On a breezy morning in Singapore, I walk along a circular pathway into the new therapeutic garden in HortPark, a 22-acre park in the city-state’s southwestern corner. Water dribbles in a fountain. Wind chimes tinkle. The sweet smells of gardenia and ylang ylang attract butterflies from the nearby butterfly garden, and the aromas of screw pine and basil evoke the Southeast Asian kitchen. The shaded benches and gazebos here provide a respite from the hyper-urban city.
Copious evidence has shown that urban green spaces have a net positive effect on people’s health. Access to green spaces can improve mood, and ease anxiety, stress, and depression. Green spaces also have a long history as specific therapeutic modalities. According to the American Horticultural Therapy Association, horticulture has been used as therapy since ancient times; the use of horticulture to calm the senses dates as far back as 2000 BCE in Mesopotamia. In the United States, the practice became widespread and acceptable in the 1940s and 1950s, when these therapies were used as part of the rehabilitative care of hospitalized war veterans. Now, the landscapes—which often include a variety of plants with interesting form, texture, and color to provide sensory stimulation and firm, smooth path surfaces easy for wheelchairs to navigate—have been installed in hospitals, nursing homes, and retirement communities.
Situated in a land-scarce, densely populated metropolis, the Therapeutic Garden@HortPark is the city’s first and only therapeutic garden in a public park designed specifically for post-stroke patients and seniors with dementia. It’s a welcome addition to a city where, by 2030, a quarter of the residents will be older than 65.
The garden is only one prong in Singapore’s Action Plan for Successful Aging, an ambitious $3 billion plan to better the lives of the elderly in urban spaces. The plan, announced by a cabinet-level committee on aging in 2015, details over 30 initiatives to transform Singapore by 2030, from revamping public transportation and pedestrian and road infrastructure to doubling the number of hospital beds and increasing nursing home capacity by more than 70 percent over the next decade.
The therapeutic “pocket” garden, which opened in May, is a permanent pilot project in an existing park, and HortPark is an obvious choice for a site. The park is already a hub for gardening enthusiasts: It houses community gardening plots, hosts public gardening events, and even has a garden supply shop.
The design of Therapeutic Garden@HortPark conforms to best practices for healing gardens: The 850-square-meter garden includes mature shade trees, colorful flowers that aid biodiversity, and shrubs and herbs that can be seen, touched, and smelled. Its walkways can accommodate wheelchairs, and there’s ample seating for caregivers. Movable planting beds make activities more accessible for those with mobility concerns.
The garden’s design is guided by evidence, says Mohamad Azmi Shahbudin, HortPark’s director. In Singapore, a dementia patient is expected to live 10 to 12 years from diagnosis, says Dr. Kua Ee Heok, a professor and psychiatrist at National University of Singapore's Department of Psychological Medicine, whose research on horticultural therapy, dementia, mental illness, and quality of life informed the construction and design of this park. While horticultural therapy does not increase life expectancy, it can improve cognition, increase social interaction, and stave off depression, which is often co-morbid with dementia. In a large-scale randomized control study wherein elderly participants at risk of dementia grew vegetables and herbs, Kua and his colleagues demonstrated that patients who received horticultural therapy fared better than a control group in scores for life satisfaction, memory, and psychological well-being.
While Therapeutic Garden@HortPark currently does not have staff trained in horticultural therapy, Centre for Urban Greenery and Ecology (CUGE), jointly run by National Parks Board and the Singapore Workforce Development Agency, aims to build capacity in horticultural therapy in Singapore. “We [park managers] currently work in tandem with patients’ caregivers or occupational therapists to provide them general knowledge about gardening and this park,” says Shahbudin. But the long-term aim is to encourage trained therapists to get additional certifications in horticultural therapy, he adds.
Singapore hopes to create ten more such gardens if the pilot project if HortPark is deemed a success by the various ministries and statutory boards who have stakes in the project. “This is an experimental space,” says Shahbudin. “We will continually improve based on our researchers’ and partners’ feedback.”
Since the Action Plan for Successful Aging aspires to be a blueprint for successful aging across Asia, HortPark’s design trial may have implications beyond Singapore’s borders. The garden is full of many different design and sensory elements, adds Andrew Foke, landscape architect and Manager at HortPark. Researchers will collect data about them so that the space can serve as a living laboratory for future gardens in Singapore and elsewhere. Asia's elderly population is projected to reach nearly 1 billion by 2050, and the continent is “on track in the next few decades to become the oldest region in the world” according to the Asian Development Bank. “More and more, our cities need to cater for these trends in growth,” says Shahbudin. “Our parks must remain relevant to our greying population.”