A1257787156NhPLJ

1
(No Transcript)
2
The People-Plant Connection
3
The People-Plant Connection

• Plants and gardening can be part of all programs
  that strive to improve the quality of life.
• Plants provide appealing, adaptable ways to
  transform the environment that we live and work
  in.

4
The People-Plant Connection

• Horticulture and gardening is a popular leisure
  activity that offers opportunities for
  socialization.
• Is an enjoyable experience that renews enthusiasm
  for living.

5
The People-Plant Connection

• A developed Horticultural Therapy program
  provides the tools for
• increased physical activity
• increased social activity
• increased cognitive functioning
• increased relatedness to the Natural
• world

6
Benefits

• Exercises the eyes through visual scanning,
  seeing near far, and improves seeing spatial
  relationships
• Provides practice in eye hand coordination

7
Benefits

• Exercises the eyes through visual scanning,
  seeing near far, and improves seeing spatial
  relationships
• Provides practice in eye hand coordination

8
Benefits

• Learn to see differences in size, color, shapes
  textures
• Exercises hands, fingers, arms, and upper body
• Fosters involvement in physical activity when
  nothing else will

9
Benefits

• Pleasure is derived from our senses
• seeing smelling, feeling and tasting
• Motivates us to use adaptive equipment as it is
  needed

10
Benefits

• Provides pleasurable physical activity to those
  with physical disabilities or sensory impairments
  who may wish to enjoy gardening

11
Benefits
12
Intellectual Benefits

• Teaches new skills techniques in horticulture
• Increases interest
• Stimulates understanding of abstract concepts
• Time, growth, change death

13
Intellectual Benefits

• Increases awareness of the living world
• Exercises our minds in terms of memory logic

14
Intellectual Benefits

• Promotes a can-do attitude
• Leads toward anticipation of future events
• Lifts the spirit of those who have lost a sense
  of purpose or hope and provides an element of
  control

15
Intellectual Benefits

• Gives us practice in following directions
• Improves attention span
• Learn about needs for life
• Requirements, interdependence, energy,
• Diversity, population, species

16
Affective Benefits

• Increases self-esteem and self-confidence
• Satisfies our need to be nurturing and caring

17
The People-Plant Connection

• Horticultural therapy activities enrich and
  expand lifes experiences.
• Horticulture activities can facilitate clinical
  goals
• While adding to the individual's capacity for
  enjoyment.

18
The People-Plant Connection

• Research has shows that involvement in
  therapeutic horticulture programs maintains or
  improves life satisfaction or the quality of life
  of participants.
• Kansas State University
• Rusk Institute
• Calvary Hospital
• Palliative Care Institute

19
Goals

• To create an environment conducive to social
  interaction and increased life satisfaction.
• To foster a beneficial relationship between the
  participants and the community
• Leading to a better understanding of
  social/cultural and leisure needs of any
  particular group.

20
Goals

• To provide the opportunity for engaging in a new
  or previously acquired hobby or interest adapted
  to the limitations of the participant.
• To maintain or improve the physical health of the
  participants.

21
Goals

• To encourage social interaction through
  participation.
• To provide opportunities that allow for
  individual self expression.

22
Affective Benefits

• Increases self-esteem and self-confidence
• Satisfies our need to be nurturing and caring

23
Social Benefits
24
Social Benefits

• Promotes healthy interdependence
• Increases leadership possibilities
• Promotes the sharing of fond childhood memories

25
Financial Benefits

• Employment possibility
• Learn skills for full/part-time work in business
  or sheltered workshop
• Development of skills in sales and finances

26
Financial Benefits

• Increased time management skills
• Opportunities to meet the public
• Budget planning

27
Financial Benefits

• Low cost food/decorations/gifts
• Can be a partially self supporting program
• Horticultural Therapy grants

28
The Therapist As Teacher

• The Horticultural Therapist
• Excites the participants while providing an
  active, stimulating, educational transfer
• that seeks to stimulate natural curiosity
• Wants to develop an awareness
• appreciation, and an affinity for living things.

29
The Garden

• Accessible
• Relaxing
• Educational
• Inviting

30
The Garden
31
Getting Around the Garden

• Paths surfaces paved area must be smooth,
  level firm
• Provide good traction at all times
• Ramps must not exceed 5 grade
• Handrails may be needed
• Proper width of paths

32
Getting Around

• Provide direct routes through the garden
• Paths shall have a sharp contrast at the edge
• Provide a large gathering area
• Reduce glare and heat absorption

33
Getting Around
34
Getting Around

• Soft surface options
• Turf
• Wood chips
• Packed soil-unacceptable
• Crushed stone-gravel
• Low cost
• Good drainage
• Requires excavation to 6

35
Getting Around

• Number 9 screenings
• excellent choice for paths
• Hard surface options
• Concrete-dries out, can be colored
• Asphalt-absorbs heat
• Loose pavers
• Allow for interesting designs, warmth character

36
Getting Around

• Brick- very versatile
• Wood-for decking adds a natural feel
• Recycled rubber foot paths

37
Enabling Garden Structures

• Raised beds
• Customize soil height
• Contain large area of soil to increase plant
  diversity
• Less frequent watering
• Durable
• Warms up quickly in the spring
• Can raise short plants to eye level
• Should be 30 wide for reaching to back

38
Raised Beds
39
Affective Benefits

• Opportunities to be creative and self expressive
• Develops a sense of responsibility and
  accomplishment

40
Social Benefits

• Improves social skills, self esteem, and
  confidence
• Promotes interaction by developing a common
  interest that presents challenges that can be
  shared

41
Social Benefits

• Provides endless topics for discussion where
  opinions can be freely expressed
• on an equal level, as one gardener to another
• Motivates cooperation among groups

42
The Garden
43
Getting Around the Garden

• Paths surfaces paved area must be smooth,
  level firm
• Provide good traction at all times
• Ramps must not exceed 5 grade
• Handrails may be needed
• Proper width of paths

44
Getting Around

• Provide direct routes through the garden
• Paths shall have a sharp contrast at the edge
• Provide a large gathering area
• Reduce glare and heat absorption

45
Getting Around
46
Getting Around

• Soft surface options
• Turf
• Wood chips
• Packed soil-unacceptable
• Crushed stone-gravel
• Low cost
• Good drainage
• Requires excavation to 6

47
Getting Around

• Number 9 screenings
• excellent choice for paths
• Hard surface options
• Concrete-dries out, can be colored
• Asphalt-absorbs heat
• Loose pavers
• Allow for interesting designs, warmth character

48
Getting Around

• Brick- very versatile
• Wood-for decking adds a natural feel
• Recycled rubber foot paths

49
Enabling Garden Structures

• Raised beds
• Customize soil height
• Contain large area of soil to increase plant
  diversity
• Less frequent watering
• Durable
• Warms up quickly in the spring
• Can raise short plants to eye level
• Should be 30 wide for reaching to back

50
Raised Beds
51
Enabling Garden Structures

• Home made containers
• Box chains on walls
• Trellis box
• Table planters

52
Enabling Garden Structures

• Manufactured Containers
• Accessibility
• Durability
• Weight
• Appearance
• Cost

53
Enabling Garden Structures
54
Enabling Garden Structures
55
Enabling Garden Structures
56
Enabling Garden Structures

• Manufactured Containers
• Cedar
• Whiskey barrels
• Self-watering plastic
• Flue tiles/drain pipes

57
Enabling Garden Structures

• Vertical structures
• Walls and fences
• Arbors trellises
• Vertical wall gardens

58
Enabling Garden Structures
59
Enabling Garden Structures
60
Enabling Garden Structures
61
Garden Tools

• Adapting tools
• Lightweight
• Longer handles
• Smaller blades tool heads
• Tool handles grips
• Springs in tools for assistance

62
Garden Tools

• Types of tools
• Reaching aids
• Gripping aids
• Leverage aids
• Cutting aids
• Watering aids
• General garden helpers

63
Garden Tools
64
Garden Tools
65
Adapting the Plants

• Emphasize plants with interesting color, scent,
  texture form
• Choose plants based on amount of maintenance you
  can do
• Use plants with four-season interest

66
Adapting the Plants

• Use plants that attract birds, butterflies and
  other wildlife
• Include edible landscaping
• Use indigenous plants as much as possible

67
Adapting the Plants
68
Adapting the Plants

• Select plants that grow well in containers or
  raised beds
• Select hardy perennials
• Consider the toxicity of specific plants

69
Types of Plants

• Vegetables
• Bulbs
• Annuals
• Perennials
• Ornamental grasses

70
Perennials
71
Perennials
72
Types of Plants
73
Vegetables
74
Ornamental Grasses
75
Types of Plants

• Vines
• Herbs
• Shrubs
• Trees
• Fruit trees
• Dwarf fruit trees

76
Garden Design

• Choosing a landscape architect
• Site analysis
• Equipment
• Graph paper
• Drafting table
• Vellum-transfer paper to make blue prints

77
Garden Design

• Medium hardness pencils
• Flexible curve
• French Curve
• Templates
• Compass

78
Five Steps to Garden Design

• Base information size, location, sun pattern
  etc.
• Site analysis
• Checklist of wants needs (wish list)
• Concept plans
• Final design

79
Garden Design

• Architects or engineers scale
• T-square
• Imagination

80
Garden Care

• Watering
• Materials and requirements
• Timing
• Requirements
• Zones
• Sprinklers
• Overhead vs. leaky pipe

81
Garden Care

• Weeding mulch, mulch, mulch
• Fertilizing
• required activity for healthy plants, do not over
  do it
• Granular water-soluble fertilizers
• Composting

82
Garden Care

• Pruning
• good activity for gardeners, be safety conscious
• Pest disease control
• minimize chemical use, avoid accidental
  poisonings
• Use integrated pest management
• least toxic, biological, cultural and mechanical
  controls

83
Garden Care

• Avoid pest prone plants
• Select plants with built in resistance
• Use proper cultural methods
• keep plants healthy
• Tolerate a few bugs blemishes
• do not run for the sprayer

84
Garden Care

• Wear appropriate clothing
• Follow directions on labels
• Keep a pest management log

85
Garden Care

• Fall Winter maintenance
• Plant protection
• Mark, stake, fertilize
• Pruning
• Woody perennials
• Mulching
• Mulch, hay conifer branches
• Watch for mice

86
Garden Care

• Spring Summer Maintenance
• Dead head
• Pruning
• Mulching
• Removing dead materials
• Watering

87
Seed Starting Trays
88
Whiskey Barrels Containers
89
Wood, Concrete Clay
90
Gradual Curves
91
Leaky Pipe Herbs
92
Steps as a Container Space
93
Maine
94
Maine
95
Monsignor Murray Garden
96
Monsignor Murray Garden
97
Monsignor Murray Garden
98
Monsignor Murray Garden
99
Monsignor Murray Garden
100
Monsignor Murray Garden
101
Monsignor Murray Garden
102
Monsignor Murray Garden
103
Hebrew Hospital Home
104
Hebrew Hospital Home
105
Hebrew Hospital Home
106
Calvary Hospital
107
Calvary Hospital
108
Calvary Hospital
109
Calvary Hospital
110
Calvary Hospital
111
Calvary Hospital
112
Calvary Hospital
113
Calvary Hospital
114
Calvary Hospital
115
Trumpet Vine Butterfly Bush
116
Contemplation
117
Conceptual Paradigms

• Holistic Approach
• Looks at the whole person their needs
• Recognizes integrates multiple factors
• Developed from a broad base of information
• Integrated from a interdisciplinary frame of
  reference

118
Conceptual Paradigms

• Treatment Concept
• A treatment tool to heal
• To meet needs/goals
• To strengthen or improve

119
Models of HT Service

• HT Service Model
• Four Step Continuum From maximum control by
• therapist to minimum control by horticultural
  therapist
• 1. Assess
• ID problem, gather data
• 2. Treatment
• Improve functional ability
• 3. Education
• Acquire knowledge Skills
• 4. Lifestyle
• Engage participate voluntarily

120
Models of HT Service

• Continuum
• HTR directed
• Equal participation between client HTRgtPatient
  directed activity gtlt
• Poor healthgtto gtoptimal health
• Prescribed activitygtdirected by HTRgt
• Horticultural Therapy yields
• mutual participation between HTR participant
• through self direction

121
Models of HT Service

• Medical Model
• Health protection/promotion model
• Dr. prescribes HT treatment
• Horticultural Therapy is a treatment gtgt as a
  means to and end, is clinical
• HT prescribed, goal oriented, curative

122
Human Services Models

• Long-term Care (Custodial) Model
• To maintain ones functioning. To enable
  individuals whose functional capabilities are
  chronically impaired to be maintained at the
  maximum level of health well being.
• Therapeutic Milieu Model
• Where every person interaction can be
  therapeutic. Everyone has equal impact.

123
Human Services Models

• Educational Training Model
• Gain vocational skills through HT.
• Community Model
• Special Recreation, horticultural therapy leads
  to increasing leisure repertoire in the
  community.

124
Human Services Models
125
Diagnostic Groupings

• Cognitive Impairments-MR/DD
• Sub-average intellectual functioning IQlt70, is
  displayed during the developmental period
• Symptoms low frustration level, short attention
  span, social immaturity, unable to function
  independently, poor judgment
• Significant impairments in adaptive functioning.
• Delays in motor, language, self care
• Onset prior to age 18

126
Diagnostic Groupings

• MR-DD
• Offer choice, inclusion, mainstreaming
• Age appropriate
• chronological, not mental age
• promote high success activities for low self
  esteem
• Simplify/Adapt
• Repetitive Movements

127
Diagnostic Groupings

• Head Injury
• traumatic injury from a head wound
• Impaired attention span, concentration, memory,
  lower tolerance for noise, low frustration
  tolerance

128
Diagnostic Groupings

• Head Injuries
• HT Utilize social skills need for
  socialization, community reintegration, build
  independence, physical development

129
Diagnostic Groupings

• Learning Disabilities
• dyslexia, deficits in language development, hyper
  activity, thought process difficulty, low
  attention span, distractible, behavior problems
  in school, low self-esteem
• HT Provide choice, challenge, age appropriate
  activities which are structured for success

130
Diagnostic Groupings

• Learning Disabilities
• Provide choice
• Challenge
• age appropriate activities
• structure for success

131
Diagnostic Groupings

• Physical Impairments-Musculoskeletal System
• Spina Bifida defective closure of spinal canal
  causing protrusion of spinal cord. Can cause
  paralysis can have an emotional impact

132
Diagnostic Groupings

• Physical Impairments-Musculoskeletal System
• HT Wheelchair activities utilize skills to
  promote independence, education, community
  re-integration exercises to strengthen muscles

133
Diagnostic Groupings

• Muscular Dystrophy
• Progressive, inherited disease, gradual wasting
  of muscle tissue.
• Can lead to wheelchair use, cause socially
  impaired interactions

134
Diagnostic Groupings

• Muscular Dystrophy
• HT Maintain muscle tone-promote movement,
  accomplishment, and assistive devices, promote
  creativity

135
Diagnostic Groupings

• Spinal Cord Injuries The higher up the injury
  occurs, the greater damage. Includes loss of
  sensation below injury
• Cervical
• Thoracic
• Lumbar
• Sacral

136
Diagnostic Groupings

• Multiple Sclerosis 20-50 years of age for onset
• Symptoms muscle spasms, loss of sensation,
  bladder control. Physical emotional changes.
• Progressive
• HT Social activities, success-oriented, Range of
  Motion

137
Diagnostic Groupings

• Cerebral Palsy Neuromuscular disorder
• athetosis involuntary motor movement
• Spasticity
• speech disturbance
• poor balanceataxia
• Stiffness
• non-progressive is not degenerative

138
Diagnostic Groupings

• Epilepsy seizures Grand mal, petit mal
• Convulsions, loss of consciousness
• HT
• Encourage normalization
• Reduce stress, fears stigma
• Community activities
• Increase locus of control.

139
Diagnostic Groupings

• Visual legally blind 20-200
• 2-5 read Braille
• 5 completely blind, others see shadows/movement.
• HT talking books encourage other senses,
  environmental cues, movement, large print books,
  bright colors

140
Diagnostic Groupings

• Aphasia
• Expressive, cannot speak
• Global aphasia cannot speak or understand

141
Diagnostic Groupings

• Hearing Loss have minimal noise, lighting is
  important, have them face you, close-up
  interactions
• HT use of other senses, emphasize lip movements
  hand gestures adaptive activities encourage
  sign language

142
Diagnostic Groupings

• Stroke
• Left CVA gt Right hemi affects the right side
  affects speech, may cause aphasia
• Right hemi gt impaired emotions. Social
  interactions, poor memory, difficulty with spoken
  language written communication.
• HT use demonstration, modeling, reality
  orientation

143
Diagnostic Groupings

• Right CVAgtleft hemi loss of perceptual/intellectu
  al functioning, logic, visual and spatial depth,
  difficulty in perceiving around them.
• HT use words rather than gestures, keep
  environment clear of distractions, leisure
  education

144
Diagnostic Groupings

• Autism
• Onset in childhood
• Language difficulty
• Echolalia
• 1/3 Have epilepsy
• 75 Mental Retardation.
• HT structuregtfamily needsgtrespite

145
Psychological Problems

• Anxiety disorders
• Fear or panic with no apparent reason.
• obsessive/compulsive behaviors obsessive
  thoughts compulsive behaviors/rituals
• Phobias
• unrealistic fears of
• flying, heights, panic all affect functioning.
• Post Traumatic Stress Disorder (PTSD)
• headaches, loss of memory

146
Psychological Problems

• Personality Disorder chronic longstanding
• distorted view of relating to others self
• paranoid
• passive-aggressive
• anti-social

147
Psychological Problems

• Borderline instability of mood, interpersonal
  relationships self-image
• mood change during the day/several times a day
• feelings of emptiness/boredom. will try suicide
  for attention
• HT help make decisions, challenging activities,
  modeling, contracts

148
Mood Disorders

• Depression
• loss of appetite, sleep disturbance, lack of
  motivation, low self-esteem
• Manic
• endless energy, expertise in area, know famous
  figure
• Bi-polar (manic-depressive)
• fluctuating moods, lithium to control from
  manicgttogtdepressed

149
Mood Disorders

• Schizophrenia
• A break from reality, disorder in
  thinking/reality,
• delusional, bizarre behaviors hallucinations.
  (Thorazine)
• Auditory Hallucinations
• talking to self, Im Jesus, feel others are out
  to get them, lack of social skills.

150
Mood Disorders
151
Mood Disorders

• Addictions
• Eating Disorders
• Anorexia Thin. force self to vomit up meals to
  stay thin, organ damage
• Bulimia gorge purge, onset to young women,
  poor self image

152
Mood Disorders

• Chemical Dependency
• Drugs/Alcohol
• Prison
• Sex offenders, murderers etc.
• Social Impairments
• Organic Brain Syndrome
• Acute chronic physical changes to brain,
  memory loss, emotional instability, mood changes,
  poor judgment, confusion, disorientation.

153
Behavioral Health

• Horticultural Therapy
• Symbolism
• Leaves shedding
• Thorns
• The touch, smell and feel of soil
• Cleansing
• Seasons of change
• Cleansing
• Beauty
• Roots
• Spiritual connection

154
Assessment

• Four Behavioral Domains
• Cognitive intellectual processes of learning or
  knowing learning capability decision making
  follows directions, short term memory, problem
  solving, concentration/attention span, attention
  to details
• Psycho/Social
• psychological social functioning
  Independence, ability to form relationships,
  frustration tolerance, self concept, evaluate and
  value oneself.

155
Assessment

• Physical
• Physical functioning in the environment
• Overall coordination functioning of sensory
  system body parts
• Activity level intensity of sensory system
  body parts
• Strength capacity for exertion, flexibility,
  bending/stretching
• Balancegt Endurancegt Physical Health
• Ability to right selfgtWithstand exertion over
  timegtmobilitygt overall state of wellness

156
Assessment

• Affective facial expression, body gesture,
  self-esteem

157
Task Analysis

• Takes a task and breaks it down step by step into
  small steps
• explaining each single part of the activity
• planting a seedling, filling a window box with
  annuals, watering

158
Activity Modification

• When certain functional abilities are absent or
  impaired (disabled individuals)

159
Goals

• A broad general statement of direction purpose
• proposed changes in the individual or their
  environment
• a broad statement of a desired behavior that the
  participant will demonstrate
• set in a positive term a sense of direction

160
Objective

• States what the participant will do
• Describes an outcome
• A course of action to meet goal
• Describes observable behavior
• Written in terms of participants behavior

161
Objective

• Contains three parts
• 1. Behavior a specific behavior to be
  demonstrated by participant
• 2. Condition When where the behavior will
  occur, a given or a restriction.
• 3. Criteria the measurable outcome how well
  must it be done, correctness, time span,
  percentage, what is acceptable or successful
  performance

162
Counseling

• Basic Counseling Techniques Client-centered
  therapy Carl Rogers Active listening
• Attending pay attention, eye contact, posture,
  gestures, verbal affirmation of listening
• Paraphrasing listen for basic message, restate
  in own words
• Clarifying admit your confusion, ask for
  clarification

163
Counseling

• Perception
• checking-paraphrase what you think you heard
• Probing
• questions directed to obtain information-to gain
  an understanding
• Reflecting
• to reflect feelings received-interpreting
• Confronting
• point out what seems apparent in an honest manner
  without blame

164
Counseling

• Informing
• providing factual information
• Affective Listening
• voice, tone, volume
• Summarizing
• to bring together ideas, to synthesize

165
Counseling

• Non-verbal behaviors
• Visual cues
• Physical appearance, use of jewelry, clothing,
  facial expression
• Eye contact, body movement, vocal cues, volume,
  pitch, availability, personal space.

166
ADA 1990

• Commercial, private settings must make reasonable
  accommodations

167
ADA 1990

• Accessibility
• Signs light characters on dark background
• Curb ramps maximum grade 8.33 other ramps 5
  must be usable
• Doorways 32
• Parking 12.5 x 20.5

168
LAWS

• Section 504 Rehabilitation Act 1973
• individuals shall not be discriminated against
  solely by reason of handicap

169
LAWS

• Program Accessibility Act
• Ramps 8.333 maximum grade
• Parking Space 12.5 x 20.5
• Hand rails 32 high
• Toilet 20 from floor stall at least 36 wide

170
LAWS

• 94-142 Law (1975)
• Education for all Handicapped Children Act
• free and appropriate public education in a least
  restrictive environment (IEP) mandates),
  education can include recreation

171
LAWS

• Individuals with disabilities Education Act
  (IDEA)
• Americans with Disabilities Act (ADA) 1990
• Civil rights for people with disabilities, with
  reasonable accommodations in public places
  defines disabilities
• Advocacy is an important role

172
References

• Rothert, Gene Laurie Nauffs, The Enabling
  Garden,
• Taylor Publishing, TX 1993.
• Sourby, Charles Michaela Byrnes, Therapeutic
  Recreation Certification Study Guide, Therapeutic
  Recreation Directory, WV 1999.