year. If one has been in the hospital for a very long time they lose track of time. It's always seventy-five degrees so going outside or having plant material brought in orientates one to the season, the day, the time, all of those types of things.
Good GARDEN DESIGN certainly takes into account the utilization of space. How are people going to experience it here? Is it different from garden to garden? A.G Rhodes is a unique situation. Eric would like for Kirk to talk about the garden design here and what had to be taken into consideration when putting this together. Good horticultural therapy or therapeutic garden design is population specific. Whom does the garden serve? In this particular setting its serving the geriatric population and directed towards sub acute rehabilitation. This garden was designed primarily for mobility, working on walking skills, range of motion and strengthening and endurance. So as you go through this garden there are hand rails and there is access to seating at frequent intervals, there is shade as well as raised beds so one can work from a wheelchair or standing. As well the plant material is selected to engage ones' senses while moving through the garden. Eric definitely notices fragrant plants, edible plants, plants that offer great opportunity for pruning and even some really neat fruit trees. Kirk points out the calamondin orange trees. While picking them one is standing, reaching, using fine and growth motor skills. They then take what they grow, things like tomatoes and oranges, into their rehabilitation kitchen and there work on life skills that need to be assessed. That way they know when a patient goes home they feel fairly certain that they will be safe and can fend for themselves.
Eric has noticed a lot of RAISED BEDS, even some really interesting ones that are up on legs. He's assuming that’s for a client that may be in a wheelchair. Correct, for raised access and also for standing endurance. They will have someone stand, then time them so they can track progress. If they're in a wheelchair then you want a raised bed that allows the wheelchair to go underneath the bed allowing the person to be able to reach and access the plant material.
Eric comments that they have also put a lot of focus on this being an AESTHETICALLY BEAUTIFUL garden. There is a lot of color here, it’s not just a functional, utilitarian place, its also very peaceful and beautiful. Well, Kirk feels, pretty counts. One wants to go into the garden and feel good. And that happens when the plant material is healthy, the plants are lush, they are fragrant and engaging. Some of the theories behind horticultural therapy call for providing a lot of the emotional benefits of gardening, for the patients to come in here and feel like this is an oasis in this big city. Going out into a natural space allows our bodies to rest, to recover and also have a little mini vacation from a lot of stresses.
Eric notices the PATIO here and wonders - Our viewers might have a small patio that they want to convert into an area where they can take part in horticultural therapy or maybe someone who has an existing garden and they would like to know how they can creatively start integrating these principles and these kind of designs into their space. What kind of advice would Kirk have for them? He would say first off, consider your interests, consider what you enjoy doing with the garden whether it be vegetables, herbs, sun or shade. Do you have a courtyard area or a patio that you would like to work in and on? How can it be set up so that one can enjoy it lifelong? Can you age in place? Kirk feels that one of the best things to do is to make it enabling, make it easy to access. Include raised beds, large containers, smooth surfaces, areas where you can sit down and have a little shade, areas that have access to water. Having all of that within easy reach incentivizes one to want to go out and garden and work with your plants. It can easily become an impossible labor particularly as one ages if these important things are not in place, thus very important. Eric thinks that’s a very important tip, we should look for things that are not, at least initially, very maintenance intensive. He believes that is one of the things that bogs down young gardeners or folks that are new to gardening. If it becomes too difficult to maintain, you've essentially created a monster. It’s also important to look for the kinds of plants that are easier to grow. Do your research, read up on it. A lot of people have childhood memories of having their grandmother make them pull weeds and they think that is what their garden space is going to be, but that not need be the case. With raised beds and containers you are making it easy, you are not pulling a lot of weeds, you are not really killing yourself, hurting your back, nor injuring your knees. Gardening can be something that one can do until they are one hundred and three but it does require some planning.
A very important component of Kirk’s job is making gardening accessible to people that might have a limited range of motion. These folks may very well not be as strong as other gardeners. Something super important on that front is selecting the RIGHT TOOL FOR THE JOB. And that is part of the assessment process. Kirk must determine how and where a patient needs assistance and if adapted equipment is needed. Fortunately these days, gardening equipment is made specifically to meet those needs. One of the best things one can do is to have a good, smart set up, soft soil, even raised beds or large containers. These things can make the process easier. But, if one has loss of function or weakness perhaps in an arm or hands then there are some wonderful tools available to use. The guys go through some of the options. Many are tools Eric has not seen before and they look a little different. But for instance you may have a trowel or something that can be used as a hoe, something that fits on your arm. A brace allows one to hold onto the handle, that way one can use that arm motion to make holes in the raised bed or container. Some very light weight tools are made out of plastic. One has an ergonomic handle, even with limited wrist flexion one is able to dig in the soil. It is light weight, thus makes it much easier. If one has loss of strength and not able to pick things up, light, plastic tools are durable but they can also be easier to handle. There are tools that have trigger grips that make it just a little easier to hold onto. If someone has arthritis it can be tough holding onto small handles which then makes it difficult to perhaps cut flowers, even light pruning can be problematic. One tool is a cutter, gatherer, it will allow one to make a cut and then hold onto what has been cut, then bring it back. So it doesn't just cut it off, then fall on the ground. Because one may have trouble then bending over and picking it up, this tool makes it much easier. Tools that have extensions are quite often helpful. With them when sitting in a chair or wheelchair one can extend their arm to a length that accommodates ones arms. They are pretty handy, some have interchangeable tools at the end. There are a lot of things that we can find around the home or in retail garden centers and shops that can be made to work.
And there is a lot of focus, of late, that is being put into the ERGONOMICS OF TOOLS. These are designed to take some of the impact out of the joints which makes it more comfortable to garden. The guys show us a few great examples of ergonomic tools. Instead of straight handles these have really nice, curved handles that utilize all the strength in your hand. One is a basic scraper. Especially if we are dealing with soil that is already somewhat loose, it's an easy way to weed. With the curved handle, if one has limited wrist flexion or arthritis, it makes it a little easier on those joints. Another tool is a weeder that Eric likes to use. It has the same kind of ergonomic design. They both like the way that it is shaped. It is particularly useful working with things like dandelions where it is hard to get rid of that taproot, in fact if we don’t excise the entire taproot we simply end up making more dandelions, then dealing with little baby dandelions. It is a really easy tool, it penetrates down into the ground enabling us to extract the entire root. Eric also likes a basic scoop for gardening. If moving soil into containers, it works great, not as big as a shovel but not as small as a trowel, so a really good universal tool. Once again it is a great ergonomic design, and a very comfortable handle. One can work with it for hours without any fatigue.
There are also some very easy things that we can do at home if we don't happen to have an adapted piece of equipment. Take a standard trowel, just something we would typically find, wrap it with a bit of plumbing insulation. Cut the insulation, wrap the handle, use maybe a little duct tape (it holds the world together) and you have a built up handle which makes it much easier to hold onto. Kirk also often uses very inexpensive, kids rubber boards, some may use these for surfing, they are great for kneeling pads. For working down on the ground it's easier on our knees. All are ideas for gardening equipment that can make gardening easier and in so many instances make it possible for folks to garden.
Our time has come too an end. Eric thanks Kirk for sharing his time, it has been enjoyable, and we’ve explored a topic that we’ve never explored before on GardenSMART. Kirk has given us a behind the scenes look at the healing power of plants through horticultural therapy and how we can apply these principles at home. Kirk is happy to have had Eric and the GardenSMART audience visit and asks us to come back again. We’ll do it. Thanks Kirk.
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