Thinking Green: Landscape Enhancements Boost Mental Health and Wellness at Friendship Village

Andy Howland and his landscape team at Friendship Village of Dublin planted 10,000 annuals in May 2020 when COVID-19 kept residents isolated. As director of enhancements and landscape, Howland knew the plants would boost mental health, quicken patient recovery and enhance their social connections.

“The pandemic brought on a lot of uncertainty, anxiety and decreased social interaction, so we went all out with plants,” says Howland. “Getting outside and experiencing the spring of 2020 became a breath of fresh air for our community and their visitors.”

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Since starting at the retirement community in 2014 during a massive building expansion, Howland has been a firsthand witness to plants’ transformative power. Once considered a luxury, green spaces have gained more importance over the past four decades. In 1984, Harvard professor Edward O. Wilson wrote a landmark book, “Biophilia,” in which he argued our natural affinity for other forms of life in nature is the very essence of our humanity and binds us to all other living species.

Karen McCoy, landscape architect and principal at MKSK, confirms the increasing role nature is playing, specifically in health care design. In the 1980s, McCoy was working at Karlsberger Cos., a former regional architecture firm focused primarily on health care development.

“At the time, some interesting research showed the value of biophilic design in health care recovery,” says McCoy. The pioneering study by Roger Ulrich compared groups of post-surgery patients that viewed natural scenes versus urban walls. The patients with the natural views recovered faster and needed less pain medication. More studies supported the value of nature, not only for the patient but also their entire family and even hospital staff. As these studies recorded outcomes, an evidence-based design approach emerged and still drives design today.

“When you start quantifying design impact in terms of reduced mistakes and staff retention and measure the impact in dollars, it becomes easier to dedicate money to these improvements,” says McCoy. In her tenure at MKSK, she has worked locally on a courtyard design approach at Dublin Methodist Hospital, the rooftop gardens and Spirit of Women Park at the Ohio State University Wexner Center, and the outdoor gardens and dining areas for Nationwide Children’s Hospital regional ambulatory facilities.

Friendship Village’s landscape emphasis has also evolved with the times. What started as mainly a volunteer effort by residents there has dramatically grown. Today, the 26-acre community not only has thousands of annuals but also has 50 raised-bed gardens for residents to tend, 115 containers sprinkled throughout the campus, landscaped courtyards and dining areas, entry flower beds, three miles of landscaped walking trails, a putting green and bocce and shuffleboard courts. Next up, the facility will further expand its horticulture therapy programs with an indoor solarium that will have worktables to plant seeds, pot bulbs and care for houseplants.

“In an urban setting you really have to make use of your space with trees, shrubs and plants,” he says. ‘It’s especially the annuals and perennials that create movement and encourage frequent exploration.”

As Howland has expanded Friendship Village’s landscape areas, he found horticulture easily fit with the community’s focus on nine dimensions of wellness—physical, social, emotional, spiritual, intellectual, nutritional, health services, vocational and environmental. Today, the impact is felt among residents, their visiting families, staff and outside groups requesting tours. Family members further endorse the efforts with notes of gratitude and donations to plant more trees and gardens.

Perhaps the most remarkable impact is the Friendship in Bloom therapeutic horticulture program in a central courtyard. Four accessible planters are arranged on a patio space and surrounded by landscaped beds of colorful floral plants and eye-catching sculptures. Here, a multi-sensory program partners memory-care residents with independent living residents, family members and master gardener volunteers. Together, they plant bulbs, harvest herbs for a tea, pot container arrangements, make salsa from the garden and take notes in garden journals.

“Through the senses, this garden reaches residents at a different level,” says Barbara Holliday, who directs the enrichment programs. She explains that while dementia patients first lose short-term memory, many are still able to connect with memories through multi-sensory stimulation like these garden activities.

She retells how one memory-care resident denied ever gardening but when invited to help plant bulbs the patient drew on plenty of garden knowledge, offering tips and identifying plants. Garden activities also helped another patient, a retired soil scientist who was experiencing feelings of agitation.

“The minute he put his hands in the dirt, you could see him relax,” says Holliday. “It was very therapeutic.”

This story is from the 2022 issue of Columbus Monthly Health.