Path system and continuous flow
One way of starting a design of a therapeutic garden is to do the layout of paths and ways to stroll and to circulate in the given area. If the area is very small, it might not be possible, and we would have to start at the second step, zoning.
First step, circulation or flow, is a fundamental of any landscaped space and can be very frustrating to the people using the space if it is not done correctly. In most cases, there should be a closed loop of continuous flow from and to all entrances and exits to a space – there shouldn’t be a lot of dead ends and closed corridors. So you wouldn’t want to plant a hedge halfway across the middle of a lawn area and make people walk a long way out of the way to get into the next space.
Usually, it is the minimum measure of the path width that will give the information if it possible to use a path system circulating through the garden or not. The minimum width for a wheelchair and a person to walk comfortably side by side is 1.80m.
Walking around the outside spaces should provide exercise and be a journey, with things to look at and enjoy on the way. Maybe a combination of planting, hard surfaces, places to sit and rest in sun and in the shade. Paths should lead somewhere, at the very least around a feature. Features might be games, ball plane, pergolas, trees, or horticulture activities. Paths should not lead to dead ends or locked gates if it can be avoided. The loop is a very easy way to divide the site and create an interesting tour for everyone in the garden.

Image 15. Flow and Circulation in the healing garden, a Loop in the courtyard in Pryconsa Residence of 650 m2 that connect different functional zones. (Source: Therapeutic Gardens Palmlöf)

Image 16. Flow and Circulation in a smaller garden (450 m2) enclosed by walls. Even in a small place it is important to consider the movements we would like to happen in the garden. (Source: map from therapeutic Gardens, Cooper ,Marcus,Barnes)
There are no fixed rules when designing the path system. Sometimes the cultural environment and the buildings force us to use a different solution than a “Loop”. Like in the next picture where the garden is a rectangle a long a building.

Image 17. Example of a rectangular narrow garden with straight lines. There is no space for walking in circles and the walk must be a line of transport through the different functional zones. Source: Modern Landscape Designers
Utilizing curves and circles is a way to break away from the typically squared designs of houses and interior rooms. Nature is more likely to use organic forms and not very often straight lines. In this way we imitate nature, and the feeling will be involvement by nature. Using curves there is also a bigger possibility that unplanned surfaces will appear, flower beds to fill with vegetation. This usually does not happen when planning in rectangles and squares.
The use of organic shapes is a recommendation, but it is not necessary. As said before, there will be places where using organic shapes is not possible for example long rectangle terraces or very small courtyards. It is also easier to use straight angles when designing for examples porches and social areas along the building to place to as many chairs and tables as possible.
Functional zoning
The second step in the layout will be to plan for shapes where activities such as social come- together, games, workshops, and therapy can take place. Most of the time these areas are planned to be scaled with a size that will be in harmony with the house and the surroundings. In the therapeutic garden these areas need to be dimensioned for the number of persons that are going to be active in this area. The biggest challenge is to balance these areas with vegetation while they normally are paved areas or hard surfaced areas. We will come back to materials and characteristics of these pavements later.
In the first needs analysis there will be an outcome of what kind of areas should be planned. The following are some examples of different spaces and how to consider their dimensions.
Social areas
These areas are always present, and it could be wise to start planning for your social area first. The size should be large enough for tables and chairs and if it is possible adjacent to the building /entrance in the garden. In many communities, there might be individuals that never go further into the garden while staff and tutors do not have the time to take them, and it is therefore interesting to plan social areas close to the entrance.
Calculate for various groups of seats and tables. Depending on the table and chairs the groups occupy more or less 6 m2. In between there should be at least 4 m2. See size dimensions picture.

Image 18. Example of garden furniture dimensions. Drawing by E.Nucera, JTP.
Social areas next to the entrance need protection from the climate to ensure maximum usage, for example, the use of parasols or a simple roof structure to provide protection from rain or strong sun.
Horticulture therapy area
The next area to plan might be an area for horticulture therapy. In the needs analysis it is important to find out where this area should be located. To grow vegetables and to have a greenhouse there should be as much sun as possible during the day. It is also highly recommended to have a water source close by, and not to have a water hose laying out all over the garden, as it could be a falls risk. The dimension of the area depends again on the available space and on the number of people and their abilities when carrying out horticulture activities. In a care home, it could be enough with 4 raised beds and flowerpots. For younger adults with higher physical endurance, we would prefer to have ground level /cultivation beds that occupy at least 50 m2. Remember to check all the measures for raised beds and measures in between the raised beds. At least 1.50m between the raised beds. See more about raised beds in the chapter about furniture’s.
Horticulture is not only digging and weeding. Cleaning flowerpots, potting, pruning, sowing and taking cuttings are all activities that could be done while seated by a table or a work bench (even inside). Therefore, it is a good idea to create a working area with a big sturdy table and benches. Perhaps protected by shade.
If there is space enough it is nice to plan for a compost container. This container must not be very big and is not only recycling the plant material to useful soil, but is also an educational opportunity.

Image 19. Idea for an adapted compost container. By Pia Winnber-Lindquist. Möjligheternas Trädgard. Hjälpmedelsinstitutet.
Another element that is very useful close to the horticulture area is a place to store tools, bags of soil, pots etc. This doesn´t have to be a big storage but it is recommendable that is has an easy access for everybody to be able to serve themselves and it should have a lock to be able to lock the door when the tools are not in use.

Image 20. Elements in the horticulture area. Illustration by Jardines Terapeuticos Palmlöf.

Image 21. Storage for tools. Photo Karin Palmlöf from Chicago botanical garden.
Physical exercise and game areas:
There are many kinds of physical activity and the most common might be the strolling. Even a small stroll of 50 -100 m is worthwhile, and it is possible to design in small spaces. Another possibility is to design a surface for ball games (hard surface). Ball games like basket and football are not considered here. A surface for aerobic exercise, yoga and other activities that could be done on a lawn or a paved area is useful in most gardens. To make an exercise with a group of 10 persons you will need a surface of at least 80 m3. This size is also suitable for games like crocket and exercise in a circle.
If the users need gross motor training, part of the lawn could be used for this. These kind of training elements could also be included in alternative paths with changes in levels. In the therapeutic garden it is more common to use natural elements than prefabricated equipment. With natural elements we refer to designed elements that still belong in the garden or in nature. An example is a path made from sand or a tunnel made from climbing plants that force you to bend or stones to climb etc. See comparison pictures below.


Image 22. Comparing space occupied by gross motor equipment, prefabricated, and natural designed gross motor challenges in place. Photos Karin Palmlöf. Therapeutic gardens in Madrid and in Denmark.
Relaxation and private areas:
Perhaps this area is small, and the form and the layout are not so important. However, the location should be carefully chosen. Quiet areas are a necessity for some service users, a place to escape and be private. So, if there is enough ground, a retreat can be much appreciated. Plants and the surrounding area should be chosen with care to create a healing place. It should be located with no interfering circulation or noisy activities beside it. Nevertheless, it should not be completely isolated. Preferably, the area should be visible to the staff.

Image 23. Small quiet area with orange planters. Apart but visible. Photo Therapeutic Garden Palmlöf, Barcelona.

Image 24. Functional zoning. Example from the therapeutic garden in the national Centre of Alzheimer’s in Salamanca, Spain. Illustration by Jardines Terapéuticos Palmlöf
Sensory Modules and Reminiscence Module
To facilitate the understanding of the different environments in the garden JTP created a modular system for the different needs of the users. As explained in the introduction, each module contains some of the elements that would be needed in certain therapies and are supposed to help the designer and the therapists in the design process of the garden. Apart from the general areas explained above, here we include the reminiscence module and sensory module.
Sensory Module-design elements
The main features in this module are the plants. A separate chapter will go further into plant specifications, but here the interaction between the person and the plants is essential in order to have a meaningful experience. How do we achieve this? With paths going through the vegetation, raised beds and smaller paved areas so you feel you can reach and touch and smell the vegetation.
Apart from plants a sensory module can contain other interesting elements:
- Water features (see chapter 4.10) to listen to running water, reflect the light or reflect the sky…
- Sensory paths (wood, sand, vegetation)
- Different pavements that are naturally included as secondary paths (stones, bark, grass…)
- Stones, sand from your area. Stones have their own world. There are small stones that you pick up and rattle in your hands, there are big stones to sit and crawl on and there are soft and sculptured stones.
- Perennial shrubs for the birds to hide in (listening to their song in springtime)
- Bamboo and other moving plants to hear and feel the movements of wind
- Create “a roof with plants” to feel “the change of temperature” and the difference between dark and light under the plant roof (pergola, arches, trees).
The meaning of the sensory module is to bring nature experiences to those that cannot go to the beach and feel the sand and smell the sand between their feet or take a walk a rainy morning in the woods to feel the cool drops and air and to smell the wet ground and maybe a special flower that smells of honey. Thinking this way will guide us to include the elements that could bring experiences for the senses.

Image 25. Sensorial elements in the gardens. Photos JTP, except from the lady climbing stones. Helle Nebelong therapeutic Garden at Christians Have Nursing Home.
Reminiscence module
Objects that trigger memories are usually underused in the gardens. They depend on the background of the users and must be culturally appropriate, as outside spaces and how they are used vary greatly from one culture to another. The plants also have an important role in the reminiscence module and they constitute the most natural way of evoking positive memories and start communications. An example is the orange tree from southern Spain. A therapeutic garden in Seville or Granada would plant orange and lemon trees in this module to smell the typical “azhar” during spring.
Here is a list of other reminiscence objects, except from plants that can be incorporated. It is important to avoid creating an amusement park atmosphere as this only would be confusing for the users.
- Sheds, green houses, chicken coops,
- A place where something happens: mending bicycles, a beehive without bees, wood work
- Post boxes
- Thermometer and pluviometer
- Barbecue
- Sports games
- Bird feeders and birdhouses
Part of the memories are also the materials we use to build the garden. The brick wall or the brick path is something very common in Great Britain and Germany and would be appropriate to incorporate in the garden there. Greek gardens would have typically lighter colors of stones and perhaps sculptures hidden in the planting, while in the Scandinavian countries a fruit yard (orchard) is something common that make persons “feel like home” in the garden.

Image 26. Reminiscence module in the basque country in Spain. A typical country house, “caserío”, where vegetables were grown and animals taken care of. Design and photo, JTP.