Design of elder sanatorium based on healing landscape (case study: Baraki sanatorium of Borujerd)

Introduction
Elderly is a period of human life cycle. Men need especial heath and spiritual care in aging stage.Elder sanatorium is one of care providers introduced for aging people nursery and accommodation. Elder sanatoriums are symbols of aging people isolation in Iran. It is reflect of society tendency to ostracizethis class of society. Loneliness, boredom, frustration and helpless imposed to sanatorium residents. Some of conditions are created due to unsuitable environmental characteristics. Elder sanatoriums could be improved by application of environmental design principles and solutions. Environmental design is able to enhance the sanatoriums location and reduce improper circumstances. Healing landscape approach is the main strategy for environmental design in such sites. Healing landscape applied different elements and natural features to enrich the landscape in such manner that helps to improve physical and mental health. Natural views, pleasure aroma, song and sound of nature, fresh air, colorizing landscape by natural plants are some of natural elements and feature that could have effective in reduction of stress and enhanced people health. The article tried to design an elder sanatorium based on healing approach. It tried to prepare a comfort and favorable place which aging people experience a quality of life inside the sanatorium.
Healing approach discussed here from three view stand of point:
-          Providing nature landscape or naturalism strategy;
-          Horticultural therapy;
-          Aromatherapy.
 Providing natural landscape views has positive impact in improving thepatient's physical and psychological diseases. Positive effects realized through four statuses: 1- avoiding daily stress and anxiety, 2- Natural landscape is favor of men, 3- perception of naturalness and feeling freedom, 4- participatory actions in nature and concentration on favor natural features by any person.
Horticultural therapy is set of patients’ participation in gardening and related activities in order to help acceleration of patient healing process. It accelerate healing process through:1- Adoptability of such activities with patient ability, 2- they could it in different places from normal therapeutic spaces , 3- Normally patients are interested to undertake such kind of activities.
Aromatherapy is a third aspect of healing landscape. It is a branch of herbal medicine. The art of aromatherapy is use of herbal perfume, oils and pharmaceutical essences through massage and inhalation for the treatment of diseases. Use of natural fragrant flower in healing landscape is an especial dimension of aromatherapy. It is common method in depress treatment.
Materials and methods:
Area of study:
This study has been done in the Brakati Sanatorium. The Brakati sanatorium is one of elder care center in the Borujerd. Borjerd is center of Borujerd County in Lorestan province that located in west of Iran. Borujerd city had population about 245737 in 2012. The elder people are about 13123 people. The Brakati Sanatorium located in ShaikhMiri village nearby the city. The sanitarium area is about 1500 square meters include two main parts: 30 present allocated into the buildings and remain areas are open spaces.
Method:
The article comprises from two parts: First part include selected approaches, second; related to the study area. Two main approaches are selected to create a healing landscape. First approach is naturalism approach and second is horticultural approach. First approach concentration is on creating natural landscape in order to generate relationship between elders and nature (Table 1).
Table1. Naturalism approach solutions for healing landscape





Effect on health


Solution




Increase concentration power


Diversity and heterogeneity




Increase elders right of selection 




Increase concentration power and Heart rate


Planting colored flowers




Use of treatment  characteristics


Planting herbs with medical benefits




Reduce noise pollution and relaxation and reduce stress


Create natural sounds




Positive impact on heart rate


Water effects in different form




Reducing anger, fear, reduce the heartbeat





 
Second approach emphasis on physical activities in form light garden actions to increase and improvement of physical power. Gardening aspects are important in healing landscape design for elders. Different solutions is applied in healing landscape design (Table 2)
Table2. design solutions based on horticulture approach in healing landscape





Effect on health


Landscape design solution




Increase physical movement, Physiotherapy and socializing


Use of private croft




Increase physical movement of disable people


Use high gardens




Create sense of usefulness for elders and disable people




Create sense of usefulness after work


Use of fruit plant




factory stimulation, relaxation and reduce stress


Use of fragrant plant




Positive impact on heart rate, sedation


Create natural sounds




Increase concentration power


Colored Flowers




Risk of poisoning


Non-use of poisonous plants





 
Design comprises the indoor and outdoor spaces. Based on these three approaches, first for study of area, field survey has been done. Then a limit interview is done with resident and personnel of sanatorium in order to identify the facility of changes in area and primary assessment of elders. Then the area was analyzed based on filed survey, assessment and also aerial photos. Indoor and outdoor spatial relationship is identified and reorganized. Challenges and problems of status quo are revealed and simultaneously facilities and capabilities are identified. In continue healing landscape solutions categorized in two main groups: 1: Naturalism approach, 2: Horticultural approach. Finally design concept is prepared and finalized based on site analysis. Final design tried to complete interaction of elements and spaces in order to realize healing landscape for elder.
Result:
In the first step, problem of space organization was identified. Elder room was located in isolation arrangement with limit view on walls.
The existing plants restricted torosa, Turf grass, moros alba and Salix babilonicathat planted uniform. The interviews showed that planted area has not any attraction for residents and they have no relationship with open spaces and its landscape. While the relationship between people and landscape is an important part of such spaces and it has vital role in diseases treatment and elder people health.
Discussion:
In the first step rooms’ reconfiguration should be done. The organization of sanatorium is corrected and new configuration of rooms and spaces are presented. The new arrangement prepares a view to open space. More ever, environment entered into the rooms by add some natural elements and features like natural flower vases in interior spaces.
Landscape Design:
All design solutions are presented for better quality of life and enhance living condition based on healing landscape concept. Development strategies used from geometric forms. All steps between spaces are omitted. It will facilitate elder movements in all corners of sites. The height differentiation is about 60 centimeters along the site. The calculated slope is about 1% to strengthen the spaces relationship and people movements. All other movement barriers are removed and path and pedestrians are floored by flexible Rubber Flooring. Water fountain and streams add to the site to enhance the sense of naturalness. Some experimental gardens designed nearby the residential rooms to increase easy access.
Verity of plants and trees introduced to the site. Combination of cherries, red maple and eucalyptus are emphasized. Planting shrubs composition of lavender, Rosa and elder be rarified in irregular forms make the landscape closer to the natural. The floor is covered by Lawn and spearm in edge. Some significant plant species have been preserved in the area.
Conclusion:
The high percent of Iranians population will be in aging in near future. These parts of population need suitable elder sanatoriums. Thus a healing landscape concept is a necessary approach to make such spaces as appropriate place. Barekati sanatorium is designed based on this concept and emphasis on two naturalism and horticulture strategies and solutions. Naturalness brought into the site and interior spaces in order to enrichment of living elder places and enhances elders’ health. The study of elder behavior could help to design more accurate and effective space.