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1 The Importance of Nature to Health & Well-being Dr. Joanne Westphal, PhD,, M.D.
2 Background Medicine Landscape Architecture
3 Background Medicine effects of nature on human health» Conscious sensory sensory input Landscape Architecture
4 Background Medicine effects of nature on human health» Conscious sensory sensory input» Subconscious endocrine system Landscape Architecture
5 Background Medicine effects of nature on human health» Conscious sensory sensory input» Subconscious-- endocrine» Unconscious-- --bio- rhythms Landscape Architecture
6 Background Medicine effects of nature on human health» Conscious sensory sensory input» Subconscious-- endocrine» Unconscious-- --bio- rhythms Landscape Architecture effects of built environments on human health
7 Background Medicine effects of nature on human health Conscious sensory sensory input Subconscious-- --endocrine Unconscious-- --bio- rhythms Landscape Architecture effects of built environments on human health» Learned behavior
8 Current Situation Medicine Art Science Evidence Based Practice» Cause & effect» Predictability factor» Best practices» Well-defined outcomes
9 Current Situation Medicine Art Science Evidence Based Practice» Cause & effect» Predictability factor» Best practices» Well-defined outcomes Landscape Architecture Art Intuitive design Historic absence of research» No predictability» Performance standards for materials & construction» Outcomes poorly defined
10 Problem How Do You Convert an Art to a Science?
11 Therapeutic Site Design 1984 Roger Ulrich publishes View through a window may influence recovery from surgery. Science 224:
12 Therapeutic Site Design Study measured these parameters: blood pressure post-surgical surgical days to discharge nature & amounts of analgesics (pain killers) number of complaints
13 Therapeutic Site Design Significant difference in patients who had a window looking out to a natural setting vs. patients who looked out to a roof top with no natural features
14 Therapeutic Garden Design: Martin Luther Alzheimer Garden Julie Galbraith, San Diego Recreation and Parks Department, San Diego, California Joanne M. Westphal, MSU, Landscape Architecture Program, E. Lansing, Michigan
15 Martin Luther Alzheimer Garden: Site, User Group, & Resources Holt, MI Third Stage Alzheimer s Type Dementia Unit Approximately 18 patients Standard Nursing Records
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18 Martin Luther Alzheimer Garden: Study Parameters Garden: constructed in Fall, 1999 First summer of use: 2000 Data collection for two years (1999, 2000) Two months in April & May (pre-garden use) Two months in July & August (high garden use)
19 Martin Luther Alzheimer Garden: Variables of Interest Examined nursing records for eight variables Behavior (aggressive and non-aggressive) Medications (physician ordered and as needed) Pulse rate Blood pressure (diastolic and systolic) Weight change
20 Martin Luther Alzheimer Garden: Experimental Design Compared these eight variables with the amount of time the resident spent in the garden 0-55 minutes >5 minutes but less than 10 minutes >10 minutes April/May records versus July/August records
21 Martin Luther Alzheimer Garden: Findings-Low Use Residents who spent minutes on average during the summer months Deteriorating parameter on five criteria*» (blood pressure [systolic], aggressive behavior, non- aggressive behavior, pulse, weight) Improved performance on two criteria» (blood pressure [diastolic], medication [as requested]), Stayed the same on one parameter» (physician ordered medication) *Pulse Pressure increased (BP sys-bp dia= = Pulse Pressure)
22 Martin Luther Alzheimer Garden: Findings-Moderate Use Residents who spent >5-10 minutes on average during the summer months Deteriorating parameter on four criteria*» (blood pressure [systolic], non-aggressive behavior, pulse, weight) Improved performance on three criteria» (blood pressure [diastolic], aggressive behavior, medication [as requested]) Stayed the same on one parameter» (physician ordered medication) *Pulse pressure increased (BP sys-bp dia=pulse Pressure)
23 Martin Luther Alzheimer Garden: Findings-Highest Use Residents who spent > minutes on average during the summer months Deteriorating parameter: none Improved performance on seven criteria*» (blood pressure [systolic], blood pressure [diastolic], non- aggressive behavior, aggressive behavior, medication [as requested], pulse, weight) Stayed the same on one parameter» (physician ordered medication) *Pulse Pressure decreased
24 Therapeutic Garden Design: Martin Luther Alzheimer Garden Conclusions Significant improvements with as little as 10 minutes in a garden area Garden activity does not appear to require programming Substantial savings in medications, staff stress, etc. possible
25 Martin Luther Alzheimer Garden: Post-Occupancy Evaluation of Site Positive Attributes 8 foot wide, brushed concrete Strong edge delineation (color, texture) Simple returning path system Ample seating (shade & sun) Non-poisonous/toxic plants Planting/work area near entrance with water & storage (ADA accessible) Minimum annual plantings, maximum perennial species, small amount of grass
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27 Martin Luther Alzheimer Garden: Post-Occupancy Evaluation of Site Positive Attributes 8 foot wide, brushed concrete Strong edge delineation (color, texture) Simple returning path system Ample seating (shade & sun) Non-poisonous/toxic plants Planting/work area near entrance with water & storage (ADA accessible) Minimum annual plantings, maximum perennial species, small amount of grass
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29 Martin Luther Alzheimer Garden: Post-Occupancy Evaluation of Site Negative Attributes Off-white paving-- --too bright Upward, bevel-edge edge along walk perimeter needed Bounce light off of structure Annuals present annual problems Shadows problems Planter materials harbor yellow-jackets, wasps Annual staff education program for garden use needed
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31 Martin Luther Alzheimer Garden: Post-Occupancy Evaluation of Site Negative Attributes Off-white paving-- --too bright Upward,bevel-edge edge along walk perimeter needed Bounce light off of structure Annuals present annual problems Shadows problems Planter materials harbor yellow-jackets, wasps Annual staff education program for garden use needed
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33 Health by Design Joanne M. Westphal, Ph.D., M.D. Landscape Architecture Program Michigan State University East Lansing, MI (517)
34 Therapeutic Environments Questions?
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