Healing Spaces

January 14, 2013

Gracious Living Day by DayAn interesting article about designing architecture for psychiatric wards caught my attention last Sunday.

In his opinion piece, Designing for Calm, Roger S. Ulrich writes about violence against care workers in psychiatric hospitals and suggests that one of the solutions to this problem could be better design of the facilities these patients live in.

“For patients, the stress of mental illness itself can be intensified by the trauma of being confined for weeks in a locked ward. A care facility that’s also noisy, lacks privacy and hinders communication between staff and patients is sure to increase that trauma. Likewise, architectural designs that minimize noise and crowding, enhance patients’ coping and sense of control, and offer calming distractions can reduce trauma.”

I couldn’t agree more. To this I would like to add one more suggestion – outdoor healing spaces.

And this is true not just for psychiatric wards, but for hospitals, nursing homes, and all other places where people go to recover and heal.

After my treatments and surgeries for breast cancer I spent a lot of time in a hospital. Lying in an ugly, impersonal, noisy room I longed for beauty, color, quiet. But more than anything else, I longed for fresh air. The hospital had no balconies, gardens or outdoor spaces. I lay in my room looking at a closed window with a view of the parking lot imagining that I was sitting on a shady bench in a pretty garden.

The same hospital recently spent millions of dollars adding luxuries like jacuzzi tubs to many rooms, but not a single balcony or garden was added to the complex.

My mother spent the last year of her life in a nursing home. Ravaged by Alzheimer’s Disease she didn’t know who she was, she didn’t know who we were, and there were almost no pleasures left for her to enjoy. But every day, when I visited and took her for a walk in the nearby park, she took a deep breath of fresh air and turned her face towards the sun like a sunflower.

The nursing home had an enclosed green space, but the staff was so busy they had no time to take the patients outside. When my mother couldn’t walk any more, I asked the nurses if I could take her into the garden and I volunteered to watch other Alzheimer’s patients as they walked around and enjoyed the air.

I will never forget as men and women slowly ventured outside through that open door. Alzheimer’s Disease robs patients of smiling and displays of emotion but these people demonstrated their joy in other ways. Some walked around in wonder, stepping on shadows or looking at the sunlight. Some sat on the ground, delicately caressing blades of grass. Some held hands. Everyone was quiet.

The nurses later told me that it was the quietest night they had in the facility for a very long time. Tired out form walking and breathing fresh air, the patients slept peacefully through the night.

Gardens and green spaces have been an integral part of convalescent design since ancient times. I understand that restrictions in urban spaces force us to build high rise medical facilities, but that should not prevent us from including gardens and green spaces.

Think of hospitals with balconies (safely but beautifully enclosed) with vertical gardens and comfortable chairs where patients can sit for hours in the fresh air, instead of watching television. Think of meandering walkways designed around the outer perimeter of the building where patients can walk slowly and build up their strength so they can heal faster.

Think of the kind of hospital or nursing home that you’d like to stay in.

Bosco Verticale, a 27-story structure, currently under construction in Milan, Italy Bosco Verticale, a 27-story structure, currently under construction in Milan, Italy

Bosco Verticale is an apartment building but the ideas implemented in this innovative space would work beautiful for convalescent spaces as well.

“Each apartment in the building will have a balcony planted with trees that are able to respond to the city’s weather — shade will be provided within the summer, while also filtering city pollution; and in the winter the bare trees will allow sunlight to permeate through the spaces. Plant irrigation will be supported through the filtering and reuse of the greywater produced by the building. Additionally, Aeolian and photovoltaic energy systems will further promote the tower’s self-sufficiency.” Read More. 


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{ 8 comments… read them below or add one }

Nikole February 16, 2013 at 10:15 pm

Thanks Liliana — I have been meaning to write. I had my 6 month cat scan two weeks ago and all is well; a small hernia may need to be looked at some time. And I read another article about an initiative to make beautiful spaces, green spaces, in hospitals but I have lost it. It was exactly what we are discussing here. After I left the hospital in June I spent a week at a friend’s home. Pat has a small garden and I can tell you that I literally swallowed the small hanging plants and flowers with my eyes and breath. Tiny flitting birds added to the wonder of it all.


Liliana February 18, 2013 at 7:27 am

Dear Nikole,
I am so happy to hear that you are doing well.
Good friends and beautiful gardens can do wonders for our health.
I know what you mean about the birds, just thinking about them makes me smile.
Take good care, dear friend, and keep in touch.
Hugs and good wishes to you,


Nikole January 30, 2013 at 1:38 am

Hi Liliana — Oh how I understand your message! Last June I had surgery for colon cancer. The rule is to keep walking to make your system “start up.” Up and down I walked with my pole passing others who were in the same boat. Because of the intensity of the floor activity — laundry and so on, even the glass covering the beautiful paintings in the corrider was hazy, unclean. It wasn’t the same on other floors I saw later. While the hospital was clean the stale smells became unbearable and I asked my husband to bring some lavender essence that I held to my nose as I walked. I begam to long for beauty. My prayers were answered when I strolling guitarist visited rooms and I was able to follow along! Live music! I thought, if only there was some kind of arcade, outside the perimeter of this ward, anything to get away from those subliminal odors. I was there for only ten days.


Liliana January 30, 2013 at 5:48 am

Dear Nikole,
I hope you are well now and wish you all the best. Thank you for your very vivid description – anyone who has been in a hospital can recognize how true and honest the picture you paint is.

How ironic that when we need nurture and beauty most for our body and soul to heal, we have to endure added strain on our health!


Jeff January 16, 2013 at 4:52 pm

It would be a wonderful alternative to the usual facility – I know that some of the assisted living facilities I’ve visited tried to offer more of a home environment than an institutional one. Unfortunately, it comes down to a financial model – a harsh fact of life when it comes to our medical and after-care.

One other thing to offer – therapy dogs! Everyone responds to the absolute love and attention these 4-leggeds supply. I can testify to that personally since two of mine took close care of me while I was recovering from treatment. One is still around – and she continues to follow me from room to room, keeping an eye on me, even though I’m years out now from treatment.

But I agree – the option to breathe the air and walk under trees does as much for the spirit as it does for the body…

– J.


Liliana January 17, 2013 at 8:39 am

Oh Jeff, I couldn’t agree more!
My niece was just telling me that therapy dogs are used in Canada to help students get through the stress of the finals week. Animals can help us at any time of life.
Hug to you.


John January 14, 2013 at 10:05 am

Ah yes… the best (and rarest) hospitals include a focus on healing in addition to their other ministrations. The worst, and I fear the current trend, focus on patient turnover.

This winter, I read a unique book, God’s Hotel, by Dr. Victoria Sweet. She writes eloquently about her decades serving patients at Laguna Honda Hospital in San Francisco, a municipal facility (almshouse) for its indigent population. Environmental concepts and “slow medicine” are among several ideas explored by this thoughtful physician.

Happy New Year Liliana!


Liliana January 14, 2013 at 12:36 pm

I heard of that book, John, but then I forgot all about it. I will pick it up from our library today.
Best wishes for a wonderful year to you and your family,


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