APPLSCATIOM OF HORTKULTURE AS A
MEANS OF THERAPY

Thesis {or rho Dogma drflxo M. S.
MICHfGAN STATE UVIVERSITY
Rama Dal-is Zischko
1956

 

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APPLICATION OF HORTICULTURE AS A MEANS OF THERAPY

by

Reva Dorismgischke

.A THESIS
Submitted to the School of Graduate studies of Michigan State University
of Agriculture and Applied Science in partial fulfillment of the

requirements for the degree of
MASTER OF SCIENCE
' Department of Horticulture

1956

'[HFSlS

ACKNOWLEDGEMENT

I wish to express appreciation to all those who have assisted
in this study. Especially I wish to thank Dr. Donald P. Watson for
his wise counseling, criticism, and encouragement; Dr. H. B. Tukey,
Dr. Moiree Compare, and Miss Genevieve Jonas for their constructive
criticism: Miss fibrion R. Spear and Miss Barbara Jewett for their
assistance in compiling the bibliography; Dr. Roy A. Mortar, Medical
Superintendent of Kalamazoo State Hospital, and his staff for making
possible the pilot study: Hrs. Katherine Babel for her interest and
guidance in conducting the pilot study: and the mental patients whose
willing cooperation in the pilot study has heen a constant source of

inspiration.

TABLE OF CONTENTS

page

I INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
II SIGNIFICANCE OF HORTICULTURAL THERAPY . ......... . . . . 2
Values of Horticultural Therapy.b¢ . . . . . . . . . . . . . . 2

Scope of Opportunity')v. . . . . . . . . . . . . . . . . . . . 7

Types of Disabilities. ...... . . . . . . . . . . . . . . 12

Types of Activities . . . . . . . . . . . . . . . . . . . . . 16

III DEVELOPMENT OF HORTIOULTUBAL THERAPY . . . . . . . . . . . . . . . 20
// In the Early Period . . . . . . . .'. . . . . . . . . . . . . 20

i In the Eighteenth and Nineteenth Centuries . . . . . . . . . . 20
\vIn-the Twentieth Century . . . . . . . . . . . . . . . . . . . 22

iv PRELIMINARY TESTS AT KALAMAzoo STATE HOSPITAL . . . . . . . . . . 25
Introduction . . . . .. . . . . . . . .' ..... . . . . . . 25

Outline of Activity . . . . . . . . . . . . . . . . . . . . 25
Explanation of Procedure . . . . . . . . . . . . . . . . . . . 26
Observations . . . . . . . . . . . . . . . . . . . . . . . . . 29

v SUGGESTED PROGRAM FOR occurimxosii THERAPISTS . . . . . . . . . . 32
Introduction . . . . . . . . L . . . ; . . . . . . . . . . . . 32

Types of Patients . . ..... . . . . . . . . . . . . . . . 32
Required Facilities . . .‘: . . . . . . . . . . . . . . . . . 35
Limitations .d. . . . . . . . . . . . . . .'. . . . . . . . . 38

VI SELECTED PROJECTS APPLICABLE TO TREATMENT PROGRAM . . . . . . . . 41
Introduction . . . .‘. . . . . . . .'. . . . . . . . . . . . . 41
Projects. : . . . . . . . . . . . . . . . . . . . . . . . . . #2
Description and Source of Information . . . . . . . . . . . . 43

Additional Source Material . . . . . . . . . ._. . . . . . . 77

Activities to be analyzed . . . . . . . . . . . . . . . . . 80

page
AnaLysis of Activities . . . . . . . . . . . . . . . . . . . . 80

VII SWY o e o O o o o e o o e e e e o e o o o " e o e e e o I e e e 110

VIII AVAILABLE LITERATURE . . . . . . . . . . . . . . . . . . . . . . . . 112

I . INTRODUCTION

Horticulture has been used in the treatment of illness for many
years. Recently, great interest has developed in this treatment medium

largely through the activities of garden club members. Although many

————— ”V VF.-

informative articles and a handbook have been written. no comprehensive
study of this type of treatmenthas been located.

Horticultural Therapy is the use of plants or plant materials for
the improvement of mental or physical health. Horticulture. as considered
here. refers not only to gardening procedures, but also to any activity
involving plants or plant materials, or other projects closely related to

indoor or outdoor gardening. Therapy. in a strict sense. is any prescribed

. treatment which cures or relieves illiness. Here, however, therapy refers
not only to that treatment which cures illness, but also treatment which

fihelps to maintain health. Since Occupational Therapy is, by definition.

- any activity, medically prescribed, and administered by trained therapists;

Horticultural Therapy may well be considered merely form of Occupational

I

Therapy

The purpose of the present study is to investigate the possibilities
of horticulture as a therapy, and to outline a suggested program for Occu-
pational Therapists based on the observations trade during a pilot study
and on reports of authorities who have in the past recommended or observed
the use of horticulture in the treatment of the sick.

The pilot study was planned to include, in a twelve week program.
the following: gardening, plant identification. plant propagation, ele-
mentary plant science, flower arrangement, and related short term projects.

No attempt has been made to set up this program as a controlled

experiment . ~

II. SIGNIFICANCE OF HORTICULTURAL THERAPY

Horticulture can be an important part of any Occupational Therapy
program. Its value is significant because it can add a breadth of oppor-
tunity, a variety of treatments for many types of disabilities, and choice
of horticultural activities which may be selected or adapted as part of the
treatment program.

Values of Horticultural Therapy

The primary value of Horticultural Therapy is not as a new and
distinct therapy to supersede other therapies, but as one form of activity
which has beennnsed—alcngrwith mamr others in the treatment of illness.

The purpose of Horticultural Therapy is the improvement of mental or physi-

cal health. Many authorities have recorded benefits to patients and to

H‘__ ”uh—k

Vw’pénstitutions through the use of horticulture. jPatients, also, testify to

KR

N ...._.m.

the help they have received from engaging in horticulture.

Relation 1:3 Occupational Therapy: The use of horticultural skills
as a therapy is considered merely one form of therapeutic activity for the
following reasons: from the earliest records to the present time. refer-
ences to the use of occupation in the treatment of illiness mention garden-
ing as one of the activities so used: and horticultural activities
adequately meet the requirements of activities having therapeutic value.

In 1798 Benjamin Rush wrote to the Board of Managers of Pennsylvania
Hospital that spinning thread, sewing, and churning butter might be contrived
for the women. Turning a wheel, particularly 'in grinding Indian corn in a
hand mill for food for the horses and cows of the hospital, cutting straw,
weaving, digging in the garden, sawing or planing boards were recommended
for the men (Packard, 1931).

Edgerton in 1947, listed characteristics of activities having
therapeutic value. It is apparent from the following list--adaptability
to patient's working position, adaptability to patient's physical needs,
variability, freedom from dangers and annoyances, appeal, stimulation of
creative expression on the part of the patient, suitability to budget and
space allowance, further application-that there are few activities of a
horticultural nature which would not adequately suffice the requirements
of the Occupational Therapist.

In 1845, in g M 91 _t_h_e_,History, fining, 93d Orggization 2;
thg_Pennszlvania Hospital £2£_ghg.;ggggg, Thomas S. Kirkbride indicated
that outdoor labor in the gardens and on the grounds or on farms was one of
the many means of moral treatment. It was mentioned by William Rush Duntcn,
Jr. (1915) that many hospitals had a part of their grounds which was iden-
tified as patients' gardens. Flowers were grown to beautify the wards and
rooms, and vegetalles were used to add to the menu and raised with much
enJoyment. He mentioned that a few seeds in a pot of soil is a good be-
ginning, and that rose petals might be used in a "sweet jar“, for rose
syrup, candied rose petals, sandwiches, and lozenges. In fact, he referred
to recipes compiled by Henrietta D. Grauel and Caroline B. King and listed
in the "Woman's Home Companion“ for June of 1913.

In 1925, Anne E. Perkins mentioned that one of the best avenues of
escape from work and worry was to cultivate an interest in the out-cf-doors
and.to study at least one branch of nature. She mentioned ferns and flowers
and suggested that it was important to use whatever was at hand. emphasising
the importance of observation and intelligent enchment of horticultural

activities.

u

Hora A. Haworth and 1. Mary MacDonald (19%) emphasised that during
the latter half of the 18th century, there are many records of occupation
being used as a form of treatment. That they also referred to the work of
Doctor Rush in 1798 is further evidence of the forms of horticulture which
have been used in Occupational Therapy.

Purmse 91 Horticultural Therapz: The purpose of Horticultural
Therapy has been the improvement of mental and physical health. This has
implied aiding in recovery from illness, and it might include vocational
rehabilitation and prevention of illness by promotion of general well being.

“any medical doctors have recognized the value or prescribed the use
of horticultural activities (Francis, 1887: Dunton, 1917: Hamilton, 1942:
Licht, 1944; Wright, 1945).

Prescribing Horticultural Therapy for a patient depended on the
possibility of benefit to the patient. Daniel H. Tresevant (Amer. Jeur.
Insanity 1811.5) . recognizing the value of the custom of keeping patients
employed at some trade or on the farm, recommended that they be forced to
work or 'engage in amusements“ if this would benefit the patients. He
pointed out that the welfare of the patient and not the profit to the in-
stitution should be a deciding factor.

An important aim of therapy is to help the patient adjust to hospi-
talisation. It was believed that Horticultural Therapy could help the
patient relax and be in a more receptive attitude toward treatment. (Jonas ,
1955).

An effective Horticultural Therapy program depended on making the
most of facilities available, meeting the need of the patient, and following

the prescribed medical program (Watson and Tukey, 1954).

5

Benefits 23,Horticultural Therapy: Benefits have been demonstrated
by many authorities.

is long ago as 1887 Lloyd Francis recognized that outdoor employment
helped combat sleeplessness, improved the appetite, and provided opportunity
for mental patients to relieve angry feelings by viciously digging in the
earth instead of attacking attendants.

William Bush Danton, Jr. (1917) inferred that employment of patients
in gardens and other activities connected with maintenance of Bethlehem
Hospital diminished the need for restraints. W. I. Shewell-Oooper (1938)
stated that gardening.helped train character by helping the impatient to
become patient and the careless to become more meticulous.

Growing and propagating plants satisfied the self-preservative and
procreative instincts. Gardening increased muscle strength and gave self
satisfaction that came with success and an opportunity to follow the
routine of the seasons. This was of value because it made the individual
feel in accord with nature (Hamilton, l9h2).

Sidney Licht (19h4) said that gardening strengthened muscles and pro-
vided mental relaxation. Sunshine, fresh air, satisfaction of parental
instinct, opportunities for discovering and sharing, and opportunities for
learning coordination are listed by Drs. Dunton and Licht (1950) as advantages
offered by gardening.

Maureen Mahar (1953) believed that garden therapy relieved tension,
developed reassurance, and provided a.new source of absorbing interest.

One of the benefits was hunroved morale of the patients. Roland H.
Berg (1955) commented that there had.been no attempts among the criminalhy

insane to escape from the gardens at St. llisabeth's Hospital in Washington,

D. C.

Genevieve Jonas (1955) considered Horticultural Therapy to be
'valuable in helping a tubercular patient regain work tolerance. She stated
that it could be used in diagnosis. is an example she mentioned the indi-
cation of incoordination by the irregular path of a lawn mower pushed by a
neurological patient. She claimed that Horticultural Therapy had helped
blind, mentalhy ill, tubercular, heart, polio, crippled, and geriatric
patients.

Another evidence of improved morale was a poem quoted by Eleanor
Clark Slagle (1914) in which a,patient wrote of hoeing and spading as "health-
ful labors.',

The work of patients can be of economic value to an institution. The
Thirteenth Annual Report of the New York State Commission in.Dunacy (1903)
stated that the proportion of patients employed in maintenance had increased
to the extent that the labor had actual monetary value.

Richardson Iright (1945) was very wise with his warning that to engage
in horticulture is not a cure-all. He offered the advice that help should be
given those who are exploring this field, but others should proceed cautiously.

Testimonials: “any whose health has been improved by working in the
garden are willing to testify to that fact.

Gertrude Schendk (1911) described her personal experiences in gardening
and stated that this helped her regain her health.

“The Garden Doctor,“ (1913) which was published anonymously as a
serial story told of a young woman whose interest was aroused by watching
her neighbor prune his roses. From this beginning her interest grow until
she conceived the idea of working in her own garden. Gradually, as she
worked under her nurse's direction she regained strength and health after

having been mentally ill for two or three years.

7

a slightly different approamh is that of Montrose Moses (1933) who
described how an invalid guest taught her host and hostess to appreciate
their garden.

Laura Gaye (1953) stated that the hobby of gardening, as suggested
by her doctor, pulled her out of a “neurotic coma".

Gardening was recommended by G. I. Bayless (1955) for indivicuals who
hhd impaired hearts. This author cited personal experience as proof of
its value and emphasised that the amount of exercise could be suited to the
individual need.

Scope of Opportunity

Horticulture has been used for: hospital patients, vocational
rehabilitation, school children, prisoners,and as a form of leisure for
many'years.

Hospitals: For many years individuals concerned with organization
and management of hospitals have advocated maintaing a garden both as a
source of fruit and vegetables and a recreation area for patients.

In 1792 a meeting of the Society of Friends was held at York to
consider building a habitation for those of their number who were "in a
state of lunacy.‘ One of the stipulations was that the site be designed
to include a few acres for cows and a garden. At the time this description
was written the garden furnished an abundance of fruit and vegetables as
‘well as a place of recreation and employment of many patients (Tuke, 1813).

The visiting committee of the board of the Society of the new York
Hospital reported on December 1, 1821, that female patients were employed
in spinning, sewing, and knitting, but the only occupation found for male

patients was work on the farm or in the garden. In 1882 it was resolved

8
that a man be provided to supervise male patients who were able to assist
on farm and grounds and to see that they were employed in a manner con-
sistent with the plan of moral treatment (Haas, 1924).

Benjamin‘Rush (1830) noted that maniacs who assisted in cutting
_wood, gardening, and other tasks connected with maintenance of the hospitals
'often recovered while those whose rank exempted them from labor did not
recover.

Susan Tracy (1912) recommended indoor gardening as a bedside occu-
pation. She suggested planning a garden, caring for window boxes, growing
seedlings, and propagating plants.

At Nopeming Sanatorium in Minnesota outdoor hobbies were encouraged
(Laird, 1917).

Louis J..Haas (l92h) reported that gardening proved so valuable for
the patients, both male and female, that in 1917 an instructor in gardening
was added to the women's department.

In the 1920's the administration of Iankakee State Hospital provided
opportunities to engage in basketry, horticulture, agriculture, calisthenics,
games, sight seeing trips, and moving pictures for patients in the closed
wards. These activities were administered under the guidance of a recoup
struction aide (Pratt, 1922).

Uilliam.d. Scott in 1923 reported that at Kalamazoo State Hospital
many of the patients were provided with their own small gardens during the
garden season. Vegetables that did not have to be cooked and flowers were
grown: a prise was given to the patient who had the best garden.

Hartwell (1933) reported that landscape gardening had.been used for

several years at Edward Hines Jr. Veteran's Administration Hospital at

Hines, Illinois. The work was done in geenhouses and a half-mile of
landscaped gardens , borders, and lawns. The hospital garden club became a
member of the Federation of Garden Clubs of Illinois in September, 1930.

Hatson and Tukey (1953) described several Horticultural Therapy
projects suitable for use in a hospital and emphasized the importance of
planning the project to suit the probable length of illness.

In 1955 a handbook was published to help volunteers interested in
Horticultural Therapy to use their time most effectively. It pointed out
the need for more volunteer workers and stressed the importance of working
under medical supervision and in cooperation with the hospital staff
(Jones. 1955).

Vocational rehabilitation: During World War I gardening was recom—
mended for the reeducation of disabled soldiers. The curative value of
the work was demonstrated in Stu-spear: hospitals and reconstruction centers.
It was observed that those who were taught gardening and field work made
more rapid recoveries than others. One of the reasons for the therapeutic
value was the emphasis on creation rather than destruction, a more recent
association of soldiers (Harris, 1918).

Walter Campbell (1919) recommended the training of injured soldiers
to become head gardeners on large estates.

During this period the Federal Board for Vocational Education offered
courses in gardening for disabled soldiers and suggested that the con-
tinuation of garden work, which aided in recovery, would help maintain
health. Using the same reasoning, the Red Cross established truck gardens
[near hospitals for wounded soldiers. This proved beneficial physically

and psychologically (0.8. Federal...lducation, 1920).

10

§_g_h_9_9_l_ Gardens: Gardening has been found stimulating for children.
:1. A. Baldwin (1906). principal of State Hormel School, Hyannis, Massa-
chusetts, described their work in school gardens. He stated that the pupils
showed less nervous tension, more freedom, more personal responsibility,
more earnestness, and greater loyalty to the school as a result of this
programme. He suggested that gardening could be coordinated with other
subjects such as business arithmstic, lessons in plants and animals,
sociology, and ethics but advised the teachers to refrain from gardening
programs until they thoroughly believed in them.

Harlan Smith (1916) reported that the system of school gardening as
used in Portland, Oregon, proved valuable not only in terms of monetary
returns, but also in knowledge, health and happiness.

A garden project in East Side New York City provided valuable recrea-
tion and experience for children (Sorden, 1921+). It was such a popular
project that more children applied for gardens than could be accomodated.
Crippled children were brought one afternoon a week to work in the gardens.
These children were helped by other children who were not handicapped.

The annual cash value of the vegetables and flowers grown in this project
was reported to be $6,000.

A rather extensive garden prog'am is operated in the greater Cleve land
Area for the school children (Young, 1955).

Prisons: Prison officials, too, have found gardening beneficial.
Vegetable gardens were planted at San Quentin Prison during World War I
for production of food. An amazing change was noted in the mental attitude
of many prisoners: there were more applications for help than there were

vacancies. After the war, when food production was no' longer vital,

ll
vegetable gardening was abandoned, and the area was used to create a
beautiful garden (Garden Magazine, 1921).

Ira,J. Mills, Director of Agricultural Education, Eastern State Peni-
tentiary, Gratsrford, Pennsylvania (l9#2) reported that one of the subjects
taught was landscape gardening; Two factors were kept in mind. Custody
was foremost but the object to create rather than elimdnate work'was empha-
sized. He even complained because his work was hampered by the lack of
landscape gardeners among the prisoners. An important aspect was Occupa-
tional Therapy for individuals with poor health or physical defects, and
those on the verge of mental disorders. the value was attributed to close
association with the soil and flowers, personal supervision, and continuous
activity.

Leisure: Gardening has long been considered a suitable activity for
leisure time. BenJamin Rush (1789) in a lecture for medical students
recommended that those who intended to serve rural areas establish themselves
on small farms. He suggested that the principal attention be directed to
grass and horticulture because these afforded the most amusement. required
only moderate labor, and would interfere the least with the practice of
' medicine.

After the eight hour day was established in Trance, measures were
taken to provide means for workers to spend their leisure time profitably
since it was believed that idleness would.be injurious to their health and
lives. Labor inspectors were asked to report instances in which employers
had taken the initiative in providing gardens for their employees. Some
of the projects reported were houses with gardens, garden plots near

factories, prizes for keeping gardens in order, and gardens for fathers

12
of the largest families (International Review of Agricultural Economics,
1921).

It was believed that Horticultural Therapy could ease the tension

of daily living and thus become preventive medicine (M.S.C. Leaflet, 195s).
types of Disabilities

[53332; Illness: During the nineteenth century, progress in the
treatment of mental illness was characterized by humane treatment and pro-
vision for activity. Planting gardens and farms, harvesting crops, spading
flower beds, mowing the lawn, repairing roads, helping erect new buildings,
and helping in the greenhouse are listed as activities that proved bene-
ficial to certain classes of the insane (Wagner, 1903).

who use of horticultural activity has been endorsed by many authori-
ties. In 1822, Dr. Hyman, Superintendent of McLean Hospital in.Waverly,
Massachusetts, included gardening as one of the amusements that afforded 4
exercise for the body and the mind (Slagle and.Robeson, 1941). William
Rush Dunton, Jr. (1917) mentioned the opportunity for patients in the
garden at Bethlehem Hospital as long ago as 1840. Dr. Yellowlees of
Glamorgan county Lunatic Asylum reported in 186? that nothing was so con-
ducive to physical and mental health as occupation and that great effort
was made to find employment for all who were capable of it. He said that
the men worked in gardens and fields or with tailors, masons, or blacksmiths.

After visiting several of the principal hospitals for the insane in
Europe, Isaac Ray (18fi6) reported that agriculture was a favorite kind of
employment. At Gloucester, patients were allotted a plot of ground where

they were permitted to grow vegetables for their own table.

13

Lloyd Francis (1887) indicated that in private hospitals the use of
gardening and farming as a treatment, although beneficial, often presented
a problem because the patients resented being asked to work. In public
institutions, however, pauper patients could usually be induced to work by
being given some small luxury, but it was not easy with patients in private
hospitals. Relatives, rather than the patients, often raised objections,
but once the patient did some gardening he seldom objected again. Three
cases were cited (hypochondriacal melancholia, mania, and acute mania--
secondary dementia) in which complete recovery rapidly followed steady
application to outdoor work. Patients with chronic insanity responded
favorably although not always with complete recovery.

Gardening was claimed as a cure for mental breakdowns. In fact,
Bolton Hall (c, 1910) describes three cases in which cultivation of a small
plot of ground proved valuable in cases of melancholia. He even stated that
gardening was considered to be almost as specific a treatment as had been
discovered at that time.

Some of the appreciative as well as the most skilled workers at King's
Park Hospital in New York in 1912, were male patients employed out-of-doors.
They lived in an open door cottage, had the parole of the grounds and re-
ceived fifty cents allowance per week. This group composed a superior class
based solely on conduct: the fact that this privilege had not been abused
indicated how highly the patients had valued the treatment (Haviland, 1912).

Robert Carroll, in a paper read before the Tri State Medical Society
in Richmond, Virginia in 1910, discussed the therapy of work in the treat-
ment of neuroses. In three of the five cases which he cited to prove the

value of workh- not mere passive diversions-gardening played a vital part in

14
the patients' recoveries.

It was recommended that mental patients who had led a life of pleasure
might be prescribed the opposite form of occupation and that at least part
of their time should be spent in the open. Work in flower or vegetable.
gardens was highly recommended (Clark, 1917).

Roy. A. Morter (Jonas, 1955), Medical Superintendent of Kalamazoo
State Hospital, believed that gardening, flower arranging, and competitive
exhibiting of garden prodJects would help mental patients sublimate
useless drives into channels of social and spiritual value.

Egberculosis: Gardening has gained recognition much more slowly as
a treatment medium for tuberculosis than for mental illness. In 1917,
Arthur Laird, without evaluating its success, reported gardening as one of
the activities carried on by convalescent patients at Nopeming Senatorium
in Minnesota.

T. B. Kidner reported in 1922, that attempts had been made to provide
outdoor work for therapeutic purposes but that there had been few examples
of success. Floriculture and gardening were included in a list of activities
suited for patients who have reached the stage in their recovery where more
strenuous activity was indicated. Market gardening was suggested as a
satisfactory field for farmers who have recovered from tuberculosis
(Townsend, 1927).

Mary Lydia Rowe and Ernest S. Mariette (1928) recommended lighter
phases of farm work such as poultry raising, bee culture, floriculture, and
tree surgery for exhpatients. They suggested that the theoretical phase of
these occupations could be taught while the patient was in bed, and the
practical aspect learned after the patient was well enough to use some

exercise.

15

Handicapped: A program of garden therapy was set up at Camp Kilmer
in New Jersey for both functional and psychiatric treatment. The patients
were assigned by medical prescription and the work was supervised by Mrs.
Stephen G. Van Hoesen (Flower Grower, 19#5).

John H. C. Colson (1994) devoted one section of his book, Th2
Rehabilitatigpflgf the ijured, to a discussion and analysis of gardening
procedures as means of treating physical injuries.

In the case of the physically handicapped, hoeing and raking were
considered good for strengthening muscles of disabled arms, and the use
of small, self-propelled lawn mowers was suggested for exercise of the
legs (Tukey and Watson, 1953).

Some of the reasons listed by Mildred Ibach (1955) that garden therapy
can be adapted to the physically handicapped were the following: perfect use
of the hands is not compulsory for planting: complete vision is not needed to
keep planter boxes well watered; good hearing is not essential to enjoy
planting, potting, and caring for tender plants in a greenhouse.

Bligd: One of the first gardens for the blind in this country was
started in 19h9 at John J. Tyler Arboretum at Lima, Pennsylvania (Strong,
1955). Volunteer help was given by many organizations and individuals.

The garden is on a slope where borders may be planted waist high. Plants
were selected for fragrance or flavor, hardiness, and ease of maintenance:
and labelled in Braille. Since then gardens for the blind have been started
in other parts of the Uhited States.

Growing herbs was recommended for blind patients by H. B. Tukey and
Donald P. Watson (1953). They recommended an outdoor herb garden as ideal,

but suggest growing herbs in pots indoors where this was not feasible.

16

The Georgia Academy for the Blind located in Macon, Georgia, built
a greenhouse and started a vocational program in horticulture. Objectives
of the program were: to develop methods for instructing the blind in green-
house production and operation: to devise means by which the blind might
achieve the same objectives as those who see; to set up a course of training
for those over sixteen: to furnish information on new methods of instruction:
and to stimulate expansion of employment opportunities for the blind (Southern
Florist and nurseryman, 1955).

Cardiac: During a pilot study on various aspects of the total care
of the rheumatic and cardiac child conducted at Bellevue Hospital, growing
seeds and caring for plants were among the Occupational Therapy activities
in which the children participated. The educational values of this type
of project was stressed (Yasumura and Baldwin, 1953).

C. R. Bayless (1955) offered the following interesting suggestions
for people who are interested in gardening, but whose hearts do not permit
strenuous activity: don't grow vegetables; sit while working: don't do

heavy digging with spade or fork; and stop at the first feeling of fatigue.
Types of Activities

Aggicultur : In lBQS, the American Journal of Insanity recommended
at least one hundred acres for each institution so the patients would have
an area for labor, exercise, and amusement where they would not be bothered
by intruders.

Isaac Ray (1896) reported that many of the hospitals in Europe
operated farms: ‘Glasgow Asylum, 57 acres; Surrey, 97 acres: Bicetre, 30 or

#0 acres: Illenau, 55 acres. He reported frequent complaints that this was

not enough land.

17

The manager of the Pennsylvania Hospital acquired possession of a
tract of land in 1889, then later obtained several other farms. A group
of patients was sent to live at one of the farm houses: the colony was
changed occasionally. In addition, other patients were taken to the farm
to spend the day. It was noted that a large number of these patients began
and continued to recover (Norton, 1895).

Bolton Hall (b, 1910) commented that farming in connection with
institutions was not new, but he expressed amazement that it was not used
more universally.

Outdoor Gardenigg: Gardening was found to be beneficial for tuber-
cular children by John winters Brennan. Gentle work, fresh air, sunshine,
and interest were considered important factors. J. McKee Borden, secretary
of Public Charities of New York, approved the use of school gardens and
stated that gardens for normal, crippled, feebleminded, and epileptic
children had been increased. Gardening was found so useful in arousing
interest among patients in the Northampton State Hospital for Women that
more extensive plans were made for the future. It was reported that the
Western House of Refuge, Albion, New York, needed women trained in agri-
culture to direct the garden work of the girls (Hall, b, 1910).

Bolton Hall (a, 1910) believed that children who were accustomed to
healthful outdoor occupation as well as play were more likely to become
useful, healthy, and happy adults. He inferred that outdoor occupation
would be especially good for tubercular patients and suggested that each
inmate should have an individual garden plot.

Many of the steps in gardening such as preparation of the ground,

irrigation, and.ditching could not be done by a sick individual: the

18
patients might have to begin by picking flowers (Barton, 1919).

John Ivison Russell (1938) contrasted ordinary garden work, where
patients were expected to show results under the direction of supervisors,
with special parties consisting mainly of dull schizophrenic patients who
were not able to work in the regular groups. He concluded that the duty
of directing these groups was much more exacting than regular garden work
and pointed out the following difficulties: desiring to do the Job one-
self, attempting a Job that was in part too difficult for the patients,
working with valuable material, agreeing to adhere to a work schedule upon
which another group depended. He recommended that authority should be
sufficiently decentralized so that nurses could use their discretion in
planning the work for each group.

The following advantages of gardening were listed by John Colson
(l9##): outdoor work, minimum facilities, inexpensive equipment, productive
work, and work that is familiar to most patients. <He mentioned the follow-
ing disadvantages: the seasonal restriction, limitation of facilities in
every garden, and dependence upon the weather.

Ruth Masher Place (19h8) reported that the possibilities of Horti-
cultural'Therapy had been tentatively explored in rehabilitation programs
for disabld veterans .

Greenhouse gggdenigg: Gardening in a sunrheated pit as carried on at
Gushing General Hospital was described by Kathryn S. Taylor (l9h5). She
recommended that type of greenhouse in preference to a regular greenhouse.
She believed that working with the flowers was valuable in the struggle
back to health.

Bedside gegdenigs: Gardening was suggested by Susan Tracy (1912)

 

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as me of the 8.:
Parker (1952} I
with plants {or

Luiscate
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wining. Ca:
statement that

the treatment 0

19
as one of the activities suitable for bed patients. Cornelia Stratton
Parker (1952) and Maryslle Dodds (1953) each described simple projects
with plants for children who must remain in bed for long periods.

Landscape ameciation: Isaac Bay (18%) was favorably impressed
with the bemtifully landscaped grounds of many European hospitals for the
insane and commented that these beautiful surroundings were capable of
arresting the attention of the violent and excited, diverting the melan-
cholic, and furnishing occupation and delight to the convalescent. He
recommended that selection of a hospital site should be based not only on
the prospect it afforded, but also on its possibilities for landscape
gardening. Carl 1'. Pilat (1921:) summed up the therapeutic values in the
statement that pleasant surroundings were more important than pills in

the treatment of tuberculosis.

III. DEVELOPMENT 03‘ HQRTICULTUHAL THERAPY
In the Early Period

Egyptian temples dedicated to Saturn were early examples of the use
of gardens for the treatment of illness. These temples were surrounded by
beautiful groves and gardens. Boating, concerts, and other amsements
were provided for the diversion of the ill (Pratt, 1922: Slegle, 1941).

The Aesculapian temples at Ipidaurus were famous for their "cures”.
These temples, also, were surrounded by groves and located so that there
was a beautiful view in every direction. The beautiful surroundings and

pure mountain air contributed to many recoveries (Ball, 1924).

f

In the Eighteenth and Nineteenth Century

Little more evidence of the use of horticulture as a therapy was
noted until the latter half of the eighteenth century. At a time considered
to be the beginning of modern psychiatry, physicians began emphasizing
“moral treatment" of mental patients instead of imprisonment and treatment
by purely physical methods. This "moral" management consisted essentially
in treating the mentally ill as human beings, releasing them from chains,
placing on them as much responsibility as they could carry, and providing
them with diversional activity (Pinel, 1806: Deutsch, 1938: Clendening, 1942).

The value of the use of activity in the treatment of the ill was
discov red somewhat by accident. It became customary for the poorer
patients to be forced to work in’ the hospitals. Growing fruit and vege-
tables for use in the institutions and keeping of cows and horses were

vital phases of maintaining the hospital Consequently gardening and other

21
agricultural work were among the first tasks to which patients able to
work were assimed. It was noted rather universally that these poorer
inmates frequently recovered while the idle rich remained ill (Rush, 1830).

Pinel (1806) mentioned specifically a hospital in Saragossa, Spain,
where agriculture and horticulture proved beneficial to patients.

Gardening was considered sufficiently important that in 1792, when
the Society of Friends planned The Retreat, a hospital near York for the
mentally ill, it was thought necessary to procure a site where there would
be a few acres for cows and a garden.

Benjamin Rush, in 1798, was sufficiently convinced of the therapeutic
value of work that he recommended that effort be made to find employment
for as many patients as were able to work. One of the activities he
suggested was digging in the garden (Norton, 1895: Packard, 1931; Haworth
and MacDonald, 19%).

By 1845, the practice of keeping patients employed at some trade or
on the farms was apparently widespread. The value of the exercise and
diversion that kept the patients from dwelling on their troubles was so
apparent to Daniel Trezevant (American Journal of Insanity, 1845) that he
recommended forcing patients to work although he did not state how this was
to be done.

Outdoor labor in the garden, on the grounds or farm was reported as
one of the many means of "moral treatment“ need at the Pennsylvania Hospital
(Iirkbride, 1845: Morton, 1895). There are reports of similar activities
being used during this period at McLean Hospital, Bethlehem Hospital, and
Glamorgan County Lunatic Asylum (Danton, 1917).

The importance of a suitable location for a hospital was pointed out

22

in the American Journal of Insanity for 18b5. A farm area and pleasant
surroundings where the patients would be shielded from intruders were
considered vital.

In 1846, Isaac Bay reported that during his recent tour of several
mental hospitals in Europe he had observed that agricultural labor was
a favorite kind of employment and complained that patients in America
would not work without pay. He, too, pointed out the necessity of selecting
a suitable site for an institution so that the grounds could be made attrac—
’tive.

Dr. Danton, (1917), inferred that during the period from 1860-1890,
many hospital superintendents and physicians stressed the economic value
of work above its therapeutic application.

During the nineteenth century most of the activities were necessary
Jobs connected with maintenance of the institutions (Wagner, 1903; American

Journal of Insanity, 1903).
In'the Twentieth Century

During the early part of the twentieth centuryy gardening
and other activities were being used in a variety of institutions. W..A.
Baldwin, principal of State Normal School, Hyannis, Massachusetts (1906),
and Harlan D. Smith of Bortland, Oregon, (1906) both reported favorable
results from the use of gardening activities in connection with schools.
Gardening was found beneficial in tuberculosis hospitals, an orphan
asylum, and a women's reformitory (Hall, a, b, 1910: Laird, 1917).
Discussions of the therapeutic value of work in the treatment of

the mentally ill written during this period continued to list gardening

D.

23
as one of the valuable activities (Hall, c, 1910: Carroll, 1910; Haviland,
1912: Clark, 191?). Bolton Hall (c, 1910) and Robert S. Carroll (1910)
both describe case histories in which gardening and other outdoor work was
valuable in promoting recovery. -

By this time,activity as an aid in the treatment of disease had \
stained Wmsmiefiort vssmds-tolse_viss- 99mpations—B-Part
from maintenance of the institution. We have evidence of this in the pub-
licaticnu’Studies in_lnvalid Occupations by Susan E. Tracy (1912),
Occupation Therapy by William Rush Dunton Jr. (1918), and Teachigg_the Sick
by George Edward Barton (1919). All three of these'books recommend gardening
as one of the activities that may be used.

It is interesting to note that in 1917 an instructor in gardening was
-addsd to the women's Occupational Therapy department in Bloomingdale Hospital
located in white Plains, New York (Haas 1924).

During and immediately following World War I, gardening was used in
the treatment and reeducation of disabled soldiers. The primary emphasis
appears to have been diversional and psychiatric rather than functional
(Harris, 1918: Campbell, 1919: U.S. Federal Board for Vocational Education,
1920).

Several of the articles and books about Occupational Therapy which
were written during the period from 1920 to 1940 mentioned gardening with
varying degrees of emphasis (Scott, 1923; Haas, 1924; Perkins, 1925; Howe
and Mariette, 1928; Hartwell, 1933: Russell, 1938).

Beginning about 1940 there were increasing instances where "garden
therapy“ was discussed as a separate type of treatment (Hamilton, 1942;
Mills, 1942; Taylor, 1945). Richard.Wright (194j) used the word 'horto-

therapy,“ and Ruth Masher Place (1948) called it "horticultural therapy."

2h
During the second World War gardening was used as treatment for injured
soldiers with apparently much greater emphasis on functional treatment
than was evident during World.War I (Licht, 19h4; Flower Grower, 1945).
All of these refer primarily to outdoor gardening or greenhouse gardening.

Investigations into the potentialities of the use of horticulture
as a therapy were begun in the Department of Horticulture at Michigan State
College in 1951. .A series of workshops for interested therapists, nurses,
and horticulturists was followed by testing procedures, demonstrations,
and distribution of information (M-S-C. Leaflet, 195k),

About this time much of the impetus and activity for the work in
Horticultural Therapy was the result of vigorous activity on the part of
many garden club members in the United States (Ibach, 1956).

Carl Menninger (Jonas, 1955) strongly favored training individuals
in Horticultural Therapy since this is one type of adjunctive therapy
which brings the individual close to the soil, to beauty,and to the
mystery of growth and development.

Other phases of horticulture such as floriculture, plant propaga-
tion, and plant physiology were stressed during the early 1950's. There
was increasing effort made to devise horticultural projects suitable for

use indoors and for bed patients (Horticulture, 1953; Watson and Tukey,

1953; Ibach. 1955: @99511925),

/////////;j;§;paratively recent development was the emphasis on gardensaigr
' \

(r the blind as teaching devices, possible vocations, and recreation (Strong,

‘ dfl‘.-‘-~-.-—*, ,... ~

1

\ 1955: Ibach. 1955).

IV. PRELIMINARY TESTS AT KALAMAZOO STATE HOSPITAL

Introduction

In order to serve as a pilot study, an exploratory program of
HorticulturalTTherapy was conducted at Kalamazoo State Hospital during
July and August of 1955.

Specific horticultural skills were taught to a selected group of
eight mental patients. Previously, except for a few years during the
early l920's,1ittle closely supervised gardening was conducted.

This pilot study included the following: outdoor gardening, plant
identification, elementary plant science, flower arrangement, plant
propagation, and related short term.projects.

Host of the patients were women; occasionally both men and women ,
were exposed to a project at the same time. Some of the short term
projects were executed by a small group of men who were confined to their
ward. Three half-days a week were devoted to preparation for classes,
written reports, and introduction of Occupational Therapy students to the

values of horticulture as a treatment medium.
Outline of Activity

Table 1 has been made to illustrate the system of operation that

was used for an outline of activity at Kalamazoo State Hospital.

 

 

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26

Explanation of Procedure

Ho department of Occupational Therapy can function efficiently
without the integration of all its units. The original plan for the
Horticultural Therapy group, one of the units of the department, was
adapted to fit into the Occupational Therapy program. In the interest
of good integration, upon occasion, plans had to be changed, and the
patients were encouraged to use their newly-learned skills for the benefits
of the larger group, for example: filling planters for the new Occupational
Therapy building, arranging flowers for the lmployees' Luncheon. Sometimes
horticultural activities were canceled in the interest of a general pro-
Ject, such as the pageant, which involved a greater number of patients.

The patients were motivated to feel that the horticultural group was not
an entity in itself, but that anything the group could do for the good of
the hospital community was important.

June 20. The case history of each patient assigned to Horticultural

Therapy was studied for better understanding of their individual problems.

June 21. Each.year the Occupational Therapy department presents a
pageant in which fifty to one hundred patients participate. .411 other
patients' activities are canceled for the day, and the entire Occupational
Therapy staff is expected to assist with the preparation, production, and

cleaning up afterwards.

June 22. Once a month the hospital Employees Association meets during
the noon hour for luncheon, business meeting and short program. Once a year

retired employees attend and are each given a corsage or boutonniere. Cut

27
flowers for the corsages and table decorations are furnished by the

hospital greenhouse.

June 23. It was originally planned to cover a different phase in
flower arranging--arrangements in low bowls, arrangements in tall containers,
miniatures, color combinations, stone-each week. Considering the hesitance
with which the patients participated in a new project, it was decided,
rather, to give the group only a few general rules and let them work with
the flowers as they wanted, varying the instruction with each patient as

she gained self-confidence and skill.

June 24. Potter Club, a selected group of women patients, meets
once a week under the direction of a Red Cross Grey Lady; During the
summer, the principle activity is planting and maintaining a group garden.
No attempt was made to supervise or change the plan that has been followed
in the past, but only to assist the volunteer and take charge when she was

unable to come.

June 27. It was planned to work with men and women at the same
time, and permission was obtained for a selected group of men to meet
with the women. But since hospital rules required a male employee to be
present whenever male patients were in the group, it was decided to have
a mixed group only on the Tuesday afternoon walks, when a male recreation
worker could be with them. Several of the short term.proJects were intro-

duced to another group of men who were too 111 to leave their ward.

June 28. The Tuesday afternoon walks were less varied than origi-

nally planned. Identification of trees with the intention of labeling

28

them proved so slow that most of the time was spent in this activity.

June 29. A.new building for the Occupational Therapy department
was completed recently, all members of the department spent some time help-
ing love supplies and equipment from the old quarters to the new building.
The task of filling planters to be placed in the windows and stair landings,

was assigned to the Horticultural Therapy group.

July 8. Since this was a trial program, more time was spent writing
reports and preparing for class than ordinarily would be used this way.

Part of the responsibility of each therapist is to help train
Occupational Therapy students who are affiliated with the hospital for a
twelve-week period. Each student was assigned to Horticultural Therapy for
one week during which she was given a brief history of Horticultural Therapy,
was instructed in some of the skills that could be used in a treatment pro-
gram, and was given opportunity to observe patients as well as assist the

therapist.

July 8, p.m. The Potter Club usually spent Friday afternoon in the
garden, but because of inclement weather, the group remained inside, dis-
cussed the plants,and compared descriptions from books describing flowers

and vegetables.

July 19. It was decided to discontinue including men on the plant
identification walks since only one or two of the assigned group had been

‘present each week.

July 20. These gardens were examples of unsupervised gardening by

some patients who were permitted on the grounds without an attendant.

29
Some of the gardens had been maintained by the same patients for several
years. Pictures were taken to be compared with pictures of supervised

'activities.

August 1. Pictures of patients engaged in Horticultural Therapy
activities were shown to the medical staff to get the medical superin-
tendent's permission to use them with the lecture to be given at the state

meeting of the Michigan Association of Nurserymen.

August 9, 10. The dedication of the new Occupational Therapy build-
ing was followed by open house and conducted tours of the building. The
preceding day was spent in last minute preparation with which patients
were encouraged to help. After thirty years of planning for a separate
Occupational Therapy building, this opening day was a momentous occasion

and afforded a good opportunity to incorporate horticultural enthusiasm.

August 24. Leaves were collected and pressed each time the group
studied types of trees. Some of these were used for spatter prints.
Others were used for making leaf designs by pasting leaves and leaflets on

colored construction paper.

September 8. Since this was planned to be a temporary program, at
the end of the twelve week period all borrowed books and other articles.
were returned, the room cleaned, and the collection of potted plants dis-

tributed to various rooms in the new Occupational Therapy building.

Observations

Part of the garden area was divided into small plots, each of which

30
was assigned to one patient who was responsible for its maintenance. The
remainder of the garden was designated for a group project supervised by
a volunteer. Gardening was by far the most popular activity.

As the group learned to look for identifying characteristics of
leaves, flowers, and other plant parts, interest grew, and a few of the
patients became keenly observant. Plant identification.was much slower
in arousing interest than was gardening. Plant identification appealed to
fewer people.

Several leaf and stem cuttings of plants were rooted in moist sand
or vermiculite, potted, and used in the Occupational Therapy Department.

It was impossible to propagate some species because of the high temperature
of the Horticultural Therapy rooms. Propagation provided good contact

with living plants and was of great interest to those who were confined
indoors.

One afternoon a'week was devoted to the study of plant parts and
plant functions. A series of ten lessons was planned to expose the patients
to a cross section of general elementary plant science. Each lesson con-
sisted of a short lecture with examples, or demonstrations, followed by a
simple laboratory exercise in which the patients participated. Educational
films were used to supplement some of the lessons. It was observed that
as the patients learned more about the plants they became more interested
in all phases of horticulture.

Once a week the patients arranged flowers. Following a few rules,
they were allowed to choose containers, select flowers, and make any type
of an arrangement. Frequently they asked for criticism. Many were eager

to help one another.

31

Making corsages aroused considerable interest, not only among the
members of the Horticultural Therapy group, but also among other patients.
One of the groups which had not been exposed to the work in Horticultural
Therapy was sufficiently interested to request instruction in corsage mak-
ing, so that the group could use these corsages for special occasions.

Many short projects related to herticulture offered opportunities
for self-expression. Spatter prints of leaves allowed choices in color
of paper, color of paint, and.variety in leaves. Pictures made by pasting
pressed leaves to construction paper in an original design also provided
opportunity for creative expression.

Papier—mfidhfi pots were made in a variety of shapes, and each
painted a different color. This project, although not utilizing plant
materials, was closely related to propagation of house plants. Hanging
baskets were lined with.sphagnum and filled with soil for planting Philg:
dendron and Tradescantia. These provided interest not only during the short
time required for constructing them, but also this interest continued day by
day as the plants grew and developed.

An attempt was made to grow grass on corncobs which were resting up-
right in shallow containers of water. This project was disappointing
because the moisture did not rise high enough on the cob for the grass seed
to germinate.

The group spent one afternoon making mobiles of dried flowers. Since
none of the patients had seen mobiles before, this session served to intro-
duce the idea, and to demonstrate some of the principles involved. A.mobile

made of flowers offered possibilities for artistic expression.

V. SUGGESTED FROG: { FOR OCCUPATIONAL THERAPISTS
Introduction

Horticultural Therapy presents such a variety of possibilities that
some activity may be suitable for any type of patient. The actual program
will vary with.the type of hospital, the facilities, and the personnel.

If the hospital staff is large enough, one person might give full
time to a program of Horticultural Therapy. A.therapist might work only
with one group of patients who would spend their entire time in horticul-
ture. A.second system‘would be to work with a different group each day,
with patients working in other activities the rest of the time. A.third
system would be one in which the therapist could work with individuals
either in the wards or within an Occupational Therapy group.

Where there are not enough therapists so that one can devote full
time to horticulture, one afternoon a.week might be given to gardening or '
flower arranging for all patients. When this is not done, patients could
engage in a horticultural activity and serve as a source of stimulation
for the interest of others in the group.

Frequently most of the actual program is administered by volunteers.
Since volunteers ordinarily work one half day a.week, it is most suitable
to assign a small group of patients to each volunteer. This type of pro-
gram is most effective when it is directed by a therapist who understands

not only the patients, but also the fundamentals of the activity.

Types of Patients

Probably a greater variety of Horticultural Therapy activities has

33
been used in the treatment of mental illness than any other type of disa-

bility. Gardening, plant identification walks, and gathering materials for
dish gardens or vegetable dyes can be used to develop group feeling. They
provide outdoor activity and help maintain physical well-being. Dish gardens,
spatter prints of leaves, and mobiles of flowers provide outlet for creative
expression. Vegetables and flowers may be given to those who cannot par-
ticipate: this will help develop the attitude of sharing. Hoeing and spading
can provide release for aggression.

The use of Horticultural Therapy in tuberculosis hospitals is largely
diversional during the active stages of the disease. As the lesions heal,
horticultural activities may be increased to begin building work tolerance.
Activities may range from watching the growth of seedlings, sweet potato
Vine, or terrarium to limited work in the garden such as tying plants to
3takes. Some activities involving mostly movements of hand and lower arm
are the following: button gardens, raking scrapbooks of flower arrangements,
and-c-for those who are ambulatory—transplanting seedlings into flats.

The duration of hospitalization of patients in general hospitals may
Vary from a few days to several months. Projects involving gowing plants
Vould be of little benefit to the short term patient; flower arranging,
making pictures from pressed flowers or leaves, or simple experiments in
botany would be of benefit. If the patient can make a garden after he
has returned home, he might plan one on paper. Choice of projects for the
long term patient such as cardiac or metabolic disorders would be limited
Only by the nature of the illness.

Many horticultural activities can be used with or without adaptations

to increase range of motion, strengthen weak muscles, and increase co-

 

 

34
ordination. Running a lawn mower or pushing a cultivator will help

increase strength and coordination of the legs. Pruning will strengthen
gasp. Raking may be used to strengthen shoulder girdle muscles and
increase range of motion of elbow and shoulder. Shoveling soil affords
exercise for nearly every muscle. Making corsages or picking off dead
flowers or leaves may be used to develop coordination of the hand.

Horticniltural Therapy for the blind should be directed toward
increasing tactile sense, and developing self confidence and independence.
Plant materials should be chosen which can be recoglised by smell or touch.
Herbs are excellent, also plants which have thick, hairy, or distinctively
Shaped leaves. Avoid plants that have thorns or those that will be easily
damaged by handling. Potting plants, weeding, loosening soil with a trowel,
and. counting large seeds for germination tests can be used to advantage.,

People who have hearing difficulties often feel neglected. Plant
61‘owth is a msteriously silent function, and can give as much satisfac-
tion to the deaf as to those who have normal hearing. Horticulture provides
many opportunities to work in a group. Distributing potted plants or flowers
to the wards or making collections of flowers or leaves for study will help
develop the feeling of importance.

Children are often intrigued by processes of growth. Watching bulbs
come into flower, forcing branches of spring-flowering shrubs , and planting
seeds from oranges or gapes foster this interest. flaking collections of
Pressed flowers, making pictures from seeds, or performing simple experi-
‘“ants in plant growth can provide many hours of interesting activity for
a. child who must remain in bed. Gardening activities such as sowing seeds,

Picking berries, clipping grass with shears, or pushing a small wheelbarrow

 

 

35
can help a cerebral palsied child develop coordination, while getting the

benefits of sun, fresh air, and contact with the soil. “any of these
children lack this opportunity because of overprotection by the parents.
Horticulture may have special appeal for older people. Many geriatric

patients feel that life offers them little purpose. Caring for growing
plants and propagation of house plants can help reawaken an interest in

life and keep the older person interested in the future. Old people may
feel useless and unwanted and a burden to others. Drying and packaging
herbs for sale, or dying leaves for winter arrangements may provide enough

pin money to help the person maintain a feeling of independence.
Required Facilities

The amount of equipment varies with the mimber of patients and the
tYpes of illness or disability being treated. As with other types of
Occupational Therapy, the ingenious therapist must be willing to substitute
or adapt equipment to make the most of what facilities are available.

03.9.22: Whenever possible, outside work should be encouraged. A
garden plot devoted only to Horticultural Therapy would be ideal, but the
care of the hospital grounds can provide a variety of activities. The
area should be large enough so there may be both individual and group
gardens. If the patients are to work only a short time in the garden,
11: may be well to choose a location that can be plowed and fitted with a
tractor. While annual flowers and vegetables are probably more useful in
a. treatment program, added space for per/ennial flowers, bulbs, and small
fruits will add variety to the project.

Greenhouse: A yeenhouse is valuable to extend gardening activities

 

L7

 

36
in cold weather throughout the months when it is impossible to garden
outdoors. If it is connected to the main building, it will be accessible
to wheelchair patients or others who cannot go outside during severe
weather.

9&1; £5993: A cold frame may be used as a supplement or a substi-
tute for a greenhouse for starting seedlings in the spring, for protecting
some of the less hardy perennials during the winter, or for rooting potted
bulbs prior to forcing them into flower. Heating coils buried in the soil
or incandescent light bulbs placed above the plants will increase the
length of time for using a hot bed during the winter months.

193:5 £993: lhether or not a greenhouse is available, there should
I be a work room for activities not directly related to growing the plants.
The room should have plenty of table space, sufficient storage for flower
containers, pots, soil, tools and other supplies. A refrigerator is
necessary if cut flowers are to be stored any length of time. If there
in no greenhouse, this room should have water outlets and windows suitable
1‘ or growing plants. There should be some means of controlling temperature
and ventilation. It is preferable to locate this room on the ground floor
to minimise the labor of bringing in soil, sand, and other heavy supplies.

m 221$: If much work is to be done on the wards, a cart with
which to transport supplies to the patients is useful. The exact design
will vary with the type of projects. It should have bins for sand and
Soil; space for pets; drawers for florist wire, tape, and ribbons: and
Space for shears, pliers, knife and other small tools. If the number
Of stairs makes a cart impractical, a basket is useful.

Promtion case: A propagation case is necessary for rooting

3?
cuttings. Basically it is a box to hold sand with a depth of three inches

and covered with a pane of glass. It may be one coldframe within another
for added insulation, or it may be a metal frame covered with plastic film
and. placed over a shallow planting box. For one or two cuttings, two
inches of moist sand in a mason jar is satisfactory. Provision for supply-
ing bottom heat is good.

§_9__i_l sterilizer: Electricity, steam, or chemicals are used to
sterilize soil, and the selection of the method will depend upon the other
facilities, the frequency of its use, and the amount of money available.

Library: A bookcase for gardening books for patients to read and
reference books for the therapist is necessary. Files of clippings, pam-
Phlets, seed and equipment catalogues are useful.

M: Always remember to arrange as unch hand work as possible. It
may not be necessary to have many tools. The type of program and number of
Patients will influence the selection of tools.

A suggested listing of tools and equipment is compiled in Table II.

Adaptive egipment: In addition to equipment and tools needed for
the gardening processes, other equipment is necessary to adapt these pro-
ceases to the patients. An ace bandage holds a hand with weak grasp on the
handle of a tool. Foam rubber held on the handle of a trowel with adhesive
tape makes it large enough for a hand that cannot close tightly. Adhesive
tape is necessary to protect sensitive hands from becoming blistered from
unaccustomed tools. Wheelchairs should be provided with lap boards at a .
comfortable height. A plastic sheet should be used to protect bedding,

rubber coated gloves for patients who must not use water.

 

TABLE II

SUGGESTED TOOLS AND EQUIPMENT

Essential
Bamboo lawn rake Labels (wood and plastic)
Bamboo stakes Lawn mower
Baskets Measuring cup
Flats Measuring spoons
File for sharpening hoes Pruning shears
Garden hose (plastic) Spade
Garden line and stakes Spading fork
Hand duster String
Band sprayer Trowel
Hoe Watering can
Iron rake Yardstick
Knife
For specialised projects

Asparagus knife Manure fork
Carryall for tools Pruning saw
Dibber Pushcart for leaves, etc.
Flats Rotary tiller
Gloves Sickle
Grass edging shears Soil sieve
Hedge shears soil test kit
Knapsack sprayer Tamper
Kneeling pad Turf edger
Lawn fertiliser distributer Wand for weed control
Lawn roller chemicals
Lawn sprinkler Wheelbarrow
Loping shears Wheel hoe cultivator

For ward or work room activities
Gannister set for soils Pots
Chenile wires Ribbons
Chicken wire Scotch tape
Container for flowers Seed catalogues
Floral clay Shears
Floral tape Stapler
Florists wire: f28,l8,10 Syringe
Flower holders Tablespoon
Knife Thermometer

Longbnosed pliars
Magnifying glass

38
Limitations

.All programs of Horticultural Therapy are limited by the avail-
ability of facilities. The size of the garden area determines the extent
of outdoor activity.

Horticultural programs are necessarily limited by the nature of the
illnessor disability. ror instance, patients who must lie flat in bed
cannot be expected to be as active or engage in as great a variety of
activities as wheelchair patients. A.patient with.tuberculosis cannot
work with materials that are dusty; hospital rules forbid the use .f'
certain materials or tools by mental patients.

The living qualities of plants present additional limitations, one
of the most serious of which is their seasonal requirement. Not only are
outdoor activities seasonal and dependent on the weather, but indoor
activities often are dependent on the growth of plants. An unexpected
shower can upset the program for several days.

Living plants require regular and constant attention. This is one
of the advantages of Horticultural Therapy since it tends to sustain
interest. When the patient becomes temporarily too ill or for other
reasons is unable to give the plants the care they need, the entire
project may fail unless someone else does the work. Special provision
may have to be made to care for plants during weekends or vacations, but
a break in the sequence of personal attention often defeats the purpose
of the therapy.

Many projects which involve a variety of activities do not provide
enough of any one acrivity to be beneficial to patients who need to de-

velop a specific muscle. As an example, the use of a trowel for planting

39
tomato seedlings may provide the desired motion for the wrist and arm,
but the process of planting is a minor part of the total work involved
in growing tomatoes. Clipping hedges might be an ideal exercise, but
few hospitals have enough hedges to provide activity for a long period
of treatment. I

Horticultural Therapy projects can be messy. Making spatter prints
of leaves may be a desirable project for abed patient, but it is not
practical without adequate protection. Corsage making invariably leaves
the bed scattered with debris unless precautions are taken to protect
the bed with a plastic sheet. With previous planning and considerap
tion for the necessary hospital sanitation, most projects can be adapted
to suit the existing conditions. .

Cut flowers are perishible. Surpluses cannot be stored for a long
period of time.

Disposing of the produce or finished product may be a limiting
factor. Propagation of house plants may be the project of choice for
one mental patient, but there is a limit to the number of plants one can
give away. An important motivation is that the patient feel that the
product will be used.

Horticultural projects require more space in relation to the hours
of activity provided than do many other crafts or skills. The use of
large potted plants may have to be denied because they require space out
of proportion to the amount of activity they provide. The interest aroused
by growing small fruits is important and the amount of work involved is a
good feature, but the space required might be too great to warrant this

activity.

40
It is difficult to time growth of plants so that there is always a
variety of projects available. Processes involving living plants cannot
be postponed for the convenience of the patient.
Some patients are not interested in plants, or dislike getting their
hands dirty. Much of the value of Horticultural Therapy is lost if the

patient is not motivated by a genuine interest.

VI. SELECTED PROJECTS APPLICABLE TO TREATMENT PROGRAM
Introduction

The following discussion of projects is not intended to be an
exhaustive list, but rather to demonstrate the wide variety of suitable
activities of a horticultural nature, and to suggest how each may be used
in a treatment program. No attempt has been made to give detailed in-
structions: instead, sources of further information are included.

Whenever possible, outdoor gardening should be the backbone of a
Horticultural Therapy program since it combines contact with living plants,
exercise, fresh air, and sunshine. Other outdoor projects requiring a
shorter time may be used for variety and are especially valuable during
periods when the gardens require less care.

When patients cannot go outside, greenhouse gardening or indoor
gardening provide excellent substitutes. Projects using cut flowers offer
opportunities for creative expression and for developing the attitude of
sharing. Other indoor projects using plant materials are suggested for
short term illnesses, to add wiriety, to maintain interest when outdoor
work is inadvisable, and for instruction regarding the structure and
function of plants. Many indoor craft projects may be related to a
Horticultural Therapy program.

The analysis of activities involved in outdoor gardening lists
only those physical or mental processes which are most prominent in each

activity.

42

 

 

Projects
Outdoor{gprdenigg;
_ Flower gardens ' ‘Hock gardens
rlowers for cutting A Vegetable gardens
Fruit Wall gardens
Gourds Water gardens
Herb gardens
.O_t_h_e_1_'_ outdoor projects:
Constructionp-coldframe Labeling plants
Constructions-greenhouse Lawns
Dish gardens-ogathering Hature hunt
materials
Gathering seeds Pruning
Identification of plants Staking plants
ladder. ass—en :
‘Aquariums Hanging baskets
Bulbs-forcing House plants--care
Bulbs-propagation} House plants-propagation
Button gardens IKitchen window
Dish gardens-aplenting Terraria
Gregghouse gardening: '
Greenhouse gardening
9111 m onects:
Corsages Flower arranging
Dried arrangements Forcing branches of flowering shrubs

Drying flowers Hobiles of flowers

Buds-identification
Buds-dissection
Germination test
Herbs--drying
Herbs-freesing
Identification of plants
Jack-o'-lanterns

Lawn in a petri dish

Belated indoor projects:

Ceramic pots
Constructionp-garden
furniture
Construction-~plant tubs
Educational films

Garden planning

1+3

Other indoor pgojects‘using’plant materials:

Plant growth
Potting plants

Preserving flowers in plastic

’ Pressed flowers--collections

Pressed flowers--pictures
Propagation
Spatter prints of leaves or flowers

Vegetable dyes

Papier mache containers
Reading
Scrapbooks

Soil testing

Description and Source of Information

Outdoor gggdenigg:

Flower gardens—-
may be planned to present a unified picture. This project takes more
preliminary planning than does a cutting garden in order to arrange the
flowers according to height and color. Suitable accessories may be made
to be used in this type of garden.

Barber,.Angus C. 1954. Annual Flowers. Faber and Faber Ltd.,

London.

an
Dakers, J. S. 1951. Annuals for Garden and Greenhouse. W. H. and

L. Collingridge, Ltd. London. Transatlantic Arts, Inc. New York.

Hottes, Alfred Carl. 1949. Flower Garden for the Amateur.
Midland Publishers. Forest Park. Ill. Distributed by Garden

City. W. Y.

Maceelf, A. J. 1950. Hardy'Perennials. W. H. and L. Collingridge,

Ltd. London. Transatlantic Arts, Inc. New York. '

Robbins, Ann.Roe, 1949. How to Grow Annuals. MacMillan.

New York,

Rockwell, P. P., and Ester Grayson. 1955. The Complete Book of
Annuals. The American Garden Guild and Doubleday and Co., Inc.

Garden City, New York.

Flowers for cutting?-

may be grown as part of a larger gardening project, or may be a separate

project. Gardens to be used only for cutting usually are planted in rows

.so the flowers may be out without trampling the other plants. Spading,

hoeing, and weeding offer plenty of opportunity for physical exercise.
Emsweller, S. L. 1950. Growing Annual Flowering Plants. U.S.D.A.

Parmers' Bulletin 171. U. S. Gov't Printing Office, Washington.

Spry, Constance. 1946. Flowers in House and Garden. J. M. Dent

and Sons, Ltd. London.

Thompson, Mollie. 1947. Cut Flowers. Cultivation and Arrangement

in the House. Garden Publications, Ltd. 55 Russell Square W. C. I.

45
Fruit-~growing apples--
valuable, if trees are well cared for. Their primary value is in main-
taining interest. Dwarf trees or espaliers produce more fruit per unit
area than do normal sized trees. What fruit is not eaten raw may be used

for cooking projects or made into miniature Jack-o'-lanterns.

Chandler, William Henry. 1951. Deciduous Orchards. Lea and

Feb iger , Philadelphia.

Hedrick, U. P. l94#. Fruits for the Home Garden. Oxford University

Press. New York. 61-73.

Seymour, F. L. D., Ed. l95fi. (Espalier) The Wise Garden Encyclo-

pedia. ‘Wm. H. Wise and Co. New Yerk. #37-438. 1236-1237.

Southwick, Lawrence. 1948. Dwarf Fruit Trees. Macmillan.

New York. 103-115. 2h9—286.

Fruit-u-zrowins blueberries-

requires acid soil so special provision must be made in areas where soil
is neutral or alkaline. They may be grown in tube of acid soil sunk in
the ground. A few such plants would add variety to the Horticultural

Therapy program and thus help maintain interest.

Johnson, Stanley. 1953. A.New Method of Growing Blueberries in

the Home Garden. Michigan Quarterly Bulletin. 36 No. 2: 226-229.

Knapp, H. 3., and E. C. Auchter. 19u1. Growing Tree and Small

Fruits. John Wiley and Sons, Inc. New York. 571-580.

Shoemaker, James Sheldon. 1950. Small-Fruit Culture. The

Blakiston Co. Philadelphia. 342-375.

Frui tna‘rowing grapes--

a good group project which may be used alone or as part of a larger garden-
ing project- One or two plants will stimulate interest and provide fruit
to be eaten raw; several plants 'can be trained to shade a porch or arbor

and. will produce enough fruit for Jelly.

Knapp, H. 3., and E. C. Auchter. 1941. Growing Tree and Small

Fruits. John Wiley and Sons, Inc. New York. 195-428.

Hagoon, C. A. 1943. Grapes for Different Regions. U. S. D. A.

Farmers' Bulletin #1936. Gov't Printing Office, Washington.

No mthor. 1955. Grapes in the Home Fruit Garden. M. S. C.

Cooperative Extension Service, East Lansing, Michigan.

Fruit--£n'owinz beaches--
the primary-value is the interest stimulated rather than the amount of
activity involved in pruning or spraying.

Chandler, William Henry. 1951. Deciduous Orchards. Lea and

Febiger. Philadelphia. 325-341.

Harris, Leon. M. H. Haller, John C. Dunegan, L. C. Cochran. and
B. A. Porter. 1951. Peach Growing East of the Rocky Mountains.
U.S. D. A. Farmers’ Bulletin #2021. Gov't Printing Office,

Washington.

4?
Hedrick, U. P. 1944. Fruits for the Home Garden. Oxford university

Press. New York. 86—97.

Fruit-arowing'raspberries--

a good group project. It may be divided into separate projects-~pruning,

picking, spreading mulch-~to provide exercise for specific muscles or joints.

Knapp. H. B., and D. C. Auchter. 1941. Growing Tree and Small

Fruits. John Wiley and Sons, Inc. New York. 529-562.

Markham, Ernest. 1936. Raspberries and Kindred Fruits. Mac-

millan and Co., Ltd. London.

Shoemaker, James Sheldon. 1950. Small-rru1t Culture. The

Blakiston Co. Philadelphia. 220-323.

Fruity-growing,strawberries--
in rows provides opportunity for exercise of most of the muscles and joints

through the following activities: preparing the soil, planting the plants,

hoeing, weeding, and picking the fruit.

Darrow, George M. 1944. Strawberry Culture: Eastern united States.
U. S. D. A. Farmers' Bulletin #1028. Gov't Printing Office.

Washington.

Knapp, H. B., and E. C. Anchter. 1941. Growing Tree and Small

Fruits. John Wiley and Sons., Inc. New York,468-494.

Shoemaker, James Sheldon. 1950. Small-Fruit Culture. The

Blakiston Co. Philadelphia. 117-219.

48
Wyld, Robin. 1953. The Howbto Book on Strawberries. The Berry

Patch. Honeoye Falls, New York.

Fruit-—Strawberrv Barrel--
will produce fruit in two or three months if overbearing varieties are
used. Other than boring the holes in the barrel and filling it with soil,
little physical labor is required. The novelty of this method of growing
strawberries arouses considerable interest.

Wyld, Robin. 1953. The Howbto Book on Strawberries. The Berry

Patch. Honeoye Falls, New York. 99-100.

Gourds--

interesting not only while they are growing in the garden, but also as
indoor craft projects using the mature gourds. These may be dried com-
pletely, then shellacked or waxed and used in dried arrangements or other

indoor decoration.

Beattie, W. R. 1940. Useful and Ornamental Gourds. U. S. D. A.

Farmers' Bulletin #1849. U.S. Gov't Printing Office. Washington.

Tillinghast, Helen M. 1937. First Gourd Book. Copyright by

author.

Young, Sibyllac, 1952. The Curing and Preserving of Gourds.

Horticulture. 30:345.

Herb gardens--
provide the same range of activities as other types of gardens. These may

contain perennial herbs, annual herbs, or some of each. They require

49
little space. Some herbs may be grown indoors as pot plants or in
window boxes.

Clarkson, Rosetta E. 1942. Herbs, Their Culture and Uses.

Macmillan. New York.

Hersey, Jean. 1953. Garden in Your Window. Andrew Malrose.

London. 158-171.

Lowman, M.S., and Miriam Birdseye. 1946. Savory Herbs: Culture
and USe. U. S. D. A. Farmers' Bulletin #1977. Gov't Printing

Office. Washington.

Miloradcvich. Milo. 1952. The Home Garden Book of Herbs and

Spices. Doubleday, Garden City, New York. 21-44.

Rock~gardens-

appropriately placed can add interest to the garden design. Considerable

labor is involved in placing the rocks, filling the spaces with top soil,

and setting the plants. The care of the garden after it is established is
almost entirely handwork. Strawberries are appropriate plants for a rock

garden that is near a vegetable or fruit garden.

Bissland, James H. 1938. Common Sense in the Rock Garden. A. T.

De La Mare 00., Inc. New York.

BushpBrown, Louise and James. 1952. America's Garden Book. Charles

Seribner's Sons. New York. 624—636.

Phillips, G- A» R- 1946- The Heck Garden and Alpine Plants. W. H.

and L. Collingridge, Ltd. ‘London.

50

Vegetable gardens--

more than flower gardens appeal to many men, though women seem to enjoy

both equally well. It is advisable to plant only those vegetables which
may be eaten raw‘unless cooking facilities are available to patients or

arrangments are made for the produce to be used in the hospital kitchen.

Coulter, Francis C. 1942. A Manual of Home Vegetable Gardening.

Doubleday, Doran and Co., Inc. Garden City, New York.

Dempsey, Paul W. 1942. Grow Your Own Vegetables. Houghton

Mifflin Co. Boston.

Foley, Daniel J. 1944. Vegetable Gardening in Color. Mac-

millan. New York.

Fox, Helen Morgenthau. 1943. Gardening for Good Eating. Mac-

millan. New York.

Wall gardens--
with plants planted in soil pockets between the rocks are best if planted
as they are being built. .A completed wall makes a good background for a

flower border, or vines may be trained on it.

BushpBrown, Louise and James. 1952. America's Garden.Book.

Charles Scribner's Sons. New York. 639-642.

Cattell, Mary Deputy. 1955. Garden on a Wall. Flower Grower.

42:98-99 . 141,142.

No author. 1954. Better Homes and Gardens Garden Book.

Meredith Publishing Co. Des Moines, Iowa. 249-258.

51

Water Gardens-

a center of attraction in any garden. The construction can provide

several hours of beneficial activity; growing water plants can stimulate

interest.

Fletcher, H. L. V. 1951. The Water Garden. John Lehmann. London.

Perry, Frances. 1938. Water Gardening. Charles Scribner's Sons.
New York.

Wells, A. Laurence. 1937. Garden Ponds, Fish and Fountains.

Federick Warns and 00., Ltd. London and New York.

Other Outdoor Projects:

Construction--ccldframe~-

a wood.working project closely related to horticulture.

Beattie, W. R. 1952. Bbtbeds and Coldframes. U. S. D. A.

Farmers' Bulletin #17Q3. Gov't Printing Office. Washington.

BushpBrown, Louise and James. 1953. .America's Garden Book.

Charles Scribner's Sons. new York. 724-737.

Construction—-zreenhouse-

the simpler types may be constructed by a group of patients working under
capable direction. Greenhouses should be constructed with special aisles,

ramps, and equipment.

Beattie, James H. 1952. Greenhouse Construction and Heating.

U. S. D. A. Farmers' Bulletin #1318. Gov't Printing Office.

Washington.

52
Beattie, J. H. 1954. Sash Greenhouses. U. S. D. A. Leaflet

#lZG. Gov't Printing Office. Washington.

No Author. 1953. Sunset Ideas for Building Plant Shelters and

Garden Work Centers. Lane Publishing Co. Menlo Park, California.
3h-5l.

Dish aardens-—gathering materials--
furnishes incentive to go on long walks. Moss, tiny native plants, interest-
ing pebbles, and other materials gathered from a nearby woods may be used to

create a miniature garden in a dish.

Gathering seeds--
followed by drying, cleaning and packaging helps patients learn names of
plants and methods of distribution of seed: provides outdoor activity after

weed control is no longer vital.

Bates, H. l. 1991. The Seasons and the Gardener. The university

Press, Cambridge. 52953.

Clarkson, Rosetta.B. 195G. Herbs: Their Culture and Uses.

Macmillan. New York. 50,65.

Identification of plants-outdoors-
gives added incentive for long walks which will be leisurely, because each
new tree or wild flower may have to be studied several minutes before it

can be identified. This helps develop keen observation.

Curtis, Carlton C. and S. C. Bauser. The Complete Guide to North

American Trees. The New Home Library. New York.

53
Hausmann, Ethel Hinckley. 1948. Beginner's Guide to Wild

Flowers. G. P. Putnam's Sons. New York.

Otis, Charles Herbert. 1938. Michigan Trees. University of

Michigan Press. Ann Arbor, Michigan.

Platt, Rutherford. 1952. "American Trees. Dodd, Mead and Co.

New York.

Selsam, Milicent E. 1950. Play with Trees. Wm. Marrow and Co.

New York.
Wherry, Edgar T. 1998. Wild.Flower Guide. Doubleday. New York.

Zia, Herbert S. and.Alexander C. Martin. 1950. Plowers:.a Guide

to Pamiliar American Wild Flowers. Simon and Schuster. New York.

Labeling plants-
helps in learning to identify plants. Making the labels is a good activity
for bed patients. Labels for plants to be used by the blind should be made

in braille.

Lamson, Mary Deputy. 1951. Garden Housekeeping. Oxford Univer-

sity Press. New York. 43-50.

Schramm, J. H. 195“. A.Heezamination of Plant Label Problems with

Some New Designs. Norris Arboretum Bulletin. 5:36—h3, 97-53.

Seymour, B. L. D. Ed. 1959. The Wise Garden Encyclopedia. Wm.

H. Wise and Co., Inc. New York. 725-726.

51+

Lawns-maintainina-
pushing a lawn mower can help develop strength and coordination of legs
and trunk. Clipping grass at edges of walk or flower beds helps strengthen

STBSP-

Flynn, Joseph F. 1951. How to Grow and Keep a Better Lawn.

Simon and Schuster. New York. 1-20, 34-7h.

Helady, John Haves. 1952. Better Lawns for Your Home.

Grosset and Dunlap. New York. 53-118.

Lawns--makingp-

involves strenuous physical exercise in leveling, rolling and seeding.

Farnham, Richard, and Van Wie Ingham, Ed. 1946. The Home
Owner's Guide to Better Lawns, Trees. and Gardens. Grosset and

Dunlap. New York. 103-111.

Flynn, Joseph P. 1951. How to Grow and Keep a.Better Lawn.

Simon and Schuster. New York. 21-33.

Melady, John Hayes. 1952. Better Lawns for Your Home.

Grosset and Dunlap. New York. 17-52.

Nature hunt-

develops keen observation. Small groups of patients may develop a competi-
tive spirit by identification of trees, flowers, birds, other native and
cultivated plant or animal life. Working as groups instead of individuals

helps develop group feeling.

55
Buck, Margaret Waring. 1950. In Woods and Fields. Abingdon-

Cokesbury Press. New York.

Parker. Bertha Morris. 1952. The Golden Treasury of Natural

History. Simon and Schuster. New York.

Pruning-
exercises hands and arms and provides a suitable outlet for the urge to
destroy. Pruning is done at various times of the year depending on the

type of plant. New plants will not respond to pruning.

Christopher, Everett P. 1954. The Pruning Manual. Macmillan.

New Yerk.

Hudson; Roy L. 1952. Sunset Pruning Handbook. Lane Publishing

Co. Menlo Park, California.

Staking plants-

important in maintaining the appearance of a garden. This procedure can be
done more easily by two people, thus providing opportunity for patients to
learn to cooperate with each other. Tying plants to stakes increases co-

ordination of hands and fingers.

Free, Montague. 1952. Let Your Garden Support Its Own. The Home

Garden. 19 No. 6:h1-h3.

Lamson, Mary Deputy. 1951. Garden Housekeeping. Oxford University

Press. New York. 35-h3.

No Author. 1954. Plant Stakes, Supports, and Ties. Better Homes

and Gardens. 32 No. 63191-192.

56
Bales; W=

Aquariums--

Probably the easiest of all indoor gardens to maintain; an ideal project

for someone who is too ill to participate in any activity. Goldfish may

be added to increase interest.

’Free, Montague. 1952. .All About House Plants. The American

Garden Guild, Inc., and Doubleday and Co., Inc. New York. “0-43.

Morgan, Alfred. 1951. An.Aquarium.Book for Boys and Girls.

Charles Scribner's Sons. New York.

Post, Kenneth. l9h5. Plants and Flowers in the Home. Orange

Judd Publishing Co., Inc. New York. 140-151.

Bulbs-forcingb-

a comparatively short term project which requires little effort on the part
of the patient if hyacinths, daffodils, paper white narcissus, or amaryllis
bulbs are used: a project which stimulates interest because of the rapid
growth of leaves and flowers. Potting of bulbs to be rooted is good for

ambulatory patients or wheel chair patients.
Field, Xenia. 1954. Growing Bulbs in the House. Collins. London.

Free, Montague. 1952. All About House Plants. The American

Garden Guild, Inc., and Doubleday and Co., Inc. New York. 178-196.

Bulbs-—prona£ation--
a project which is often too long for many patients to complete, but the

following steps of which make suitable short projects: scoring hyacinth

bulbs,

57

planting bulblets outdoors, and digging and separating bulbs.

Propagation is particularly good because it involves the creation of new

individual plants.

Button
may be
may be
offers

jects:

Adriance, Guy'w., and Fred H. Brison. 1939. Propagation of Horti-

cultural Plants. McGrawbHill Book 00., Inc. London. 9G-ll5.

Emsweller, S. L. 1954. Flowering Bulbs, National Horticulture

Magazine 33 No. 1:63-69.

Wood, Allen H., Jr. 1936. Bulbs for Your Garden. Houghton

Mifflin Co. Boston. 18h-197.

gardens-

made by glueing small dried flowers to large buttons. Live gardens
made by using bits of cacti and other succulents. This project

an opportunity for patients who must be limited to very small pro-

good to help develop coordination of the hands.

Casebolt, Florence Waye. 1952. Button Gardens and Diminutive

Arrangements. The Button Garden Studio. Berkely, California.

mo. Maurice s. 1950. How-to Garden on a Button. The American

Home. hn Ho. 6:62-63.

Dish gardens--nlanting—-

allows

opportunity for creative expression by use of a variety of plants

and other materials to form a miniature garden. Planting dish gardens

for patients who cannot participate actively develops the attitude of

sharing.

58
Beard, Patten. 1930. Adventures in Dish Gardening. A. T.

DeLa Mare 00., Inc. New York.

Noble, Mary, and J. L. Merkel. 195G. Plants Indoors. D. Van

Nostrand Co.. Inc. New York. 185-191.

Rockwell, F. F., and Ester C. Grayson. 195#. The Complete Book
of Flower Arrangements. The American Garden Guild, Inc., and

Doubleday and Co., Inc. 223-232.

Hanging baskets--
stimulate interest because of their novelty. Filling the baskets is the
major part of the activity unless the project includes making the basket
of wood. This project is better done in the work room of potting shed
than in the wards. It requires less space for growing plants than if
grown in individual pots.

Genders, Roy. The Greenhouse for Pleasure and Profit. Museum

Press Ltd. London. 135-1h3.

Shewell-Cooper W. E. 1938. Home, Window and Roof Gardening.

The Epworth Press. London. 39-h2.

No Author. 1952. The Portable Garden. Lane Publishing Con

Menlo Park, California. 31-3G.

House plants-~care--
develops sense of responsibility since plants must not be neglected. The

number and type of plants should be determined by the ability and need of

each patient.

59
Crow, Juliana. 1952. Your Indoor Plants. Weidenfeld and

Nicolson. London.

Free, Montague. 1952. All About House Plants. The American

Garden Guild, Inc., and Doubleday and Co.. Inc. New York.

Jones, Margaret 3., and H. F. Clark. 1952. Indoor Plants and

Gardens. The Archetectural Press. London.

Mulford, Furman Lloyd. 1941. 4House Plants. U. S. D. A. Farmers'

Bulletin 1872. 'U. S. Gov't Printing Office. Washington.

Noble, Mary and H. L. Merkel. l95G. Plants Indoors. D. Van

Nostrand Co., Inc. New York.

House n1ants--propagation.-

a good indoor activity that helps fulfill the urge to create. This pro~
,ject may'be limited to cuttings that root most easily, or be made a
challenge by selecting species that are difficult to root. Potting of
the rooted cuttings may be done as a bedside activity if provision is

made to protect the bedding.

Bertrand,.A. 1953. Succulent Plants. Philosophical Library.

New Ybrk. 17-29.

Crow, Juliana. 1952. Your Indoor Plants. Weidenfeld and

Nicolson. London. 38-69.

Noble, Mary, and J. L. Merkel. 1954. Plants Indoors. D. Van

Nostrand 00., Inc. New York. 161-169.

Thayer, Clark L. 1954. Propagation of House Plants. The

National Horticulture Magazine. 33 No. 1:79-86.

Kitchen Window
tops of carrots, beets, and parsnips planted in moist sand make quick-
growing “bushes” for miniature gardens. Sweet potatoes grow long

luimriant vines if the lower end is placed in a tumbler of water.

Hersey, Jean. 1953. Gardens in Your Window. Melrose.

London. 153-157.

Ickis, Marguerite. 1945. Pastimes for the patient. A. S. Barnes

and Co. , Inc. New York. 6—7.

Schneider, Herman and'Nina. 1951. Plants in the City. John

Day Co. New York. 79-482.

Selsam, Milicent E. 1916. Play with Plants. Wm. Morrow and Co.

New York. 2-15 .

Terrariap-

require delicate care after they are planted. This can supply detail for
fastidious patients to work with tweezers and manicure scissors. Native
plants may be gathered for these indoor gardens, but care must be taken to
use together only those plants that require similar environments. Ter-
raria differ from dish gardens in that the container is transparent and
deep enough so that it may be covered to keep the moisture in. A terrarium
is usually planned to be viewed from the side, while dish gardens are seen

from thO top.

61
Free, Montague. 1952. All About House Plants. The American

Garden Guild Inc., and Doubleday and Co., Inc. New York. 20-32.

Hersey, Jean. 1953. Garden in Your Window. Melrose. London.
180-185 .

Parker, Bertha Morris. 1950. Garden Indoors. Row, Peterson

Greenhouse Gardenias:

Greenhouse gardening-

continues gardening activities throughout the year. This is more appro-
jpriate for wheel chair patients or those who may be on their feet only

short periods of time than is outdoor gardening.

Chabot, Ernest. 1946. Greenhouse Gardening for Everyone. M.

Barrows and Co., Inc. New York.

Dakers, J. S. 1949. Simple Greenhouse Management. Transatlantic

Arts. New Yerk.

" Reynolds, Ray. 1952. Grow Extra Dollars at Home. Copyright

by Ray Reynolds. Armonk, New York.

Taylor, Kathryn S. and Edith.W. Gregg. 1941. Winter Flowers

in the Sunpheated Pit. Charles Scribner's Sons. New York.

011...; m w=
Corsages- _

may be made from a variety of flowers, leaves, and dried materials. This

 

 

62
is a universally fascinating phase of horticulture because corsages are
associated with happy occasions and because they stimulate the urge for
giving. This is an excellent project for developing coordination of the
hands.

Biddle, Dorthy and Dorothea Blom. 1952. Making Corsages at Home.

M. Barrows and Co., Inc. New York.

Drummond, Mary Basel. 1953. Styling Corsages with Garden Flowers.

Macmillan. New York.

Reusch, Glad, and Mary Noble. 1951. Corsage Craft. D. Van

Nastrand Co., Inc. New York.

Dried arrangements--

a good winter activity when fresh flowers may be scarce--offers oppor-
tunity for creative expression and for increasing coordination of the hands.
Working‘with.dried flowers may be considered advanced flower arranging
because, due to the brittleness of the materials, greater car must be taken

in handling them.

Bear, Elizabeth. 1953. Better Flower Arrangements for Home and
Exhibition. Laurel Publishers. Scranton. Distributed by Grosset

and Dunlap. New York. 55-61.

Gannon, Ruth. l9u9. Winter Bouquets with Color. The Studio

Publications. New York.

Ishimoto, Tatsuo. 1951. The Art of Driftwood and Dried Arrange-

ments. Crown.Publishers, Inc. New York.

63

Drying flowers--
provides an outlet for surplus flowers from patients' gardens. Some may
be dried satisfactorily in the air: others must be carefully covered with
sand, talc, or borax to preserve their shape. These may be used in winter
'bouquets, to decorate boxes and place cards, or to make three-dimensional
pictures.

Miloradovich, Milo. 1952. The Home Garden Book of Herbs and

Spices. Doubleday and Co., Inc. Garden City, New York. 185-190.

Rockwell, F. F., and Ester Grayson. 1955. The Complete Book
of Annuals. The American Garden Guild and Doubleday and Co.,

Inc. Garden City, New York. 139-143.

Uhderwood, Raye Miller. 1952. The Complete Book of Dried

Arrangements. M. Barrows and Co. New York. 23-38.

Blower arranging»-
by ambulatory, wheel chair, or bed patients provides an outlet for creative
expression, develops coordination of the hands, and gives experience in an

art that can be continued after the patients recover: one of the most popu-

lar skills.

Bear, Elizabeth. 1953. Better Flower Arrangements for Home and
Exhibition. Lem-e1 Publishers. Scranton. Distributed by Grosset

and Dunlap. New York.

Corrick, Margaret, 1955. Creative Flower Arranging. M. Barrows

and Co., Inc. New York.

64
Ishimoto, Tatsuo. 1947. The Art of Flower Arrangement. Crown

Publishers. New York.

Rockwell, F. F., and Ester Grayson. 1954. The Complete Book of
Flower Arrangement. The American Garden Guild, Inc., and Double-

day and Co., Inc. New York.

welsh, Nell True. 1942. Sunset Flower Arrangement Book. Lane

Publishing Co. Menlo Park, California.

Forcing'branchss of flowering shrubs--

brings the optimism of spring indoors during the winter months. Cutting
branches and placing them in water for the other patients to enJoy pro-

vides a short period of invigorating outdoor activity: it helps develop

the attitude of sharing.

McClelland, Hill. 1948. How to Force Branches in the House.

Plants and Gardens. 4:2394240.

McLane, Stanley. 1950. Garden Guide by Months for the Midwest.

Prank Glenn Publishing Co. Kansas City, Missouri. 30-31.

Rockwell, P. F., and Ester C. Grayson. 1954. The Complete Book
of Flower Arrangement. The American Garden Guild, Inc., and

Doubleday and Co., Inc. New York. 255-257.

Mobiles of flowers-
offer opportunity for creative expression while teaching the principles of
balance. The completed mobile may be enjoyed by a bed patient who cannot

participate in any activity. If dried flowers are used, the noble will

65
last indefinitely.

Garrick, Margaret. 1955. Creative Flower Arranging. M.

Barrows and Co., Inc. New York.. 115-128.
Lynch, John. L953. Making Mobiles. Design. 55:72-74, 100.

No Author. 1955. How to Make a Mobile. Flower Grower. I

42 No. 10:60.

Other Indoor Projects Using Plant Materials:
Buds-~identification—~

dissection of winter buds to show bud scales, tiny leaves or flowers
for next spring. This may be used as a lesson in elementary plant science,

or to arouse interest.

Otis, Charles Herbert. 1954. Michigan Trees. University of

Michigan Press. Ann Arbor.

Trelease, William. 1918. Winter Botany. Published by author.

urbane.
Wilson, Carl L. 1954. Botany. The Dryden Press. New York. 24—26.

Bulbs--dissection--
to show the miniature plant within a.hyacinth bulb. This may be used as
part of a lesson on specialized plant parts in the fall to stimulate

curiosity and interest. This project requires only a few minutes.

Post, Kenneth. 1955. Florist Crop Production and Marketing.

Orange Judd Publishing Co., Inc. New York. 568-834.

66
Germination test--
a necessity when using donated seeds of unknown age; a good pro-season
project to arouse interest. Counting large seeds can help blind persons

develop their tactile sense.

Adriance, Guy W., and Fred B. Brison. 1939. Propagation of

Horticultural Plants. McGraw-Hill Book Co. New York. 62-63.

Clarkson, Rosetta E. 1954. Herbs; Their Culture and Uses.

Macmillan. New York. 18-19.

Seymour, E. L. D., Ed. 1954. The~Wise Garden Encyclopedia.

Wm. H. Wise and Co., Inc. New York. 1114-1115.

Herbs-~dryinga-
picking the leaves is good exercise for the hands; this may be done by
blind persons because the plants may be identified by scent. Drying and

packaging are indoor projects.

Clarkson, Rosetta E. 1942. Herbs; Their Culture and Uses.

Macmillan. New York. 46-51.

Hewer, D. G., 1944. Practical Herb Growing. G. Bell and Sons,

Ltd. London. 23-33.

Miloradovich, Milo. 1952. The Home Garden Book of Herbs and

Spices. Doubleday. Garden City, New York. 45-49.

Herbs--freezingp-

where facilities are available is a good method of keeping the flavor and

odor of the herbs.

67
Miloradovich, Milo. 1953. The Home Garden Book of Herbs and

Spices. Doubleday. Garden City, New York. 51-56.

Identification of p1ants--indoors-
a collection of potted plants is valuable for teaching plant characteris-

tics-a good winter project.

Bertrand, A. 1953. Succulent Plants. Philosophical Library.

New York.

Noble, Mary, and J. L. Merkel. 1954. Plants Indoors. D. Van

Nostrand Co., Inc. New York.

Jack-o'-lanterns-
a good indoor activity for Halloween except for patients who are not per-
mitted to handle knives. Provision may be made ahead of time by planting

plenty of pumpkin seed each spring. This activity is enjoyed by all ages.

Lawn--in a petri dish-
or on a moist sponge--a simple project to stimulate interest. The "lawns"

may be used as part of a dish garden.

Plant growth--

and other phases of plant physiology can be demonstrated by experiments
which may be as simple as laying a potted coleus plant on its side to
demonstrate negative geotropism or as complex as elaborate experiments in
plant nutrition. These experiments may be used as part of a lesson or as

a separate project.

Loomis, Walter E., and Charles A. Shell. 1937. Methods in Plant

68

Physiology. McGraw-Eill Book Co. . Inc. New York and London.

Parker, Bertha Morris, and Orlin D. Frank. 1953. Plant

Factories. Row, Peterson and Co. Evanston, Ill. 35-36.

Schneider, Herman and Nina. 1951. Plants in the City. John

Day Go. New York. 149-56.

Selsam, Milicent E. 1949. Play with Plants. Wm Marrow and

Co. New York. “0-63.

Potting plants--
a. good activity involving mostly hands and arms. This is best done in the

greenhouse or workroom, but may be done to a limited extent in wards or as

a. bedside occupation.

Crow, Juliana. 1952. Your Indoor Plants. Weidenfeld and

Nicholson. London. 58—69.

Free, Montague. 1952. All About House Plants. The American

Garden Guild, Inc. and Doubleday and Go. New York. 66-73.

Noble, Mary, and J. L. Nerkel. 1951+. Plants Indoors. D. Van

Nostrand Co. , Inc. New York. 10-26.

IDreaervation of flowers in plastic--

a. specialized procedure. Imbedding living plant material in a thermosetting
ple‘fitic is definitely an advanced project for skilled patients. Either dry
or fresh flowers may be used, though some fresh flowers change color. The

BI3eczimens thus preserved may be kept for identification purposes or used as

pvaI>er weights.

69
Bick, Alexander F. 1954. Plastics for Fun. Bruce Publish-

ing Co. Milwaukee 88-89.

Walton. Barry. 1951. Plastics for the Home Craftsman.

McGraw-Hill Book Co... New York. 173-183.

Pressed flowers-u-collectionu

a three-phase project: gathering and pressing the flowers, mounting the
d_.ried flowers, and using the collection for plant identification. Divid-
ing the project among three individuals or three groups will stimulate the

Patients' interest in each other.

Underwood, Raye Miller. 1952. The Complete Book of Dried

Arrangements. M. Barrows and Co. New York. 92-129.

Zarchy, Barry. 1943. Let 's Make More Things. Alfred A.

Knopf. New York. lilo-1&1. (leaf or flower press),

Pr 98 Bed flowers-epictures-u-
a good bedside project using flowers or leaves that ambulatory patients

haVG gathered. The complete picture may be framed.

O'Brien, Patricia. 1950. How to Decorate with Pressed Leaves.

Better Homes and Gardens. 29 No. 2:7“,260.
No Aubhor. 1952. Flowers Under Glass. School Arts. 51:203.

E I Obagation-cuttinaau \

\

the usual method for propagating many house plants, such as geranium, coleus ,

and chrysanthenmm. This may also be used to propagate many plants usually

70
grown outdoors. Cuttings are made of leaf, stem, or root depending on the

8p66168.

Adriance, Guy W. , and Fred R. ‘Brison. 1939. Propagation of

Horticultural Plants. McGraw—HillBook Co. New York. 126-147.

Gardner, Victor B. 1951. Basic Horticulture. Macmillan. New

York. 284-293.

Skinner, Henry T. 1954. Leaf-and-Bud Cuttings. National

Horticulture Magasine. 33 No. 1:19-21.

PrO‘Dagation-a-zraftageu
an advanced project for skilled patients, but not recommended for mental
Patients because grafting requires the use of very sharp knives. This may

be used on gape, apple and spruce.

Mriance, Guy N. , and Prod H. Brison. 1939. Propagation of

Horticultural Plants. NcGraw-Hill Book Co. New York. 149-212.

Gardner, Victor R. 1951. Basic Horticulture. Macmillan. New

York. 293-310 .

Vhitehouse, V. B. 1951+. Budding and Grafting. National

Horticulture Magazine. 33 No. 1:25-36.

P1- Obagat ion-- layer ing—
llmathod used for propagating pyrachantha, yapes, reapberries, and ficus.
I: O‘bably not enough new plants would be needed to use this project for

exercise of a specific joint, but this would be a good project for arousing

and. sustaining interest.

71
Adriance, Guy H., and Fred R. Brison. 1939. Propagation
of Horticultural Plants. McGraw-Hill Book Co. New York.

116-125.

Greech. John L. 1954. Layering. National Horticultural

Magazine 33 No. 1:37-43.

King, R. J. 1950. The Propagation of Plants. Hutchinson's

Scientific and Technical Publications. New York. 76-109.

Pronagat ion-seeds--

flown in pots or flats provide plants for outdoor gardens. In areas raving
a short gowing season it is necessary to start some varieties indoors be-
fore the weather is suitable for outdoor planting. Some house plants can
13.! propagated by seeds. Transplanting the seedlings to other flats so they

can have more room provides activity for the hands.

Creech, J. L. , and W. 0. Harley. 1955. Sphagnum Moss for Plant

Propagation. U. S. D. A. Farmers' Bulletin No. 2085. Gov't

’Printing Office. Washington.

Dempsey, Paul. W. 1942. Grow Your Oxm Vegetables. Houghton

Mifflin. Boston. 118-128.

l‘ox, Helen Morgenthau. 1943. Gardening for Good Eating.

Macmillan. New York. 13-27.

King, E. J. 1950. The Propagation of Plants. Hutchinson's

Scientific and Technical Publications. New York. 15-83.

 

72
Snatter prints of leaves or flowers-
may be used for identification of plants or to decorate posters or signs.
This activity provides exercise for hands and arms. It may be used for

bed. patients if provision is made to protect the bed.

Ickis, Marguerite. 1943. Arts and Crafts. A. S. Barnes

and Co. New York. 43.

Parker, Cornelia Stratton. 1952. Your Child Can Be Happy in

Bed. Thomas Y. Crowell Co. New York. 169.

Zarcby, Harry. 1943. Let's Make More Things. Alfred A.

Knopf . New York. 142-118.

Vegetable dyes-
gathering and preparing plant materials to be used for dyeing cloth will
a'vIF'IPeal to the adventurous person who wants to try "something different“.

This is a good short term project.

Clarkson, Rosetta E. 1942. Herbs: Their Culture and Uses.

Macmillen. 3.. York 52-57.

Furry, Margaret S. , and Bess M. Viemont. 1935. Home Dyeing

with Natural Dyes. U. S. D. A. Washington.

Jaeger, Ellsworth. 191+9. Berry Juices and Plant Dyes. Nature

Magazine . 42:473-47».

Leechman, Douglas. 1918. Vegetable Dyes. Oxford University

Press. Toronto.

73
Related Indoor Prod ects:

Ceramic flower pots and containers-

wi 11 maintain interest in horticulture during the winter especially where
there is little work to be done with living plants. Pots may be made by
pouring "slip" into a plaster of paris mold: more opportunity for self

expression is possible with other methods.

Daugherty, John Wolfe. 1939. Pottery Made Easy. The Bruce

Publishing Co. New York.

Ickis, Marguerite. 1943. Arts and Crafts. A. S. Barnes

and Co. New York. 255-272.

Kenuv. John B. l9h9. The Complete Book of Pottery Making.

Greenberg Publisher. New York.

0 0 no trust ion-«garden furni ture--
an indoor project which may be completed indoors to maintain interest in
ga{Pauling during bad weather or to stimlate horticultural interest in

groups not directly engaged in gardening.

Champion, Pml V. 1946. Attractive Lawn Furnishings. The

Bruce Publishing Co. Milwaukee.

Wakeling. Arthur, Ed. 1953. Home Craftsman's Book of
Garden Furniture, Barbecues, and Fences. The Home Crafts-

man Publishing Corp. New York. 5-52.

No Author. 1953. How to Build Outdoor Furniture. Lane

Publishing Co. Menlo Park, California.

 

71k
construction—-plant tubs and flower pot stands--
an indoor project. The tubs may be used for large plants outdoors or in

the greenhouse.

Wakeling, Arthur, Ed. '1953. The Home Craftsman's Book of
Garden Furniture, Barbecues, and Fences. The Home Craftsman

Publishing Corp. New York. 78-79. 82.
{'1

No. Author. 1952. The Portable Garden. Lane Publishing Co.,

Menlo Park, California. 15-30.

Educati anal films-- I

 

an activity enjoyed by nearly everyone. Films may be used for teaching
Purposes, arousing interest, or merely diversion. This is especially

81.11 table for bed patients or closed ward patients.

Ga-:Pcle1:1 planning-- '

a. good short term project for bed patients who have a garden at home. This
may be used as an indoor phase of a garden project at the hospital. It may
be no more than planning the lumber of rows and plants per row in a ten

f°°t plot, or landscaping an entire home lot.

Farnham, Richard, and Van Hie Ingham. 19%. The Home Owner's

Guide to Better Lawns, Trees, and Gardens. Grosset and Dunlap.

New York. 3-90. ,

Click, D. Newton. 1955. Landscape and Planning for Residential

Properties. Michigan State University. East Musing, Michigan.

 

Korbob'o, Raymond P. 1954." Complete Home Landscaping and Garden

 

 

75

Guide. Wm. H. Wise and Co. , Inc. New York.

Morris, Norman L. 1946. Your Book of Garden Plans. The

Garden Press. Los Angeles.

I I.
No Author.‘ Sunset Ideas for Landscaping Your Home. Lane

Publishing Co. Menlo Park, California.

PEI-"o i er-maché containers--

may ‘be made in a variety of sizes, shapes, and colors for dried arrangements.

They can be used as pots for cacti and other plants that require little

 

water.
l

Moritz, Laverne. 1953. Papier-Maché. LaVee Studio.

New York. 3-11.

Zarchy, Harry. 1953. Creative Hobbies. Alfred A. Knopf.

New York. 158-159.

Readinab-
Particularly suitable for bed patients, but may be enjoyed by anyone.

Reafiling about the plants in one's garden can lessen the disappointment

°f being prevented from working outdoors because of unexpected rain.

Clarkson. Rosetta E. 1940. Green Enchantment. Macmillan

New York.

Goethe, C. M. 1948. Geogardening. The Keystone Press.

Sacramento, California.

Grigson, Geoffrey. 1952. Gardenage. Routledge and Keegan

76
Paul . London.

Hottes, Alfred C. 1949. Garden Facts and Fancies. Dodd,

Mead and Co. New York.

S crapbooks-u-

a. good individual project for bed patients. Ideas for flower arrangements,

atep-by—step illustrations of common garden procedures, or easily under-

stood instructions for culture of plants may be found in many of the

magazines that accumulate in hospitals. Seed and nursery catalogues are

good sources for pictures of flowers, vegetables, shrubs, and house plants

 

that may be used for learning plant names when actual specimens are available.

301.1 testing-- ,
a. Valuable procedure especially in geenhouse gardening. Patients interested
in the scientific aspect of gardening would enjoy this activity. Kits with

8Petrific instructions are available at most garden supply houses and most
state agricultural experiment stations.

Miller, Charles lrnest, and Lloyd M. Turk. 1951. Soil Science.

John Wiley and Sons, Inc. New York. 320-321.

Upmann, Elsa. 1941. The Visual Garden Manual. Lane

Publishing Co. San Francisco. 37.

Additional Sour ce Material

Children's Books:

Bates, H. E. l9Lrl. The Seasons and the Gardener. Cambridge
University Press. Cambridge.

Buck, Margaret Varing. 1941. The Golden Treasury of Natural
_ History. Simon and Schuster. New York.

Cormack, M. B. 1951. The First Book of Trees. Franklin Watts,
Inc. lsw York.

Dickenson, Alice. 1953. The First Book of Plants. Franklin
‘ Watts, Inc. New York.

Kaine, M. G. 1937. Adventures in Gardening for Boys and Girls.
Greenburg, Publisher. New York.

Marshall, Virginia Stone. 1954. Flower Arranging for Juniors.
Little, Brown and Co. Boston.

Morgan, Alfred. 1951. An Aquarium Book for Boys and Girls.
Charles Scribner's Sons. New York.

Parker, Bertha Morris. 1951. Garden Indoors. Row, Peterson
and Co. Evanston, Illinois.

Parker, Bertha Morris. 1952. Seeds and Seed Travels. Row,
Peterson and Co. lvsnston, Illinois.

Parker, Bertha Morris, and Orlin D. Frank. 1953. Plant Factories.
Row, Peterson and Co. Evanston, Illinois.

Parker, Bertha Morris, and Illa Podendorf. 1952. The Plant
World. Row, Peterson, and Co. Evanston, Illinois.

Schneider, Herman and Nina. 1951. Plants in the City. The
J'Ohn Day Go. New York.

Selsam, Milicent E. 19%;. Play with Plants. Wm. Morrow and Co. ,
Inc. New York.

Selsam, Milicent E. 1950. Play with Trees. Wm. Morrow and Co. ,
Inc. New York.

Weber, Irma E. Bits that Grow Big. William R. Scott, Inc. New York.

I:QIupment :

Herbert, Fred W. , and Oswald K. Hoglund. 1953. An Improved Method

78

of Making Plant Containers. U. S. Government Printing Office. Washington.

National Committee on Wood Utilisation. 1929. You Can Make It.
U. 5. Government Printing Office. Washington. 26-37.

Reynolds, Ray. 1952. Grow Extra Dollars at Home. Copyright by
Ray Reynolds. Armonk, New York.

Garden Calendgrs:

Biles, Roy F. 1943. The American Family Garden Book. Garden City,
New York. 129-160.

Lamson, Mary Deputy, 1951. Garden Housekeeping. Oxford University
Press, New York. 143-161.

McIane, Stanley. 1950. Garden Guide by Months for the Midwest.
Frank Glen Publishing Co. Kansas City, Missouri.

Melady, John Hayes. 1952. Better Flowers for Your Home and Garden.
Grosset and Dunlap. New York. 11-27.

Greenhouse Calean :

Dorrance, Anne. 1935. Gardening in the Greenhouse. Doubleday,
Doran and Co. New York. 115—118.

 

Reynolds, Ray. 1952. Grow Extra Dollars at Home. Copyright by
Ray Reynolds. Armonk, New York. 28.

Tools:

 

Biles, Roy F. 194,3. The American Family Garden Book. Garden City,
New York. 13-16. '

Bush-Brown, Louise and James. 1953. America's Garden Book.. Charles
scribner's Sons, New York.

Coulter, Francis C. 1942. A Manual of Home Vegetable Gardening.
Doubleday, Dunn, and Go. , Inc. Garden City, New York. 29-16.

Foley, Daniel J. 19144. Vegetable Gardening in Color. Macmillan.
New York. 229-232.

Q39: and Supply Companies:
American Bulb Co. 1335 W. Randolph St. , Chicago 7. Illinois;
. a '

79

31 W. 27th St., New York, New York.

phia,

George G. Ball, Inc. W. Chicago, Illinois.
Burgess Seed and Plant Co., Galesburg, Michigan.

W. Atlee Burpee Co. , Huntington Park Ave. at 18th St. , Philadel-
Pennsylvania; Clinton, Iowa: Riverside California.

D. V. Burrell Seed Growers Co. , Rocky Ford, Colorado.

Farmer Seed and Nursery 00. , Faribault, Minnesota.

Ferry-Morse Seed Co. , Detroit, Michigan: Mountain View, California.
A. M. Leonard and Son, Inc. , Piqua, Ohio.

National Agricultural Supply Co. Fort Atkinson, Wisconsin.

5. s. Skidelsky and Co. , Inc. , 1M w. 27th St. , x... York 1. New York.
Templin-Bradley Co. , Seeds and Bulbs, Cleveland 2, Ohio.

Steffek, Edwin F. , Ed. Plant Buyers Guide of Seed and Plant Materials

in the Trade. Massachusetts Horticulture Society. Boston, Massachusetts.

Activities to be Analysed

The following activities have been selected as most typical projects:

Hoeing

Raking

Spading

Digging with trowel
Pruning with hand shears
Pushing lawn mower

Clipping grass at edge of
borders

Pulling weeds

Using hand weeder
Pushing cultivator
Planting seeds or bulbs
Strawberry barrel

Transplanting seedlings

Analysis of Activities

IIt>eigg:
£D1sehnique is:

Quieting--good outlet for energy.

Stimulatingb-only if the flowers or vegetables are particularly

‘- ' interesting to patient.

Monotonous-especially'if garden is planted in rows.

Varied--only in kinds of plants being grown.

Simple-repetition of a single movement.

Slowb-if done well: speed depends on speed of patient, soil

texture, and number and size of weeds.

Adaptable-handle may be built up for patient with weak grasp;

weight may be attached to hoe for aided resistance: short

handled hoe may be used for children.

P"harsical processes involved:

81
Fingers and thumb--statically flexed position in grasping handle.
Shoulder Joint-~extension. adduction against resistance: flexion,
abduction.
Posture-—must be watched since there is a tendency to bend forward
Eye strain-ulittle eye strain except when hoeing around small
seedlings.

Fatigue—~must be watched especially on very warm days.

Mental Processes involved:
Interest-through interest in.the plants that are grown, or desire-
for a 'clean' garden.
Concentrations-in order not to destroy the wrong plants.
Initiative--litt1e required unless patient is to take full

responsibility for the care of his garden.

Mental capacity of patient:
Normal to highP-as one process of a larger project.
Borderline-~good for this grade. \
Lowb~if garden is planted in rows and plants are large enough to
be recognized easily.
Noise involvedpulittle.

Type of patient-men, women, older children.

Iiecommended for:
Mental patients:

Deteriorated—«in gardens where a variety of plants are grown.

Excited-«good outlet for energy: repetition of motion may be

quieting.

82
Depressedo-when working among bright flowers or if patient
especially enjoys gardening.
Tubercularu-only in cases where disease is arrested.
Physical disabilities--for increasing strength of arm and
shoulder muscles and extensor muscles of trunk and legs.
Deaf-not handicapped.

Geriatric-if patient is interested in gardening; watch for fatigue.

Raking:
Technique is:
Quieting-good outlet for energy.
Honotonous-particularly so if another patient carries away the
leaves or weeds raked together.
Simple--repetition of one motion.
Moderately fast.
AdaptableF-handle may be built up for patient with weak grasp;
a wide rake provides more resistance than a narrow rake;
patient, by conscientious effort, can use length.of stroke

or position best for him.

Physical processes involved:
Fingers and thumb-~stacically flexed position in grasping handle.
Elbowbeflexdon against resistance: extension.
Shoulder--extension against resistance; flexion, abduction,
adduction. Motion is primarily flexion-extension if rake
is moved essentially in sagittal plane; motion is primarily

abductionr-adduotion if rake is moved in lateral plane.

83
Posture—-watch for tendency to bend forward.
Eye strain-~none.
Fatigue-«watch: especially if patient uses a very long stroke;

less noticable if patient works with a smooth rhythm.

Mental processes involved:
Interest-only in the completed task.
Concentrationp~little required.

Initiative-onone.

Mental capacity of patient:
normal to high—-only if raking is one step of a larger project.'
Borderline-good.
Lowa-may require someone else to carry away trash that is raked
together.

Noise involved-little.

“EStpe of patient:
Men, women.

Childrenr-use sise rake in proportion to size of child.

1iecommended for:
Mental patients:
Excited-ugood for release of energy.
Tubercular—-only in cases where disease is arrested.
Physical disabilities-to strengthen arm and shoulder muscles and
axtensor muscles of trunk.and legs; in some cases may be useful

to increase range of motion of shoulder Joint.

 

Deaf-not handicapped.

Spadigg:
{Pechnique is:

Quieting--good outlet for energy and aggressive tendencies.
Monotonous-if large area is to be spaded.
Simple-«repetition of a few motions.

Slow-all spading is slow; double digging is still slower.

Physical processes involved:

Fingers and thumb--statically flexed position in grasping handle.

l‘orearm—pronation, supination in emptying spade.

Elbow-flexion against resistance when lifting spadeful of soil.

Hips-"extension against resistance in lifting spadeful of soil.
extension against resistance of hip in pushing spade into
soil: flexion.

Kneesuextension against resistance in lifting spadeful of soil;
extension against resistance of one knee in pushing spade into
soil: flexion.

'Ankle-plantar flexion against resistance when pushing spade into
soil; there is little actual motion. rather the muscles in—
volved in plantar flexion are used to stabilize the ankle.

Posture-watch that lifting is done with leg muscles rather than
with the back.

Fatigue—especially if patient is not accustomed to physical labor.

Mental processes involved:

 

85
Interest-~primarily in the flowers or vegetables to be grown.
Concentrationp-little needed.
Initiative-~little.
ldental capacity of patient:
Normal to high-only as part of a larger project or for specific
physical exercise.
Borderline-—good.

Lowb—may need supervision to do job neatly.
Boise Involvedm-little

Type of patient:
Men.

Nomenp-fatigue more prominent than with men.

Recommended for:

' Mbntal patients:

Deteriorated--may do a good job, but this activity has little
_ value other than helping to maintain general physical health.

Excitedp-excellent for release of energy.

Depressed--only if patient particularly likes gardening.

Epileptic--slight danger of injury in case of falling.

Tubercular patients-not recommended.

Physical disabilities-~strengthen flexor and extensor muscles of
trunk, extenson muscles of knee and hip, plantar flexor muscles
of ankle; increase range of pronation and supination of forearm.

Amputation-prosthetic training.

Blinds-possible.

86
Deaf-not handicapped.
Geriatric--not recommended.
Precautions-watch for blisters of hands; work for very short periods

until patient becomes accustomed to this activity.

gigging with trowel:
Erechnique is:

Quieting--may be used as outlet for aggression.
Stimulatingb-in the variety of plants which are being planted.
Monotonous-onLy if large numbers of plants are being planted. or
if the trowel is used to ”spade" the soil in greenhouse benches.
Simple--repetition of one action.
Slowb-if used to dig holes for large plants, or if used to loosen
soil in large areas.
Adaptable-ohandle may be padded for patient with weak grasp, or
see bandage may be bound around the~hand to hold finger in
flexed position: wide trowel may be used for greater resis-

tance than narrow trowel.

Ph'isical process involved:
ringers and thumb-statically flexed position in grasping handle.
Wrist-radial deviation against resistance when using trowel as a
spade for digging.
Forearmp-pronation and supination.
Elbowb-some flexion, extension: extension against resistance when
using trowel as a dibber for opening holes for small plants.

Hip--extension against resistance in moving.from place to place

87
when working in stooping or kneeling position; flexion.
lye strain-—none.
Fatigue-working in stooped position can be very fatiguing at first;

watch for fatigue in muscles of forearm.

Idental processes involved:
Interest-~in the plants being planted.
Ooncentration—-to space holes correctly.

Initiative-~little.

Mental capacity of patients:
Normal to highp-may find this activity boring unless seen as part of
a larger project.
Borderline-probably would enjoy this.
Lowe-would need supervision for spacing holes correctly.
Noise involvedp-little.
Suitable for-«greenhouse, outdoors.

Type of patient-«men, women. children. ‘

Recommended for:
Mental patients:
Deteriorated--would be beneficial only in helping maintain
general physical health.
Excited-good for release of energy.

Depressed-only if the patient especially enjoys gardening.

Epileptic—-little danger of injury in case of falling.

Tubercular patients-—when disease had been arrested.

Cardiac--acceptahle in some cases; watch for fatigue.

Physical disabilities--strengthen pronator and supinator
muscles of forearm: strengthen extensor muscles of spine,
hip and knee.

Blind-olossening soil with a trowel possible.

Deaf-~not handicapped.

Geriatric-if patient enjoys gardending.

Precautions--watch for fatigue in patients who are working in
position to which they are not accustomed: watch for blisters

on the hands.

___2st1 2.139. has asset's:
Technique is:
Quieting--good outlet for energy: outlet for urge to destroy.
Stimulatingr-if patient particularly enjoys pruning.
Varied--because of the varied positions necessary to reach
the branches or shoots to be cut.
Simple-~one principle motion.
Complexo-entire bush must be studied to know which branch or
shoot to cut and which to leave.
Moderately rapid.
Jalnysical processes involved:
Fingers-~flexion against resistance.
Thumb-~flexion, opposition against resistance.
All other motions of upper extremities are involved in reach-
ing for the right spot to cut, but these are so varied

they cannot be classified.

Mental

Mental

89
Hip and knee—-extension against resistance (the weight of the
body) when moving from place to place in a stooped posi-
tion as when cutting out dead raspberry canes.
Posture-~standing or stooped; watch that patient does most of the
bending at the hip Joint.
Rye etrain—-slight.
Fatigue-not an important factor except in the muscles of the

forearm because there are so few stereotyped movements.

processes involved:

Interest—~interest in improving appearance of grounds.

Concentrationp-each bush or shrub is different and requires
individual treatment.

Initiative-in deciding which branches to cut.

capacity of patient:
Normal to highp-yes.
Borderline-some of these could be taught the process.

Low-«only with constant individual supervision.

Noise involvedp-little.

Type of patient:

Men.

Women-some might enjoy this activity.

Recommended for:

Mental patients:

Deteriorated--yes, if they have done similar work before.

9O
Excitedp-only mildly excited unless patient can be closely
supervised: otherwise they might damage the bushes severely.
Depressed-if this activity appeals to the patient.
Epileptic-patient could be badly scratched if he fell into the bushes.
Tubercular patients-~when disease has been arrested.
Physical disabilities-—strengthen grasp.
Amputationp-good for training remaining hand; excellent to test
performance in prosthetic training of upper extremities.
Blind--no.
Deaf--not handicapped.
Geriatric—~good because it is not strenuous work; patient can work

at his own rate of speed.

Pushing lawn mower:

Technique is:

Quietingb-release for energy: the sound of a lawn mower may be
soothing to some individuals.

Mbnotonous-«unless area to be mowed is very irregular in shape.

Simple-littls more than walking.

Rapidp-a lawn mower covers space quickly and works best when pushed
at a fairly rapid rate.

Adaptable-~provision may be made for increasing tension of the wheels:
lawn spreader or very light roller provide the same motions with

less resistance.

Physical processes involved:

Fingers and thumb-~statically flexed position in grasping handle.

Mental

Kental

91
Elbowa—held in flexed position; force is against extensor muscles.
Shoulder Joint--upper arm is held in a partially flexed and

abducted position: force is against flexor muscles.

Scapulap-abduction against resistance.
Hip and Knee-extension against resistance: flexion.
Ankle-plantar flexion against resistance; flexion.
Posture-no particular problem.
Eye strain--none.
Iatigue—-frequent rests necessary, especially for those who are

not accustomed to this activity.

processes involved:
Interest--through interest in a neat lawn.
Concentrationp-little.

Initiative-~no.

capacity of patient-suitahle for any mental level.

Noise involved--some, though this type of noise is not irritating.

Type of patient:

Men, primarily;
Women—-use smaller mowers.

Older childrenp-use smaller mowers.

Recommended for:

Mental patients:
Deterioratedr-only to help maintain general physical health.

Excited-~excellent outlet for energy.

92
Depressedp-if patient enjoys mowing lawn.
Tubercular patients-—not recommended.
Physical disabilities--strengthen extensors of knee and hip,
abdominal muscles. and flexors of shoulder joint.

Deaf-not handicapped.

Clippigg grass at eggs 9_f_ borders:
Technique is:

Quietingb-beoause of the energy expended and the monotony.

Stimulatingb-if patient enjoys working near flowers.

Monotonous--because of repetition of motion and one kind of
material being cut.

Simple-one primary motion involved; no decisions to make.

Slowb-shears will out only a few blades at once: moving in
stooped position or kneeling position is slow.

Adaptable—-longrhandled grass shears. which eliminate steeping,
are available; use of regulation shears may be done in

kneeling position or stooped position.

Physical processes involved:
Fingers and thumb--flexion against resistance; extension.
Spine-~some lateral flexion and rotation toward hand that is
being'used.
Hip and knee--extension against resistance (the weight of the body)
flexion.
Posture--kneeling position or stooped position; standing position

if using long-handled shears: watch for excess bending of

93

the spine.
Eye strain-slight.

Fatigue-particularly of forearm muscles and extensor muscles of

hip.

Mental processes involved:
Interest-—through interest in a neat lawn.
Concentrationp-some because each snip of the shears cuts only a
very small area.

Initiative-no.

Mental capacity of patients-suitable for all levels, though patient with
normal to high intelligence would probably find it boring in com-
parison to pruning which involves similar physical processes.

Noise involved-slight.

Type of patient-suitable for men, women, or children.

Recommended for:
Mental patients:
Deteriorated-if work is done near attractive flower borders;
otherwise good only‘to help maintain good physical health.
Excitedp-yes, though too slow to appeal to many excited
patients.
Depressedr-only if working near bright flowers.
Epilepticp-slight danger of injury in case of falling.
Tubercular patients-clipping with long handled shears permissible

when patient is well enough to engage in activities while

91+

walking about.

Physical disabilities-~excellent for strengthening grasp.

Amputation-~to develop remaining hand.

Blind-possible.

Deaf—-not handicapped.

Geriatric-yes, though some may have difficulty working in stooped
position.

Precautions-awatch for blisters on the hand: watch for fatigue in

muscles of forearm.

Pulligg;weeds:
Technique is:

Quieting--out1et for destructive urge especially if weeds are large.
Stimulatingp-when working among bright flowers or other plants in
which the patient is especially interested.
Honotonous-particularly if area to be weeded is large.
Variedp-by the size of weed. and species of plants being grown.

Simple-~mostly repetition.

Physical processes involved:
ringers-flexion. extension.
Thumb-opposition.
Wrist-extension. hyperextension, and radial deviation against re-
sistance: flexion and ulnar deviation.
Forearm--primarily held in position of pronation when pulling small
weeds.

Elbowa-flexion against resistance when pulling larger weeds.

Mental

Mental

95

Shoulder joint-hyperextension against resistance when pulling
larger weeds.

Spine-osome rotation and lateral flexion toward hand that is being
umed.

Hip and knee-~extension against resistance when moving from place
to place in stooped position: flexion.

Posture—~kneeling, stooping when working outdoors: standing. sitting
if working in greenhouse or ward. Hatch for excessive bending
of the spine.

Eye strain—~some if plants are small.

fatigue-—not a prominent factor unless working in one position for

a long time.

processes involved:

Interest--through interest in plants being grown.
Concentrationp-to avoid pulling the wrong plants.
Initiative-~little involved unless patient is to take full respon-

sibility for his garden.

level of patient:
Normal to high-if weeding is part of the patient's garden project.
Borderline-~yes.

Lowb-only if garden plants and weeds are easily distinguished.

Noise involved-none.

Suitable for:

Vard-—weeding window boxes.

96
Greenhouse--patient may sit on stool or stand to weed greenhouse
benches, or remain in wheelchair if benches are at convenient
height.
Outdoors.

Type of patientumen, women, children.

JRecommended for:

Mental patients:

Deteriorated--opportunity to work among interesting plants.

Excitede-because of the monotony.

Depressed--when working among bright flowers, or if vegetable
gardening appeals to patient.

lpileptio-no tools involved.

Tubercular patients-when patient is well enough to sit up to do
light work involving hands and forearms (ward or greenhouse).

General hospital--as soon as patient is able to sit in chair for
short periods he can weed window boxes in ward.

Cardiac-~0ne of the least fatiguing of all outdoor gardening
activities: weeding greenhouse benches or window boxes while
seated is still less fatiguing.

Physical disabilities-good for developing coordination of hands;
good for practicing grasp and release: increasing range of
motion of flexion and extension of wrist.

Amputationp-develop remaining hand and arm: prosthetic training for
upper extremity amputation.

Blind-if working among plants that are easily recognized by touch.

97
Deaf--not handicapped.
Geriatric-~may have difficulty stooping_or kneeling.

1?recautions--watch for allergies and hay fever.

Ease 31.823. was:
Erechnique is:

Quietingp—through monotony.

Stimulatingh-threugh interest in the plants being cultivated.

Monotonous-through repetition of motion; more so if working among
plants in rows.

Varied-only through number of plants being cultivated.

Simple-~primarily repetition of one motion.

Slowbanot as slow as pulling weeds individually, but slower than
hoeing.

Adaptable-handle may be built up for patient with weak grasp;
weight may be added to increase resistance when raising tool.

‘191xysical processes involved:

Fingers and thumb-astatically flexed position in grasping handle.

Elbow-flexion against resistan ce—flexion.

Shoulder Jointe-extension: some adduction against resistance: flexion,
abduction.

Spine-some lateral flexion and rotation toward hand that is being
‘used.

Hip and knee-~extension against resistance: flexion.

Posture-stooped or kneeling when working'outdoors: standing or

sitting when working in greenhouse; watch for excessive bending

98
of the spine.
Rye strain-—little.

Fatigue-unot an important factor: some fatigue of legs and back.

Mental processes involved:
Interest-—through interest in the plants being weeded.
Concentrationp-to avoid injury to the plants being weeded.
Initiative-little; less if garden is planted in rows rather than

if plants are set in groups.

Mental capacity of patients:
Normal to high-especialxy if this is part of a larger project.
Borderline-can do this well.
Lowb-if plants are large enough to be easily recognized.

Noise involved—little.

Suitable for:
Greenhouse-patients may work seated or standing.
Outdoors.

flDype of patient-men, women or children.

Iiecommended for:
Mental patients:

Doteriorated-particularly if patient was interested in gardens
before uhe onset of his illness: good for helping maintain
general physical health.

Excitedpthreugh repetition of motion.

Depressedv-if working among bright flowers, or if patient

particulary enjoys gardening.

Epileptic—«light danger; make sure the tool is not sharp.
Tubercular patients-«work in greenhouse when they are well enough
to engage in activities requiring use of upper arm while

seated in chair or standing.

Cardiac-comparatively little fatigue involved: especially when
working while seated orstanding in greenhouse; more strenuous
than pulling weeds.

Physical disabilities-may be used to increase range of motion of
elbow.

Amputation—developing remaining hand.

Deaf—mot handicapped.

Geriatric-mm have trouble working in stooped or kneeling position.

Pushing cultivator:
Technique is:

misting-«must for energy.
Stimlating-throu@ the numberof different plants being grown:

especially if working among brigit flowers.
. nonotonousulittle variety of motion.
Simplh-primsrily a walking motion.

Moderately rapid.

Physical processes involved:
Fingers and thumb-«statically flexed position in grasping handle.
Elbow-flexed position: force is on extensor muscles.

Schoulder Joint-~flexion against resistance.

Mental

Mental

100
Scapulap-abduct ion .
Hip and Knee-«extension against resistance; flexion.
Ankle—plantar flexion against resistance.
Foamy-essentially erect, somewhat leaning foreward: watch for
excessive bending of the spine.
Eye strain--none.

fatigue—some: frequent rests advisable.

processes involved:
Interest-—through interest in the garden as a whole.
Concentrationp—only to stay between the rows.

Initiative-~little.

capacity of patients:
110er to high—if cultivating is a part of garden project.
Borderline-«pan do this well.

Lawn-probably could learn this.

Noise involved-~little.

Type of patient-men: some women.

Recommended for:

 

Mental patients:
Deteriorated--helps maintain general physical health.
Excited-«outlet for energy: release for aggression.
Depressed—only if patient especially enjoys this activity.

Tubercular patients--not recommended.

Physical disabilities-~strengthen abductors of scapulae, strengthen

extensors of hip and knee, strengthen abdominal muscles.

lOl
Amputation--gait training: advanced on rough terrain.

Deaf-unot handicapped.
Geriatrice-not recommended.
Precautions-—watch for blisters on hands: watch for fatigue if patient

is not accustomed to physical labor.

____ssPlanti 19.29; 2:: m:
erechnique is:
Quietingp-through monotony of motion: working with dull-colored
materials.
Stimulatingp-through interest in the plants that are to come from
the seeds.
Honotoneus-Tif large quantities of the same thing'are being planted.
Variedp-by the number of species of seeds or_bulbs being planted.
Simple-41f spaces are marked by someone else.
complesh-different sises of seeds must be planted different dis-
tances apart and covered with different depths of soil.
Slow to moderate-edepends on planting distance: accuracy with which
work is done.
Adaptable-flats in which seeds are being sown may be placed at
height that is best for patient.
Physical processes involved:
Fingers--flexion..extension.
Thumb-opposition.
Wrist-flexien, extension.

Nearly all other motions of hand and arm are involved-~none against

102
resistance; if a hoe is usedto open the rows, the action
is similar to that of raking; if holes are opened with a
trowel, the action is as outlined in "digging with trowel".
Hip and knee-oextension against resistance in moving 'from place to
place in stooped position when planting seeds outdoors.
Posture-u-stooped or bent foreward: stress bending from hips rather
than bending spine.
Eye straino-some if working with small seeds.

Mental processes involved:
Interest-wthrough interest in future results.
Concentration-«to follow a planting guide if one has been made:
to space seeds or bulbs correctly; to mark each species.

Initiative--if patient plans his own garden.

Mental capacity of patient:
terms]. to high—especially if patient is to have full responsibility
for garden.
Borderline-may need more detailed instruction.
Low-~need considerable supervision.

Noise invo lved--none

Suitable for:
Bed—s. few seeds in a pot of soil; be sure to protect bedding with
plastic sheet.

Warduflats or window boxes.

103
Greenhouse-~starting seedlings in flats to be potted, benched,
or planted outdoors.
0utdoors-sowing seeds or planting bulbs where they are to grow;

or in a special seed bed for transplanting later.

Type of patient:
Men, women.

Children--may require help opening rows correct depth.

Re commended f or:

Mental patients:

Deterioratedp-arouses interest in the future, provide activity
not possible every day.

Excitedp-will enjoy this activity, but will be inclined to
plant too large an area and to waste seeds.

Depressedp-stimulates interest in life and the future.

llpileptic-no tools involved.

Tubercular patients-pushing a few seeds into a pot of soil requires
very little effort for the bed patient: Planting seeds in flats
may be done while seated; outdoor planting of seeds requires
little more effort than walking if someone else opens the rows.

General hospital-quick-to-germinate seeds in a pot of soil help time
pass quickly for convalescent: use seeds that may be grown on
as pot plants for longer term illnesses.

Gardiaon-wide range of degree of activity possible; danger of
fatigue slight.

Physical disabilities-practice grasp and release: develop coordinap

tion of fingers and thumb.

104
Amputation—~develops accuracy in remaining hand.
Blindrduse large seeds and spotting board in flat.
Deaf--not handicapped.
Geriatric-stimulates interest in the future: use species that
can be grown as pot plants for patients unable to garden

outdoors.

Strawberry barrel:
Technique is:

 

Quietingb-because of energy expended in boring holes in barrel and
filling barrel with soil.

Stimulatingb-because of novelty of project.

Monotonous-only the process of boring holes.

varied--by size of barrel: choice of variety of planto-rock garden
plants may be used instead of strawberry plants.

Simple-—each_step is relatively simple.

Complex-consists of several processes: boring holes: painting
if desired: filling with soil: tamping the soil: inserting
plants through.holes as barrel is being filled.

-Slowb~boring the holes: other steps are moderately rapid.

Project is:

Inexpensive-if,barrel and plants are donated and soil is available
on grounds.
Bxpensive--if all materials must be purchased: addition of ferti-

liser increases cost.

 

105

Useful-~for fruit produced.

Ornamentalo-primarily so. because value of fruit obtained is less
than if same number of plants were grown in rows: makes a
'good focal point in a landscaped garden.

Salable-—empty'barrel with holes bored might be: filled barrel

cannot be moved.

Physical processes involved:

Fingers and thumb-flexed position in grasping handle of brace
while boring holes, and handle of shovel while filling
barrel with soil.

Forearmn-pronetion and supination in shoveling soil into barrel.

Elbowh-extension against resistance when filling shovel with soil:
flexion: extension and flexion.against resistance while boring
holes.

Shoulder-flexion against resistance when filling shovel and when
lifting shovelful to top of barrel: outward and inward ro-
tation in emptying shovel and returning it to position to be
filled: some abduction and adduction while boring holes.

Spine-rotation while shoveling.

Hip-some flexion and extension when shoveling soil into barrel.

Posture-essentially standing.

lyestrain-none.

Iatigue-especially while boring holes: if three 1" holes are bored
in triangular arrangement, then connected by sawing, the pro—
cess is less fatiguing, but takes longer than if 2" holes are

. bored with an expansion bit.

106
Mental processes involved:
Interest-because of novelty of project.
Concentrationp-in spacing holes correctly.

Initiative-little.

Mental capacity of patients:
Hermal to high-planning spacing of holes.
Lows-boring holes; painting the barrel.

Noise involved--some while boring holes.

Suitable for:

Shop—~preparing the barrel.

Outdoors--barrel must be filled exactly where it is to stand.
Type of patient:

Hen.

Womenp-caring for established barrel: some might enjoy the entire

project.
Childrenp-painting, helping place the plants, caring for barrel

after it is planted.

Recommended for:
Mental patients:

Deterioratedp-because of novelty: activity of planting
barrel good for maintaining general physical health.

Excited-boring holes excellent outlet for aggression.

Depressedp-caring for barrel, particularly after plants
have begun to show buds.

Epileptic--helping place plants: caring for established

barrel.

107

Tubercular patients-~caring for established barrel if patient
is ambulatory.

Physical disabilities-«strengthen extensors and flexors of elbow;
strengthen grasp; increase range of motion of elbow (using
brace and bit).

Deaf-—not handicapped.

Geriatriop-caring for established barrel.

Precautions-watch for blisters on hands; watch for fatigue--use of ex-
pansion bit is much harder work than regulation bit: watch for

fatigue while filling barrel.

‘gransplantigg,seedlings:
Technique is:

Quietingb-because of repetition of motion, dull colors of soil and
plants.

Stimulatingr-if patient is particularly interested in plants.

Monotonous-—much repetition of motion; plants nearly the aims size.

Simple--each step is relatively simple.

Complexp-entire process consists of several steps--filling flats or
pets, lifting seedlings, making hole in soil, inserting plant,
pressing soil around plant.

Moderately'rapid.

Adaptable-by changing position of flats in relation to patient;

using small pets for bed patients; flats for shop or greenhouse.

Physical processes involved:

Fingers-~flexion. extension.

108
Thumb-opposition.
Many other movements of upper extremities are involved, but are
too diverse to be analyzed.
Posture-standing, seated, propped.up in bed.
Eye strain—-slight.

Fatigue-not an important factor.

Mental processes involved:
Interest-because of interest in the plants.
Concentratione-to space plants properly.

Initiative-~little.

Mental capacity of patients:
Normal to high--especially if this is preliminary to outdoor
gardening.
Borderline—~cou1d do this well.
Lowb-with some supervision.

Noise involvedp-none.

Suitable for:

Bed--transplanting plants into small pots; protect bedding with
plastic sheet: use plants that may be grown as pot plants
indoors.

Shop or greenhouse-~transplanting into pots or flats; patient
may work seated or standing.

Type of patient-~men, women, children.

Recommended for:

Mental patients:

109

Deteriorated--as one among many activities.
Excited--mildly excited.
Depressed--if patient enjoys working with plants; may be
a no-tool project.
Epileptic~-need involve no tools: little danger in case of
falling.
Tubercular patients-~involves primarily hand and forearm movement.
Cardiac--adaptable to patient's activity level.
Physical disabilities-~practice grasp and release, flexion of
fingers, opposition of thumb.
Blindpupossible.
Deaf--not handicapped.

Geriatric-good.

SUMMARY

The use of horticultural skills as a therapy is considered merely
one among many occupational activities having therapeutic value.

The purpose of Horticultural Therapy has been the improvement of
mental and physical health. Values ascribed to horticulture included
combatting sleeplessness, improving appetite, diminishing need for re-
straints, satisfying procreative instincts, strengthening muscles, regain-
ing work tolerance, and improving morale. I

Gardening has been used in hospitals, vocational rehabilitation
programs, prisons, and for leisure activity. Horticultural activities
have been recommended for the mentally ill, for patients who have recovered
from tuberculosis, for those with physical disabilities, for the blind, and
for cardiac patients. farming, outdoor.gardening, greenhouse gardening,
bedside gardening, and landscape appreciation have been found usefullfij/

Early examples of the use of gardens in the treatment of illness
were the temple gardens of early Egypt and Greece. In the eighteenth and
nineteenth centuries gardening was used in mental hospitals. At the be—
ginning of the twentieth century there were instances of gardening being
'used in institutions other than mental hospitals. At that time effort was
made to devise activities to supplement those that were necessary to the
maintenance of the hospital; outdoor and bedside gardening were mentioned
in many books describing suitable activities for the sick. 4

In the early 1940's "garden therapy" was discussed as a separate

type of treatment. The use of gardening during World War II stressed

functional treatment much more than had been done previously. Investiga-

 

 

m
tions into the potentialities of the use of horticulture as a therapy
were begun at Michigan State College in 1951. At this time much of the
flapetus for the work in Horticultural Therapy was caused by the interest
of garden club members. Phases of horticulture other than outdoor gardenp
ing began to recieve more attention than previously.

In order to serve as a pilot study} an exploratory program of
Horticultural Therapy was conducted at Kalamazoo State Hospital during
July and August of 1955. Gardening was by far the most popular activity.
Plant identification appealed to fewer people. Plant propagation was of
interest to those who were confined indoors. The study of plant parts and
plant functions increased the patients' interest in all phases of horti-
culture. Plower arranging, ccrsage making, and related short term projects
provided opportunities for creative expression.

Based upon the experience of the pilot study, a suggested program
for Occupational Therapists has been outlined in detail describing the
types of patients, required facilities, and limitations. Projects have
been grouped under the following headings: outdoor gardening, other
outdoor projects, indoor gardening, greenhouse grdening, cut flower pro-
jects,other indoor projects using plant materials, and related projects.

A.brief description of each project has been provided supplying
sources of futher information.

Complete analysis of activities involved in outdoor gardening has
been included to supply a comprehensive source of current findings in the

application of horticulture as a means of therapy.

AVAILABLE LITERATURE
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Uhited States. 2:46-67, 145-175.

. 1903. Extracts from the Thirteenth
Annual Report of the New Yerk State Commission in Lunacy. 59:530-538.

 

Baldwin, W. A. 1906. The School Garden. Education 26:#47-461.

Ball, James Moores. 1924. An Early Greek Sanatorium and Dispen-
saryb-Chief Seat of Aesculapian Worship. The Modern Hospital 23:199-201.

Barton, George Edward. 1919. Teaching the Sick. V. B. Saunders.
Philadelphia.

Bayless, C. E. 1955. Flowers for Your Heart. American Home 53,
No. 3:98.

Berg, Roland H. 1955. The Mentally Ill Tell Their Own Story.
Look 19 ‘He. 19:32b37, Ho. 20:88-9“.

Campbell, Walter B. 1919. Gardening in the Curriculum of Voca-
tional Schools for Soldiers. Country Life 36:118.

Carroll, Robert S. 1910. The Therapy of Work. Journal of the
American Medical Association 54:2032-2035.

\Clark, Fred P. 1917. The Beneficial Effects of Work Therapy for
the Insane. The Modern Hospital 8:393.

Clendening, Logan. l9#2. Source Book of Medical History. Paul B.
Hoeber, Inc., Medical Booleepartment of Harper and Brothers. New York.

Colson, John H. 0. 19%. The Rehabilitation“ of the Injured. Cassell
and Co., Ltd. Toronto. .

Deutsch, Albert. 1938. The Mentally 111 in America. Doubleday,
Doran and Co., Inc. Garden City, New York.

Dodds, Maryelle. 1953. Have Fun...Get Well! American Heart
Association. New York.

Dunton, William Rush, Jr. 1915. Occupation Therapy, A Manual for
Nurses. W. B. Saunders. Philadelphia.

191?. History of Occupational Therapy.

 

The Modern Hospital 8:380-382.

Dunton, WilliamIRush.Jr., and Sidney Licht. 1950. Occupational
Therapy. Charles C. Thomas, Publisher. Springfield, Illinois.

113

Hdgertcn, Wanda Misbach. 1947. Activities in Occupational
Therapy. Principles of Occupational Therapy, edited by Helen S. Willard
and Clare 5. Spackman. J. B. Lippencott Co. Philadelphia.

Flower Grower. 1945. Garden Therapy at Camp Kilmer, New Jersey.
32:164-165.

Francis, Lloyd. 1887. Outdoor Work as a.Remedial Agent in In~
sanity. Journal of Mental Science 33:36#—372.

Garden Magazine. 1913.1 The Garden Doctor. 17:11-13. 98-100,
183-18h, 254-255. 309-310. 347-348; 18:18-19. 51-52, 105-106, 151-152,
189-190.

. 1921. The Garden Beautiful Within Prison Walls.

 

3#:l97-198.

Gaye, Laura B. 1953. Rx: Gardening Instead of Penicillin.
American Home 49 No. l“139-440.

Haas, Louis J. 1924. One Hundred Years of Occupational Therapy:
.A Local History. Occupational Therapy and Rehabilitation 3:83-100.

Hall, Bolton. a, 1910. Garden Plots for Institution Inmates.
The Survey 23:769-771.

Hall, Bolton. b, 1910. Gardening in Institutions. The Survey
23:939—9t6.

Hall, Bolton. c, 1910. Gardening as a Cure for Mental Breakdowns.
World's Work 20:13084-13086.

Hamilton, Samuel W. 1992. Mental Hygiene and Gardening. Gardener's
Chronicle of America #6851, 61.

Harris, Garrard. 1918. Gardening for Re-Educating Disabled Soldiers.
Garden Magazine 28:45-96.

Hartwell, Dessa M. 1933. Landscape Gardening and.Floricu1ture as
Occupational Therapy Treatment. Occupational Therapy and.Rehabilitation

12:47-51».

Haviland, C. Floyd. 1912. Discussion on “Occupations for the
Insane and Their Therapeutic value: What is Now Done and What, if Any-
thing, Purther Should Be Done." New York State Hospitals' Bulletin
5:13-26.

Haworth, Norah A., and E. Mary MacDonald. 19#6. Theory of Occu-
pational Therapy. The Williams and Wilkins Co. Baltimore.

Horticulture. 1953. Garden Therapy. 31:256.

lhfl

Ibach, Mildred. 1955. Garden Therapy. Dakota Horticulture
28:15-16.

. 1956. Garden Therapy. Dakota Horticulture 29:15.

 

International Review of Agricultural Economics. 1921. Gardening
by Industrial Workers in the Free Time Afforded by the Eight Hour Day in
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Jonas, Genevieve J. 1955. A.Handbook on Horticultural Therapy.
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Kidner, T. 13. 1922. Work for the Tuberculous During and After
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Kirkbride, Thomas S.~.1845. A.Sketch of the History, Buildings,
and Organization of the Pennsylvania Hospital for the Insane. American
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Laird, Arthur. 1917. Occupation and Diversion for Tuberculous
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Licht. Sidney. 1949. Gardening by Soldier Patients. Horticulture
22:377-378. .

Michigan State College. 195“. Horticulture. Cooperative Exten-
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Mills, Ira J. 1942. Gardening Behind Walls. Gardener's Chronicle
of America 46:211-212. 21“.

Morton, Thomas G. 1895. The History of the Pennsylvania Hospital.
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Parker, Cornelia Stratton. 1952. Your Child Can Be Happy in Bed.
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Perkins, Anne 3. 1925. Bird Study in Occupational Therapy.
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Pilat, Carl F. 1929. The Place of Landscape Architecture in
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Pinel, Philippe. 1806. A treatise on Insanity. Translated from

115
the French by D. D. Davis. Sheffield. Printed by w. Todd for Cadell and
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Pratt, Elgen C. 1922. A review of Occupational Therapy as Applied
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. 1830. Medical Inquiries and Observations upon
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Life in America 20 No. 11:106. 108.

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Hospital. Archives of Occupational Therapy 2:447-452.

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116

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Wright, Richardson. 1945. Hortotherapy. House and Gardens 87
No. 1:64, 91.

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Occupational Therapy 7:62—67, 80.

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National Garden Institute. Columbus, Ohio. .

APPLICATION OF HORTICULTURE.AS A MEANS OF THERAPY

by
Reva.Doris Zischke

AH ABSTRACT
Submitted to the School of Graduate Studies of Michigan State University
of Agriculture and Applied Science in partial fulfillment of the

requirements for the degree of
MASTER OF SCIENCE
Department of Horticulture

1956

Approved

 

ABSTRACT

The use of horticultural skills as a therapy is considered merely
one among many occupational activities having therapeutic vabue.
The purpose of Horticultural Therapy has been the improvement of

mental and physical health. values ascribed to horticulture included

#fl’

“Jo-lid-

combatting sleeplessness, improving appetite, diminishing need for re-

straints, satisfying procreative instincts, strengthening muscles, regain-_

/ I"
fa I I
f,

Cf"

ing work tolerance, and.improving morale. , rflgn._a~«rv"““

“‘- - m I,
K _ ”Mn“..-

Gardening has been used in hospitals, vocational rehabilitation
programs, prisons, and for leisure activity. Horticultural activities
have been recommended for the mentally ill, for patients who have recovered
from tuberculosis, for those with physical disabilities, for the blind, and
,for cardiac patients. Farming, outdoor gardening, greenhouse gardening,

bedside gardening, and landscape appreciation have been found useful.

 

 

 

 

 

 

 

'er*wflflrflafl_,fl,__
/////’"tlarly examples of the use of gardens in the treatment or illness

{ were the temple gardens of early Egypt and Greece. In the eighteenth and
i
nineteenth centuries gardening was used in mental hospitals. At the be-

// ginning of the twentieth century there were instances of gardening being ;

( used in institutions other than mental hospitals. At that time effort was
i
made to d°Vi°° aet1V1ti°5 t0 suPPlement those that were necessary to the g

\ maintenance of the hospital; outdoor and bedside gardening were mentioned}
\ ,/
is New books describing suitable activities for the sick

W'

 

_._....——.-i
it...» “-

 

m
‘__.
-_.— B_fi_- _ m..-“_,__ i .- ._,v....->

In the early 1940's "garden therapy" was discussed as a separate
type of treatment. The use of gardening during‘world War II stressed

functional treatment much more than had been done previously. Investigap

. ,.___'—.——_'~_.
r. H_ - - _

,_-\

tions into the potentialities of the use of horticulture as a therapy
were begun at Michigan State College in 1951. At this time much of the
impetus for the work in Horticultural Therapy was caused by the interest
of garden club members. Phases of horticulture other than outdoor garden-
ing began to recieve more attention than previously.

In order. to serve as a pilot study, an exploratory program of
Horticultural Therapy was conducted at Kalamazoo State Hospital during
July and August of 1955. Gardening was by far the most popular activity.
Plant identification appealed to fewer people. Plant propagation was of
interest to those who were confined indoors. The study of plant parts and
plant functions increased the patients' interest in all phases of horti-
culture. l'lower arranging, corsage making, and related short term projects

provided opportunities for creative expression.

fared upon the experienceghof‘ the pilot study, a suggest€d pray?

/f~._-——.

for Occupational Therapists has been outlined in detail describing the

types of patients, required facilities, and limitations. Projects have

been grouped under the following headings: outdoor gardening, other ~
outdoor projects, indoor gardening, greenhouse ardening, cut flower pro- /
/.

-jects, other indoor projects using plant materials, and renter/praise“;

l..- -MF"
-- k. _f... ..—-

A brief description of each project has been provided supplying

sources of futher information.

Complete analysis of activities involved in outdoor gardening has
been included to supply a comprehensive source of current findings in the

application of'horticulture as a means of therapy.

 

 

Ill11111111111111lllllllllll1111111111“”HI

 

13956465