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Renewing the hospital precinct at UBC : a restorative approach England, Karin Maria 2006

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Renewing the Hospital Precinct at U B C : A Restorative Approach by Karin Maria Eng land Bache lo r of Mus ic , McGi l l University, 1993 G r a d u a t e D ip loma in Fine Arts, University of Ca lgary , 1994 Master of T e a c h i n g , After D e g r e e in Educat ion , University of Ca lgary , 2000 A T H E S I S S U B M I T T E D IN P A R T I A L F U L F I L L M E N T O F T H E R E Q U I R E M E N T S F O R T H E D E G R E E O F Master of L a n d s c a p e Architecture in T H E F A C U L T Y O F G R A D U A T E S T U D I E S T H E U N I V E R S I T Y O F B R I T I S H C O L U M B I A August 2006 © Karin Maria E n g l a n d , 2006 Abstract H u m a n s are intimately c o n n e c t e d to the natural environment , the p lace where w e evo lved and that provides us with the fodder for our very ex is tence (Kellert & W i l s o n , 1993). R e s e a r c h conf i rms what we intuit - that people are restored through contact with natural l a n d s c a p e s (Ulrich & P a r s o n s , 1992). Restorat ive exper iences leave o n e feeling renewed; it has been s h o w n that a c c e s s to restorative l a n d s c a p e s r e d u c e s stress levels, acce le ra tes heal ing, and e a s e s mental fatigue. Kap lan a n d Kap lan have descr ibed the l a n d s c a p e e lements that create restorative exper iences , providing g u i d a n c e to des igners who wish to confer restorative exper iences to site users , improving their wel l -being (Kaplan & Kap lan , 1998). Hospital precincts are uniquely f o c u s e d on the promotion of wel l -being, where many of the users are exper iencing i l lness and negative s t ress and therefore would greatly benefit from implementing restorative l a n d s c a p e s . In particular the U B C hospital precinct could be improved to take a d v a n t a g e of the restorative a s p e c t s of nature, creating a better envi ronment for all site users; students, hospital staff, residents and visitors. Table of Contents Abstract ii Table of Contents iii List of Tables v List of Figures vi Preface viii Acknowledgements ix 1 Restorative Landscapes 1 1.1 Literature Review 1 1.2 A History of Hospital Gardens 7 1.3 Precedent Studies 11 2 Context. . , 15 2.1 National Trends 15 2.2 Context within the Region 16 2.3 Context within the University 16 2.4 The Hospital Precinct 18 2.5 An Introduction to the Hospital Pavil ions 22 2.6 An Introduction to the New Garden Space 24 2.7 An Introduction to the Existing Garden Space 25 2.8 Analysis 26 3 Design Principles and Guidelines 29 3.1 Design Principles 29 3.2 Design Guidel ines ; 30 3.3 Principles and Guidelines for the Precinct 31 3.4 Principles and Guidelines for the Residents' Garden 32 3.5 Principles and Guidelines for the Therapeutic Garden 34 4 Design Proposal 37 4.1 A Design for the Precinct 37 4.2 A Design for the Residents' Garden 42 4.3 A Design for the Therapeutic Garden 62 iii 4.4 Design Matrix 70 4.5 Discussion 75 Bibliography 76 Appendices 80 Appendix A : Wellness Walkways Recommendat ions 80 Appendix B: Purdy Questionnaire 85 iv List of Tables Table 3.1 Design Guidelines 30 Table 3.2 Guidelines That Address Purdy Resident's Needs 32 Table 3.3 Horticulture Therapy Projects 35 Table 4.1 Design Matrix 70 v List of Figures Figure 1.1 Benefits of Horticultural Activity 4 Figure 1.2 Hortus Sanitatis 8 Figure 1.3 Cloister Garden 8 Figure 1.4 Royal Navy Hospital 9 Figure 1.5 Friends Asylum 70 Figure 1.6 Ban field Rooftop Garden 12 Figure 1.7 Cedarview Plan 13 Figure 1.8 Wellness Walkway 14 Figure 2.1 Canada's Aging Population 15 Figure 2.2 UBC's Position in the GVRD 16 Figure 2.3 Local Area Destination 18 Figure 2.4 Map of Hospital Precinct 18 Figure 2.5 Patient Park 79 Figure 2.6 Pedestrian Mall 20 Figure 2.7 Koerner Cafeteria and Tunnel 20 Figure 2.8 Precinct Poor Street Crossings 21 Figure 2.9 Entrance to Koerner Pavilion 22 Figure 2.10 Benches on Site 22 Figure 2.11 Entry to Detwiller Pavilion 23 Figure 2.12 Purdy Pavilion Entrance 24 Figure 2.13 New Garden Space 25 Figure 2.14 Existing Garden Space 25 Figure 3.1 Design Principles 29 Figure 4.1 Proposed New Building Footprints 38 Figure 4.2 Proposed Walking Route 39 Figure 4.3 Proposed Breezeway Modifications 41 Figure 4.4 Proposed Residents' Garden Plan 43 Figure 4.5 Birdbath Fountain Details 44 Figure 4.6 Nestbox Details 45 Figure 4.7 Bench and Chair Details 46 Figure 4.8 Gate and Fence Details 47 Figure 4.9 Songbird Garden Section 48 Figure 4.10 Winter Retreat 50 Figure 4.11 Rose A rbor Detail 57 Figure 4.12 Babbling Fountain Details 52 Figure 4.13 Garden Wall Details 53 Figure 4.14 Accessible Picnic Table Details 53 vi Figure 4.15 Summer Gazebo Details 54 Figure 4.16 Patio Garden Section 55 Figure 4.17 Patio Garden Section 55 Figure 4.18 Patio Garden Section 56 Figure 4.19 Residents' Garden Planting Plan Part 1 58 Figure 4.20 Residents' Garden Planting Plan Part 2 59 Figure 4.21 Residents' Garden Planting Plan Part 3 60 Figure 4.22 Residents' Garden Plant List 61 Figure 4.23 Proposed Therapeutic Garden Plan 63 Figure 4.24 Retaining Wall Details 64 Figure 4.25 Watering Station Details 64 Figure 4.26 Modified Planters 65 Figure 4.27 Pergola with Canopy 65 Figure 4.28 Therapeutic Garden Section 66 Figure 4.29 Therapeutic Garden Planting Plan Part 1 67 Figure 4.30 Therapeutic Garden Planting Plan Part 2 68 Figure 4.31 Therapeutic Garden Plant List 69 vii Preface T h i s project explores severa l topics relevant in l a n d s c a p e architecture today - therapeutic garden des ign , restorative l a n d s c a p e s , a n d des ign for elderly populat ions. G a r d e n s have been a s s o c i a t e d with heal ing p l a c e s f o r t h o u s a n d s of years , and exploration of this associa t ion has been interesting a n d fruitful for me . T h i s project had its start in the s u m m e r of 2005 when I w a s working on c a m p u s at C a m p u s and C o m m u n i t y P lanning at the University of British C o l u m b i a . I rece ived a call from the Purdy Pavi l ion, a 205 bed ex tended care facility in the hospital precinct on c a m p u s . T h e y wanted des ign ideas for a new garden s p a c e m a d e poss ib le by the removal of an MRI that had b e e n h o u s e d outdoors at their facility. T h e y a lso wanted ideas for the renovation of their existing therapeutic garden s p a c e ; c o n c e r n s included a retaining I that n e e d e d to be rep laced s o o n , and b u r d e n s o m e ma in tenance requirements arising from overgrown plant material. Hospital administration w a s aware for a growing body of empir ical research showing that significant benefits to physica l a n d psycho log ica l health are ga ined with a c c e s s to natural env i ronments . Hospital staff wanted garden s p a c e that would serve to link people to the natural world. T h e precinct and its l a n d s c a p e are u s e d by students, hospital staff and patients, including a group of residential a n d transitional care patients that live at the Purdy Pavi l ion. It s e e m e d to m e that Purdy 's residents d e s e r v e d spec ia l considerat ion a s they m a k e this p lace their h o m e . T h e resident population has an a v e r a g e a g e of 85, 9 0 % are in wheelchai rs , 8 0 % suffer from s o m e form of dement ia , and 2 0 % have Park inson 's d i s e a s e . My des ign solution for the Purdy Pavil ion includes a proposal for the entire precinct a s I felt the n e e d to create a larger context where a hospital garden may appropriately be sited. T h e project therefore al lowed interventions at both the precinct and site sca le . My solution includes p lans for the precinct and two separa te garden s p a c e s , both for the exc lus ive u s e of Purdy residents, famil ies a n d hospital staff. O n e of these is to be a resident 's g a r d e n , a n d the other a redes ign to the existing therapeutic g a r d e n s p a c e to a d d horticultural therapy opportunit ies to those that a l ready exist at the Purdy Pavi l ion. viii Acknowledgements I would like to e x p r e s s my appreciat ion for the support I have received from the following people in the complet ion of this project: P ro fessor Patrick M o o n e y for serving a s my advisor a n d mentor. His unique expert ise in the a r e a of restorative des ign h a s m a d e this project richer. P ro fessor M o o n e y ' s insistence on quality work firmly rooted in research and dedicat ion to his students have been greatly apprec ia ted . P ro fessor D o u g l a s Pa terson for his gu idance . C a m p u s and C o m m u n i t y P lanning staff Patrick M c l s a a c and David Gr igg for their support a n d interest i this project. Purdy Pavi l ion staff El len Cour tney a n d Robert T o r e n for their g e n e r o u s donation of time and adv ice . Purdy Pavil ion resident Rick C h a n d l e r for helping m e understand the n e e d s of patients at the facility. Michae l E n g l a n d , J u d y O s b o r n e , a n d A n n J a c k s o n for their e n c o u r a g e m e n t . Jerry Kaita for unending pat ience a n d support. 1 Restorative Landscapes 1.1 Literature Review Evolved response to natural landscapes H u m a n s are intimately c o n n e c t e d with the natural environment . W e have evo lved in nature a n d it provides us with the fodder for our very ex istence. But nature provides us with more than just the things w e n e e d to survive. E v e n after bas ic n e e d s are met h u m a n s continue to be capt ivated by natural e lements; flora a n d fauna attract a n d hold our attention. Harvard professor of biology E d w a r d O . W i l s o n has cal led this p h e n o m e n o n "biophilia" which he def ines a s "the innately emot ional affiliation of h u m a n beings to other living organ isms" (Wilson, 1993, p31). H e bel ieves that this attraction s t e m s from an evolutionary n e e d to be aware of our surroundings and to se lect env i ronments best suited to the survival of our s p e c i e s . Psycho log is t and author S t e p h e n Pinker a g r e e s , posing that "the brain strives to put its owner in c i r c u m s t a n c e s like those that c a u s e d its a n c e s t o r s to reproduce" (Pinker, 1997, p373). T h e r e is ev idence that al though technological a d v a n c e s have m a d e it possib le for m a n to live a daily ex is tence r e m o v e d from the natural environment our brains are still adapted to prefer immers ion in the types of l a n d s c a p e s where our s p e c i e s had its beginnings. Landscape preference S e v e r a l researchers have d o n e work on l a n d s c a p e preference, and their f indings are similar. G o r d o n Or ians ' research supports Wi lson 's hypothesis . H e f inds a c r o s s cultural favouring of l a n d s c a p e s with characterist ics similar to those of the Afr ican s a v a n n a h , the environment which e v i d e n c e points to a s H o m o sap iens ' h o m e for the first two million years of the s p e c i e s ' evolution. T h e ma in e lements of preference, O r i a n s tells us, are c lear v iews in all directions, c lustered trees with spread ing c a n o p i e s for protection, o p e n g r a s s l a n d s for e a s y m o v e m e n t a n d long views, var ied topography for strategic survei l lance, diversity of plant a n d animal life, and a c c e s s to water (Or ians & H e e r w a g e n , 1992, p.558). G e o g r a p h e r J a y Apple ton descr ibes a similar kind of l a n d s c a p e a s that most preferred by h u m a n s , a setting which offers c lear v iews into the d istance yet provides e n o u g h vegetat ion a n d topographic relief to provide cover (Appleton, 1975). T h i s dialectic l a n d s c a p e of prospect and refuge not only r e s e m b l e s the s a v a n n a h , but a lso constitutes an environment where m a n has tactical advantage over his prey a n d predators. Envi ronmenta l psycholog is ts S teven and R a c h e l Kap lan find that people prefer env i ronments which provide them with the information they require to evaluate their surroundings (Kaplan and Kap lan , 1998). A ba lance between c o h e r e n c e a n d complexity is necessary ; a setting that is orderly and unified yet h a s a rich array of e lements . A combinat ion of legibility and mystery must a lso exist. T h e preferred environment is easi ly read, yet g ives the promise that more c a n be d i s c o v e r e d if one were to venture further into the s p a c e . 1 Effects on well-being R o g e r Ulr ich's research s h o w s the effect that s imply viewing photos of natural e lements has on hospital patients; r e d u c e d heart rates, r e d u c e d respiratory rates and lowered blood pressure (Ulrich & P a r s o n s , 1992). V i s u a l a c c e s s to natural s c e n e s from patient w indows r e d u c e s s t ress , shor tens the duration of post-operat ive hospital s tays, r e d u c e s minor post-operat ive compl icat ions, and i n c r e a s e s positive feel ings. T h e K a p l a n s have reported that window views provide office workers with relief of the effects of mental fatigue, a condit ion that ar ises from over exerc is ing o n e ' s capaci ty for directed attention (Kaplan & Kap lan , 1998). R u s s P a r s o n s s u g g e s t s i m m u n e s y s t e m s are positively affected w h e n people are e x p o s e d to nature ( P a r s o n s , 1991). In all of these studies, subjects benefit from e x p o s u r e to natural e lements . T h e y h ave restorative exper iences that improve health p rob lems - i l lness, s t ress , or mental fatigue - a n d are left feeling renewed. Restorative elements T h e K a p l a n s have isolated the l a n d s c a p e e lements that they feel create restorative exper iences . T h e s e need not all be present to gain restorative effects from l a n d s c a p e s , but the more that are present a n d the stronger their p r e s e n c e , the greater the effect will be. T h e y are a s e n s e of being away, fascinat ion, extent, near nature and compatibility (Kaplan & Kap lan , 1998). A s e n s e of being away is a c h i e v e d when o n e feels that they have b e e n to a whole other world, an exper ience that c a n be provided through e s c a p e from a s p e c t s of life that are "ordinarily present and presumably not a lways preferred" (Kaplan & Kap lan , 1998, p. 183). C o m m o n outdoor settings that give a s e n s e of being a w a y are parks , backyards or rooftop g a r d e n s ; p l a c e s where one is away from daily s t ressors and distractions. Fasc inat ion is invoked w h e n o n e ' s attention is fixed without the n e e d for directed attention, allowing the mind to focus without effort, allowing for recovery from mental fatigue. Fasc inat ing e lements have a directly exciting quality which attracts people a n d k e e p s them from b e c o m i n g bored . H u m a n fascinat ion is a difficult p r o c e s s to define. Kap lan and Kap lan state: "central a s s u c h fascinat ing objects may be to recover ing o n e ' s capaci ty for directed attention, they c a n only be a part of a larger picture. M u c h of h u m a n fascinat ion revolves a round i s s u e s of p r o c e s s a s well a s content. H u m a n s a re fasc inated by carrying out var ious informational activities under c i r c u m s t a n c e s of s o m e uncertainty. T h e y are fascinated by attempting to recognize in instances where recognition is difficult but not impossib le . T h e y are a lso attracted to predictions of uncertain events: gambl ing provides a c l a s s i c example . A n d they are fascinated by learning, by following the thread of someth ing of interest in order gradual ly to acqui re a bigger picture, rather than by simply being taught new things. T h e strong preference for s c e n e s high in mystery presumably e x p r e s s e s a related c o n c e r n . T h e s e p r o c e s s fascinat ions are not, however , e n g a g e d merely by r a n d o m s e q u e n c e s of interesting objects. A n o c c a s i o n a l fascinat ing e lement may cha l lenge o n e ' s capaci ty for recognit ion, but if u n c o n n e c t e d to a larger f ramework it will be only a momentary diversion or distraction. E v e n an ex tended s e q u e n c e of fascinat ing e lements , if unrelated to e a c h other, will not e n g a g e our p r o c e s s fascinat ions. T h u s fascinat ion and extent are mutually support ive. C o n n e c t e d n e s s , or re la tedness, or the ex is tence of s o m e larger pattern 2 is required in order to e n g a g e this high-level h u m a n motivation" (Kaplan & K a p l a n , 1998, p. 185). Extent is the s e n s e of being in a s p a c e that is part of a larger setting or is physical ly or psychological ly large itself, allowing for the construct ion of a mental m a p of a s p a c e that includes the imagined a s well a s the visible (Kaplan & K a p l a n , 1998). A s p a c e need not be physical ly large to have extent, a s long a s a site user is able to m a k e a connect ion to the world b e y o n d what is immediately perce ived . T h e K a p l a n s point out that this is often the c a s e in theatre s tages where a u d i e n c e s conceptual ly understand sets to be part of a larger imaginary world. In d e s i g n e d l a n d s c a p e s this c a n be a c h i e v e d many w a y s including providing v iews to features off site, or planting trees off site that will be visible from the site, psychological ly expanding its boundar ies . Smal l s p a c e s c a n be subdiv ided into separa te s u b - s p a c e s using s c r e e n s s u c h a s vegetat ion, trellis, walls or f e n c e s blocking v iews that m a k e it poss ib le to take in the entire site at o n c e . P e o p l e are then c a u s e d to imagine what is b e y o n d their field of view, increasing extent of a smal l s p a c e . Circui tous paths c a n be u s e d to guide people through a site a long a route with se lected viewing points to ach ieve the s a m e a im. A s o u n d a s s o c i a t e d with recreational outdoor s p a c e , s u c h a s babbl ing water, or banners blowing in the wind c a n a lso b e u s e d to inc rease extent in a g a r d e n setting. If the s o u r c e of the s o u n d is not visible, a person is left to imagine the object that is making the noise, increasing extent by engag ing the imagination. Near nature is the provision of env i ronments with a high amount of natural content where it is easi ly a c c e s s i b l e to people . A ne ighbourhood park, even one smal l in sca le , c a n be visited easi ly and often and offers an opportunity for frequent restorative exper iences . Near nature is doubly important in creating restorative env i ronments a s natural e lements s u c h a s water, plant a n d an imals are powerful agents in engag ing soft fascinat ion. T h e final restorative e lement descr ibed by the K a p l a n s is compatibility. L a n d s c a p e s d e s i g n e d to be compat ib le with user n e e d s support p rograms for the s p a c e and cons ider site condit ions, then provide appropriate amenity to users . A compat ib le envi ronment al lows the user to d o what they want to in a s p a c e comfortably and safely (Kaplan & Kap lan , 1998). Elderly populat ions "preferences include outdoor s p a c e s that support informal a n d pass ive activities s u c h a s walking and talking with fr iends, garden ing , nature observat ion of water, vegetat ion, and fauna; and panoramic views of a naturalistic sof tscape" (Browne, 1992). Browne a lso found that natural e lements s u c h a s plants are c o m m o n l y underuti l ized in outdoor settings for the elderly or not p laced for m a x i m u m benefit. T o accurate ly determine preferred u s e s for a new outdoor s p a c e at the Purdy Pavil ion a quest ionnaire for residents, families and staff has been u s e d and the f indings are reported later in this document . Plants as restorative element Contact with plant material c a n be powerfully restorative of its own a c c o r d . W h e n o n e grows plants, o n e takes on a nurturing role (Lewis, 1993). T h e garden rewards the gardener 's efforts with fruit, f lowers a n d a s e n s e of a c c o m p l i s h m e n t and pride. Plants e n g a g e the gardener in a p r o c e s s i o n through the s e a s o n s . N e w shoots a n d buds create anticipation for the future, a feeling that is s o m e t i m e s lost in the infirm and 3 elderly. A s plants grow, the gardener rece ives positive f e e d b a c k creating an emot ional connect ion to the plants. Espec ia l ly for patients in ex tended care where m u c h personal control over o n e ' s life has been lost, a garden plot c a n be empower ing a s the gardener tends their s p a c e , and feels n e e d e d . Horticulture therapy Horticulture therapy takes advantage of the restorative qualit ies of plants by incorporating gardening a s part of a patient's therapy program to improve their wel l -being. Health benefits for patients include ae rob ic exerc ise , relief from stress, a n d opportunit ies for soc ia l interaction. M a n y addit ional behavioura l and socia l benefits c a n be a c c r u e d from participation in a horticulture therapy program (Mattson, 1992). G a r d e n activities provide patients with opportunit ies for dec is ion making and problem solving, reinstating a s e n s e of control that is often lost when o n e enters institutionalized care . T o get an idea of the benefits horticultural therapy activities typically transfer to patients, we c a n look at those listed by V e r m o n t State Hospital . Figure 1.1 Benefits of Horticultural Activity 15 w a y s that hor t icu l ture w a s u s e d b y the A c t i v i t y T h e r a p y D e p a r t m e n t at V e r m o n t S t a t e H o s p i t a l to p r o v i d e bene f i t s to c l i en t s : 1. A c t i v i t i e s o f D a i l y L i v i n g : B y e s t a b l i s h i n g d a i l y r ou t i ne s in the g a r d e n , c l i en t s bet ter u n d e r s t a n d the i m p o r t a n c e o f c l e a n l i n e s s a n d hea l t h in their o w n l i v e s . 2 . A b i l i t y to f o c u s o n a task : T h r o u g h s e n s o r y s t i m u l a t i o n , the c l ien t is m o t i v a t e d to b e c o m e i n v o l v e d in the g a r d e n i n g ac t iv i ty . 3. E n j o y m e n t : B y c o r r e c t s e l e c t i o n a n d a d a p t a t i o n o f ac t iv i t i e s , t he hor t icu l tu ra l t h e r a p y i n s u r e s that the c l i en t h a s a n e n j o y a b l e e x p e r i e n c e . 4 . W o r k a n d frus t ra t ion t o l e r a n c e : B e g i n wi th s i m p l e r g a r d e n i n g t a s k s a n d g r a d u a l l y b u i l d to h i g h e r l e v e l s o f j o b sk i l l s . T a s k a n a l y s i s p r o c e d u r e s m a y b e he lpfu l wi th c h a l l e n g i n g w o r k . 5 . S o c i a l i z a t i o n , c o o p e r a t i o n : S h a r i n g g a r d e n i n g e x p e r i e n c e s a n d p l an t s p r o v i d e s m e a n i n g f u l i n t e rac t ion . 6. B e h a v i o u r a l con t ro l : A g g r e s s i v e b e h a v i o u r s c a n be c o n s t r u c t i v e l y c h a n n e l l e d t h r o u g h p h y s i c a l w o r k . W o r k wi th n o n - t h r e a t e n i n g p lan t m a t e r i a l in a c o m f o r t a b l e e n v i r o n m e n t e n c o u r a g e s r e l a x a t i o n . 7. L e i s u r e t ime s k i l l s : P l a n t c a r e a n d re la ted ac t iv i t i e s c a n ef fec t ive ly o c c u p y t ime . 8. R e a l i t y o r i en ta t ion : U n d e r s t a n d i n g the r e l a t i o n s h i p s of s e a s o n a l c h a n g e s a n d p lan t g r o w t h a n d d e v e l o p m e n t a r e f u n d a m e n t a l h u m a n p e r c e p t i o n s . 9. S e l f - e s t e e m : S h o r t t a s k s wi th i m m e d i a t e , o b v i o u s r e su l t s h e l p p e o p l e wi th l o w s e l f - e s t e e m . 10 . S e l f - e x p r e s s i o n : F l o r a l or l a n d s c a p e d e s i g n h e l p s p e o p l e m a k e d e c i s i o n s a n d u s e p l an t s in a c r e a t i v e w a y . 1 1 . F i n e / g r o s s m o t o r s k i l l s : M a n y e x a m p l e s c o u l d b e g i v e n o f h o w w e c a n u s e hor t icu l ture to d e v e l o p t h e s e s k i l l s . E y e - h a n d c o o r d i n a t i o n , p h y s i c a l c o n d i t i o n i n g a n d w o r k e n d u r a n c e c a n b e e v a l u a t e d wi th v a r i o u s hor t icu l tu ra l ac t iv i t i e s . 12 . I n d e p e n d e n c e : C l i e n t s s h o u l d b e e n c o u r a g e d to m a k e i n d e p e n d e n t d e c i s i o n s a n d to a c c e p t the o u t c o m e o f the i r a c t i o n s . 13 . A s s e r t i v e n e s s : T h r o u g h e x p e r i e n c e wi th a va r i e ty o f hor t i cu l tu ra l ac t iv i t i e s , c l i en t s g a i n e x p e r i e n c e a n d a n abi l i ty to b e c o m e m o r e i n v o l v e d wi th d e c i s i o n m a k i n g a n d e v e n t u a l o u t c o m e . 14. In te l lec tua l s t i m u l a t i o n : C u r i o s i t y m a y b e a r o u s e d b y s e n s o r y s t i m u l a t i o n d u r i n g the hor t icu l tura l ac t iv i ty . Inves t iga t ion of the na tu ra l w o r l d o c c u r s d u r i n g the p r o c e s s o f g a r d e n i n g . 15 . V a l u e s c la r i f i ca t ion : B y d e v e l o p i n g a t rus t ing r e l a t i onsh ip wi th a c l ien t , t he the rap i s t is a b l e to p r o v i d e a se t t ing in w h i c h p r o b l e m s a n d i s s u e s c a n b e a d d r e s s e d . " S o u r c e : Mat tson, 1992, p. 164 4 Positive image In addition to therapeutic opportunities, green outdoor env i ronments provide site u s e r s with a positive image of their envi ronments . A beautiful setting c o m m u n i c a t e s that the people living a n d working in that p lace are va lued , and deserv ing of extra care and attention. O n e could argue that this m e s s a g e is especia l ly important to the ill and aging a s it m a y have a positive effect on their health. A s e n s e of self worth has a rehabilitative effect. Dr. Edward Sta inbrook of the Depar tment of H u m a n Behav iour at the University of Southern Cal i fornia S c h o o l of Med ic ine tells us that "an envi ronment of ugl iness, dilapidation, dirtiness, over-built s p a c e , a n d a lack of natural surroundings conf i rms the negative sel f -appraisal a person may have d e v e l o p e d through other contacts with society. S e l f - e s t e e m is the keystone to emotional well -being" (Stainbrook, 1973, p.22). Purdy Pavilion resident population Purdy Pavil ion is ex tended care facility serving a primarily elderly population with an a v e r a g e a g e of 85 years . Res idents mainly require complex care; approximately 80 percent of residents suffer from s o m e form of dement ia , and an additional 20 percent have Park inson 's d i s e a s e . T h e env i ronment -behav iour mode l for any s p a c e to be u s e d by Purdy 's population must take these medica l condit ions into account . O l d a g e brings spec ia l des ign considerat ions (Jones , 1996). P e o p l e over 65 years of a g e typically have reduced visual acuity. T h i s population requires three t imes more light to s e e well than younger people , and glare c a u s e s difficulty. P e o p l e at this a g e tend to g a z e downward , a n d will not fully enjoy des ign e lements they have to look up to s e e . A g e affects perceptual ability. T h e elderly have difficulty , identifying objects or locations a n d take comfort in familiar objects and p l a c e s enjoying most those env i ronments with a homel ike quality. A gradual loss of motor function results in a lack of strength, agility and s tamina . A g i n g leads to s e n s o r y def ic iencies s u c h a s poor hearing and a r e d u c e d s e n s e of smel l . T h i s implies a n e e d for rich sensory env i ronments with s o u n d s , s c e n t s and textures in c l o s e proximity to seat ing. Elderly individuals have a reduced range of environmental a n d a tmospher ic condit ions in which they are comfortable a n d prefer resting a r e a s without bright light, glare, drafts a n d e x c e s s i v e heat while preferring lightly s h a d e d a reas . Park inson 's d i s e a s e is character ized by a gradual increase of muscu la r rigidity and w e a k n e s s . S lowing r e s p o n s e in voluntary m o v e m e n t s results in a characterist ic shuffling gait. A genera l reduction of range of motion and tremors reduce fine motor skills (Wlchrowski , C h a m b e r s & Ciccantel l i , 1998). Env i ronments for this population shou ld be obstacle- f ree , and employ min imum possib le s lopes . Decorat ive e lements shou ld be p laced w h e n they c a n be easi ly touched a s r e a c h e s are negatively affected by Park inson 's d i s e a s e . T o a c c o m m o d a t e difficulties in walking, doors should not have sills and the transition between indoors and outdoors should be a s s e a m l e s s a s possib le . 5 Dement ia , specif ically A l zhe imer 's d i s e a s e , h a s a dramatic effect on people 's perceptual abilities. M o y r a J o n e s research d e s c r i b e s typical difficulties exper ienced by A l zhe imer 's patients (Jones , 1996). A lzhe imer 's sufferers s e e patterns of light a n d dark in flooring a s c h a n g e s in level. F o r example , a floor with a black and white c h e c k e r pattern could a p p e a r a s rectangular paving s tones set amid a grid of rectangular holes making it difficult for patients to use . T o an A lzhe imer 's patient, the s h a d o w cast on the ground by an o v e r h e a d trellis may s e e m like a pit in the sidewalk. S u c h patterns of light a n d dark on the ground may prevent patients from using a s p a c e , or c a u s e people to f reeze or fall. S h a r p contrasts between brightly and dimly light s p a c e s a lso c a u s e difficulty. For example , standing in a brightly lit hallway a patient may perceive an adjacent dimly lit room a s a d a n g e r o u s c a v e , a n d not want to enter in. E v e n lighting or transition z o n e s between brightly and dimly lit a r e a s are n e e d e d . G lare , light reflected on s u r f a c e s s u c h a s newly po l ished floors or g l a s s table tops, ra ises perceptual i s s u e s for this populat ion. A g leaming hallway may a p p e a r a s a large puddle to s o m e o n e with A lzhe imer 's , and for this reason , no highly pol ished or g lazed s u r f a c e s should be u s e d . A l s o of difficulty is figure ground definition, the ability to perceptually separa te a visual s c e n e into a foreground a n d a background . T o ass is t figure ground definition monochromat ic colour s c h e m e s should be a v o i d e d . T h e point where walls meet floors c a n be visually indistinct to A l zhe imer 's patients, c a u s i n g a sort of visual white-out that m a k e s navigating s p a c e difficult. F o r this reason it is important that walls and floors be different co lours or m a d e of visually distinct materials. A l zhe imer 's patients have difficulty navigating s p a c e s and benefit from simple, geometr ic s p a c e s and m e m o r a b l e landmarks to ass is t in them in way-f inding. T h e term way-f inding refers to the ability of site users to travel through a s p a c e and reach a desi red destination. A l zhe imer 's patients often forget where they are a n d why they are there, and will s o m e t i m e s try to return to their h o m e s and responsibil i t ies from their previous lives. T h i s creates a need for s e c u r e s p a c e s to protect them from potentially d a n g e r o u s wander ing. Circulat ion routes should be looped to return site users to their starting points. Non-toxic materials shou ld b e u s e d exclusively a s A l z h e i m e r ' s patients are known to put inedible objects in their mouths. In recent years , there has been increased interest in des igning g a r d e n s specif ical ly for A l zhe imer 's patients, using des ign criteria that a d d r e s s the n e e d s of this spec ia l populat ion. S u c h g a r d e n s d o more than provide amenity for patients. M o o n e y and Nicell found a dramat ic positive effect on A lzhe imer 's patients in their study at the C e d a r v i e w L o d g e in V a n c o u v e r ( M o o n e y & Nicell , 1992). Pat ients who u s e d the garden s h o w e d a marked reduction in incidents of a g g r e s s i v e behaviour , a benefit to patient well-being and to staff. Questionnaire Results A s part of the information gathering for this project, a quest ionnaire w a s del ivered to Purdy staff, residents, a n d residents' families. Detai led results are included in A p p e n d i x 2 of this paper. G e n e r a l t rends e m e r g e d . A strong interest in p l a c e s to visit with family a n d fr iends outdoors, a p lace for smal l group gather ings, light gardening a n d bird and animal watching w a s indicated (80% of respondents or 6 more). Interest in the fol lowing des ign e l emen ts w a s s h o w n ; a patio, seat ing a r e a s in s h a d e , s h a d e t rees, fruit t rees, f lowers and a fountain or pond. Garden as a place for dying A s many of the res idents at the Purdy Pav i l ion s p e n d their last d a y s in this p lace, it s e e m s appropr iate to ment ion ga rdens ' ro les a s p laces that connec t peop le with the c y c l e s of life and death . Ca the r ine Howett tel ls us that "the art of the ga rden ought not to c o n c e a l f rom us the truth that our own l ives part ic ipate in these p r o c e s s e s ; rather, the ga rden that g i ves exp ress i ve form to the myster ies of t ime, change , and mortality may itself effect a potent t ransformat ion, reconci l ing us to nature, offering us aga in the possibi l i ty of loving sur render and an ascen t to what is beyond our unders tand ing" (Howett, 1993, p.255). P e r h a p s sett ings that demonst ra te the p a s s a g e of living mater ia l into s e n e s c e n c e wou ld offer comfort to those at the end of their l ives. If one were to c h o o s e a p lace to s p e n d the end of their days , it is e a s y to imag ine that a ga rden wou ld provide a more reassur ing sett ing than a hospi ta l ward . Death is often a s s o c i a t e d with a return to nature wh ich gave us life. Poe t Kahl i l G ib ran a s k s the quest ion "for what is it to d ie , but to s tand in the sun and melt into the w ind?" R e a d y a c c e s s to the natural wor ld s e e m s appropr ia te to this p rocess . 1.2 A History of Hospital Gardens Mi rcea E l i ade v iews ga rdens a s p laces apart f rom ordinary life, p l aces whe re one fee ls in touch with powers greater than t hemse l ves , a quali ty he refers to a s a c r e d s p a c e (E l iade, 1960). Th rough t ime a connec t ion has been m a d e between ga rdens and the s a c r e d funct ion of hea l ing. " Long after h u m a n s had begun to erect dwel l ings, local heal ing p laces were nearly a lways found in nature - a heal ing spr ing, a s a c r e d grove, a spec ia l rock or c a v e " ( C o o p e r M a r c u s & B a r n e s , 1999, p.1). S i n c e the beginn ing of history, f rom historic labyr inths, meditat ion ga rdens and scho la rs ' retreats to recent S c h r e b e r ga rdens and city parks , peop le have used ga rdens a s p laces for retreat, medi tat ion and hea l ing . In Eu rope dur ing the Midd le A g e s ga rdens we re assoc ia ted with p l aces of heal ing (Ger l ach -Sp r i ggs , K a u f m a n n & Warne r , 1998). Char i tab le rel ig ious orders ca red for the s ick and poor w h o repaid their hos ts with prayers for their sou ls . Pat ients we re often pi lgr ims, o rphans or vagrants . T h e c o v e r of Hor tus Sani tat is , a book of plant and herb lore pub l ished in M a i n z in 1491 , s h o w s a consul ta t ion be tween phys ic ians in a s ick room of s u c h an institution. A t this t ime monas te r ies and conven ts se rved a s hospi ta ls , and their faci l i t ies inc luded c lo is ter g a r d e n s and medic ina l g a r d e n s whe re plants usefu l in treating d i s e a s e s w e r e cul t ivated. M o s t s u c h hosp i ta ls we re sma l l , hous ing be tween f ive a n d ten res idents, a l though s o m e such a s Sa in t G a l l in Sw i tze r land and H o t e L D i e u in Pa r i s g rew to b e c o m e large institutions. 7 Figure 1.2 Hortus Sanitatis S o u r c e : C o u n t w a y Library, 2006 T h e cloister w a s the centre s p a c e of the monastery, e n c l o s e d by the church to the north a n d other by buildings s u c h a s the kitchen, cel lar and dining hall on the remaining s ides . T h i s o p e n green s p a c e was typically e d g e d by an a r c a d e d walkway, its interior s p a c e divided into four equa l quarters planted with g r a s s or flowers. At the centre of the garden a water s o u r c e a n d often an evergreen tree that served a s a religious symbol . T h e cloister garden presented the viewer with an orderly view of nature. Its s imple geometry and directed view induced a reflective m o o d , suited to a restorative exper ience . Figure 1.3 Cloister Garden S o u r c e : Author 's Photo At the end of the Middle A g e s monast ic ism faded away. Heal ing p l a c e s of the R e n a i s s a n c e and Reformation did not p lace as m u c h importance on outdoor env i ronments for the ill. C r o p failures, political and religious conflict and the p l a g u e s of the 14th a n d 15th centur ies left local g o v e r n m e n t s unable to deve lop effective health programs. It is not until the 18th century that w e s e e a r e s u r g e n c e in interest in 8 the healing potential of l a n d s c a p e s . However , e v e n a s the charitable hospitals of the Middle A g e s fell into disrepair, work w a s being d o n e that p a v e d the way for future innovations in restorative gardens . T h e period between the 15th and 18th centuries s a w the rise of a scientific a p p r o a c h to medic ine . D i s e a s e , o n c e attributed to poverty, w a s now s e e n a s the result of infections s p r e a d through the air. Statist icians specula ted that a healthy population would result in greater prosperity for all, increasing interest in public health. Nursing orders were establ ished and treatment of mental patients improved. N e w military hospitals led the way for innovation in hospital des ign (Ger lach -Spr iggs et al . , 1998). Pavil ion hospitals of the 17th to 18th centur ies were d e s i g n e d to take a d v a n t a g e of new medica l knowledge. S p e c i a l attention w a s paid to hygiene, a n d patients were g iven a c c e s s to fresh air and sunsh ine , a n d large g a r d e n s were c o m m o n l y part of the plan. T h e R o y a l N a v a l Hospita l at S t o n e h o u s e in E n g l a n d is a notable e x a m p l e of a pavilion hospital from this period. It cons is ted of a u -shaped ar rangement of five buildings around a central rectangular lawn. T h e buildings were joined by a c o v e r e d c o l o n n a d e . E a c h ward in the hospital was situated to take a d v a n t a g e of ventilating b reezes . Pavi l ion d e s i g n s a lso c o m m o n l y e m p l o y e d a tooth -combed des ign where single wards were p laced at right a n g l e s to a central corridor maximizing opportunities for solar a c c e s s . Hospital g r o u n d s had g e n e r o u s g a r d e n s for use by patients. E v e n those who could not walk were given views to the outdoors . F lo rence Nightingale the f a m o u s nurse a n d health care reformer of this era said that: "second only to fresh air...I should be inclined to rank light in importance for the sick. Direct sunlight, not only daylight, is n e c e s s a r y for s p e e d y recovery. . . I ment ion from exper ience , a s quite perceptible in promoting recovery, be ing able to s e e out of a window, instead of looking against a d e a d wall; the bright co lours of flowers; being ab le to read in bed by the light of the window c l o s e to the b e d - h e a d . It is general ly sa id the effect is upon the mind. P e r h a p s so , but it is not less s o upon the body on that account" (in G e r l a c h - S p r i g g s et al , 1998, p. 16). T h e idea that l a n d s c a p e s offered restorative e x p e r i e n c e s to patients cont inued to gain support through the Romant ic era. G e r m a n theorist Christ ian Hirschfeld wrote that all hospitals should be in rural settings, Figure 1.4 Royal Navy Hospital S o u r c e : Postcard Wor ld , 2006 9 on sunny hilltops amid g a r d e n s where patients c a n stroll and g a z e upon cheerful plantings (in G e r l a c h -Spr iggs et al . , 1998, p. 18). H e felt that the enjoyment of nature would lead to a healthy life. In A m e r i c a , this scholarship led to the deve lopment of mental hospitals s u c h a s the F r iends A s y l u m , built in Phi ladelphia in 1817. T h i s type of asy lum a i m e d to create a restful, homel ike setting for patients, al lowing them to recover from the s t resses that were thought to be the c a u s e of their i l lness. S u c h hospitals were set outside the city with very large, protected, wel l -maintained g rounds that provided patients with pleasant vistas a n d opportunit ies for farming or gardening that would be prescr ibed a s part of their treatment. T h i s kind of treatment met with great s u c c e s s . However , burgeoning populat ions led by w a v e s of immigration overwhe lmed the sys tem just a s political leaders cut funding for health care . Pavil ion hospitals faced the s a m e pressures , a n d in addition suffered an increased s p r e a d of d i s e a s e from one patient to the next. Hospi ta ls were in crisis, a n d by the mid 1800's it w a s "quest ioned whether hospitals ought to be c l o s e d altogether" (Ger lach -Spr iggs et al . , 1998, p.22). G e r m theory a n d antiseptic pract ices fuel led the next w a v e of medica l a d v a n c e m e n t s . Lou is Pasteur 's deve lopment of vaccinat ions and Robert K o c h ' s work on infectious d i s e a s e s brought new hope. D e m a n d s grew for increasingly spec ia l i zed facilities in hospitals. A t the e n d of WWII technological a d v a n c e s c a u s e d rapid c h a n g e s to hospital des ign . Eff ic iency w a s the new ideal, resulting in multi-storey c o m p a c t hospitals which u s e d less land a n d energy. Patients were grouped accord ing to their condit ions with contag ious patients s e p a r a t e d from the main populat ion. G a r d e n s were no longer a part of hospital des igns , a n d the land they had o n c e been allotted w a s now u s e d for parking lots. T h e r e were except ions to this rule, but t rends towards eff iciency in the 20th century led to high-rise hospitals that looked m u c h like office towers. 10 T o d a y , many health care facilities are model led after another c o m m o n urban structure, the shopp ing mall, comple te with a r c a d e s of s h o p s and atria. Author a n d l a n d s c a p e des igner N a n c y G e r l a c h - S p r i g g s feels that this is not a positive deve lopment . "To be sure , s u c h s p a c e s are familiar e n o u g h to patients, staff, and visitors, a n d in that s e n s e the repl icas of c o m m e r c i a l des igns will m a k e them comfortable. But they ignore the spec ia l emotional n e e d s of a health care facility" (Ger lach -Spr iggs et al . , 1998, p.33). S h e r e c o m m e n d s the integration of outdoor s p a c e s that provide restorative exper iences for staff, visitors and patients. T h i s idea s e e m s to be taking hold a s w e enter the 21st century. Heal ing g a r d e n s are o n c e again b e c o m i n g an a c c e p t e d part of the hospital l a n d s c a p e . 1.3 Precedent Studies A n examinat ion of p l a c e s and projects in V a n c o u v e r that deal with restorative exper iences in hospital settings w a s undertaken to provide context for this project and to generate poss ib le des ign solutions. In the c a s e of Banfield Pavi l ion, the garden supports therapeutic programs and is well suppor ted with h u m a n resources . C e d a r v i e w ' s A lzhe imer 's garden w a s comple ted a s part of an investigation into the effect that outdoor s p a c e s could play in deal ing with speci f ic populat ions. T h e W e l l n e s s W a l k w a y s project is integrated into the fabric of the larger communi ty , a n d is part of ameni ty prov ided to pedest r ians in the communi ty , but with e x p a n d e d intentions. A c o m m o n thread in all of the projects listed here is des ign r e s p o n s e that a d d r e s s e s the n e e d s a n d abilities of the users . Banfield Pavilion, Vancouver General Hospital, Vancouver, B C T h e Banfield Pavil ion is part of the V a n c o u v e r G e n e r a l Hospital C a m p u s . It is a 198 b e d ex tended care facility deal ing mainly with geriatric patients. In s ize and populat ion it is very similar to the Purdy Pavil ion at the University of British C o l u m b i a . L ike the Purdy Pavi l ion, this hospital h a s e m b r a c e d the idea that l a n d s c a p e c a n support heal ing functions. E v i d e n c e of the role that natural e lements play at the Banfield Pavil ion is present throughout the facility. R e s i d e n t s participate in gardening programs that vary in sca le from the l a n d s c a p e a rea they maintain at the main entrance, to ba lcony and roof top gardens . S h e l a g h Smith , a horticultural therapist, is e m p l o y e d to facilitate p rograms with the residents a n d to help maintain the plantings on site. S e v e r a l strategies are in p lace to ensure that residents have ready a c c e s s to sensual ly rich environments . At smal l s c a l e , residents m a k e u s e of existing ba lcony s p a c e a s e a c h floor puts forth an entry in the annual ba lcony garden competit ion. T h e plant pots u s e d in this program are of s i zes a n d heights that m a k e them a c c e s s i b l e to those who tend them. At a larger s c a l e , the Pavil ion has taken advantage of an existing rooftop to create a 3,000 square foot garden . T h e rooftop garden is the most intensively u s e d and d e s i g n e d restorative s p a c e at the Pavil ion a n d is the setting for the majority of the horticulture therapy programs on site. S e v e r a l strategies are e m p l o y e d to e n s u r e the garden is easi ly u s e d and maintained by residents. A n automatic door o p e n s on to the rooftop garden . W a l k w a y s are wide, smooth and free of obstruct ions. 11 Figure 1.6 Banfield Rooftop Garden Source: Author's Photos Accessible planters suited for use by those in wheelchairs hold plants with interesting textures and pleasant aromas. Automatic irrigation means hoses do not obstruct pathways. Hanging baskets are on pulley systems so that they can easily be lowered for maintenance by residents. Design elements allow horticulture therapy programs to take place even in inclement weather. A covered walkway allows residents to use outdoor space despite rain or heat and moveable planters come indoors for programs when the residents prefer not to venture outdoors. Shelagh Smith has amassed a collection of gardening tools adapted to residents' mobility and function. These tools serve to enable and encourage residents to participate in garden programs. Cedarview Lodge, North Vancouver, B C Cedarview Lodge is a 150 bed seniors' residential care facility located in North Vancouver. Professor of Landscape Architecture, Patrick Mooney, and Cedarview administrator, P. Lenore Nicell, undertook this project with funding from Health and Welfare Canada. Meeting the special needs of Alzheimer's patients and responding to best practices in the development of special care facilities, this garden was opened in May, 1990. A study was undertaken in conjunction with the opening of the garden to assess the effect that the new garden would have on residents. 12 T h e stated des ign intent of the garden w a s to: • reduce glare on pathways and entryways • provide a cont inuous loop s o that residents were naturally led back to the building entry, thereby avoiding disorientation • contain a central trellis and tree grove, which were to act a s landmarks and allow residents to orient t h e m s e l v e s • be e n c l o s e d , but with the surrounding fence s c r e e n e d in a way that residents were not attracted to the site e d g e • contain plants that are non-toxic s o that there is no d a n g e r of po isoning from ingesting plant material • contain footpath lights a n d handrai ls intended to minimize d a n g e r of residents falling in the garden by providing cont inuous e v e n lighting and support • contain s o m e s e a s o n a l colour but be low key, rich in familiar f ragrances , a n d intended to soothe rather than visually stimulate residents • increase the apparent s i ze of plantings, a s there was a relatively high ratio of walkway to planted area . T h e r e were four seat ing a reas , all partially s h a d e d and planted to give an illusion of privacy ( M o o n e y & Nicell , 1992). Figure 1.7 Cedarview Plan S o u r c e : M o o n e y & Nicell, 1992 R e s e a r c h e r s tracked c h a n g e s in incident reports at C e d a r v i e w L o d g e a n d other facilities that had g a r d e n s and c o m p a r e d them with facilities without gardens . T h e c o m p a r i s o n revealed a dramat ic dif ference in the numbers of violent incidents and falls with those facilities with g a r d e n s enjoying significantly fewer 13 negative incidents. T h e s e f indings support the view that special ly d e s i g n e d outdoor env i ronments c a n have a positive effect on dement ia patients. Mount Pleasant Wellness Walkways, Vancouver, B C T h i s project was comple ted in 1999 for the City of V a n c o u v e r by U B C l a n d s c a p e architecture professors Patrick M o o n e y and D o n L u y m e s . It looked at the role a walking circuit cou ld play in this V a n c o u v e r ne ighbourhood which h a s three healthcare facilities in its boundar ies including Mount Saint J o s e p h ' s Hospital ( M o o n e y & L u y m e s , 2000). T h e intent w a s to generate des ign solut ions that would e n g a g e the full range of potential site users . R e c o m m e n d a t i o n s included a ser ies of circuits d e s i g n e d to be a c c e s s i b l e to people with mobility constraints; the elderly or those with disabilities. S i d e w a l k s were to be at least 1.8 meters wide to a c c o m m o d a t e wheelcha i r traffic and u s e saw-cut control joints for m a x i m u m paving s m o o t h n e s s . Res t a reas with a c c e s s i b l e b e n c h e s and decorat ive plantings were to be p laced every 100 meters, ensur ing short trips between comfortable seat ing opportunities. C o r n e r bu lges a n d traffic circles would ca lm traffic within the study area. Street c r o s s i n g s were to be well marked a n d have perpendicular curb r a m p s directly a l igned with s idewalks a n d crosswalks . T e a S w a m p Park, an existing park within the study a rea , would be retrofitted with a c c e s s i b l e furniture a n d a universal water fountain. Way- f inding would be suppor ted throughout the area. C l e a r s i g n a g e would be installed at intersections and rest a reas . Different circuits would be colour c o d e d ; paving and plantings would match the colour of the circuit travelled. Spec ia l l a n d s c a p e a r e a s and heritage interpretation markers would serve a s landmarks, assist ing way-f inding. For comple te project guidel ines, s e e A p p e n d i x A . Figure 1.8 Wellness Walkway S o u r c e : Author 's Photos 14 2 Context 2.1 National Trends Canada's population is aging. An increase in the elderly population will translate to greater demands on the U B C Hospital Precinct over time. Statistics Canada predicts that by 2030, 20 percent of the population will be 65 years of age or older. This trend is reflected in British Columbia where it is predicted that by 2021, 18.3 per cent of residents will be seniors, translating to approximately 552,660 seniors living in Vancouver (British Columbia Statistics, 2006). In addition, demographic forecasts predict dramatic growth in Vancouver's overall population. Between 1991 and 2021 the population of the G V R D will increase from 1.78 million to 3.02 million, a 70 percent increase, including a 247 percent increase in the segment of the population 65 years old and older (GVRD Strategic Planning Department, 1994). Considering that approximately 10 percent of seniors require formalized care such as that offered at the Purdy Pavilion at UBC located in the study site. It follows that by 2021 we can increased demand for extended care as roughly 55,266 people will be housed in such facilities in the Vancouver area. The implication of this trend for the study site is an anticipated increase in demand on UBC 's hospital precinct, perhaps even its expansion, and an increased opportunity for positive influence as visitor numbers increase. Figure 2.1 Canada's Aging Population Canada's Aging Population HUH m m 1900 5% 1950 8% 1990 12% Portion of Canadian Population 65 and over 2030 20% Source: Statistics C anada Caring for Older Canadians Community Care, Institutional Care Family and Friends 90% 10% Source: Statistics C anada Source: Mount Allison University, 2002 15 2.2 Context within the Region The Greater Vancouver Regional District creates the larger setting for the study site. Biophysically, the region enjoys one of the most amenable climates in Canada. A mountain range on Vancouver Island to the west and proximity to the ocean give Vancouver its mild climate. Vancouver has a mean temperature of 2.8 degrees Celsius in January, its coldest month, and 17.3 degrees Celsius in July, its warmest month allowing for comfortable year-round outdoor activity. The city is located in the mid-latitudes of North America where warm, humid air masses from the south meet cooler northern air resulting in precipitation. The study site receives 1200 to 1300 millimetres of precipitation annually, most of it falling in the winter months, making covered outdoor areas especially attractive from November to March (Wynn & Oke, 1992). The site falls in the Fraser Wetter Maritime Coastal Douglas Fir Biogeoclimatic Zone receives an average of 1,919 hours of sunlight each year (Wynn & Oke, 1992) and is situated in U S D A plant hardiness zone 8. A wide selection of plant material can be grown here, and gardening is a popular recreational activity. The campus' physical layout has been planned to celebrate its position and to make a visual connection to the larger region. The street grid on campus is aligned to provide a view down Main Mall to the north shore mountains. This view serves as a visual terminus to main mall, and is a powerful connection between UBC and the larger region. Figure 2.2 U B C ' s Position in the G V R D Source: Remax Realty, 2005 2.3 Context within the University The approximately 495 hectares that make up the University of British Columbia are located on the western-most edge of Vancouver. The campus enjoys an idyllic location bordered by Burrard Inlet to the north, the Straight of Georgia to the west and parkland to the southeast. Its situation amid ocean and 16 parkland leaves it d i s c o n n e c t e d from the greater fabric of the city, and a s a result, the University functions largely a s a separa te entity. T h e University's vision statement, T rek 2010, lists five pillars a round which goa ls a n d strategies are determined; research , learning, communi ty , people a n d internationalization. T h e pillar cal led 'people ' is most directly related to this project a s it states that the university va lues rich env i ronments for all m e m b e r s of the c a m p u s community . G o a l s and strategies relating to people include "ensuring that all m e m b e r s of the U B C communi ty have the best poss ib le surroundings in which to live, study, work and play" ( U B C , 2004) suggest ing strong support for initiatives to improve l a n d s c a p e s on c a m p u s . F r o m the inception of the university, land u s a g e p lans des ignated the study a r e a a s part of a sect ion of c a m p u s set as ide for medica l buildings. T h e r e are severa l buildings immediately adjacent to the study site with amenit ies of interest to people living and working in the study a rea . University Vi l lage is located to the north east. T h e vi l lage's food outlets, c o n v e n i e n c e stores, f inancial serv ices , hairdresser , drycleaner, newsstand , dollar store, gifts and h o u s e - w a r e s m a k e it a popular destination. R e g e n t C o l l e g e , a n interdenominational graduate s c h o o l of theology, is directly eas t a n d o n c e inc luded a p leasant park with seat ing a s part of its g rounds . T h e co l lege is currently undergoing renovat ions, a n d al though the garden has been d e m o l i s h e d while an underground library is installed, there are plans to reconstruct the previously existing l a n d s c a p e o n c e construction is complete . T o the south west, the T e c h n o l o g y Enterpr ise Facility ( T E F ) with its c o n v e n i e n c e store and S ta rbucks cof fee s h o p draws c u s t o m e r s from a c r o s s this quadrant of c a m p u s . T o the west of the site is the Health S c i e n c e s P a r k a d e , which provides parking in c lose proximity to the study area . T o the north are the W o o d w a r d B iomedica l Library a n d the Instructional R e s o u r c e Cent re (IRC), co - loca ted in a c o m p l e x that inc ludes a food outlet a n d an indoor mall. 17 Figure 2.3 Local Area Destination UNIVERSITY 2.4 The Hospital Precinct The hospital precinct is on the eastern edge of campus and houses of three hospital buildings; Koerner Pavilion, Detwiller Pavilion and Purdy Pavilion. The precinct is bounded by the Instructional Resource Centre (IRC) to the north, Wesbrook Mall to the east, the Life Sciences Centre (LSC) to the south and Health Sciences Mall to the west. Amenities The site has several amenities that are shared and enjoyed by people living and working in the precinct. Figure 2.4 Map of Hospital Precinct © Patient Park 18 T h e A c u t e C a r e Unit Patient Park is located in the north western part of the precinct. It w a s d e s i g n e d by V a g e l a t o s and A s s o c i a t e s , a V a n c o u v e r l a n d s c a p e architecture firm, and o p e n e d in 1987. T h e park is currently c losed a s is it se rves a s the staging ground for a renovation to the B iomed ica l R e s e a r c h Cent re immediately to the north. Figure 2.5 Patient Park S o u r c e : Author 's Photo Patient Park will be altered before it is re -opened to the public. In a s c h e m a t i c des ign report prepared in March 2003, V a g e l a t o s A s s o c i a t e s lists p lanned c h a n g e s including improved a c c e s s to the park through the addition of an entrance to the park from Health S c i e n c e s Mall . T h i s ent rance will provide direct a c c e s s to the park for people working in the neighbouring research facility a n d invite pass ing pedestr ians to cut through on their way to dest inat ions in the hospital precinct. It is h o p e d that this c h a n g e will m a k e Patient Park avai lable to a wider variety of users . Pedestrian Breezeway A n outdoor pedestr ian mall is created in the s p a c e between Koerner and Purdy Pavi l ions. T h i s mall currently offers the greatest pedestr ian amenity on site. In warm weather peop le sit in the s h a d e a long its e d g e s . A c o v e r e d walkway planted with wisteria l eads from Health S c i e n c e s Mal l to the ent rance to Koerner Pavi l ion. T h e mall a lso leads to the main a c c e s s point for Patient Park. 19 Figure 2.6 Pedestrian Mall Source: Author's Photos Koerner Cafeteria and Tunnel A cafeteria is located on the ground floor of the Koerner Pavilion, and is one of the few places on campus where a healthy meal can be purchased at a reasonable cost. It is a popular dining choice for staff, students and hospital residents. The Koerner Pavilion is connected on the cafeteria level to the Purdy Pavilion by underground tunnel. This circulation route is commonly used as it protects site users from inclement weather as they travel between buildings. Figure 2.7 Koerner Cafeteria and Tunnel Source: Author's Photos Circulation Issues Circulation issues are cited by Purdy residents as one of their main concerns. Grades cause problems for Purdy residents in wheelchairs who report difficulty using the sidewalk that connects Koerner and Purdy Pavilions to the sidewalk running parallel to Wesbrook Mall. This poor connection prevents Purdy's residents from venturing from the hospital to the village. Instead, they wait until for visitors to come so that they can be taken out to shop. Hospital Lane is too steep for wheelchair users and is risky for less-able pedestrians as autos cross the sidewalk to access parking. Another hazard exists on site; pavers in the sidewalk leading to the Koerner Pavilion are heaving, creating an uneven surface. 20 Street crossings in the hospital precinct are generally well marked and have curb cuts making travel safe for wheelchair users. There are notable exceptions, however. The crossing at the intersection of Hospital Lane and Health Sciences Mall is missing curb cuts on the north side of the intersection and markings are not consistent. The crossing immediately west from the Purdy Pavilion is missing a curb cut on the south east corner of the intersection. To the south of the Acute Care Hospital parking lot, the main pedestrian walk is crossed by a road. This intersection has no signage at all, making crossing risky. Perhaps the least safe crossing on site is the crosswalk over Wesbrook Mall. This pedestrian crossing has curb cuts, is well marked, and has an overhead flashing signal. Despite these precautions, the crossing is still hazardous. The flashing signal lasts only 15 seconds. This is not adequate time for an able-bodied person to cross the street, let alone someone in a wheelchair. A second push-button is located mid-intersection, but cannot be reached before the signal stops flashing, and does not ease residents' fears about this crosswalk. Figure 2.8 Precinct Poor Street Cross ings Plant Material Plant material on site is mature and consists mainly of large beds of shrubs and trees. Trees line auto-routes and are distributed throughout open spaces. Recently renovated foundation plantings of azaleas and rhododendrons in the pedestrian mall create a pleasant atmosphere, although the view to Purdy Pavilion is obscured by large shrubs in places. Planters are distributed throughout the site and are various states of repair. 21 Figure 2.9 Entrance to Koerner Pavilion S o u r c e : Author 's Photo Site Furnishings M a n y people live, work and study in the hospital precinct, a n d many more p a s s through the site on their c o m m u t e to work and c l a s s e s . B e n c h e s and g a r b a g e receptac les are avai lable a s ameni t ies for site users . B e n c h e s are w o o d e n a n d b e c o m e unpleasant ly wet and m o s s y in wet weather. T h e b e n c h e s located in front of Koerner Pavil ion are protected from weather, but are located in a smok ing a rea making them unattractive to m a n y potential users . Figure 2.10 Benches on Site S o u r c e : Author 's Photos Wildlife Wildlife on site includes birds, squirrels and r a c c o o n s . C o n s i d e r i n g the site's proximity to Paci f ic Spirit Park, it is likely that m a n y s p e c i e s of birds could be attracted here by adding wildlife-supporting plantings. 2.5 An Introduction to the Hospital Pavilions Detwiller Pavilion Detwiller Pavil ion is a psychiatr ic hospital offering extended care and outpatient serv ices . It w a s built in 1968, a n d has s e e n a s teady erosion of its usab le green s p a c e . A o n c e active rooftop rose garden w a s the victim of budget cuts , and large g r e e n s p a c e to the immediate south which w a s u s e d for sports and 22 passive recreation was recently paved. It seems that when campus greenspace is lost to development, there is no requirement to make up the loss on another part of the site. A partially-covered courtyard garden exists on the ground level of the hospital, but is falling into disrepair due to inadequate maintenance. This courtyard could be refurbished and serve as the smoking area for the hospital, a necessary function as a disproportionate percentage of psychiatric patients smoke. The shaded part of the site would be especially useful to patients on medication that make them sensitive to light (interview with hospital staff, Feb 3, 2006). Other issues of concern on site include circulation and poor entry experience. A path connecting the pedestrian mall to the east entrance of Life Science Building passes through Detwiller site. This connection needs to be addressed as it is currently hard to find, and lacking experientially. Recent concerns about safety led to the "limbing-up" of Detwiller Pavilion's hedge, resulting in an unsightly street image. Space immediately in front of the building's main entry has been set aside for an entry courtyard, but is not meeting its potential. Figure 2.11 Entry to Detwiller Pavilion Source: Author's Photo Purdy Pavilion The Purdy Pavilion is home to an extended care residence and houses pathology, laboratory medicine, positron emission tomography (PET), radiology, and school of nursing departments. The building was designed by Paul Smith Architects and was erected in 1977. It is named after Dr. Harry Purdy in honour of his service as first chairman of the G V R H D and professor at U B C . This 205 bed facility offers extended residential and transitional care and serves as a training facility for health care students. There is new interest in the development of useable outdoor spaces on site. There are two garden spaces under consideration at the Purdy Pavilion; one is the existing garden on the south side of the building and the other is a recently available space on the east side of the building. The building is a walk-out, with steep grades on sides of building and uneven grades on the eastern side of the building. 23 T h e population of the Purdy Pavil ion is mainly elderly and frail. Interviews with Purdy occupat iona l therapy staff s u g g e s t that 90 percent or more of residents are in whee lcha i rs , 80 percent suffer from dement ia , and 20 percent have Park inson 's d i s e a s e . Clear ly any d e s i g n for garden s p a c e at the Purdy Pavil ion will n e e d to a d d r e s s the spec ia l n e e d s of the residents. Figure 2.12 Purdy Pavilion Entrance S o u r c e : Author 's Photo Koerner Pavilion T h e Koerner Pavi l ion is h o m e to an acute a n d sub-acu te ca re hospital with a n a e s t h e s i a , urgent care , a m b u l a n c e , pathology a n d laboratory medic ine , P E T , radiology, rehabilitation s c i e n c e , s c h o o l of nursing, student health serv ice , a n d surgery depar tments . T h e hospital o p e n e d in 1980 a n d is n a m e d after Wal ter C . Koerner who donated to the project a long with the Greater V a n c o u v e r Hospital District. A s previously ment ioned, this building is h o m e to a popular cafeteria which serv ices all three pavil ions and draws c u s t o m e r s from a c r o s s c a m p u s . A n underground tunnel c o n n e c t s Koerner and Purdy Pavi l ions, and exits on this level to c o n n e c t to a sidewalk leading to the indoor mall at the Instructional R e s o u r c e s Cent re (IRC). T h i s connec t ion is functional, but cou ld be better. T h e outdoor path between Koerner a n d IRC has difficult g rades , poor s i g n a g e for a c c e s s i b l e doors a n d is weak experientially. T h e east side of the Koerner Pavil ion from door to street is taken up a lmost entirely with parking and circulation infrastructure, including a m b u l a n c e e m e r g e n c y a c c e s s . T h e result may be functional, but is experientially weak. T h e hospital lacks a strong street p r e s e n c e , and feels a s though it has its back to the street. 2.6 An Introduction to the New Garden Space A site on the eastern s ide of the Purdy Pavil ion has recently b e c o m e avai lable for re -development . W h e n an MRI was removed from this location in 2005 the administration at the hospital a p p r o a c h e d C a m p u s and C o m m u n i t y Planning for a s s i s t a n c e in creating a patient g a r d e n on this 1200 s q u a r e meter site. 24 Mature trees, ready a c c e s s to the building and a connect ion to the existing pedestr ian mall are a s s e t s . A group of three mature pine trees form a grove in the south eastern corner of the g a r d e n . Liabilities include the existing 12.5 foot by 60 foot reinforced concre te MRI p a d , s t e e p g r a d e s on the garden 's southern edge , and the looming p r e s e n c e of a n d u n c e a s i n g noise from the Life S c i e n c e s Cent re to the south. A s this site will need to be wheelchai r a c c e s s i b l e , g r a d e s will be crucial . A Purdy Pavil ion occupat ional therapist h a s ment ioned that g r a d e s a b o v e 1 percent are very difficult for residents, a figure well below the 5 percent grade typically c o n s i d e r e d the m a x i m u m a c c e s s i b l e grade . Figure 2.13 New Garden Space S o u r c e : Author 's Photos 2.7 A n Introduction to the Existing Garden Space T h e existing garden s p a c e is located on the southern face of the Purdy Pavi l ion. It is on the lowest level of the hospital, one level below the new garden s p a c e . Figure 2.14 Existing Garden Space S o u r c e : Author 's Photo Hospital staff, visitors a n d residents enjoy resting outside, tinkering in the garden a n d social iz ing in this s p a c e . G r o u p events, s u c h a s ice c r e a m socia ls , are held here in the s u m m e r . 25 Maintenance falls mainly upon two volunteers, and is a thorny issue. A large retaining wall defines the southern border of the garden, and is up for renovation (cyclical maintenance) by UBC Plant Operations. The Life Science Building to the south looms over the site. Trees are currently being added by Plant Operations along the top of this slope to screen views of this building from the Purdy Pavilion. 2.8 Analysis Taking site conditions into consideration, site suitability and constraints can be identified. Several factors combine to make this site suitable for use as a restorative landscape; the need for such a landscape in the hospital precinct, the interest among stakeholders to create a restorative landscape, and the suitability of the site for such a purpose. Constraints arising from the site's physical attributes can be more easily overcome than issues of funding and long-term maintenance. While maintenance and funding may ideally be out of the purview of the designer, they are very real obstacles to projects' successful implementation. Proposals to mitigate these constraints are also given. The need for a restorative landscape in the hospital precinct is manifested in several ways. Hospitals are places uniquely focused on health and well-being, making a restorative landscape a natural fit. The land surrounding the hospital is used by staff, students, visitors and patients. Visitors and patients are typically suffering from reduced physical ability and negative stress, more so than in the general population, and would greatly benefit from the improved cognitive and physical function provided to users of restorative landscapes. When one considers that this type of landscape experience is currently unavailable within the precinct, the need for this genre of space is further highlighted. Residents living in the Purdy Pavilion make up a significant portion of potential site users. This population has specific requirements for their physical environments. As discussed in chapter one, failure to meet these requirements can result in spaces that are neither safe nor comfortable for this population. The existing outdoor environment is not designed to meet these needs, resulting in spaces that are inappropriate for resident use. Although Patient Park is intended for use by residents, it is not designed to meet their unique needs. Current plans to renovate Patient Park will leave it even less suitable. By increasing the number of entrances to the park and increasing traffic through the site it will be rendered unusable by dementia patients who require boundaries to prevent potentially dangerous wandering. Perhaps worse than providing poor outdoor spaces is missing the opportunity provide this important user group with restorative outdoor environments which would benefit their health. Adding to the suitability of this site is the interest among stakeholders to implement a restorative landscape. Purdy administration, staff, patients and family council members have demonstrated a commitment to improving the existing greenspace adjacent to the Pavilion, and adding to it to create spaces that support residents' needs. Administrators are aware of the benefits that restorative landscapes provide and are eager to include restorative spaces as part of the hospital's outdoor environment. Purdy's occupational therapists incorporate horticultural therapy as part of their practice, a program that could be expanded with additional suitable gardening space. Both UBC's Campus and v 2 6 C o m m u n i t y P lanning depar tment and Plant Opera t ions staff have e x p r e s s e d support for alteration of the existing hospital l a n d s c a p e to provide a restorative l a n d s c a p e for the hospital precinct. University policy u n d e r s c o r e s the importance of providing rich env i ronments to the c a m p u s communi ty . T h e will exists for s u c h a project. M a n y of the physica l character ist ics of the site m a k e it suitable for s u c h a use . T h e V a n c o u v e r a rea en joys mild temperatures making c o v e r e d outdoor s p a c e s hospi table throughout the year. T h e hospital precinct is not yet complete ly built out, a n d has retained o p e n a r e a s that could be adapted to deliver restorative programs. G r e e n s p a c e is avai lable immediately adjacent to the hospital pavi l ions, a n d in the c a s e of the Purdy Pavi l ion in a n a m o u n t that c rea tes the possibility for a significant g a r d e n s p a c e . T h i s currently u n - u s e d site at the Purdy Pavil ion is in a s e c l u d e d spot between buildings providing s o m e protection from wind and s u n , an important a s s e t w h e n des ign ing for older populat ions. Mature trees on site cou ld be incorporated in s h a d e d seat ing a r e a s , a n d to ass is t in attracting songb i rds to the s p a c e . T h e garden s p a c e a lso benefits from direct and e a s y ground level a c c e s s to the hospital , mak ing it more likely that any new garden would be well u s e d by staff, residents and family m e m b e r s . S o m e the site's physica l attributes must be mitigated. A l though not c o m m o n , s teep g r a d e s c a n be found within the hospital precinct, specif ical ly on the eastern e n d of the existing pedestr ian b reezeway and at the southern e d g e of the new garden s p a c e . Re -g rad ing , installation of retaining walls and taking up g rades in planted l a n d s c a p e a reas could bring these g r a d e s within A D A s tandards . Genera l ly , s idewalks and street c r o s s i n g s are in g o o d condit ion, but in noted c a s e s repair a n d rep lacement should take place. Auto and pedestr ian circulation are often at o d d s within the precinct. M u c h of the precinct has b e e n given over to ground level parking reducing s p a c e avai lable for g r e e n s p a c e , or new buildings. Del ineation between car a n d pedestr ian s p a c e is s o m e t i m e s hazy , most notably at the western end of the pedestr ian breezeway . Distinct and separa te auto and pedestr ian routes should be implemented. F o c u s i n g on the Purdy Pavi l ion, the existing garden s p a c e ' s southern e x p o s u r e m a k e s it too hot and s u n n y for comfortable u s e in the s u m m e r . T h e introduction of permanent s h a d e structures a n d s h a d e trees would help remedy this situation. Both the new and existing garden s p a c e s feel the looming p r e s e n c e of the adjacent Life S c i e n c e Building. T h e noise from this building could be m a s k e d by introducing a babbling water feature, or fabric e lements that rustle in the breeze . V i s u a l s c r e e n i n g of the bui ldings is a lso n e c e s s a r y and could take many forms including planting both on a n d off site, or introducing f e n c e s or trellises. Alternatively, the garden s p a c e could be d e s i g n e d with an inward focus to draw the e y e away from the adjacent building. T h i s c o u l d be a c c o m p l i s h e d by p lacing focal e lements in the centre of the garden rather than at the e d g e s . Plant operat ions currently performs s o m e ma in tenance of the existing garden s p a c e while the remainder of ma in tenance is d o n e by a hospital volunteer who reports having difficulty keeping up with the work load. P lanning for any additional garden s p a c e at the Purdy Pavi l ion must a d d r e s s long-term main tenance from the outset to avoid unduly stretching the reso u rces of Plant Opera t ions or volunteers. 27 T h e des ign must include e lements that reduce the ma in tenance burden. Irrigation shou ld be u s e d in all planted a r e a s until plant material is es tab l ished a n d cont inued in a r e a s that require high water u s e s u c h a s planters, and perennial beds . T h e plant palette shou ld consis t mainly of trees, shrubs and evergreen groundcovers . Perennia ls that require higher levels of ma in tenance shou ld be u s e d sparingly a n d strategically located at p l a c e s where peop le will c o m e in c l o s e contact with them to max imize their effect. Whi le it would be ideal to have resources in p lace for professional ma in tenance , either from Plant Opera t ions or through a position funded by the hospital , this s e e m s unlikely. A n y new garden s p a c e would probably require recruiting more volunteers to help with main tenance . In addition to c a n v a s s i n g family m e m b e r s , the hospital could cons ider secur ing student volunteers from faculties with an interest in restorative or therapeutic s p a c e s s u c h a s nursing, horticulture or l a n d s c a p e architecture. A partnership with existing volunteer g roups on c a m p u s , s u c h a s U B C Botanical G a r d e n ' s Fr iends of the G a r d e n ( F O G s ) , or Student Fr iends of the G a r d e n ( S O G s ) could a lso be d i s c u s s e d . F u n d s are a perennial problem when it c o m e s to implementing a project. S e v e r a l things c a n be d o n e by a des igner to help with this difficult task. T h e distillation of s takeholders ' ideas into a c lear plan is essent ia l . A c lear graphic presentat ion of the projects' goa ls lets funders understand what their m o n e y will be u s e d for. Funding-ra is ing c a n a lso be ass is ted by including e lements and materials that allow funders to easily s e e where their m o n e y is going. F o r example , bricks that m a k e up a wall c a n be 'bought' by individual d o n o r s while concrete walls d o not offer this opportunity. G a r d e n structures c a n b e n a m e d after benefactors, a n d trees c a n be tagged with individuals' n a m e s letting funders s e e the results of their donat ion. In balancing this site is suitable for u s e a s a restorative l a n d s c a p e . Phys ica l constraints c a n be easi ly o v e r c o m e , the p r o p o s e d u s e is appropriate and there is interest in see ing s u c h a project progress . T h e real i ssue is not that the site is suitable for u s e a s a restorative l a n d s c a p e , but whether s u c h a site c a n be afforded and maintained. 28 3 Design Principles and Guidelines 3.1 Design Principles A s site u s e r s m o v e through the hospital precinct they encounter a ser ies of distinct s p a c e s e a c h with its own set of functions and user groups . Imagine a trip from the main parking lot through the pedestr ian b reezeway toward the therapeutic garden at the Purdy Pavi l ion; it is a journey that s e e s an increasingly specif ic set of users a n d a correspondingly speci f ic set of intended u s e s requiring increasingly stringent des ign requirements. Spec i f ic des ign principles have been d e v e l o p e d at three s c a l e s ; those that apply to the entire precinct, those that apply to the new residents' g a r d e n , and finally those for the existing therapeutic garden . T h e s e des ign principles are meant to be understood a s being nested a n d cumulat ive. Figure 3.1 Design Principles precinct residents' garden therapeutic garden • restorative exper ience • meet residents' unique n e e d s • support therapeutic p rograms A s illustrated in the a b o v e d iagram, all of the s p a c e s that m a k e up the hospital precinct are intended to have a restorative quality. A s previously ment ioned, restorative exper iences provide relief of the effects of mental fatigue, a condit ion that ar ises from over exercis ing o n e ' s capaci ty for directed attention (Kaplan & Kap lan , 1998). A s this is a nested model all of the s p a c e s that fall within the precinct, including the residents' and therapeutic ga rdens , shou ld meet the principles relating to the precinct. A s des ign principles are meant to be cumulat ive, the principles that apply to the residents' garden are a new layer of criteria a d d e d to the principles applying to the precinct. T h i s is appropriate a s the residents' 29 garden 's user group has unique n e e d s arising from their a g e and medica l condit ion, n e e d s that e x c e e d those of the genera l populat ion. Refer to C h a p t e r o n e for a thorough d i s c u s s i o n of these unique n e e d s . T h e therapeutic garden with provide a p lace for horticulture therapy to take place. Horticultural therapy takes advantage of the restorative qualit ies of plants by incorporating garden ing a s part of a patient's therapy program. A s the therapeutic garden falls within the circle represent ing the residents' garden in the a b o v e d iagram, the principles that apply to the residents' garden will a lso apply to the therapeutic garden . T h i s m o v e a c k n o w l e d g e s that the s a m e population will be using the therapeutic garden a s the residents' garden . T h e difference is that the therapeutic garden h a s an additional set of des ign principles that enab le this s p a c e to meet therapy program n e e d s , making it the most stringently d e s i g n e d s p a c e cons idered in this project. T h e new garden will be d e s i g n e d a s a restorative s p a c e , to offer an intensely restorative exper ience to Purdy residents, staff and visitors. Strategies implemented in this garden will max imize the Kap lans ' criteria (Kaplan & Kap lan , 1998). T h e new residents' garden will a lso a d d r e s s the unique n e e d s of Purdy 's residents. T h e therapeutic garden must meet the criteria that apply to the precinct and the residents' ga rden . A s this garden will be u s e d to deliver therapy to patients it has speci f ic n e e d s b e y o n d what is n e c e s s a r y in the residents' garden and must meet a more detailed and speci f ic set of criteria that apply only to this s p a c e . Des ign details must cons ider site users ' physica l abilities and meet therapy program n e e d s . 3.2 Design Guidelines Guide l ines relating to the principles a b o v e have b e e n d e v e l o p e d to e n s u r e that the precinct m e e t s its goals . T h e s e relate to the principles and are therefore a lso understood to be cumulat ive. Table 3.1 Design Guidelines S c a l e P r i n c i p l e G u i d e l i n e P r e c i n c t P r o v i d e a r e s to ra t ive e x p e r i e n c e to a l l s i t e u s e r s F o l l o w K a p l a n s ' g u i d e l i n e s by p r o v i d i n g f a s c i n a t i o n , extent , a s e n s e of b e i n g a w a y , n e a r na tu re a n d c o m p a t i b i l i t y E n s u r e n e w b u i l d i n g s c r e a t e p o s i t i v e o u t d o o r s p a c e M e e t A D A g u i d e l i n e s S u p p o r t w a y - f i n d i n g D e s i g n for s o c i a l i n t e rac t ion R e s i d e n t s ' G a r d e n M e e t P u r d y r e s i d e n t s ' s p e c i f i c n e e d s A d d r e s s l o s s o f s e n s o r y acu i ty , r e d u c e d p h y s i c a l abi l i ty a n d n e e d s o f pa t i en t s wi th d e m e n t i a M a x i m i z e o n r e s to ra t ive effect C r e a t e p l a c e s for g a t h e r i n g M a k e a s t r o n g i n d o o r - o u t d o o r c o n n e c t i o n Inc lude e l e m e n t s r e q u e s t e d b y r e s iden t s , f a m i l i e s a n d staff C o n s i d e r m a i n t e n a n c e r e q u i r e m e n t s T h e r a p e u t i c G a r d e n S u p p o r t t h e r a p e u t i c p r o g r a m s A l l o w for a f l ex ib le u s e o f s p a c e S u p p o r t hor t icu l tura l ac t iv i ty M a x i m i z e a c c e s s i b l e p l an t ing s p a c e P l a n for e x t e n s i v e u s e o f s p a c e 30 3.3 Principles and Guidelines for the Precinct T h e precinct is to provide a restorative exper ience to all site users . T h i s principle is singularly appropriate to a hospital precinct, delivering to site users restorative exper iences that benefit their health a n d leave them feeling renewed. Follow Kaplans' Guidel ines A s d i s c u s s e d in the literature review sect ion of this paper, restorative l a n d s c a p e s c a n be created by introducing e lements that provide fascinat ion, extent, a s e n s e of being away, near nature and compatibility (Kaplan & Kap lan , 1998). D e s i g n for the precinct shou ld take a d v a n t a g e s of opportunit ies for engag ing non-directed attention by introducing natural e lements that stimulate the s e n s e s . C o n n e c t i o n s should be m a d e to the extensive l a n d s c a p e employ ing strategies s u c h a s u s e of local materials a n d providing v iews to off-site landmarks. T h e precinct should be distinct from its surrounding envi ronment in e n o u g h m e a s u r e to provide the visitor with a s e n s e of be ing away. Compatibi l i ty is especia l ly important in the precinct, and care must be taken to ensure that the l a n d s c a p e e n a b l e s people to do what they want to do there effortlessly. All of the guidel ines for the precinct touch on compatibility to s o m e degree , underscor ing its importance. Ensure New Buildings Create Positive Outdoor Space T h e d e m a n d for healthcare facilities cont inues to grow, and it s e e m s likely that new buildings will be a d d e d to the precinct over time. It is prudent to think now about the effect these bui ldings m a y h a v e on the precinct. The i r p lacement a n d form will go a long way to creating compatibility and extent on site. Without careful considerat ion, confus ing circulation, b locked views, erosion of public outdoor s p a c e a n d uncomfortable env i ronments next to looming buildings c a n be the result. Indeed, all of these negat ive c o n s e q u e n c e s c a n be sa id to have been the result when new Life S c i e n c e s Cent re w a s erected; circulation on the west s ide of Detwiller w a s i m p e d e d , green s p a c e to the south w a s lost without c o m p e n s a t i o n , v iews from Purdy were b locked , and the large sca le of the Life S c i e n c e s Cent re cont inues to o p p r e s s the existing therapeutic garden . N e w buildings a d d e d to the precinct should have footprints that create what Chr is topher A l e x a n d e r refers to a s positive outdoor s p a c e . H e expla ins that "outdoor s p a c e s which are merely "left over" between buildings will, in genera l , not be u s e d . T h e r e are two fundamental ly different kinds of outdoor s p a c e : negat ive s p a c e a n d positive s p a c e . Outdoor s p a c e is negat ive when it is s h a p e l e s s , the res idue left behind when buildings - which are general ly v iewed a s positive - are p laced on the land. A n outdoor s p a c e is positive when its s h a p e is a s important a s the s h a p e s of the buildings which surround it" (Alexander , 1977, p.518). Posit ive outdoor s p a c e s c a n be created, A l e x a n d e r tells us, by ensur ing that they offer a d e g r e e of enc losure . Meet A D A Guidelines T h e hospital precinct is u s e d by many people who are ill or have reduced physical ability. T a k i n g this into considerat ion, it is e v e n more critical here than in other settings that l a n d s c a p e be universally a c c e s s i b l e . 31 Universal des ign involves the creat ion of env i ronments that c a n be u s e d by all people , regard less of disability, without the n e e d for segregat ion or stigmatization. T h e A m e r i c a n s with Disabil it ies A c t ( A D A ) sets forth guidel ines that are c o m m o n l y u s e d a s the standard which must be met to ensure universal accessibi l i ty. Support Way-finding M a n y people using the l a n d s c a p e are visitors or patients on short s tays and n e e d a s s i s t a n c e finding their way around the precinct. S imp le circulation routes shou ld be e m p l o y e d a n d these could be reinforced with spec ia l paving treatments that mark circulation routes to dest inat ions within precinct. Dest inat ions shou ld be visible f rom a d is tance a n d s i g n a g e directing peop le to these dest inat ions shou ld be at eye leve l and e a s y to read. T h e ability to give and receive intelligible directions should be supported through the u s e of memorab le p lace -markers at dec is ion points. Design for Socia l Interaction All site users benefit from l a n d s c a p e s that support socia l interaction. Al though des ign ing outdoor s p a c e s for socia l activity d o e s not ensure that people will interact, failure to des ign for socia l activity e n s u r e s that interaction will not take p lace (Gehl , 1996). T o e n c o u r a g e socia l interaction, the des ign shou ld provide soc ia l s p a c e s inside bui ldings with complementa ry outdoor soc ia l s p a c e s . A n e x a m p l e would b e the addition of an outdoor patio c o n n e c t e d to the existing indoor cafeteria at the Koerner Pavi l ion. All outdoor s p a c e s should support many u s e s and focus on pedestr ian u s e . T h e precinct shou ld offer a variety of p laces to sit and these should allow for var ious s i z e s of g roups to congregate . F requent rest s tops with comfortable street furniture a n d fine detail ing shou ld b e provided. Sea t ing s h o u l d b e sited where people like to sit; with their b a c k s protected a n d v iews to pedestr ian circulation. Microcl imates should be cons idered when locating rest s tops to e n s u r e protection from the e lements and maximize physical comfort. E v e n paving and adequa te lighting will help m a k e the precinct sa fe for site users . 3.4 Principles and Guidelines for the Residents' Garden T h e new residents' garden at the Purdy Pavil ion must meet the des ign principles for the precinct in addition to those speci f ic to this new s p a c e , T h e garden will be u s e d exclusively by Purdy residents, visitors a n d staff. A s d i s c u s s e d in chapter one , Purdy 's residents h a v e s p e c i a l n e e d s that must b e a d d r e s s e d . T a b l e 3.2 details des ign guidel ines that a d d r e s s these n e e d s . Table 3.2 Guidelines That Address Purdy Resident's Needs Condition Design Guideline L o s s of S e n s o r y Acu i ty H e a r i n g • P l a c e e l e m e n t s that r e v e a l the s o u n d o f the w i n d s u c h a s w i n d c h i m e s o r f ab r i c b a n n e r s a l o n g c i r c u l a t i o n rou tes • Inc lude w a t e r f ea tu re s that b a b b l e c o n s p i c u o u s l y • P l a c e s bird b a t h s a n d f e e d e r s n e a r s e a t i n g S i g h t • P r o v i d e a d e q u a t e l ight ing a l o n g p a t h w a y s a n d i n s i d e s t ruc tu re s • E n s u r e c i r c u l a t i o n rou tes a re o b s t a c l e free • P l a c e d e s i g n e l e m e n t s w h e r e t h e y c a n b e e a s i l y s e e n - b e l o w e y e l e v e l • P r o v i d e t r ans i t ion z o n e s b e t w e e n light a n d d a r k s p a c e s • E l i m i n a t e m a t e r i a l s that c r e a t e g l a re , e s p e c i a l l y o n the g r o u n d p l a n e 32 Condition Design Guideline S c e n t • P r o v i d e p l an t s wi th p l e a s a n t s c e n t s in p rox imi ty to rest s t o p s T o u c h • P l a c e m a t e r i a l s wi th in te res t ing t ex tu res wi th in e a s y r e a c h • E n s u r e w a t e r f ea tu re s a r e in t e rac t ive Reduced Physical Ability L o s s of S t r e n g t h • S l o p e s not to e x c e e d 5 % • M a x i m i z e p h y s i c a l comfo r t b y p r o v i d i n g s h e l t e r f rom the e l e m e n t s a n d h e a t e d s e a t i n g a r e a s L o s s o f S t a m i n a • P r o v i d e f requen t rest s t ops , at l eas t e v e r y 2 0 0 m L o s s of A g i l i t y • C r e a t e a s e a m l e s s t r ans i t i on f rom i n d o o r s to o u t d o o r s ; n o d o o r s i l l s • P l a c e in te rac t ive e l e m e n t s wi th in . 6 m of c i r c u l a t i o n o f rest a r e a s Dementia Population P e r c e p t u a l A b i l i t y E f f e c t e d • S u p p o r t w a y - f i n d i n g wi th g e o m e t r i c s p a c e s a n d s i m p l e c i r c u l a t i o n • A v o i d s ta rk c o n t r a s t s b e t w e e n light a n d dark , e s p e c i a l l y o n the g r o u n d p l a n e • E m p l o y w a r m m i d - r a n g e c o l o u r s a n d a v o i d m o n o c h r o m a t i c c o l o u r s c h e m e s H o m e l i k e A t m o s p h e r e P r e f e r r e d • In t roduce fami l i a r ob j ec t s a n d p lan t m a t e r i a l • D e s i g n s p a c e s to h a v e a r e s iden t i a l s c a l e S a f e E n v i r o n m e n t • E n s u r e s p a c e s a r e s e c u r e but not j a i l - l i ke • U s e o n l y n o n - t o x i c p lan t m a t e r i a l Maximize on Restorative Effect P r o g r a m s for this garden relate to the s p a c e ' s restorative qualities a n d restorative e lements will be u s e d to m a x i m u m effect here. T h e garden will provide near nature a n d feature natural e lements , increasing its restorative value. Res iden ts will be able to u s e this garden a s a p lace of respite; for taking walks, for social izat ion a n d for bird watching. Nest boxes , birdbaths a n d plants that supply food to birds shou ld be included in this s p a c e to support this use . T h e separa te s p a c e s that m a k e up the g a r d e n should e a c h be furnished with a focal e lement that provides an opportunity for fascinat ion. T h e s e could include water features, bird baths or outdoor f i replaces. Create Places for Gathering Patient recreation programs could be held in the g a r d e n and a gathering s p a c e for ten to fifteen people shou ld b e inc luded. C o n c e r t s a n d other spec ia l events cou ld a lso b e hos ted in the g a r d e n . T h e g a r d e n should be d e s i g n e d so that part of the s p a c e c a n be easily c l o s e d off to allow spec ia l events to h a p p e n without c los ing the garden completely. T h e new garden should provide p l a c e s for Purdy residents to visit with family a n d friends. Smal l seat ing a r e a s with facing b e n c h e s should be provided for this purpose . T h e s e should meet precinct principles pertaining to seat ing s p a c e s . In addition, c o v e r e d seat ing shou ld be provided for inclement weather and this should be e q u i p p e d with heaters to e n s u r e year - round use . Seat ing structures should be s e c u r e d and the seat ing sur face itself shou ld be level and p laced at a height of 19 inches . A rmres ts should be d e s i g n e d to be easi ly g r a s p e d . C o n c r e t e p a d s measur ing 1 meter by 1 meter should be avai lable bes ide permanent seat ing structures to allow those in whee lcha i rs to join those in chairs or b e n c h e s . Make a Strong Indoor-Outdoor Connect ion T h e interior of the building shou ld hold c u e s that e n c o u r a g e residents to u s e the adjacent outdoor s p a c e . T h i s is especia l ly important for dement ia patients who may otherwise forget that the s p a c e is avai lable to 33 them. Circulat ion routes from hospital wards to the garden cou ld be marked with co loured tile flooring, or a cont inuous stencil led vine on the wall that leads to the garden . F lower a r rangements from the garden could be p laced on residents' dining tables or nursing stations. S a c h e t s or bowls of potpourri m a d e from garden flowers could be p laced in residents' r o o m s to remind them that the garden is near. A wall mural depict ing a garden s c e n e could a lso be e m p l o y e d a s a c u e to venture outdoors. S i g n a g e inside building could be u s e d to direct families and visitors to the garden , and list events being hosted in the garden . Include Elements Requested by Residents, Families and Staff Quest ionnai re results (see A p p e n d i x B) s h o w strong interest in inc reased outdoor socia l s p a c e with a variety of seat ing opt ions. Natural e lements s u c h a s s h a d e trees, f lowers and water a lso were high in preference. It is fortuitous that these e lements a lso help create the restorative quality des i red for this garden , making it doubly important that they be included. Maintenance Requirements Main tenance staff must be able to a c c e s s the g a r d e n , but the a c c e s s point shou ld not detract from the garden 's restorative quality. T o reduce maintenance , the garden shou ld be on an automat ic irrigation s y s t e m . Plant ings should be d e s i g n e d to be low-maintenance. Lawn a reas shou ld be e d g e d with pavers to el iminate the n e e d for edg ing . T r e e s se lec ted shou ld h a v e light leaf litter a n d b e under-p lanted with open- fo rmed groundcovers that allow leaves to fall through reducing the n e e d for raking. Labour -intensive ornamenta l planting b e d s shou ld be limited to a few select a reas . 3.5 Principles and Guidelines for the Therapeutic Garden Allow for a Flexible use of Space T h e therapeutic garden s p a c e will be d e s i g n e d to meet the d e m a n d s of the precinct, the residents' garden , and in addition support therapy programs. T h e garden should be d e s i g n e d to be flexible a n d support var ious programs a s interests of residents a n d staff will vary over t ime a n d programs will c o m e and go a s interests c h a n g e . A functional a n d aesthetically delightful des ign framework should be establ ished and c h a n g e a b l e e lements introduced. T h e s e could include m o v e a b l e planters, ra ised b e d s , hanging baskets or planted pots. W h e n introducing structures to the garden , resident 's r a n g e s of mobility should be c o n s i d e r e d to maximize opportunit ies for tactile contact with plant material. Support Horticultural Activity Th is s p a c e will support residents' horticultural activities. All a s s o c i a t e d garden ameni t ies should be on hand . C o m p o s t bins, trash receptac les a n d storage for gardening equ ipment should be nearby, but not obv ious. T h e garden should be e q u i p p e d with an automat ic irrigation s y s t e m that includes drip irrigation for hanging baskets . A h o s e for resident u s e should a lso be avai lable in a location in proximity to the a r e a that will be watered. T h e h o s e bib must b e d e s i g n e d s o that it c a n be easi ly u s e d by residents. Hang ing baskets should be on pulleys s o that they c a n be lowered for ma in tenance . Adapt ive tools should be avai lable to allow those with physical disabilit ies to participate horticultural p rograms. 34 Maximize Access ib le Planting Space T h e existing retaining wall shou ld b e fitted with a n e w whee lcha i r a c c e s s i b l e front. T h i s shou ld b e 60 cent imetres in height to allow a wheelchai r to fit underneath its lip. T h e front 60 cent imetres of this planter should be m a d e avai lable for u s e by the residents. T h e existing g r e e n h o u s e crea tes marvel lous opportunit ies for a l l - season horticultural activity. T h e b e n c h e s could be adjusted to heights appropriate for wheelchair users , and adapt ive tools could be m a d e avai lable and programs that take a d v a n t a g e of this structure could be implemented. Plan for Extensive Use of Space Severa l popular activities currently take p lace in the therapeutic garden; ice c r e a m socia ls , family visits and horticultural therapy programs are c o m m o n . It is h o p e d that a s the s p a c e is improved, p rogramming will be inc reased , creating an extensive use of the garden . T a b l e 3.3 lists horticultural projects that could b e appropriately inc luded a s part of a hospital 's occupat iona l therapy program. Th is listing of projects is included for considerat ion for adoption at the Purdy Pavi l ion. Table 3.3 Horticulture Therapy Projects Indoor Activities • Growing orchids • Making fresh holiday a r rangements • Repott ing older plants • Growing Afr ican violets • Terrar iums • Planting bulbs for indoor b loom • Windowsi l l herbs • Order ing s e e d s for the s u m m e r garden • Kitchen gardening • Planting s e e d for the s u m m e r garden • Deser t d ish g a r d e n s • C o o k i n g with herbs • Learning to take cuttings Outdoor Activities • P repare a garden site • Butterfly gardening • T a k e the garden down • W e e d i n g , watering, pruning • Plant a p izza garden • H e r b s • Vege tab le gardening • B i rdseed plants • Plant a tree • C o m p o s t i n g • G r o w fruit • A n n u a l cuttings • F lower arranging • Craft and Nature-related p rograms • Edib le f lowers • S a c h e t s • F lower gardening • F lower press ing • M a k e a garden sa lad • Dried flower a r rangements • F lower drying • Decorat ing pumpkins • B o o k m a r k s • Nature walks • Build b i rdhouses • Col lect butterflies • M a k e pine c o n e feeders • Mix a sp ice bowl • Potpourri • W r e a t h s S o u r c e : S i m o n s & S t rauss , .1999, p. 358 35 A s the des ign principles are understood to be cumulat ive a n d nested the guidel ines that apply to the precinct a n d residents' g a r d e n a lso apply to this s p a c e including guide l ines c o n c e r n i n g the creat ion of a strong link between indoor and outdoor s p a c e s and sensitivity to ma in tenance n e e d s . T h e r e are i tems worth adding in these a r e a s that are unique to the therapeutic garden . T h e existing therapeutic garden s p a c e has an opportunity for a strong l inkage with the adjacent hospital garden room. Currently, the existing door sill c rea tes a barrier that k e e p s s o m e residents from travelling from the indoor garden room to the outdoor therapeutic garden , a situation that could be easi ly remedied . Portable garden e lements should be included outdoors to allow gardening activities to be brought indoors w h e n weather is poor. Recreat ional activities that o c c u r indoors should be a l lowed to spill out into the garden s p a c e . T h i s could be facilitated by including permanent o v e r h e a d structure outdoors to provide protection from sun and rain. Outdoor lighting and heating in the garden would e n c o u r a g e night use . Existing plantings on the s lope behind the retaining wall are hard to a c c e s s a n d currently p o s e main tenance prob lems. W h e n the existing retaining wall is repaired or rep laced , an opportunity will exist to renovate the planting in the a rea disturbed during construct ion. T h i s part of the s lope should be replanted with a n assor tment of s h r u b s a n d trees which provide wildlife habitat, a l l - s e a s o n interest a n d require little maintenance . 36 4 Design Proposal 4.1 A Design for the Precinct Des ign work at the precinct sca le takes severa l forms; a s u g g e s t e d plan for new building footprints, a pedestr ian walking route m o d e l e d after the W e l l n e s s W a l k w a y s project and a redesign of the pedestr ian b reezeway that runs between the hospital pavil ions. E a c h will be d i s c u s s e d in turn. A matrix is provided at the end of this sect ion that links des ign m o v e s to the principles a n d guidel ines establ ished for the project. Proposed New Building Footprints A s previously d i s c u s s e d , new buildings will h a v e a large effect on the s u c c e s s of the precinct in the future. Thei r addition should be calculated to create positive outdoor s p a c e using A l e x a n d e r ' s technique of creating a ser ies of outdoor s p a c e s that have a s e n s e of enc losure or b o u n d e d - n e s s (Alexander , 1977). F igure 4.1 s h o w s how this m a y b e a c h i e v e d through the addit ion of three buildings to the precinct. T h e two northernmost buildings would be located on existing parking lots, and it is s u g g e s t e d that parking be relocated underground. Auto-circulat ion routes have been re-routed to allow this to h a p p e n without interrupting a m b u l a n c e a c c e s s to the hospital. A third building is s h o w n a s an extension to Detwiller Pavil ion creating an e n c l o s e d entry s p a c e that the building currently lacks. In this plan, care h a s been taken to preserve v iews to W e s b r o o k Mall and its major crosswalk , helping with way-f inding on site. Direct pedestr ian routes through the site would not be negatively affected by the addition of these buildings, and useab le green s p a c e would not be lost. Proposed Walking Route Res idents report frustration at being unable to get the p l a c e s they want to go . T o remedy this, popular local dest inat ions should be c o n n e c t e d by a walking route m o d e l e d after the W e l l n e s s W a l k w a y s . S u c h a route would increase opportunit ies for residents to exerc ise outdoors, a n d m a k e connect ions with the larger community . A p p e n d i x 1 lists W e l l n e s s W a l k w a y s d e s i g n guidel ines for reference. A s shown in figure 4.2, a universally a c c e s s i b l e walking route that c o n n e c t s University Vi l lage in the northeast to S ta rbucks in the T E F building in the southwest by way of R e g e n t Park a n d the hospital pavi l ions on the way is s u g g e s t e d . Street c r o s s i n g s in the precinct including those a long the walking route shou ld be fitted with perpendicular curb ramps a s these are safest for wheelcha i r users . T h e walking route shou ld have rest s tops p laced a long it at 100 meter intervals. T h e s e should be sited in a reas with comfortable microcl imates and include b e n c h e s and litter receptac les . Decorat ive paving a n d plantings are p r o p o s e d in rest a r e a s to increase amenity a n d opportunit ies for near nature. 37 Purpendicular C u r b Cuts Typical Rest Stop Figure 4.2 P r o p o s e d Walking Route ft S c a l e 1: 5000 39 Proposed Pedestrian Breezeway Modifications Figure 4.3 s h o w s s u g g e s t e d modif ications to the b reezeway connect ing the hospital pavil ions. Looking at the b reezeway from west to east, severa l improvements are p r o p o s e d . • It is s u g g e s t e d that pedestr ian and auto circulation be separa ted by a row of t rees at the western end of the breezeway . • Car -or iented infrastructure would improved by add ing angle parking a n d an auto-turnaround with drop off z o n e for the Handi -Dar t bus. • A n entry arch to match the existing arbour us p lanned just inside the western e d g e of the breezeway , creating a s e n s e of enc losure for the site and assist ing way-f inding. • A l s o to ass is t way-f inding, large s igns or e y e - c a t c h e r s are p r o p o s e d for the entries to both Purdy and Koerner Pavi l ions and at the eastern e d g e of the b reezeway creat ing landmarks at dec is ion points. • A s u n k e n staff garden is p roposed for the northern face of the Purdy Pavi l ion to offer a p lace for socia l activity and respite for hospital workers. T h i s currently un -useab le portion of the l a n d s c a p e could be a c c e s s e d through a new hallway and door to be installed in an existing mechan ica l room on the bottom floor of the Purdy Pavi l ion. • Travel l ing east , the existing path shou ld re -graded to meet A D A s tandards a s residents report that existing g r a d e s m a k e this s lope d a n g e r o u s for wheelchai r users . • T h e plan s h o w s a rest stop near the eastern e d g e of the breezeway , the first of severa l that would line the new walking route. • T h e existing ineffective pedestr ian c r o s s i n g at W e s b r o o k Mall shou ld b e remed ied through the introduction of a new cross ing signal fitted with an infra-red s e n s o r that k e e p s the light from turning green until all pedestr ian traffic has c leared the intersection. Not directly on the b reezeway but immediately adjacent, a rooftop garden for residents a n d staff at the Detwiller Pavil ion is a lso p r o p o s e d . W h e n the new Life S c i e n c e s Cent re w a s built Detwiller staff and residents lost frequently u s e d recreational g r e e n s p a c e to the new building's parking lot. W h e n speak ing with staff at Detwiller, there w a s interest in gaining back s o m e of this lost s p a c e through the creat ion of a roof-top garden . 40 Figure 4.3 P r o p o s e d Pedestr ian B r e e z e w a y Modifications N S c a l e 1:1000 41 4.2 A Design for the Residents' Garden A s previously stated, this s p a c e must meet the precinct guidel ines, that is offer a restorative exper ience , but must a lso meet the residents' unique n e e d s relating to their a g e a n d infirmity. E x p a n d e d guidel ines were outlined in sect ion 3.4 of this paper a n d included strategies to a d d r e s s loss of s e n s o r y acuity, r e d u c e d physica l ability, a n d effects of dement ia . F igure 4.4 s h o w s a plan for the residents' garden to be created in the new garden s p a c e . T h e plan for the residents' garden is m a d e up of three z o n e s ; the songbird garden , the winter retreat a n d the patio garden . Wildlife viewing is an extremely powerful dev ice in engag ing fascinat ion, a characterist ic of restorative exper ience , a n d is someth ing that the residents requested . F o r these r e a s o n s it h a s b e e n given prominence in this plan through the inclusion of a songbird garden . T h e winter retreat is nearest the main entrance to the building a n d features a hea ted shelter for u s e in winter a n d in inclement weather. T h e patio garden is the active heart of the des ign offering s p a c e for events and celebrat ions. E a c h s p a c e follows a s imple, geometr ic form and conta ins a m e m o r a b l e landmark. T h e s e landmarks are meant to act a s local focal points and to ass is t way-f inding, but a lso serve a s a ser ies of eye -ca tchers that draw you through the garden . All of the z o n e s are c o n n e c t e d by a clear, s imple looped circulation s c h e m e that m e e t s A D A s tandards for accessibi l i ty. The Songbird Garden T h i s sect ion of the garden max imizes wildlife viewing opportunities, especia l ly bird watching. T h e main structural e lement in this part of the garden is a decorat ive fountain with s h e l v e s set at depths that m a k e them perfect for bird bathing. Detail drawings for the fountain are found in F igure 4.5. T h e fountain's boundary wall is set below eye- leve l for e a s y viewing ensur ing that the fountain will serve a s a not only a birdbath, but a lso a s a focal and restorative e lement engag ing soft fascinat ion by offering v iews to water and wildlife. Nest b o x e s for s p e c i e s o b s e r v e d on site are included a s a decorat ive e lement a n d to provide h o m e s for these avian s p e c i e s . S e e Figure 4.6 for detail drawings. Plant material in this part of the garden has been se lec ted for its aesthet ic va lue a n d for its ability to provide vertical stratification or foliage layers at varying heights from c a n o p y to shrub layer to ground cover . Plants u s e d in this part of the g a r d e n provide n e e d e d shelter a n d food. S p e c i e s with fruit that persists through the winter h a v e b e e n included to provide nour ishment throughout the year. T r e e s have been introduced a long the western face of Detwiller Pavi l ion to bring down the s c a l e of this neighbouring building, and create a v isual connect ion between the residents' garden and its surroundings. B e n c h e s p laced in n iches are provided for seat ing a n d have been d e s i g n e d with d i m e n s i o n s that m a k e them comfortable for sen iors to use . S e a t s are to be set at nineteen inches a b o v e the ground, a height that m a k e s them e a s y to get back up out of. A rmres t s are p laced twelve inches a b o v e the seat, a height that m a k e s them useful for leverage when standing up. B e n c h b a c k s are tall and straight to provide support. Seat ing is located in microcl imates that offer dapp led s h a d e , v iews to nearby b l o o m s , and proximity to scented plants. F igure 4.7 s h o w s b e n c h a n d chair details. 42 Figure 4.4 P r o p o s e d Residents ' G a r d e n Plan N S c a l e 1:250 43 0.925m/3' 4 , 9 2 5 m / 1 6 ' 3 bubb ler je ts sol ished conc re te founta in i a s e houses p u m p 1" deep she lves f o r birds to bathe cen t re bath ing to max . viewing co lou red br ick c a p and fac ing c o n c r e t e wall keyed into base l ights r e c e s s e d , ' rebar re in forced figgrpgnte h n s * J l A Jt-J1' J l > , 1 . ^ VA' - ' .4 - ,t -— T - y tr-\n .T—Wi—c=iti—edad — — ' — • ,1122m,; Q.55m ,, &55m , 0.3m 0.2rr. 0.36m D.?nr. ' CP* E CN Figure 4.5 Birdbath Fountain Details 44 p i v o t na i l 0 . 4 m ( 1 6 ' 1 c m ( 0 . 5 ° ) t h i c k m e t a l p l a t e , w i t h h o l e s t o r e c e i v e s c r e w s c o n n e c t i n g n e s t b o x t o p l a t e 6 c m ( 2 . 5 " ) d i a m e t e r m e t a l p o l e , w e l d e d t o p l a t e , d i s c o u r a g e r a c c o o n s c o u l d a l s o l e a v e t h e p o l e o u t a n d m o u n t w i t h s c r e w s t o f e n c e Nest Box for W r e n s and C h i c k a d e e s 0 . 1 m (4") 1 c m (0.5") th ick m e t a l p la te , with ho les to rece ive s c r e w s 6 c m (2.5") d i a m e t e r m e t a l p o l e , welded to p la te , d i s c o u r a g e r a c c o o n s o 15 m (6") c o u l d a l s o leave the pole out a n d m o u n t with s c r e w s to f e n c e Nesting Shelf for Swal lows 0.2m (8") 1cm (0.5") thick metal plate, with holes to receive screws 0.15 m (6") 6 c m (2.5") d iameter metal pole, welded to plate, d iscourage raccoons Nesting Shelf for Robins Figure 4.6 Nestbox Details 0 . 2 m ( 8 " ) 0 . 1 3 m ( 5 " ) 3 / 4 " p i n e w o o d s c r e w s , g a l v a n i z e d n a i l , w o o d g l u e d o u b l e h e a d e d g a l v a n i z e d n a i l , d o o r l o c k h o l e 2 9 m m ( 1 . 1 / 8 " ) t o a c c o m m o d a t e w r e n s a n d c h i c k a d e e s e x c l u d e h o u s e s p a r r o w s a n d s t a r l i n g s 0 . 2 3 m (9") 0.2 m (8") 3 / 4 p ine wood s c r e w s , g a l v a n i z e d nai l , wood glue she l f 0 . 1 m (4") to a c c o m m o d a t e b a r n swal lows e x c l u d e r o b i n s 0.23 m (9") 0.2 m (8") 3 / 4 pine wood screws, galvanized nail, wood glue shelf 0 .2m (8") to accommoda te robins 45 E CN \ £ ro 46 2 X 4 c e d a r (89 mm) 2 X 6 c e d a r (89 m m ) V V v A y A A 4^ N \ N K Gate V iewed from Outs ide 4 X 6 rough c e d o r 2 X 2 rough c e d a r 14' 6 X 6 rough c e d a r 2 X 4 c e d a r (89 m m ) 2 X 2 rough c e d a r 4X6 rough c e d a r c ted c o m p a pea gravel t ? . O m / f i * f i " , i tvpical j this panel on h inges , gate "i inside "late out Gate V iewed from Inside Figure 4.8 G a t e and F e n c e Detai ls f - 1 0 . 4 5 m / 1 ' 6 " 47 Sect ion D S c a l e 1:150 b i rdhouses birdbath fountain b e n c h birdhouses fence Figure 4.9 Songbi rd G a r d e n Sect ion 48 T h e entire garden s p a c e is sur rounded by a fence that var ies in height a s required to s c r e e n undesi rable off-site v iews. T h e fence height ranges from six feet at the songbird garden to six feet with an additional two and a half feet of trellis on top at the southern e d g e of the garden where g r a d e s drop off. A gate in the fence is required to meet fire c o d e and to provide a c c e s s to ma in tenance workers, a n d is located at the northernmost e d g e of the garden . T h e gate has been d e s i g n e d to be visually s e a m l e s s from the inside to d iscourage A lzhe imer 's patients from exhibiting e s c a p e behaviour. F igure 4.8 s h o w s gate a n d fence details. A m o v e a b l e seat has been p laced directly in front of the gate to further the illusion. A n illustrative sect ion, s h o w n a s sect ion D on the residents' garden plan, is included in figure 4.9 to give a s e n s e of the character of the songbird garden . The Winter Retreat T h i s part of the garden features a c o v e r e d , heated structure which provides an outdoor recreational s p a c e protected from the e lements . T h e winter retreat is intended to be usable throughout V a n c o u v e r ' s rainy winter s e a s o n . T h e structure s h o w n is model led after a des ign by the H o m e P lanners G r o u p , ( H o m e P lanners , 2001) a n d h a s b e e n a d a p t e d to suit this site. It is located n e a r the d o o r s which c o n n e c t the garden to the building's interior. T h e path leading from the building to the structure is c o v e r e d by an existing c a n o p y which would remain, making the structure easi ly a c c e s s i b l e in inclement weather. T h e main circulation p a s s e s through the front of the structure providing a p lace for site u s e r s to p a u s e a n d dec ide which part of the garden to visit. Seat ing is located in the structure s o visitors c a n rest a n d watch people c o m e and go. A n existing vent is a lso h o u s e d in the structure; it is s u g g e s t e d that it be given a decorat ive housing. T h i s part of the garden e m p l o y s a palette of plant material with winter interest. Planting combinat ions have been carefully c o n s i d e r e d to include fragrant winter b looming plants with complementary textures and forms. 49 Figure 4.10 Winter Retreat The Patio Garden T h e patio garden is located in the southern half of the site a n d en joys a s u n n y aspect . It has b e e n p lanned a s the active centre of the residents' garden , providing s p a c e for larger g roups to congregate . T h i s sect ion of the garden c a n easi ly be physical ly separa ted from the rest of the garden by placing a barrier at the rose arbour dividing the g a r d e n into two s p a c e s for spec ia l events . A c c e s s would be through the s e c o n d a r y building entry behind the s u m m e r g a z e b o . A n a r c h e d rose arbor c rea tes the threshold between the winter g a r d e n a n d the patio g a r d e n . It is intended that yellow cl imbing roses , a popular resident plant request, be trained up the arbor. Seat ing opportunities are provided beneath its s h a d e providing respite from the s u n and a delightful s e n s o r y exper ience w h e n the r o s e s are in b loom. D e s i g n detai ls are included in figure 4 .11. F r o m the rose arbour the s o u n d of babbl ing water would be heard drawing site u s e r s d e e p e r into the patio garden . T h e s o u n d c o m e s from a formal fountain which is cont inuous with a g a r d e n wall bounding the s p a c e . T h e fountain basin is set at a height and depth that al lows wheelcha i r users to interact with the water, increasing opportunit ies for s e n s o r y delight. T h e s o u n d of water provided by the fountain is meant to both increase the restorative qualit ies of the s p a c e a n d to s c r e e n the no ise c o m i n g from the nearby Life S c i e n c e s Cent re . S e e figure 4.12 for details. 50 3,??m/l?'rT 1 am/fi' 2.36m/7'10" I.Sm/6' I.5m/1T 6 X 6 lominoted orch 2X2 laminate rail attoched 6 X 6 rough cedar beam notched to receive 6 X 6 posts 6X6 rough cedar post lattice, powder cooted 1" square metal tubing 0Di9h_g|fTVftl compa pea gravel iff 1 I M til 3 to bi "v E a> :4« in o _ E' d Figure 4.11 R o s e Arbor Detail Figure 4.12 Babbl ing Fountain Details c o l o u r e d b r i ck c o p s t o n e b e n c h seo t , 4"-thick w o o d s lo t s c o l o u r e d b r i ck wa l l , s u p p o r t s b e n c h c o l o u r e d b r i ck p l g n t e r co lou red b r i ck c o p s t o n e co lou red br ick wall b e n c h sea t . 4" wood s lo t s co lou red br ick wall s e c t i o n Figure 4.13 G a r d e n Wal l Details Figure 4.14 A c c e s s i b l e Picnic Table Details Figure 4.15 S u m m e r G a z e b o Details 54 s u m m e r gazebo Sect ion A S c a l e 1:150 + 92.0 Figure 4.16 Patio G a r d e n Sect ion new star magnol ia existing terrace Sect ion B S c a l e 1:150 planter +94.5 picnic table hummingbird vine trellis +93.0 bench existing mature tree +95.17 Figure 4.17 Patio G a r d e n Sect ion 55 Sect ion C S c a l e 1:150 bench + 93.5 Figure 4.18 Patio G a r d e n Sect ion 56 he garden wall performs severa l functions; it c rea tes visual a n d physical enc losure to the s p a c e which is important for A lzhe imer 's patients, and s e r v e s a s a retaining wall levelling g r a d e s to m a k e the site wheelchai r a c c e s s i b l e . Included in the garden wall are planters set at sitting height providing site u s e r s with e a s y physica l a c c e s s to plant material. T h e wall is constructed of brick in warm, mid- range co lours most easi ly s e e n by the elderly. T h e face of the wall is broken at intervals by b e n c h e s set into the wall which meet the s tandards for seat ing previously d i s c u s s e d . T h e s e are paired with p a d s for wheelchai r users and have been sited to allow the option of sitting in either s u n or s h a d e . F igure 4.13 illustrates the garden wall in detail. A c c e s s i b l e picnic tables are included in this plan for their home- l ike quality, to create an opportunity for taking m e a l s outdoors, and for visiting with family m e m b e r s . F igure 4.14 details the tables. T h e s e have been adapted from a des ign by J o a n n e W o y (Woy, 1997) and are suited for g roups of three or four people . A grove of m i m o s a trees, another resident plant request, provides light s h a d e over these tables and a showy display of b l o o m s in s u m m e r . T h e picnic a r e a is set amid s c e n t e d lilies a n d roses which put on a beautiful s h o w in s u m m e r months . A trellis f r a m e s the a r e a a n d is meant to be planted with hummingbird vine ( C a m p s i s X tagl iabuana), creating another wildlife viewing opportunity a s birds c o m e to feed on the nectar provided by the vine's b looms. A sect ion of lawn fills the centre of the patio garden s p a c e and is included for its strong assoc ia t ion with residential backyards . A s p e c i m e n tree, a honey locust (Robinia p s e u d o a c a c i a 'Frisia') is set in the lawn, providing s h a d e a n d a focal point. A g a z e b o is included to provide respite from the s u m m e r s u n and to support outdoor group activities. Details for the g a z e b o c a n be found in F igure 4.15. T h e g a z e b o a lso s e r v e s to improve way-f inding within the residents' ga rden . Sec t ions taken through the residents' garden are included in F igures 4.16 - 4 .18 (sect ions A , B and C on the residents' garden plan), to give a s e n s e of exper ience this des ign offers to site users . Planting Plan T h e planting p lans in this project include both plants in the garden s p a c e s a n d those p lanned in adjacent s p a c e s . Th is is n e c e s s a r y b e c a u s e nearby trees are n e e d e d to provide screen ing and create v iews off-site, increasing the garden 's psychologica l extent. In the residents' garden planting plan (figures 4.19-4.22), ma in tenance considerat ions are reflected in a palette that cons is ts mainly of smal l trees, shrubs a n d evergreen g roundcovers . Perennia ls a n d v ines which require more ca re have been strategically p laced where they will create the most impact, a long circulation routes a n d framing seat ing a reas . All plants speci f ied are non-toxic and b loom in warm, midrange colours. T h i s plan retains existing mature pine trees to help give the garden instant effect. 57 Figure 4.19 Residents ' G a r d e n Planting Plan Part 1 58 Figure 4.20 Residents ' G a r d e n Planting Plan Part 2 59 RESIDENTS' GARDEN PLANT LIST TYPE QTY CODE BOTANIC NAME Tree COMMON NAME 1 AC Acer circmatum vine maple 5 AJ Albizia julibrissin silk tree i CA Cedrus atlantica 'Glauca' blue Atlas cedar 3 LS Liquidambar styraciflua liquidambar 2 MS Magnolia stellata star magnolia 3 PN Pinus nigra Austrian pine 3 PO Picea omorika Serbian spruce 3 PS Pinus sylvestris Scots pine 2 s v Sorbus vilmorinii mountain ash 1 RP Robinia pseudoacacia 'Frisia ' black locust 1 TC Tilia cordata littleleaf linden COMMENTS multi-stem existing to be located east and south of garden site to be located east of garden site e xisting existing tree form specimen existing Shrub 3 Ac Ameianchier canadensis serviceberry 15 Au Arbutus unedo 'Elfin King' strawberry tree 36 Auu Arctostaphylos uva-ursi kinnikinnick 90 Bs Buxus sempervirens boxwood hedge 12 Cc Cistus X corbariensis rock rose 3 Cs Corylopsis spicata winter hazel 6 Ct Choiysa ternata Mexican orange blossom 2 Ge Garrya elliptica 'Evie' garrya male 128 Gs Gaultheria shallon salal 75cm oc 4 Hi Hamamelis X intermedia witch hazel 21 Ma Mahonia aquifolium Oregon grape 12 Md Microbiota decussata microbiota 19 Oh Osmanthus heterophyllus 'Kembu' osmanthus 3 Pm Philadelphus 'Lemonei' mock orange 19 Rf Rhododendron 'Fragrantissimum' rhododendron 8 Rg Rosa 'Golden Showers' climbing rose on arbor 9 Rgl Rhododendron 'Glory of Littleworth'rhododendron 15 Rh Rhododendron 'Hino-crimson' rhododendron 15 Rs Rosa 'Snow Carpet' groundcover rose 23 Vp Vaccinium parvifolium red huckleberry Figure 4.22 Residents ' G a r d e n Plant List TYPE QTY CODE BOTANIC NAME COMMON NAME COMMENTS Perennial 70 aa Alstromeria aurea Peruvian lily 30cm oc 65 ae Asarum europaeum European wild ginger 32 af Aquilegia formosa columbine 3 av Adiantum venustum Himalyan maidenhair fern 56 bs Blechnum spicant deer fern 41 cl Crocosmia 'Lucifer' crocosmia 25 cs Carex siderosticha 'Variegata' sedge 32 fg Fuchsia 'Gartenmeister Bonstedt' fuchsia 37 ha Helianthemum apenninum 'Fire Dragon' rock rose 14 hb Heuchera X brizoides 'Firefly' evergreen coral bells 22 hn Helleborus niger lenten rose 28 lp Lilium pumilum lily 14 It Lilium testaceum lily 22 ms Matteuccia struthiopteris ostrich fern 40 oo Oxalis oregana alba wood sorrel 86 pm Polystichum munitum Western sword fern 2 ps Phormium 'Sundowner' phormuim 70 sg Saxifraga X geum evergreen saxifrage 36 tg Trillium grandiflorum great white trillium 8 za Zantedeschia aethiopica calla lily turf 56.25 sq meters Vine 1 ca Clematis armandii evergreen clematis on fence 13 cc Clematis chiisanensis 'Lemon Bells' clematis on fence 2 ch Clematis henryi clematis on trellis 2 ct Campsis X tagliabuana 'Mme. Galen'hummingbird vine on trellis 2 lj Lonicera japonica evergreen honeysuckle on fence 3 lm Lonicera 'Mandarin' honeysuckle on fence 3 Pt Parthenocissus tricuspidata Boston ivy 1 existing 10 sm Symphoricarpos mollis trailing snowberry Bulb 100 c Crocus vermis crocus white 5cm oc O existing, to remain + new 61 4.3 A Design for the Therapeutic Garden T h e therapeutic garden s p a c e must meet the criteria, for the precinct, the resident 's garden a n d in addition it must support therapy programs. D i s c u s s i o n with occupat iona l therapy staff at the Purdy Pavi l ion revealed a n e e d for the therapy garden to be a flexible s p a c e , allowing for a variety of activities. A s residents c o m e and g o a n d staff are posted in and out of the facility interests c h a n g e a n d p r o g r a m s are modif ied to reflect new interests. T h e plan presented here a i m s to create a f ramework where many different activities a n d p r o g r a m s c a n take place. T h i s is a c h i e v e d by maximiz ing a c c e s s i b l e planting s p a c e and providing a c c e s s i b l e infrastructure to support gardening activities. T h e des ign separa tes the garden into 3 z o n e s a s noted in figure 4.23. Functional Space T h i s part of the garden h o u s e s a c o m p o s t centre and the re4ocated existing g r e e n h o u s e . N e w patio s p a c e has been m a d e avai lable by relocating planters. C h a i r s , tables a n d new planted pots are r e c o m m e n d e d for this e n d of the garden . Therapy Space T h e majority of the new a c c e s s i b l e gardening s p a c e is provided by a new retaining wall to replace the current wall which is in n e e d of repair. T h e new wall features an a c c e s s i b l e planting shelf on its front e d g e , a n d a focal watering station at its centre. T h e planting shel f is set at a height that al lows whee lcha i r users to pull up underneath its front lip, and to a depth easily reached from a sea ted posit ion. Its curved s h a p e def ines the therapy a rea of the garden while avoiding unusab le r ight-angled corners . C u r v e d e n d s a lso m e a n that the wall has no sharp corners to b u m p in to. Water ing is currently difficult for residents a s the h o s e bib is poorly located a n d difficult for many to manipulate. T h e new watering station h a s a large spigot making it e a s y for those with reduced range of motion to use . Is has been d e s i g n e d to have a homel ike quality take a form reminiscent of a water pump, yet be decorat ive e n o u g h to capture o n e ' s attention. Details of the retaining wall and watering station are provided in figure 4.24 - 4.25. Addit ional a c c e s s i b l e planting s p a c e is provided by modifying existing planters. B a s e s are fitted with new top ledges set at heights that allow wheelchai rs to fit underneath . 62 existing retaining wall ith clematis recreational s p a c e therapy s p a c e functional new street tree Figure 4.23 P r o p o s e d Therapeut ic G a r d e n P lan N S c a l e 1:200 63 0.3m/12" Figure 4.24 Retating Wall Details water foucet, focal element wntBr fniifpt hondle Cfllctuiftd pol ished concrete , sage huIlflfiSSi in, concrete, , lip t f t .stoD woter SBSsSsa g loss t i les in ^mult i-colouredi patte bullnose in concrete liin__porceiain tiie Figure 4.25 Watering Station Details Figure 4.26 Modified Planters existing planter modif ied planter S o u r c e : Author 's Photos Finally, planting s p a c e could be ga ined through the addition of hanging baskets . It is s u g g e s t e d that these be on pul leys s u c h a s those u s e d in nurser ies , and be c o n n e c t e d to a drip irrigation s y s t e m to minimize main tenance requirements. Recreational Space T h e therapy garden is currently u s e d for socia l events , a use that increased markedly when two s h a d e tents were introduced it the s u m m e r of 2005. Unfortunately, the tents are not of high quality, a n d one has already fallen into disrepair. It is s u g g e s t e d that heftier s h a d e structures be introduced, both a permanent pergola with c a n o p y a n d an arbour. S e e figure 4.23 for locat ions of these structures. T h e permanent pergola is sited at the doors that join the garden and the building helping to blur the boundary between indoor and outdoor s p a c e . Its s h a d e will offer residents a transition z o n e between indoor light levels and the bright sunsh ine outdoors. It is s u g g e s t e d that the pergola be fitted with a c a n v a s c a n o p y to match the existing window c a n o p i e s on site. Figure 4.27 Pergola with Canopy S o u r c e : by Col in O ' B y r n e - Author 's Photo 65 The easternmost edge of the therapeutic garden is commonly used for intimate gatherings, a use that would be complemented by the addition of an overhead structure that provides shade in the summer. An arbour is planned here, to be planted with summer blooming clematis vines increasing near nature. An illustrative section (labelled section A on the therapeutic garden plan) is found in figure 4.27. Figure 4.28 Therapeutic Garden Section Planting Plan In addition to being non-toxic and low maintenance, plants used in the therapeutic garden have been selected to provide year-round interest. A palette of red and white has been used to match the building's exterior. Off-site street trees are proposed along to the northern face of the Life Sciences Centre to screen its mass. A planting plan and plant list for this garden can be found in figures 4.29-4.30. 66 Figure 4.29 Therapeut ic G a r d e n Planting Plan Part 1 67 Figure 4.30 Therapeut ic G a r d e n Planting P lan Part 2 68 THERAPEUTIC GARDEN PLANT LIST TYPE QTY CODE BOTANIC NAME COMMON NAME COMMENTS Tree 2 AC Acer circinatum vine maple in planters 1 AK Abies koreana Korean fir 1 AJ Acer japonicum var. full-moon maple existing 1 AU Arbutus unedo strawberry tree multi-stem form 6 CE Cornus 'Eddie's White Wonder' dogwood 1 tree form, to 5 match existing 5 LS Liquidambar styraciflua liquidambar to line south side of street south of garden 2 MS Magnolia stellata star magnolia relocated existing 1 MV Malus variety apple existing 2 TP Thuja plicata Western red cedar existing Shrub 7 Az Azalea 'Persil' deciduous azalea 13 Bs Buxus sempervirens boxwood not clipped 2 Ct Choisya ternata Mexican mock orange 5 Cta Choisya ternate 'Aztec Pearl' Mexican mock orange i Ei Escallonia 'Red Elf red elf escallonia 3 Fj Fatsiajaponica Japanese aralia 3 Gp Gaultheria procumbens wintergreen 8 Hp Hebe pinguifolia hebe 8 Hi Hamamelis X intermedia witch hazel 8 Oh Osmanthus heterophyllus 'Kembu' osmanthus 5 Rt Rhododendron 'Titian Beauty' rhododendron 5 Rv Rosa 'Veteran's Honor' rose Perennial 12 cf Cyrtomium falcatum Japanese holly fern 13 pb Polystichum polyblepharum Japanese tassel fern 20 gm Geranium macrorrhizum 'Album' bigroot geranium spaced 50cm o.c. 25 vm Vinca minor 'Miss Jekyll' periwinkle spaced 60cm o.c. between shrubs Vine 3 cr Clematis 'Rouge Cardinal' clematis blooms on current season's growth i WS Wisteria sinensis 'Alba'proper white wisteria existing annual vines on trellis as requested by residents O existing, to remain j~J existing, to be moved to this location + new Figure 4.31 Therapeut ic G a r d e n Plant List 4.4 Design Matrix Des ign principles and guidel ines were given in sect ion 3.2 of this paper . T h e matrix below s h o w s how the des ign presented meets guidel ines by listing des ign strategies and e lements e m p l o y e d that a d d r e s s e a c h guideline. Table 4.1 Design Matrix GUIDELINES F O R T H E PRECINCT 1. Follow Kaplans' guidelines by providing fascination, extent, a sense of being away, near nature and compatibility (Kaplan and Kaplan, 1998). Strategies and Elements Employed to Meet this Guideline a. Increase g r e e n s p a c e within the precinct to increase near nature a n d opportunit ies for fascinat ion. T h i s is ach ieved by adding to existing g r e e n s p a c e by add ing a s u n k e n staff garden a n d residents' garden at the Purdy Pavi l ion, and a rooftop garden at the Detwiller Pavi l ion. b. Introduce natural e lements a n d support wildlife on site to allow for fascinat ion. Fasc inat ion is activated by e lements that attract our attention a n d hold it without requiring our f o c u s e d attention (Kaplan and K a p l a n , 1998). D e c i d u o u s trees with colourful b l o o m s and leaves that rustle in the wind have been included for their ability to e n g a g e the s e n s e s . Colourful and aromat ic perennial plantings have been included for the s a m e reason . W a t e r is a powerful tool in engag ing fascinat ion; for this reason the residents' garden inc ludes two water features p laced where they c a n be easi ly v iewed by garden visitors. W a t e r a lso attracts wildlife, another powerful tool in inducing fascinat ion. T h e wildlife g a r d e n in the residents' garden max imizes on plant s p e c i e s that provide year round food and shelter for birds. B i r d h o u s e s for s p e c i e s o b s e r v e d on site have been included to e n c o u r a g e birds to nest here. A water feature with s h e l v e s set at depths best for bird bathing has been included to provide site users with opportunit ies to s e e birds sp lash ing in the water. T h e patio garden inc ludes trellis panel planted with hummingbird vine to attract this gregar ious bird s p e c i e s . c. Include plantings at seat ing a reas to increase near nature and fascinat ion. At the precinct sca le this is a c h i e v e d by placing pedestr ian rest s tops a long the p r o p o s e d walking circuit that p a s s e s through the precinct. R e s t s tops are to feature plantings a s part of their des ign . At the garden sca le , every chair a n d b e n c h is set amid plants with colourful, fragrant b looms. T h e residents' garden takes a d d s to this idea by providing seat ing underneath an o v e r h e a d trellis to be planted with cl imbing roses . In this c a s e the seat ing a r e a is complete ly sur rounded by b looms, providing an excel lent opportunity for fascinat ion. d. Maintain v iews off-site and provide new views to increase extent. W h e n consider ing the precinct sca le , site lines cutting through the precinct were maintained through careful location of new p r o p o s e d building footprints. V i e w s to the ne ighbourhood b e y o n d help site u s e r s m a k e mental connect ions between the precinct and its surroundings, increasing the area 's extent. Street trees p laced northern e d g e of the Life S c i e n c e Building s u g g e s t a connect ion to Health S c i e n c e s Mall to the west, suggest ing a larger context for the site. 70 e. M a k e physical connec t ions to dest inat ions off-site. T h e p r o p o s e d walking route (model led after M o o n e y and L u y m e s , 2000) physical ly c o n n e c t s the precinct with popular dest inat ions nearby. A s peop le u s e the route they will exper ience a real connect ion between these p laces , and form an a s s o c i a t e d mental m a p of the way in which these locations are c o n n e c t e d . f. Des ign s p a c e s with e n c l o s u r e to create a s e n s e of being away. T h e new building footprints p r o p o s e d for the precinct create positive s p a c e by bounding the s p a c e between them. T h e enc losure o n e exper iences between the bui ldings offers the exper ience of being in a distinct s p a c e creating a s e n s e of being away. A similar strategy is e m p l o y e d in the residents' and therapeutic ga rdens . Both s p a c e s h ave strong e d g e s that create both physica l and visual boundar ies . T h e s e e d g e s have been d e s i g n e d to provide enc losure without being jail-like. T h e environment within these boundar ies is different e n o u g h from what lies outside them to offer site users a s e n s e of having b e e n away from their usual surroundings (Kaplan and Kap lan , 1998). g. U s e regional materials to allow mental connec t ions with the region, increasing extent. Native plant material links us with the p lace we live allowing a mental connect ion to be m a d e between the plant a n d its natural environment , increasing extent. Native plants are included in planting p lans for both the residents' and therapeutic garden s p a c e . h. Crea te s p a c e s that support des i red u s e s to increase compatibility. A s previously d i s c u s s e d restorative l a n d s c a p e s are appropriate to hospital precincts and there is interest in their inclusion here. A quest ionnaire w a s u s e d to accurate ly a s s e s s des i red u s e s for the new a n d existing garden s p a c e s at the Purdy Pavi l ion. T h e w i s h e s of staff, families and residents have been incorporated in the d e s i g n s presented here. A p p e n d i x B details quest ionnaire results. In addition, the unique n e e d s of residents h ave a lso b e e n cons idered . S e e table 3.2 for a comple te d i s c u s s i o n of these n e e d s . 2. Ensure new buildings create positive outdoor space (Alexander, 1977). Strategies and Elements Employed to Meet this Guideline a. D e s i g n building footprints to f rame outdoor s p a c e s . b. A v o i d awkward s p a c e s left over after buildings have been p laced . T h e thought less p lacement of a building c a n leave uncomfortable s p a c e s behind. F o r example , the new Life S c i e n c e Building w a s al lowed to extend to the east in a way that b locks v iews a n d interrupts circulation flows. A few meters would h ave m a d e the outdoor s p a c e s around the building m u c h more comfortable. T h e p r o p o s e d new building footprints for the precinct preserve v iews and allow for s imple circulation. Building e d g e s serve to f rame outdoor s p a c e s allowing for comfortable outdoor env i ronments (Alexander , 1977). 3. IV eet A D A guidelines (ADA, 1994). Strategies and Elements Employed to Meet this Guideline a. E n s u r e all des ign e lements comply with these regulations. All paths in the precinct have been d e s i g n e d to h ave a m a x i m u m 5 percent s lope in a c c o r d a n c e with A D A guidel ines. With the residents' and therapeutic g a r d e n s path widths meet s tandards for two pass ing wheelchai rs . S l o p e s are kept below 5 % to e n s u r e e a s e of u s e by this population. W h e e l c h a i r p a d s are included a s a seat ing option and these match A D A guidel ines. Plant material intended for residents to touch has b e e n p laced at heights a n d r e a c h e s that m a k e is easi ly a c c e s s i b l e ( A D A , 1994). 71 4. Support way-finding (Lynch, 1960). Strategies and Elements Employed to Meet this Guideline a. P l a c e landmarks at dec is ion points. E y e - c a t c h e r s and s igns are p lanned at dec is ion points in the precinct. A n entry arch is p r o p o s e d for the western entrance to the pedestr ian b reezeway and s igns are p r o p o s e d at building ent rances . T h e s e will help way-f inding by providing m e m o r a b l e points of reference. T h e garden s p a c e s a lso employ landmarks . E a c h s u b s p a c e within the residents' garden h a s a focal element; a water feature in the songbird garden , a c o v e r e d seat ing structure in the winter retreat and a g a z e b o in the patio garden . T h e therapeutic garden s p a c e a lso features focal e lements that aid way-f inding; a g r e e n h o u s e , a watering station and a c o v e r e d seat ing structure. b. E m p l o y s imple circulation s c h e m e s . Way- f inding is m a d e eas ier by s imple circulation s c h e m e s . T h i s des ign p r o p o s e s two direct east -west connect ions through the precinct and s imple a north-south connect ion midway through the site. G a r d e n s p a c e s a lso feature s imple geometr ic circulation routes. T h i s is especia l ly important for dement ia populat ions who c a n have difficulty understanding how to navigate s p a c e (Jones , 1996). c. A v o i d d e a d - e n d s in circulation routes. T h e des ign for the precinct avo ids d e a d - e n d s in circulation. C o n f u s i n g or annoy ing to the genera l populat ion, d e a d - e n d s are especia l ly difficult for those with dement ia w h o m a y get stuck at the end of a path and not turn around to g o back the way they c a m e (Jones , 1996). 5. Design for social interaction (Gehl, 1996). Strategies and Elements Employed to Meet this Guideline a. Include outdoor s p a c e s adjacent to indoor socia l s p a c e s . T h e addition of an outdoor patio to the existing cafeteria at the Koerner Pavil ion would allow diners to spill outdoors, creating a more socia l a t m o s p h e r e than currently exists in this s p a c e . In the s a m e way, a more s e a m l e s s connect ion between the existing therapeutic garden and the garden room adjacent to it would allow more residents to take their activities out of doors . b. E n s u r e outdoor a r e a s are comfortable and high in amenity s o that they will be u s e d . J a n G e h l ' s (1996) work on creating condit ions for socia l interaction in outdoor s p a c e s underl ines the importance of creating comfortable outdoor s p a c e s that are high in amenity to foster use . T h e walking route p lanned for the precinct would feature rest s tops high in pedestr ian amenity. In addition, garden s p a c e s in the precinct would offer comfortable p l a c e s to sit in both s u n and s h a d e and be able to a c c o m m o d a t e g roups of var ious s i zes . GUIDELINES F O R T H E RESIDENTS' G A R D E N 1. Address loss of sensory acuity, reduced physical ability and needs of patients with dementia (Jones, 1996). Strategies and Elements Employed to Meet this Guideline a. Max imize on e lements that e n g a g e the s e n s e s including plant material a n d water. A g e often results in reduced s e n s o r y acuity (Jones , 1996). T h i s implies that des ign e lements n e e d to have bright colours, strong s c e n t s interesting textures to be fully apprec ia ted by this populat ion. F o r this r e a s o n , a plant palette with colourful b l o o m s and heady a r o m a s has b e e n se lec ted for both the residents' and therapeutic g a r d e n s . Plants with interesting textures have been p laced within e a s y reach of those sea ted in wheelchai rs . T w o water features that allow site users to e n g a g e with the water are p lanned , o n e in the residents' g a r d e n , a n d one in the therapeutic garden . 72 b. E n s u r e lighting at appropriate levels, avoid glare. Transi t ions between moderately and brightly lit s p a c e s and c a n be uncomfortable for the genera l population but c a n c a u s e more ser ious difficulty for those with dement ia (Jones , 1996). F o r this reason transition a r e a s between indoor and outdoor s p a c e s have been inc luded, allowing e y e s time to adjust to new light levels w h e n travelling between indoors and outdoors. Pav ing materials without glare have been speci f ied - co loured concre te with a decorat ive band of pavers - to ensure e a s y u s e by residents. c. Des ign s p a c e s to be a c c e s s i b l e ; s l o p e s not to e x c e e d 5%, paths wide e n o u g h for two whee lcha i rs to p a s s . Whee lcha i r users c a n have difficultly travelling on circulation routes with s l o p e s greater than 5 percent. ( A D A , 1994) F o r this r e a s o n g r a d e s are kept to a min imum within the precinct. d. Provide frequent rest s tops. Site users include a g e d and inform populat ions making frequent rest s tops important ( M o o n e y and L u y m e s , 2000). High amenity pedestr ian rest s tops are p lanned a long the walking route p r o p o s e d for the precinct and are a lso featured in both the residents' a n d therapeutic garden s p a c e s . e, Fol low des ign guidel ines for dement ia patients; employ s imple geometr ic s c h e m e s , avoid stark contrasts between light and dark, employ warm, mid- range colours , u s e familiar forms and materials, des ign for a residential sca le , e n s u r e s p a c e s are s e c u r e but not jail-like, and u s e non-toxic materials (Jones , 1996). A s this s p a c e will be u s e d predominantly by residents it is critical that it meet their n e e d s a s d i s c u s s e d previously in this paper. F o r this reason , guidel ines for dement ia patients have been adhered to w h e n consider ing all e lements of the garden including forms (simple and geometr ic) , structures (homelike with residential scale) , plant material (familiar and non-toxic), paving material (level a n d of a warm mid- range colour), seat ing (homelike a n d of appropriate d imensions) , and fencing (secure but not jail-like). 2. Maximize on restorative effect (Kaplan and Kaplan, 1998). a. T a k e every opportunity to employ the Kap lans ' criteria (Kaplan and K a p l a n , 1998). T h e residents using this garden s p a c e would greatly benefit for e x p o s u r e to a restorative environment. T h e des ign for this s p a c e offers fascinat ion, extent, a s e n s e of being away, compatibility and near nature a s d i s c u s s e d in sect ion 1 of this table. 3. Create places for gathering. a. Prov ide a range of seat ing options. T o support a variety of u s e s and to provide comfortable seat ing in many weather condit ions a range of seat ing opt ions have been provided. T h e s e include wheelcha i r rest p a d s , b e n c h e s , planter l edges a n d picnic tables p laced in s u n , s h a d e and under cover . 4. Make a strong indoor-outdoor connect ion. a. M a k e a s e a m l e s s transition between inside and outside. Quest ionnai re results highlight the difficulty that c a n ar ise from something a s s imple a s a door sill. It is important that residents have e a s y a c c e s s to the garden to e n s u r e its use . 73 b. Prov ide o v e r h e a d protection from rain to e n c o u r a g e u s e of outdoor s p a c e s in inclement weather. Living in V a n c o u v e r m e a n s wet weather during winter months. T o e n s u r e outdoor s p a c e s c a n be u s e d year round, o v e r h e a d protection from rain must be provided. 5. Consider maintenance requirements. a. U s e predominately low-maintenance plants, u s e perennials judiciously. Ma in tenance must be c o n s i d e r e d from the outset to e n s u r e that any new g a r d e n s p a c e will be s u c c e s s f u l . Low main tenance plantings and irrigation will help reduce ma in tenance loads from the outset. 6. Include elements requested by residents, families and staff. a. E m p l o y d e s i g n e lements and plant materials requested . Quest ionnai re results s h o w e d an interest in p laces to sit and visit with family m e m b e r s and room for smal l group gather ings. Activities popular with residents were light gardening a n d wildlife viewing. GUIDELINES F O R T H E T H E R A P E U T I C G A R D E N 1. Allow for a flexible use of space. a. Prov ide a green framework and infrastructure that c a n support many activities. A s interests c h a n g e over time, p rograms c h a n g e to reflect new interests. W h a t is n e e d e d here is a s p a c e with a strong framework that al lows for a variety of u s e s . T h i s des ign p l a c e s n e c e s s a r y infrastructure - c o m p o s t , g r e e n h o u s e a n d watering station - in a setting that provides a low ma in tenance backdrop for a variety of horticultural therapy activities. 2. Support horticultural activity a. Increase planting a reas . T h e p roposed new retaining wall with planting trough would greatly increase the amount of a c c e s s i b l e planting s p a c e on site. Existing planters could be modif ied to be a c c e s s i b l e to wheelchai r users , providing additional planting s p a c e . b. Prov ide a c c e s s i b l e garden infrastructure. In order for residents to participate in compost ing and watering, infrastructure for these u s e s must be d e s i g n e d to be a c c e s s i b l e . T h e watering wall featured in this des ign for the therapeutic garden s p a c e is not only a c c e s s i b l e , but a lso attractive a n d s e r v e s a s a focal e lement a s well a s a practical one . 3. Plan for extensive use of space. a. S u g g e s t horticultural therapy projects for inclusion in existing horticultural therapy program. Addit ional planting s p a c e creates the opportunity for e x p a n d e d programming in the therapeutic garden . S u g g e s t e d activities are listed in table 3.3 ( S i m o n s and S t rauss , 1994). b. Des ign garden s p a c e to be a great p lace to be. In addition to being functional, the therapeutic garden h a s been d e s i g n e d to be an aesthetical ly delightful p lace to be. R ich plantings and comfortable seat ing are included to draw residents out of doors e v e n if they are not participating in a horticultural therapy program. 74 4.5 D iscussion T h e design presented in this project s h o w s how a g iven site c a n be adapted to provide a restorative exper ience to site users . T h e l e s s o n s learned in the c o u r s e of this study d o not only apply to this project, but c a n be appl ied to many other situations. Indeed, l a n d s c a p e architects are increasingly cal led upon to participate in s u c h projects. L a n d s c a p e Architecture m a g a z i n e , a professional journal, c o m m o n l y features projects at h o s p i c e s , hospitals and care h o m e s , and the A m e r i c a n Socie ty of L a n d s c a p e Architects h a s a professional practice network for professionals working in therapeutic garden d e s i g n . A s the C a n a d i a n population a g e s , the number of people that could benefit from a c c e s s to an outdoor s p a c e s u c h a s the o n e p r o p o s e d a lso increases . L a n d s c a p e architects have an important role to play in providing appropriate d e s i g n s for specia l populat ions a m o n g the elderly s u c h a s therapeutic g a r d e n s for hospital patients and outdoor s p a c e s for A lzhe imer 's patients. In addition to s p a c e s intended for specia l user groups, it is appropriate given the rising proportion of elderly in the populat ion that all d e s i g n s for the public realm cons ider their n e e d s . R e s e a r c h s h o w s that health benefits a c c r u e to users of restorative environments; o n e h o p e s that in the future this kind of s p a c e is m a d e more widely avai lable to all cit izens a s a way of improving genera l health. W h a t is n e e d e d to push this a g e n d a forward is more research showing the m e a s u r a b l e effect that immersion in a restorative environment has on site users . Kap lan and Kap lan have started this work by expand ing on R o g e r Ulrich's research with hospital patients. T h e y have s h o w n that outdoor envi ronments c a n offer restorative exper iences a n d have isolated the character ist ics of restorative l a n d s c a p e s . Exper iments measur ing exact physio logical c h a n g e s e x p e r i e n c e d in outdoor restorative env i ronments are persuas ive to hospital administrators and government officials, and more n e e d to be done . If a cost benefit could be establ ished, one imagines a day w h e n restorative s p a c e s are c o m m o n l y part of hospital and city plans. 75 Bibliography A D A S t a n d a r d s for A c c e s s i b l e D e s i g n , Depar tment of Just ice . 1994. Apple ton , Jay . (1975). The Experience of Landscape. 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(Eds. ) . The Biophilia Hypothesis (pp.31-41). W a s h i n g t o n D . C , Island P r e s s . W o y , J o a n n . (1997). Accessible Gardening: Tips and Techniques for Seniors and the Disabled. , M e c h a n i c s b u r g , P A . : S tackpo le B o o k s . W y n n , G r a e m e & O k e , Timothy, (1992). Vancouver and its Region. V a n c o u v e r : U B C P r e s s . 79 Appendices Appendix A : Wel lness Walkways Recommendat ions A . Circuits A1 Crea te Circuits Crea te a ser ies of circuits of varying lengths, and with differing e m p h a s e s , i.e. provision for heritage interpretation, provision for visually impaired people , and provision for people who have impaired mobility. O v e r l a p the t h e m e s of circuits to create a hierarchy or circuits. A 2 Differentiate Between Circuits U s e difference in paving widths, textures and colour, a n d in plantings to def ine the W e l l n e s s W a l k w a y s circuits, dist inguish between primary and s e c o n d a r y routes and dist inguish them from e a c h other and the surrounding ne ighbourhoods . A 3 E n c o u r a g e Mobility O n circuits that are prioritized for people with mobility constraints, follow the gentlest g rades and p a s s through those intersections that provide the eas ies t c r o s s i n g s for whee lcha i rs and m a k e all new s idewalks a c c e s s i b l e . B. S idewa lks B1 W i d e r (1.8m) S idewalks N e w s idewalks should be at least 1.8 metres wide to provide a m p l e room for movement , recogniz ing that users include those in whee lcha i rs and walkers. B2 S a w c u t Control Joints Control joints in new s idewalks should be sawcut rather than trowelled in order to improve e v e n n e s s and s m o o t h n e s s for u s e by whee lcha i rs and walkers. B 3 C r a c k e d / H e a v e d / S e t t l e d S e c t i o n s T o provide a smooth sidewalk sur face , any c r a c k e d , h e a v e d , or settled s idewalk paving should be rep laces where poss ib le with new sidewalks. B4 Street T r e e Planting E n s u r e adequa te root z o n e preparation and carefully se lect tree s p e c i e s to reduce sidewalk heaving by tree roots. B5 Spec ia l S idewalk Trea tments Un ique sidewalk d e s i g n s should be c o n s i d e r e d for beautification a reas . Cons idera t ion shou ld be given to creating a smooth sur face on the s idewalk a long Main Street with a thin coat ing (10mm) of co loured asphal t paving over the existing concrete . A smooth travel path in the centre of the sidewalk should be dist inguished from textured paving around street trees (to allow water penetration into the soil a round the trees) and a long the building face (to create a z o n e for sidewalk stalls, outdoor seat ing, etc.). B6 Tacti le Strips A l o n g S idewa lks W h e r e appropriate, install tactile strips wither on both e d g e of the s idewalk or on the inner e d g e to aid people using c a n e s to stay on the path. B7 R e c e s s e d Tacti le S u r f a c e s M a k e sure that the texture of the tactile strips or other pavement markings result f rom r e c e s s e s rather than a raised sur face s o they are not disruptive to those in wheelcha i rs . C . ' Streets and Intersections 80 C1 U s e C u r v e d Street A l ignments U s e curved street a l ignments and narrowed traffic lanes on busy local streets. C 2 Traffic C i rc les Install traffic circles where appropriate to d iscourage non- local traffic cutting through the ne ighbourhood. C 3 6 Meter C o r n e r B u l g e s Prov ide corner bu lges to create a narrower roadway at intersections. C 4 Seat ing A r e a s P l a c e rest a reas a long the busiest pedestr ians routes, wherever people tend to congregate and at intersections. U s e the wider boulevard strip between the sidewalk and the curb face , created by the corner bulges, for the creation of seat ing p laces , thus e n h a n c i n g the comfort of the public s t reetscape. C 5 A l igned S i d e w a l k s / C r o s s w a l k s R e p l a c e all d iagonal curb r a m p s with perpendicular curb r a m p s and align them directly with the s idewalks and c rosswalks . C 6 S m o o t h R a m p s M a k e curb r a m p s flush with the street at the base . M a k e the b a s e of these r a m p s well -drained to avoid puddl ing. In any future improvements in the study area , strive to m a k e c r o s s s l o p e s 1.5% on s idewalks and 0% on curb ramps. C 7 Tact i le Strips at C u r b R a m p s T o signal the user 's arrival at intersections, cons ider providing markings, contrasting paving or tactile strips a c r o s s the top and /o r bottom of curb ramps. C 8 Textured Intersection Pav ing Cont inue the tactile strip a long sidewalk e d g e s or other mark ings or contrasting paving a c r o s s intersections to help the visually impaired navigate. At very least, m a k e sure that painted crosswalk line mark ings are repainted frequently and not a l lowed to b e c o m e dim through wear. C 9 Pedest r ian /Cyc l is t -Actuated Traffic S igna ls M a k e sure that there are pedestr ian/cycl ist -actuated traffic s ignals to c o n n e c t the W e l l n e s s W a l k w a y s a c r o s s busy streets. C o n s i d e r the u s e of new technolog ies to e n s u r e that the elderly and those in whee lcha i rs have sufficient time to c r o s s the road. D. Street Furn ish ings D1 C o n s i s t e n c y in Street Furniture T o assist all, but especia l ly the visually impaired, the des ign of all street furniture and its p lacement must be consistent throughout the W e l l n e s s W a l k w a y s . D2 Short W a l k s R e d u c e walking d is tances by providing mid-b lock rest a rea . Ideally, provide either a p l a c e of interest or a p lace of rest every 40 - 50 metres. D 3 Universal ly A c c e s s i b l e Street Furniture Des ign or adapt all street furniture to be universally a c c e s s i b l e . Increase a c c e s s to existing street furniture, s u c h a s by adding concre te p a d s b e s i d e b e n c h e s to allow wheelcha i r users to sit next to people on the b e n c h e s . D 4 W h ee l ch a i r P a d s B e s i d e B e n c h e s 81 At e a c h b e n c h , include a 1-metre square paving pad on at least o n e e n d , s o that people in whee lcha i rs c a n sit a longs ide the b e n c h e s a n d join more easi ly in conversat ion , or transfer onto the b e n c h . D 5 R e s t A r e a s C r e a t e rest a reas which c o m b i n e s imple b e n c h e s with other amenit ies to create comfortable, universally a c c e s s i b l e a n d attractive p laces . Va ry seat ing a r rangements to provide c h o i c e s and socia l opportunity. D6 Street Furniture P l a c e m e n t P l a c e all street furniture a n d rest a r e a s s u c h a s b e n c h e s , drinking fountains a n d tables off the major circulation and signal its position by a tactile strip or contrasting or textured paving. D7 Heritage Style Furniture In her i tage- themed rest a reas , u s e heritage lighting a n d street furniture. D 8 S h a d e Structures a n d Shel ters R e s t a r e a s shou ld be d e s i g n e d to provide microcl imatic protection in the form of s h a d e structures, which may support v ines and cl imbing plants a s well, or shel ters from the ain. D9 Universal Drinking Founta ins D10 A c c e s s i b l e T a b l e s D11 Universal ly A c c e s s i b l e B u s Shel ters Provide universally a c c e s s i b l e bus shelters with c lear s i g n a g e at bus s tops serv ing the W e l l n e s s Wa l kw ays . P o s t s shou ld have a distinct c ross-sect iona l s h a p e and reflective co loured b a n d s . S i g n a g e should be safely at e y e level and Braille pane ls should be u s e d to extend s i g n a g e m e s s a g e s to visually impaired people . D12 Founta ins and P o o l s At spec ia l location near to hospital. E T r e e s , Plants a n d Wildlife E1 Increase Plant ings Retrofit the ne ighbourhood streets with additional plantings, including voluntary plantings on private lands, new street trees where lacking and additional plantings oat spec ia l l a n d s c a p e a reas , intersections, mid-block and corner rest a reas . D e c i d e on location, nature and type of plantings on public and private lands through public consultat ions a n d u s e volunteers in planting them. E 2 R e d u c e G l a r e Plant street trees, particularly on circuits prioritized for the elderly a n d visually impaired, to reduce glare from the sidewalk sur face and to provide s h a d e . E 3 Planted Bou levards U s e the wider boulevard strip between the s idewalk a n d the curb f a c e created by the corner bulges for additional plantings to e n h a n c e the attract iveness of the public s t reetscape. E 4 Maintain O p e n Sight L ines W h e n retrofitting the ne ighbourhood streets with additional plantings, ensure that o p e n sight l ines are maintained to provide v iews of traffic for public safety. K e e p plantings in traffic circles low for m a x i m u m visibility. E 5 Distinctive L a n d s c a p e Charac te r Des ign additional plantings s o that distinctive l a n d s c a p e character z o n e s are created within the W e l l n e s s W a l k w a y s circuits. 82 E 6 S p e c i a l L a n d s c a p e A r e a s M a k e the origins and dest inat ions of e a c h circuit's spec ia l l a n d s c a p e a reas . T h e s e include the ent rances to ca re facilities and local parks, a s well a s destination b u s i n e s s or travel corr idors. Des ign should increase a c c e s s and provide a variety of seat ing that promotes social izat ion and viewing opportunities. E 7 Aromat ic Plant ings Res t a reas walkways should be d e s i g n e d to provide perennia ls , flowering s h r u b s a n d trees planted for a r o m a . E 8 Colour/Wildl i fe Plant ings Res t a reas shou ld be d e s i g n e d to provide perennials , f lowering shrubs and trees planted for colour or to e n h a n c e the viewing of birds and butterflies. Prov ide new vines, s h r u b s and perennial plantings which attract hummingbi rds and butterflies c lose to where people sit. E 9 Bird F e e d e r s , Nest ing B o x e s and Bat B o x e s Res t a reas should be d e s i g n e d to provide bat b o x e s and feeders and nesting boxes . E 1 0 A c c e s s i b l e Planting A r e a s and G a r d e n Plots Seat ing a r e a s should have wheelcha i r a c c e s s i b l e , ra ised planting beds . F Lighting F1 Increased P e d e s t r i a n - S c a l e d Lighting Increase s e n s e of safety by upgrading all street lighting where required. F2 U p g r a d e Lighting U s e the most natural light spec t rum, i.e. the 'whitest light", in all new lighting. F 3 Heri tage Light S t a n d a r d s Reinforce the heritage a s p e c t of the W e l l n e s s W a l k w a y s circuits by providing any addit ional lighting with heritage light s tandards or heritage h e a d s on existing light s tandards . F4 Res t A r e a Pedestr ian Lighting E n s u r e that rest a reas are well lit with heritage style pedestr ian s c a l e d light s tandards . F 5 Intersection Lighting Provide a m p l e well-directed lighting at intersections. F6 Street T r e e s Prune street trees, a s n e c e s s a r y , s o that street lighting is able to reach the ground. G Way-f inding G1 Pedestr ian Directional S i g n s Support way-f inding by installing s ignposts at key points in the l a n d s c a p e , s u c h a s at intersections and rest a reas . G i v e s igns bold, c lear lettering a n d arrows that point the direction to key dest inat ions and landmarks. M a k e the lettering black on a white background and p lace it safely at e y e level. G 2 C o l o u r C o d i n g M a k e different routes a n d dest inat ions visually distinct by m e a n s of colour cod ing . G 3 C o l o u r C o d e d Tact i le Strips C o n s i d e r reinforcing colour t h e m e s with co loured tactile strips a long s idewalks . G 4 Co lour C o d e d Plant ings 83 M a k e different routes a n d dest inat ions visually distinct by m e a n s of colour c o d e d plantings. Further differentiate the circuits by using cool co lours on north-south streets a n d warm colours on east -west streets. G 5 Reflective Banding on P o l e s Dist inguish different routes and reinforce colour themes , particularly at intersections with reflective b a n d s on light s tandards a n d other poles. G 6 Distinctive L a n d m a r k s U s e distinctively d e s i g n e d specia l l a n d s c a p e a reas , intersections, rest a reas a n d heritage interpretation markers to serve a s landmarks . H Safety and Securi ty H1 Low C r i m e Circuits Locate the W e l l n e s s W a l k w a y s circuits in a r e a s of lowest cr ime. H2 Defensib le S p a c e E n c o u r a g e natural survei l lance on the street by des ign ing the s p a c e s a long the street a n d in from of apartment buildings that give s h a d e , shelter, amenity a n d c o n v e n i e n c e . Physical ly separa te these s p a c e s from the street by us ing low walls, h e d g e s or plantings. S u b d i v i d e these apar tment "front yards" into two areas; a semi -publ ic a rea nearer the street and a semi-pr ivate a rea of amenity and u s e nearer the building. H3 Publ ic-Pr ivate "Blurring" M a k e the entries of care facilities a m e r g e d public/private z o n e . H4 Maintain O p e n V i e w s Implement C r i m e Prevent ion T h r o u g h Envi ronmenta l Des ign principles throughout the study a rea a n d maintain o p e n v iews to e n s u r e the safety of the user. I Heritage and Interpretation II Heri tage T h e m e s G i v e rest a rea different and appropriate t h e m e s s u c h a s heritage. Link significant heritage locations together to create circuits with heritage themes . 12 Heritage Style Street Furniture and Heri tage Interpretation U s e heri tage style street furniture a n d unified heri tage interpretive markers to reinforce heritage rest a reas , strengthen way-f inding and establ ish distinctly different circuits and districts in the ne ighbourhood. 84 Appendix B: Purdy Questionnaire Purdy Pavilion Garden Questionnaire T h a n k you for your time and effort in complet ing this quest ionnaire. T h e information will be u s e d by C a m p u s and C o m m u n i t y P lanning to deve lop a des ign for a future outdoor s p a c e between the Detwiller and Purdy Pavi l ions, and to plan renovat ions to existing g a r d e n s at the Purdy Pavi l ion. Please complete and return to Ellen Courtney's office on Purdy 1 before July 25, 2005. 1. W o u l d you like to participate in the following activit ies? Y E S N O Blank Visit ing with family a n d fr iends outside 17 0 0 Smal l group gathering outside 17 0 0 Bird/animal watching 13 3 1 Light gardening tasks 14 5 0 Other activities: 2. W h i c h features would you like to s e e in a future outdoor s p a c e ? Y E S N O Blank Patio for group gathering 16 1 0 O p e n lawn a rea for g a m e s 9 6 2 L o o p e d Pathway 12 3 2 S c r e e n e d porch 11 5 1 Seat ing a reas in s u n s h i n e 12 2 3 Seat ing a reas in s h a d e 16 0 1 S h a d e trees 16 0 1 Fruit t rees 13 1 3 F lowers 16 0 1 Conta iner ga rdens 13 2 2 Founta in /pond 16 0 1 Other features: Written c o m m e n t s : 1. (family member ) N o smok ing 2. (resident) T h e y get birds now. H a v e bird feeders now. En joys just being in garden . Res iden ts organize t h e m s e l v e s in smal l g roups to visit garden now. Enjoys walking. S c r e e n e d porch would be useful to keep the b u g s away. Prefers sitting in s u n . Prefers strongly s c e n t e d f lowers . F inds container g a r d e n s very useful . F e e l s they have to have fountain or a p o n d . W o u l d like to s e e chairs included. 85 W o u l d like a M i m o s a tree a n d violets. W o u l d like to s e e trees ment ioned in G e r m a n poetry, plants from Croat ia , Southern F r a n c e . W o u l d like trees with fragrant b looms. W o u l d like a Magnol ia like the o n e at the S h a u g h n e s s y Hospital . 3. (resident) Existing garden room not u s e d m u c h , there is a b u m p at the threshold that you can't get over in a wheelchair . Birds c o m e to existing feeder . W o u l d like to attract hummingbi rds a n d butterflies. W o u l d enjoy filling bird feeders . T h e r e is a resident group (1st and 2nd floors) that d o pots and vegetab les in existing garden . Croque t is impossib le , all of the residents are in wheelcha i rs . N o - o n e u s e s the existing c h e c k e r board painted on the pavement . T h e r e a re not e n o u g h staff m e m b e r s for p lanned activity p rograms. En joys low-key sports that u s e balls a n d rackets. C o u l d u s e a h o r s e s h o e pit if there were staff /volunteers to help. O p e n lawn g a m e s are not g o o d for wheelcha i rs . Include b e n c h e s . S c r e e n e d porch not n e c e s s a r y , there are no b u g s here. W o u l d like an umbrel la tree. W o u l d like foxgloves, de lphin iums, phlox, roses , peon ies , h y d r a n g e a s , fuchsias . Fountain would be alright if it could be maintained. Include sculpture, p e r h a p s busts of doctors that h a v e worked at the hospital . Include vegetables , fruit. Include a p lace to eat fruit in the garden , or have an ice c r e a m socia l . Include s p a c e s for families to visit. Include white-barked trees in c lumps . L ikes weep ing willows. F o y e r on the main floor is not inviting, it's too dark. Re-uphols ter chairs to be brighter, rep lace rugs with hardwood flooring or lino. T h e r e are lots of birds a round , would be nice to have a feeder. Res iden ts would enjoy filling the feeder if they c o u l d reach it. Existing walkway has w e e d s everywhere: En joys sitting outside in s p a c e between Purdy a n d A c u t e C a r e Hospital . Big pots in front of A c u t e C a r e Hospital are empty. B a c k door to the hospital could be very nice if s o m e o n e took an interest. G a r d e n sculptures, s tone b e n c h e s , statue of Saint that w a s a ga rdener (St. F iacre) that n e e d not be large, pe rhaps a smal l statue sitting on a pedesta l . Trell is with grapes . N e w awnings for lower garden . O l d fash ioned g a r d e n . More plastic chairs. T a b l e s should be lower or have a variety of heights to suit different s i zes of wheelchai rs , furniture could be more permanent . Automat ic watering s y s t e m , water spouts that residents could use . Existing retaining wall is deteriorating, rep lace with concre te or stone. ( 4. (left with staff) Water feature to include fish. 5. (family member ) "Looking at f lowers, fresh air, strolling, flower f ragrances and co lours s e e m to a lmost rejuvenate my M o m " . Fountain or pond at the ent rance to the Purdy, reflective pool and smal l fountain. Water features promote a feeling of tranquility and harmony with nature and self. 86 Providing s o m e raised b e d s or containers e n a b l e s peop le in chairs to get c loser to plantings. 6. (resident) W e have a patio for group gathering. O p e n a r e a for g a m e s not n e e d e d - we are all in wheelcha i rs . A looped pathway would be fine if you are able to walk. S c r e e n e d porch not n e c e s s a r y a s they have two c a n o p i e s . W o u l d like another green s p a c e . W o u l d like a garden that g o e s over your head - up walls and a c r o s s cei l ing. 7. (left with staff) W o u l d like to s e e p lace for g a m e s included. 8. (resident) A l ready u s e s existing s p a c e for visiting with family a n d friends. W o u l d like to grow roses . W o u l d like a wheelchai r a c c e s s i b l e lawn. W o u l d strongly support more fruit trees. C o n c e r n e d that addition of pond or fountain would c a u s e eros ion on site. L ikes palm trees, roses (especial ly yellow o n e s a s his father grew yellow roses) His wife c o m e s to visit every night a n d likes to g o outside for f resh air, they go to the village together and find getting there difficult b e c a u s e of s lope , m a k e s it hard to navigate the street c ross ing . C r o s s i n g light is too short, and c a r s don't stop at the crosswalk . Doesn ' t like the idea of an o v e r h e a d garden 'not ready to g o underground yet!" T e r r a c e s are a g o o d idea. L ikes to s e e f lowers a n d smel l them. H e ' s on the garden commit tee, s a y s they have s o m e funding. It all c o m e s down to m o n e y C h e c k out the entry to the existing garden - the threshold is hard to c r o s s in a wheelchair , you c a n get out, nut not back in. 9. (resident) Fami ly c o m e s for B B Q . Patient Park has been c l o s e d a long time. W o u l d like to have c l a s s e s that teach patients how to plant. N e e d to get rid of smok ing on site, this is an issue that n e e d s resolution. En joys making blankets and knitting, would like to do light work in the garden , rake leaves . L ikes the new c a n o p i e s , would like to have 2 more at least. Patio for group gather ings already exists in lower garden . W o u l d like a little sect ion of lawn. S c r e e n e d porch not n e c e s s a r y a s there are no b u g s here. Currently u s e s s p a c e between Purdy and A c u t e C a r e Hospital for sitting in s h a d e . A l ready have 3 apple trees on site. W o u l d especia l ly enjoy roses . More flower pots. W o u l d like to have a fountain to attract birds. L ikes to sit in the breeze . G a r d e n commit tee will be getting new tables in the fall, the o n e s they have are falling apart. Plastic lasts better than w o o d . W a n t s to help out in the garden , very appreciat ive. W o u l d like to s e e a garden at every nursing h o m e , improves the mind, n e e d to have someth ing to work on . Likes to go to the Vi l lage, but is s c a r e d to c r o s s the street, ca rs don't s low down e v e n though the c ross ing light is on . H e ' s got a power chair, s o the s l o p e isn't an issue. H e a lso likes to travel around c a m p u s , and g o e s to old bus loop. Th inks that wheelchai r u s e s should have spec ia l leeway 'I didn't ask to be in this chair' . H e would travel the entire c a m p u s , but is prevented from doing s o by poor road c r o s s i n g s . 87 T h e bus shelter in front of the hospital is not g o o d for wheelcha i rs , poor hearing, not e n c l o s e d (no o v e r h e a d protection). Patient Park had a pool that residents could w a d e in, loved it. W h a t h a p p e n e d to it? H e is willing to take m e on a wheelchai r tour a round the buildings. 10. (left with staff) S p a c e for B B Q ' s and activities. 11. (left with staff) N o s m o k i n g . 12. (left with staff) P o s s i b l e a c c e s s to water m a k e tea or water to drink. 13. (left with staff) N e w tables to go with new chairs a n d c a n o p i e s 14. (left with staff) H o w c a n whee lcha i rs be rolled over g r a s s ? T h e 2 gazebos / ten ts are a great addition. W a n t all smok ing to c e a s e in the outdoor a rea . 15. (left with staff) Not able to participate in light gardening tasks, but would like to watch others. W o u l d like to watch others play lawn g a m e s . W o u l d like a c h o i c e between sitting in s u n or s h a d e . Lots of f lowers, p lease . A butterfly garden (special plants). N o traffic, no noise cars or trucks. Quiet , no b o o m - b o x e s or c a n n e d music , but concer ts would be nice. T a b l e s . 16. (maintenance volunteer) T a k e into a c c o u n t that food scattered attracts rats - a hospital no-no. Every resident or visitor c a p a b l e of doing s o shou ld r e m o v e d e a d flower h e a d s . T h e r e is room on the S W side of the g r e e n h o u s e for outdoor sports s u c h a s ball ca tch , wheelchai r obstac le races , etc. Patio for group gathering of residents a g o o d idea. G r a s s is hard to maintain, U B C g a r d e n e r s will probably ignore. Proper whole window s c r e e n s would be nice. S u n n y seat ing a lready avai lable throughout existing garden . Seat ing in s h a d e already avai lable throughout, including window a reas . S h a d e trees, a l ready growing Star magnol ia , A p p l e trees. T o p bank to be planted by U B C . F lowers, a s many a s c a n be maintained. Existing raised b o x e s badly p lanned for wheelcha i rs . Fountain - residents could tumble and drown, o n e trickling J a p a n e s e style fountain would s o u n d nice. "Many ideas s o u n d g o o d until the time and h u m a n m a n a g e m e n t is c o n s i d e r e d . F o r 4 years I have been request ing volunteer help, and s o far only 3 students have kindly offered o n e hour per w e e k e a c h . I a m truly grateful until I read a quest ionnaire s u c h a s this, practicality is nowhere to be found." T h e central a r e a from hospital c o v e r e d patio to wall where flag flies should , at all t imes, be for the u s e of residents, a s should s h a d e tents. 17. (resident) 88 O n e of the main u s e s of any new s p a c e would be to increase opportunit ies for visiting with family a n d fr iends outside. T h e r e are not many p l a c e s to meet outside, the Patient Park is under construct ion, and e v e n w h e n it w a s o p e n , there were s m o k e r s in there making it unpleasant . W o u l d enjoy participating in light gardening tasks if he could find tools that let him do it. H e is quadriplegic, but it able to feed himself, and s e e m s quite able. W o u l d like a p lace for picnics, to s p e n d time with visitors outdoors. U s e d to d o that at Patient Park, but can' t get in there now. W o u l d like a p lace to eat outdoors, like a cafe or restaurant patio. S c r e e n e d porch not n e c e s s a r y , there are no bugs here. Prefers to sit in the s h a d e , drink a K o k a n e e . L ikes the idea of fruit trees, thinks that there w a s a plum at Patient Park. P e o p l e like to be e n g a g e d in an activity, to be doing someth ing . L o v e s flowers, (keeps a C h r i s t m a s c a c t u s in his room). L a n d s c a p e around building should be nice for residents and visitors. 89 

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