**2. Method**

and fine motor skills, eventually improving their physical activity and self-maintenance abilities [30]. Thelander introduced a 6-week outdoor gardening intervention to eight older residents with dementia at a frequency of three times a week, for 40–70 minutes per session [31]. The results indicated that landscape maintenance tasks such as watering, weeding, and fallen leaf picking significantly improved the residents' balance. Gigliotti and Jarrott compared the elderly participating in gardening activities with counterparts receiving conventional treatment, and found that those in the horticultural therapy group exhibited significantly higher levels of activity involvement and positive emotions [32]. Lee and Kim implemented a 4-week gardening intervention comprising selecting bean cultivars, sowing seeds, watering plants, touching the plants they had planted, cleaning and maintaining the planting environment, and harvesting, cutting, and washing the plants; their results indicated that these indoor gardening activities significantly reduced anxiety [33]. Austin determined that after receiving horticultural therapy, the elderly exhibited significantly lower levels of anxiety [29]. By touching the plants they had planted, cleaning and maintaining the planting environment, and harvesting, cutting, and cleaning the plants, the elderly were engaged in higher levels of physical activity, which in turn improved their cognitive functions [33]. In addition, Sempik, Aldridge, and Becker noted that gardening activities strengthened the elderly's sense of responsibility and increased the opportunities for decision-making, through which their degradation could be slowed and the group became consolidated because of sharpened social skills [34]. However, gardening activities remain inadequate in the elderly's nursing homes. Although lawns and gardens are common in nursing institutions, they are rarely designed according to user needs. SCUs in France conducted a survey from 1992 to 2007, determining that less than 82% of medical institutions had freely accessible outdoor space, and only 43% provided patients with access to this outdoor space; thus, gardens were not regarded as a part of health management. Nevertheless, compared with conventional treatments that require hospitalization, horticultural therapy is generally more accessible to patients and easier to adapt to; furthermore, the costs are cheaper than other types of therapy. Despite gardening activities being widely recognized as a positive therapy, substantial efforts are still required to popularize this therapy in public care systems. Engaging in gardening activities typically requires the elderly to bend or squat. When planting is conducted in a standing posture, people in a wheelchair have difficulty participating because square tables have limited availability. Therefore, defining design conditions that support the elderly's participation in gardening activities is paramount. Research has shown that the first condition to be considered in horticultural equipment design is to lower the participants' physical burden. When the elderly are allowed to engage in the activities by themselves, their opportunities for mutual communication increased; however, their exchanges and communications reduced when a facilitator joined [35]. Circle theory in the field of environmental psychology maintains that using a round table enables people to see each other. However, results of one experiment revealed that simple concentric tables could not satisfy the requirements of wheelchair users and others with diversified physical conditions [36]. Even so, designers may still experiment with other shapes that have the effect of a circle to determine which table shape facilitates the interaction of people with varying physical conditions in a variety of venues. Horticultural therapy courses stimulate emotions, boost activity levels, reduce stress and fear through human-to-plant interactions, increase muscle relaxation, and promote confidence and knowledge. These courses promote user's sense of responsibility and self-fulfillment through

110 Occupational Therapy - Therapeutic and Creative Use of Activity

"House of Love" is a private nursing home and a research base established in 1923, for the elderly, people with no assistance, the sick, and the homeless. "House of Love" is also awarded for excellence by the Ministry of Home Affairs and Taipei City Hall. "House of Love" is the best long-term care center in Taipei that focuses on treatment of the body and mind (**Figure 1**). This study implemented records of long-term behavioral observation in "House of Love" with a focus on cases who participated in these horticulture classes, the

**Figure 1.** Private nursing home "House of Love".

**Figure 2.** Observation one, class one (control group).

interaction between them, their problems in grading, and studies of these classes. Behavioral observation and post-occupancy evaluation were used in this study. Behavioral observation is referred to as sequential action marking; this method is a type of continuous observationrecording, and its objective is to record the relationship between time and actions. This study adopted behavioral observation to record the process of the elderly's engagement in gardening activities. Post-occupancy evaluation was adopted to evaluate user evaluations after experiencing the design. Weaknesses in the proposed design could be determined from users' behaviors and reactions, and corresponding design strategies could be developed.

This study was carried out in three sections. The first section focuses on observation of elders who participated in horticulture classes. We implemented behavioral observations in the three classes as below:

were coded and divided into four categories: class-related objects, classroom interactions, the

New Flower Bed Design and Verification Supporting Horticultural Therapy Classes Based…

http://dx.doi.org/10.5772/intechopen.78311

113

Section 2 focuses on how we make a design proposal of gardening tools and then new design proposal will put into section three which uses behavioral observation again in another horti-

Class participation: five elders, one teacher, no social workers, and no volunteer.

This study is based on behavioral observation and post-occupancy evaluation. We hope the result would combine gardening therapy and class design in an amicable environment for

The observation results indicated that classes two and three involved longer durations of activities conducted in a sitting posture. Compared with a standing posture, engaging the elderly during the classes in a sitting posture led to more satisfactory evaluations from the teacher in the postclass interviews. Both the teacher and social workers expressed that adopting a sitting posture effectively prevented the elderly from developing exhaustion or muscle pain, whereas

elderly's upper extremity activities, and the elderly's lower extremity activities.

Class location: side exit of the main building in the plaza.

cultural therapy class to see its effect.

elders.

**3. Results**

**4.** Observation of new class (test group)

**Figure 4.** Observation one, class three (control group).

**Figure 3.** Observation one, class two (control group).

Elder group: currently in wheelchair.

**1.** Observation of class one (control group) (**Figure 2**)

Class location: flower beds with sitting areas.

Elder group: the elderly with dementia and ambulatory.

Class participation: nine elders, one teacher, one social worker, and three volunteers

**2.** Observation one, class two (control group) (**Figure 3**)

Class location: operating area.

Elder group: the elderly in wheelchair and ambulatory.

Class participation: total of 13 elders. Nine in wheelchair and four ambulatory, one teacher, one social worker, and seven volunteers

**3.** Observation one, class three (control group) (**Figure 4**)

Class location: low floral display area in the back of the garden.

Elder group: the elderly on lower treatment.

Class participation: total of eight elders, one teacher, one social worker, and 10 volunteers.

The investigation was conducted using behavioral observation. The gardening course was implemented in the Garden of Fragrance in the House of Love. Classes for the control group were documented faithfully in their entirety with videos and photographs. The collected files New Flower Bed Design and Verification Supporting Horticultural Therapy Classes Based… http://dx.doi.org/10.5772/intechopen.78311 113

**Figure 3.** Observation one, class two (control group).

interaction between them, their problems in grading, and studies of these classes. Behavioral observation and post-occupancy evaluation were used in this study. Behavioral observation is referred to as sequential action marking; this method is a type of continuous observationrecording, and its objective is to record the relationship between time and actions. This study adopted behavioral observation to record the process of the elderly's engagement in gardening activities. Post-occupancy evaluation was adopted to evaluate user evaluations after experiencing the design. Weaknesses in the proposed design could be determined from users' behaviors and reactions, and corresponding design strategies could be developed.

This study was carried out in three sections. The first section focuses on observation of elders who participated in horticulture classes. We implemented behavioral observations in the

Class participation: nine elders, one teacher, one social worker, and three volunteers

Class participation: total of 13 elders. Nine in wheelchair and four ambulatory, one teacher,

Class participation: total of eight elders, one teacher, one social worker, and 10 volunteers.

The investigation was conducted using behavioral observation. The gardening course was implemented in the Garden of Fragrance in the House of Love. Classes for the control group were documented faithfully in their entirety with videos and photographs. The collected files

three classes as below:

**1.** Observation of class one (control group) (**Figure 2**)

**2.** Observation one, class two (control group) (**Figure 3**)

Class location: operating area.

one social worker, and seven volunteers

Elder group: the elderly on lower treatment.

Elder group: the elderly with dementia and ambulatory.

Elder group: the elderly in wheelchair and ambulatory.

**3.** Observation one, class three (control group) (**Figure 4**)

Class location: low floral display area in the back of the garden.

Class location: flower beds with sitting areas.

**Figure 2.** Observation one, class one (control group).

112 Occupational Therapy - Therapeutic and Creative Use of Activity

**Figure 4.** Observation one, class three (control group).

were coded and divided into four categories: class-related objects, classroom interactions, the elderly's upper extremity activities, and the elderly's lower extremity activities.

Section 2 focuses on how we make a design proposal of gardening tools and then new design proposal will put into section three which uses behavioral observation again in another horticultural therapy class to see its effect.

**4.** Observation of new class (test group)

Class location: side exit of the main building in the plaza.

Elder group: currently in wheelchair.

Class participation: five elders, one teacher, no social workers, and no volunteer.

This study is based on behavioral observation and post-occupancy evaluation. We hope the result would combine gardening therapy and class design in an amicable environment for elders.
