Recovering with nature at your side

Various concepts of quality of life (or life satisfaction) emerged in the realms of medicine, health and social sciences in the 1950s. Early methods for measuring quality of life now seem somewhat primitive, focusing on the mobility of the individual or on other more basic measures generally associated with an individual’s independence.  
However, a recent model has been created that consists of six major life domains: social wellbeing, physical wellbeing, psychological wellbeing, cognitive wellbeing, spiritual wellbeing and environmental wellbeing. Each of these domains can be divided into several sub-dimensions in order to operationalise the concept of ‘quality of life’ so that a common standard of useful measurement can be used. Each of these life domains can also be directly linked to good quality landscape design and construction, which we will look at in this article.

The benefits of plants
A large amount of research has been undertaken into the benefits that ensue from people’s proximity to plants, especially in healthcare and work environments. The results from many studies show that a person’s wellbeing increases across numerous levels when working near plants or in a natural setting. Concentration and memory are shown to improve, often dramatically, and this is often combined with a higher quality of work being produced by working in a more natural environment. The results from studies investigating the effects of indoor plants typically show the same results as being near plants outdoors. Two recent studies both show that the number of indoor plants in proximity to a worker’s desk has a small but statistically reliable correlation with levels of sick leave and productivity.
Importantly, a range of studies has shown that plants accelerate the healing process, with the presence of plants in patient recovery rooms reducing the recovery period. Simply giving patients daily access to flowers and other ornamental plants in landscaped areas outside patient recovery rooms can also significantly speed up recovery time.
A number of studies have also shown that the presence of ornamental indoor plants is conducive to generating a positive learning environment and reducing children’s tendency to be distracted. This effect can be amplified in children with specific attention disorders such as ADHD.
At the other end of the age spectrum it has been shown in a number of studies that elderly care home residents working with plants showed an increase in alertness, interacted more with fellow residents and staff and required less staff care.

Environmental benefits
Even without supporting research evidence, most people are able to appreciate the environmental benefits of plants, e.g. cleaner air, reduced soil erosion and reduced flooding/less stress on urban drainage. Other benefits are more relevant to a healthcare setting, such as reduced noise pollution, an offsetting of the urban heat island effect and reduced building energy costs.
Modern building design, particularly in high rise city business districts, is increasing the incidence of urban glare. This was demonstrated with dramatic effect in London in the summer of 2013 when the now infamous ‘Walkie Talkie’ building’s design resulted in damage to the paintwork of a parked car at street level from sunlight reflected from the building’s expanse of glass. Urban glare can also be unpleasant for those working in urban areas and for hospital patients and their visitors where a lack of foliage from shrubs and trees in external landscaped areas surrounding hospital buildings increases the risk of this phenomenon.
Landscape planting plays an important part in reducing the effects of storm water runoff by absorbing rainwater through the foliage and the roots. This helps to prevent flooding in urban areas and reduces the amount of water that requires treatment. Plants also absorb some of the pollutants in run-off water from roads and car parks.   
It is well documented that plants help to clean our air by removing potentially harmful gases from the atmosphere and by filtering particulate matter from the air. Particulates are known to exacerbate a range of health problems, including asthma, bronchitis and other lung conditions that relate to premature deaths.
Quality landscape design
The research already undertaken confirms what the landscape industry has been saying for many years – that the presence of plants and foliage in the internal and external environment leads to healthier, more productive, more alert and happier people. Plants also enhance the natural and built environment in numerous ways. However, many of these positive aspects can be lost by poor design and construction carried out by unqualified or inexperienced landscape contractors.
The British Association of Landscape Industries (BALI) is the UK’s largest trade association for interior and exterior landscapers and designers, grounds maintenance contractors, and companies supplying industry-related products and services. BALI members have designed and built many landscape schemes at healthcare facilities, many of which have won national awards.  
Maggie’s Cancer Care Centre in Cheltenham, Gloucestershire, offers practical, emotional and social support to people with cancer and their families and friends. The centre’s garden was skilfully designed by BALI Registered Designer Christine Facer Hoffman and constructed by BALI Registered Contractor Graduate Gardeners, both based in Gloucestershire. The design brief from Maggie’s was clear –  to create spaces that encourage a positive mindset. This has been well achieved and the garden creates a calm environment in which patients and visitors feel less stressed.
Horatio’s Garden, at the Duke of Cornwall Spinal Centre in Salisbury, Wiltshire, is a garden inspired by Horatio Chapple, who was tragically killed at the age of 17. The garden was constructed by Bournemouth based BALI Registered Contractor Wycliffe Landscapes and went on to win two BALI National Awards in 2013. The garden has been carefully designed and expertly constructed to allow use by patients in their beds and wheelchairs. This is a beautiful garden and a great example of how outside space can be inclusive to all, even those who are bedridden.
These are just two examples of a host of beautiful and functional outside spaces that have been designed and built by BALI members specifically for healthcare facilities. If hospitals have outside space, whether a small neglected area at an existing site or at an entirely new healthcare development, they can benefit from working with a BALI registered designer or contractor.

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