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Raised Garden for the Spinal Injuries and Rehabilitation Units

Raised Garden for the Spinal Injuries and Rehabilitation Units

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Published by prussin
PROPOSAL FOR A RAISED GARDEN FOR THE SPINAL INJURIES AND REHABILITATION UNITS
An Initiative supported by Diversity Health, POWH

Project Background The outdoor area attached to the Spinal Injuries Rehabilitation Unit was assessed in 2004 for its capacity to house a potted garden. The outcome of this assessment flagged the area as satisfactory for raised (potted) gardening and it was agreed that it is a space in desperate need for improvement to facilitate recreation and relaxation for its users.
PROPOSAL FOR A RAISED GARDEN FOR THE SPINAL INJURIES AND REHABILITATION UNITS
An Initiative supported by Diversity Health, POWH

Project Background The outdoor area attached to the Spinal Injuries Rehabilitation Unit was assessed in 2004 for its capacity to house a potted garden. The outcome of this assessment flagged the area as satisfactory for raised (potted) gardening and it was agreed that it is a space in desperate need for improvement to facilitate recreation and relaxation for its users.

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Published by: prussin on Sep 10, 2011
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05/25/2012

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PROPOSAL FOR A RAISED GARDEN FOR THE SPINAL INJURIES ANDREHABILITATION UNITS
An Initiative supported by Diversity Health, POWH
Project Background
The outdoor area attached to the Spinal Injuries Rehabilitation Unit was assessed in2004 for its capacity to house a potted garden. The outcome of this assessmentflagged the area as satisfactory for raised (potted) gardening and it was agreed that itis a space in desperate need for improvement to facilitate recreation and relaxation for its users. Currently the area offers some small potted trees and an expanse of concrete.The site is used daily by Spinal and General Rehabilitation patients and their familiesas a communal meeting place beyond the hospital walls, and offers a fresh air reprievefor those people enduring a prolonged hospital length of stay due to a generally highlevel of disability. The two units comprise over 40 inpatient rehabilitation beds.Gardening offers an age appropriate activity to all who attend from the respectiveunits.
Rationale for the raised garden project
An extensive raised garden bed with wheelchair access for wheelchair dependentrehabilitation inpatients would improve the environment and assist with therapyin the two rehabilitation units attached to it. It is proposed that appropriatewheelchair accessible benches would be provided along with adaptive gardeningtools. It is envisioned that a range of plants will be grown including annuals,vegetables, herbs and fruit trees. In addition to work benches, a wheelchair accessible greenhouse is necessary to offer protection to some varieties of plants(fruit trees and vegetables) and can double as a secure storage area for tools.Provision of shade by a trellis or similar would also be a useful feature.Gardening offers patients a meaningful and worthy activity to engage with and/or can be structured by an occupational therapist to specifically target functional goals.These functional outcomes can relate specifically to upper limb function, balance, finemotor dexterity and education pertaining to joint protection and energy conservation.In addition produce from the garden could be used in cooking sessions as part of theoccupation and nutrition intervention programs.Patients undergoing rehabilitation for spinal cord injury, neurological event eg strokeor from amputation are engaged in an intensive and demanding program, wherelearning new and difficult skills to negotiate one’s future is paramount. This is oftendone in a context of isolation, as during this phase patients cannot access their homesor the wider community including public gardens, beaches and national parks.Providing an accessible natural garden setting at the ward is a sustainable andinvaluable asset to the rehabilitation program.
 
Proposal for a Raised Garden for the Spinal Injuries and Rehabilitation Units
An Initiative supported by Diversity Health, POWH, December 2005
The impetus for developing this project arose from participation by the project co-ordinator in the Diversity Health Leadership Project at POWH. The LeadershipProject supported a group of hospital staff to build their knowledge and skills inDiversity Health and take a leadership role in this area through training and ongoingsupport from the Diversity Health Coordinators. Part of the project involveddeveloping and implementing a diversity health project. The development of acommunity garden lent itself well to the aims, objectives and processes that were promoted in the leadership course. This project is supported by Diversity Health,POWH.
Project Aims and Objectives
The project aims to create a garden for rehabilitation patients, their families and staff on the verandah adjacent to the Rehabilitation Wards at POWH. The project aims toachieve the following objectives:
To create a garden that offers patients a space for rest and relaxation, in anatural environment that reflects wellness, uses natural light and offers a pleasant, ‘green’, natural and beautiful setting.
To extend the patients’ treatment regimes and influence patients’ healingincluding the design of wheelchair accessible space with appropriateworkbenches, furniture and seating for:
o
meetings,
o
future therapeutic activity programs eg art, woodwork,
o
gardening,
o
 patient education sessions
o
 peaceful retreat for patients, families and staff 
o
BBQs and social events
To provide a venue which can be incorporated into occupational therapy,creative arts and nutrition intervention programs, including growing of a rangeof plants including vegetables, herbs, fruit trees and flowers and utilising produce from the garden to be used in cooking sessions.
To utilise community cultural development processes to support patients, staff and families to work alongside each other, using familiar and new skills in the process of creating and maintaining the garden.
Literature Review
The following literature review provides evidence for the value and benefits that can be derived from community, restorative and healing gardens in the health care setting.It is organised into four clusters:Healing environments and health care designThe relationship between well-being and natureThe roles and benefits of community and healing gardens
Community cultural development2
 
Proposal for a Raised Garden for the Spinal Injuries and Rehabilitation Units
An Initiative supported by Diversity Health, POWH, December 2005
Overview of the literature
The field of health care design has increasingly recognised the impact of physicalenvironments on the well-being of patients, staff and family in terms of healthoutcomes such as healing rates, reduced stress and overall quality of health caredelivery. There has also been a renewed acknowledgment of the relationship betweenconnecting with nature and our state of health and well-being (theory of ‘biophylia’).Based on this theory there is now more acceptance of the positive responses inducedthrough human contact with living things.The restorative and therapeutic qualities of gardens have also been highlighted in theliterature, especially the research work by Ulrich, which focuses on the effects of builtand natural environments on people's psychological well-being and health. Ulrich hasinvestigated extensively the links between nature, specifically access to gardens andresulting improved health outcomes of hospital patients. The benefits for health careworkers and families in reducing stress have also been noted.The concept of a community garden where people interact and work alongside eachother to create a beautiful space has been used as a health promotion strategy invarious settings, especially in public housing estates. The positive outcomes in termsof fostering community building, developing social supports and inclusion incommunity are well recognised and as a result community gardens have been adoptedin many other settings. The act of creating the garden as a communal, participativeactivity and the use of the garden setting for creative art pursuits is a newly emergingarea. Creative arts have a well-recognised potential to promote health and wellbeingand the ‘art for health movement’ is being adopted by many services and programs.The above concepts are explored in more detail below.
Healing environments in health care design
The physical environment affects well-being and there is growing internationalacceptance that the design of health care facilities should be human centred andfunctionally efficient to benefit patients, their families and staff.
1
 
In a review of 600studies in peer reviewed journals establishing how hospital design can affect clinicaloutcomes, the physical environment was found to be linked to patient and staff outcomes in four areas, namely, reduced staff stress and fatigue and increasedeffectiveness in delivering care, improved patient safety, reduced stress and improvedoutcomes, and improved overall health care quality.
2
Ulrich has written several theoretical articles focusing on the effects of design onhealing and wellness and how we need to move away from health care and design thatis ‘psychologically hard’ to design that is more physically and psychologicallysupportive.
3
 Ulrich proposes a stress model stating that there are two major sources of stress for hospital patients: ‘illnesses’ that reduce control and physical capability and
1
Martin C. Putting patients first: integrating hospital design and care. The 2
nd
InternationalConference on Health and Design, Stockholm Sweden, June 18-21, 2000.
The Lancet.
2000; 356:518.
2
The role of the physical environment in the hospital of the 21
st
century: a once in a lifetimeopportunity.
 AIA Architect 
02/05 www.aia.org/aiaarchitect/thisweek05.
3
Ulrich RS. Cited in Mroczek J, Mikitarian G, Vieira EK, Rotarius T. Hospital Design and Staff Perceptions: An Exploratory Analysis.
The Health Care Manager.
2005; 24(3):233-244.
3

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