Toronto East General Hospital Rooftop Garden
Designed by Tales of the Earth
The Philosophical Basis
for Designing the Restorative Garden:
To help strengthen physical, mental and spiritual health
in a balanced and harmonious relationship
with the natural and social environment
Tales of the Earth is designing a rooftop garden at Toronto East General Hospital. Atop the fifth floor of H Wing overlooking the old City of East York, the garden will be an integral component of Complex Continuing Care, a new department of the hospital. Construction of the structural components of the garden is scheduled to begin during the winter of 2001.
The facilities of Complex Continuing Care will be the residence for 75 elderly men and women. It will likely be their last homes. In most instances they will be far from their places of birth. Many of them have emigrated from Britain, Ireland, Greece, Italy, Sri Lanka, India, Vietnam, Philippines and China. Many languages will be spoken; many cultures will be represented. While most of the residents will have moved from their most recent homes below the garden, here in East York, the garden will be a little like the United Nations.
"A hospital's physical plant should mirror its patient care philosophy…Environments
that engender in patients a belief that healing will occur sow the seeds of healing
by stimulating emotions that trigger beneficial biological mechanisms."
The photo shows the working model of the garden, which evolved during the design process. It is a “working model” in that we used it as one would use a series of sketches, adding pieces, and replacing pieces with of various sizes and shapes. It made visualizing the schemes much more clear. Throughout the design Exploration phase of the project, Tales of the Earth collaborated closely with a committee composed of Carol Ross, Health Service Director of Complex Continuing Care; a group of caregivers affiliated with the program; Theresa Vasalopoulus, Acting President of the Hospital Foundation; and John MacSween of Parkin Architects Ltd. We met often and regularly, working to clarify the program and taking the opportunity to continually ask, “Did we hear correctly? Is this what you need?”
Our goal was to provide a physical expression of the Vision Statement for Complex Continuing Care in the garden, an integral “Humanistic Place for Healing” having these objectives:
a) Providing a home for residents of Complex Continuing Care, a Safe and Caring Environment.
b) Providing an environment that respects and values the diversity of residents and their support network: their cultural, ethnic, physical psychological, socio-economic, religious, spiritual, lifestyle choices, values and beliefs.
c) Providing an environment in which to reconstruct a sense of reassurance and restoration of confidence gained through healthful aging or lost during illness.
d) Recognizing the need for both privacy and interaction with others so as to preserve personal dignity.
e) Creating a sense of order to help reduce ambiguity, uncertainty and anxiety.
f) Helping to alleviate physical, mental and emotional suffering.
g) Respecting the ways in which people negotiate mental and emotional shock associated with illness, pain and suffering and the resulting loss of a sense of self.
h) Providing a place for staff to readily perform their duties with professional excellence, a sense of empathy for residents and passion for their work.
i) Making a garden that provides for high quality compassionate care for each individual.
Genesis of the Design
During the last fifteen years, design professionals and hospital administrators have extensively documented the importance of the garden for physical, mental and emotional health care in hospital environments. The restorative garden is best when it is not conceived as an after-thought, nor of a way to deal with "leftover space.” We believe that the healing garden is an integral component of the hospital environment, requiring careful design in order to meet the requirements of caregivers and those receiving care. This is particularly important for landscape environments used for personal healing and restoration, where a design vocabulary can be used most effectively to develop features and characteristics of the healing garden.
As we developed a series of rough sketches and drawings of alternative garden concepts and schemes, we sought to express the program, objectives and values of Complex Continuing Care. They became responses to the natural and social factors giving character and meaning to the spirit of the place. Five essential ingredients came into play:
1. Physical characteristics of the garden site and the surrounding neighbourhood. The rooftop is an extremely challenging site. Long and narrow, the terrace is 140 feet long. It is 23 feet wide at the widest point and nine feet at the narrowest. The fifth-floor terrace is presently covered by rectangular concrete pavers and is surrounded by an 8-foot high glass security barrier. The terrace faces east, greeting the morning sun. The high-rise apartments of Scarborough and East York can be seen over the treetops. Small single-unit houses on individual lots line the streets below. An Anglican church steeple rises in the southeast behind the tall hospital exhaust chimney, which dominates the sky. Two floors of the hospital rise above the terrace on the west, protecting the terrace from prevailing westerlies, but the terrace is exposed to strong northerly winds and heavy storms rolling in from the east.
2. The residents’ places of birth, their homelands, as their cultural points of reference – where the depth and richness of materials that once shaped familiar natural processes and social interactions over long periods of time will give comfort and a sense of well-being…tending fig trees from Greece, grape vines from Italy, vegetable and fruit gardens. Familiar features helping things to make sense.
3. Their places of residence just before moving to Complex Continuing Care. The edge of the garden is a window onto their previous homes, actually framing the streets on which they walked or motored in their scooters. The window helps to bridge the different phases of their lives, so that a semblance of continuity will ease any discomfort caused by the seemingly disparate segments of their lives.
4. Teachings from Sacred Landscapes, having much to teach those engaged in designing therapeutic landscapes for humanistic health-care facilities, these places have qualities and characteristics that help to strengthen physical, mental, emotional and spiritual health in a balanced and harmonious relationship with the natural and social environment. A sacred landscape is a place that opens up the heart and energizes thoughts and feelings associated with spiritual dimensions of life.
Produced by natural forces, a sacred landscape possesses unique physical features, an environment invested with profound power and importance free from all afflictions and ailments. As a medium for devotional practices, a sacred landscape is an integral component of spiritual teachings; in turn, helping people gather inner spiritual strength, a necessary companion to healing.
Because of their abilities to heal, sacred landscapes provide inspiration for the design of gardens in therapeutic health-care environments. I have found that gardens designed for contemplation and healing are most effective and responsive to the healing process when design elements of the sacred landscape are applied. The following design elements constitute such a landscape: 1) Being of favourable context; 2) It is contained; 3) It is coherent; 4) It is composed; 5) It has clarity; 6) It is an artistic expression of contemplation.
5. Vision Statement of Complex Continuing Care. The program emphasizes things its caregivers believe in and are committed to:
a) Holistic care for residents and their support network, which respects and values their diversity – encompassing a person’s physical, spiritual and psycho-emotional well-being.
b) High quality, compassionate care for each individual in a safe, caring environment – a place that is home-like and comfortable, reflecting the resident’s personal style and tastes, enabling them to experience continuity between the home and the facility.
c) Resident-directed care, which focuses on informed health management and quality of life decisions.
d) A staff passionate about its work, striving for professional excellence and committed to lifelong learning – actively encouraging creativity, taking risks and attempting new approaches.
The Garden
A garden to stimulate all the senses, it was also designed as an architectural sculpture. Two pavilions frame the garden: on the north, the pavilion for gatherings, on the south, the pavilion for semi-private family visits. The large old weeping willow tree favoured by the hospital staff before it was cut down inspired the form of the gathering pavilion. The green house removed years ago inspired the form of the visiting pavilion. The richness and depth found in the layered details of historical structures of the “old country” inspired details of the steel structures without being historically redundant.
Residents leave and enter the pavilions on the stone path. The path sweeps past the activity room, enclosed by the stone wall of the planting beds. While directing residents from the centres of the pavilions at each end, the path changes the orientation of the residents as they move from one field of the garden to another, revealing something that wasn’t apparent before, like the “seen and hidden” technique used in the Japanese stroll garden. This helps the residents to experience the garden as something larger than it truly is.
Near the activity room, the width of the garden is very narrow, so the path is designed as transition, rather than for sitting. Towards the visiting pavilion, space is set to the side for the “piazza,” its shape resembling the plan of Piazza Navonna in Rome. A shallow pond-table, covered with less than an inch of water, sits in the middle of the “piazza,” high enough for the residents to run their fingers through when they sit in their wheelchairs. On the other side of the path, a trellis separates the path from the building, also making the garden feel larger.
The planting plan heightens the memories of places having meaning to the residents. Climbing roses, grapes, fruiting plants, perennials and shrubs are chosen, as well, for their abilities to survive under difficult rooftop conditions.
Key words and phrases, characteristics and features helped direct the actual design: Quiet corners and socially active areas… public--semi public--semi private--private areas … maneuverable by wheelchair…stimulating all senses to increase alertness…cutting gardens of variable heights…outdoor dining…tables and umbrellas…aromatic… all four seasons, AM and PM, 7/24…well lighted and no pockets of dark… music to stimulate memory… bird feeders…no cobblestones…a trip around the world in the garden…tying inside to outside through operable windows…modify extremes in temperature, humidity and sunlight, protected from winds, invitation to breezes…non glaring…orientation landmarks…water as a palliative agent, sitting by the fountain…respect historical and cultural traditions…integrate familiar features from homelands…home-like…varied places in which to be…clear organization, hierarchy of spaces…soft sounds, leaves rustling, water falling, birds singing, breezes singing.
1:2001