As biophilic design becomes more of a focus in senior living, it’s important to consider therapeutic horticulture, defined as a modality that supports program goals aimed at enhancing participants’ health and wellbeing  through active and passive interaction with nature and plant-related activities such as gardening, according to the session “Outdoor Antidote: Introducing Therapeutic Horticulture into Senior Living Design” at the 2021 EFA Expo, Aug. 29-31 in Chattanooga, Tenn.

Therapeutic horticulture elevates a horticulture activity or a gardening activity to an intentional therapeutic intervention by targeting particular goals (physical function, cognitive function, activities of daily living function) in the implementation of that activity. With such a wide body of research about the benefits of biophilic design, the senior living industry should be exploring ways to creatively plan and design purposeful outdoor spaces, according to speakers Brad Smith, founder of BSA Place Creation, landscape architects and planners, and Elizabeth “Leah” Diehl, director of therapeutic horticulture at the University of Florida’s (UF) Wilmot Botanical Gardens, who presented the session.

“While it’s great to create places where people enjoy being, how much more effective would it be if we also plan and program purposeful activities to take place in those spaces?,” said Smith.

“Outdoor area development in senior living involves so much more than mere site cosmetology,” he said. “Our aim is to develop evidence-based design solutions that truly add value, enriching the lives of residents, their families, and those who work on site. That’s why we initially reached out to Leah—we saw the need for communities to not only plan and design outdoor spaces, but to also plan and program the therapeutic activities that can happen there.”

In the Wilmot Botanical Gardens Therapeutic Horticulture Program at UF, Diehl works with diverse client groups—including veterans, young adults in addiction recovery, people with movement disorders, cancer patients, and people recovering from stroke-associated paralysis, and adults with autism spectrum disorders and other developmental disabilities. The program utilizes a greenhouse and garden environment for class activities that encourage participants to explore horticulture through propagating and nurturing plants, with each activity designed to incorporate specific therapeutic benefits, such as socialization, intellectual and sensory stimulation, gross/fine motor skills, and eye/hand coordination.

Smith recognized how easily this program could be adapted for the needs of those in the senior living community.

One of the best ways to incorporate therapeutic horticulture into senior living communities is by designing outdoor and other plant-filled spaces that aren’t just beautiful but also engaging in both passive and active ways. “These spaces need to be physically accessible, but they also need to be psychologically accessible—in other words, do they look safe, comfortable, and interesting? Are there things to explore, discover, and engage with throughout the space while also providing comfortable resting areas?,” Diehl said.

Furthermore, she added, it’s important for the landscape architect, horticultural therapist, administrators, staff, and residents at a community to create and plan ways for people to interact with the space and each other. “Growing and maintaining plants is an inherently meaningful activity that contributes to one’s community and through that process we can help people build self-efficacy, self-esteem, and increase control over one’s environment,” Diehl said.

Smith encouraged attendees to go beyond adding a mobile cart with potted plants and instead look to create sensory gardens that offer a variety of experiences. Citing an example outside the industry, he said Boothbay Botanical Gardens in Maine runs a therapeutic horticulture program for all ages with a garden that has individual spaces devoted to each of the senses.

Smith presented creative ideas on ways to reimagine the outdoor space at senior living communities that create community while increasing engagement and life satisfaction. Diehl underscored the importance of those outdoor spaces by outlining a multitude of research studies on the benefits of nature interaction for older adults. She described how integrating therapeutic horticulture into those settings provides intentional and meaningful opportunities for seniors to build self-esteem, self-efficacy, and social connection that may have been lost in the aging process or in the transition into a new, shared living environment.

Smith and Diehl challenged leaders and designers in senior living to press the envelope and delve into the low-cost, high-yield mix of interactive design and therapeutic horticulture that is tailored to the needs of seniors while energizing outdoor space and enhancing health and well-being for the entire senior community.