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Gardening Connection - Update 8/4/16 (UX Map and Prototype)

Partnering with a community garden can lead to new opportunities to connect with nature and people, to nurture others and oneself, to live!

Photo of Bettina Fliegel
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Who is your idea designed for and how does it reimagine the end-of-life experience?

A project that partners "at home hospice and at home palliative care" programs in urban areas with community gardens. Connecting one to nature, their families, and new people, working with a garden that provides healthy food to those that need it, can lead to self growth and enhance one’s life experiences through to the end of life. Might this also contribute to legacy, with a garden becoming a site that family and friends look to as a memorial after death?

A Palliative Care + Community Garden Partnership Project


The Premise

How Does Gardening Connection Work?

Program Users 

Benefits for Users

UX Map  (Update 8/4)

Prototype - Newspaper Blog Post  (Update 8/4)


Timeline of Project Development to Date

Going Forward

Implementation and Scaling the Idea




Closeness to nature and working in a community garden amongst others can be therapeutic for patients in both palliative care and hospice programs.

The experience can provide:

  • A distraction.
  • An opportunity to interact with the natural world, stimulating the senses.
  • Reduction in pain perception and a decreased need for medication.
  • An opportunity to connect to new people, as well an opportunity to enrich the relationship with one's caretaker if they decide to participate in the project together.
  • An opportunity for families to share an activity that takes them out of the home, to an outside space where they can enjoy time together. They can also connect over gardening projects in the home.
  • An opportunity to continue to contribute to one's community.  How?  By creating sustainability.  By growing healthy food to share with those that need it. By contributing to the beautification of one's neighborhood.  By being present.
  • For caregivers - Working in a garden can help to decrease stress.  By report this may be rejuvenating for the fatigue which they experience.

On site hospices often have gardens that connect patients to nature.  Some sites have programming for patients that support them to work in the garden. Gardening Connection is for patients who are in at home programs and may not have exposure to gardens or nature.  It provides them with an opportunity to connect to community, nature and nurture themselves and others.  In the process they can continue to develop their identity and connect to new people, through to the end of life.

Might families forge stronger connections while participating in gardening activities and spending time in nature together, as a loved one approaches end of life?
Might the actions that a person carries out at the end of their life become part of their legacy that the family carries forward?  


This is a volunteer and hospitality program.  It ignites passion as it promotes wellness and community for patients receiving at home palliative care services.  Visiting nurses make referrals to the program for patients when they are caring for them in the home.

The program is flexible. There are a variety of opportunities for participation that one can move between as needed or desired.  Caregivers and family members are welcome and encouraged to participate in all aspects of the program. 

Each community garden is unique in set up and needs.  Participants will learn what they can do to support a local garden and their community.   

Possibilities for participation include:

At Home:  Plant and nurture seedlings that may later be transplanted in a garden.  One can participate alone, with a family member, or a caregiver.  Gardening Connection volunteers will assist you at home, to get you set up.  They will follow up with home visits, or by phone/Skype, to answer questions and share gardening tips! 

In A Garden:  Work on site in a garden side by side with garden members, family members, a caregiver, or with a designated volunteer garden buddy.  Volunteer work tasks may include: planting, watering, weeding, harvesting, maintenance of planters and other community garden needs.  Enjoying nature!

Visit a garden to relax, enjoy nature, and connect with others!

Participants can join community gatherings in a garden.  These may include cultural events and communal meals.

Each garden community is unique with it's own organization and structure.  Each one that would like to partner with Gardening Connection, to support and embrace their greater community, may consider how this might fit within their framework as they work to fulfill needs and towards goals.

The Idea has evolved based on feedback and insights from hospice nurses, a palliative care physician and community gardeners.   (See the original Mock Up Prototype -Brochure attached.)
The iterated program is focused on engaging families, to strengthen connections at end of life, if a patient wants that.  In addition it now offers hospitality as an option – spending time in a garden without working, in order to engage as many folk who would like to participate by simply spending time outside, connecting to others, in a garden.

Program Users


Visiting Nurse - As a referral source

Family Members - As co-participants.

Caregiver - As co-participant.

Garden Members and Garden Volunteers

Connector - Working for Gardening Connection as a volunteer.  Someone who volunteers or works for hospice with interest in gardening, or works in a garden and is interested in supporting patients.  They are the go to person for patient and gardeners.

Benefits for Users:

Patient - A path for urban at home palliative patients without access to nature to gain access.

Visiting Nurse - An opportunity to offer a patient a nature program that may ignite passion and wellness through to the end of life.

Caregiver -  A path for a caregiver in the city to access nature which can decrease stress, lessen fatigue.

Family - An opportunity for different generations living in a city to spend time together and create together.  An opportunity for one at the end of life to share values with family, building something with and for our community is important.   

Garden Members and Volunteers - An opportunity to extend programming to support vulnerable members within one's community.  An opportunity to bring new volunteers, patients and families, into the garden.  

Society - An opportunity to change the conversation on death and dying in our culture by bringing community members together on a regular basis, in a shared space where they interact in a natural way.

Update 8/4

User Experience Map  

Prototype - Newspaper Blog Post  (Related to the UX Map) 

Created to test the assumption:

Families will be eligible for garden membership, if desired, after participating as general garden volunteers over a period of time, as part of Gardening Connection Program with a loved one who was at EOL, and has now passed away.

One gardener I spoke to mentioned that in some gardens volunteers are asked to work for a period of time, doing general garden work - cleaning, fixing structures, guarding the garden when open to the public, before being considered for membership.  The prototype might be used to share with potential garden partners - How does the path to membership work with their garden?


PROTOTYPE/Brochure - Version 2.  - The prototype was created to test the assumption that palliative care providers, nurses and doctors, would find this program feasible and advantageous to their patients.  

The brochure can also be used to share with patients.  Does this program resonate with them?  Would they join?

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Timeline of Project Development through 8/3/16

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Going Forward

Continue to explore different community gardens.

Explore a local geriatric garden.  What are they doing?  Who is their referral source?  What services does the garden have for users?

Explore oversight organizations such as

Make contacts with garden Principals via monthly garden meetings.

Reach out to contacts received by by gardener to date.

Meet with home hospice nurses to discuss the idea.  

IMPLEMENTATION:  Incorporating Hospice Patients Into Existing Gardens

Short-time frame for implementation  

Reach out to local gardens as partners.  Assess accessibility.  Assess excitement for this project.                                                          

Long-time frame for implementation   

Update 8/3/16

Consider developing relationships within communities with clergy and community health centers as referral sources.

Explore bringing part of this program to inpatient hospice units that do not have gardens available.  Consider partnering with inpatient recreational therapists.

Update 7/17/16

Explore the idea of partnering with a community health organization or system to create a garden for a local community, building this Idea into the plan. Might this be a way to bring in extra services such as recreation therapists who would work with the patients in the garden?

Explore the role of this program for children receiving palliative care.

Scaling the Idea

Do a pilot project.  Iterate based on feedback and a needs assessment.  

Share the idea with oversight organizations and get their support to scale to other communities locally.  

Share best practices with other communities and organizations in the long term.



What Is the Evidence To Support The Role of Therapeutic Gardens For the Elderly?

Horticulture Sessions Help Hospice Patients   

Try Gardening to Balance Caretaker Fatigue


Thank you to the team for your input and feedback!

What early, lightweight experiment might you try out in your own community to find out if the idea will meet your expectations?

Speak to palliative professionals regarding the feasibility of the idea. Create a prototype to present to users. Speak to a community gardeners and visiting nurses to see if they are interested in partnering on a project like this. Speak to hospice patients, caregivers, and hospice volunteers to see if this interests them as well.

What skills, input or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

Feedback from providers working with patients in palliative care and hospice programs. Input from anyone with experience with community gardening. Input from anyone with experience in horticultural therapy, or garden work in hospice settings. Collaborators from these settings.

Tell us about your work experience:

I work in healthcare as a pediatrician. I have experience in inpatient, outpatient and emergency care settings as a clinician, teacher, and as an administrator. My experience has been primarily within underserved urban communities, most recently with adolescents in the juvenile justice system.

This idea emerged from

  • An Individual
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Attachments (9)

Timeline .pdf

Timeline of project development, referencing work done and reflected in attachments here.

FEEDBACK V - Mt. Sinai, 2nd Visit.pdf

FEEDBACK V with Iterated Gardening Connection Program Description - July 30, 2016. 2nd Visit to Mt. Sinai Hospice Unit. Iterated Program, as reflected in the Prototype Iteration 2, reviewed with staff nurses.

Feedback IV - Conversations with Community Gardeners.pdf

Feedback IV - Conversations with community gardeners in NYC. Visits to two gardens. July 29 and July 31. Feedback and learnings.

Prototype Brochure - Iteration 2.pdf

PROTOTYPE 2 - Brochure - ITERATED Initial prototype/brochure iterated to reflect changes to how the Gardening Connection Program will work, based on feedback obtained from palliative care providers and community gardeners. (See Feedback II, III and IV.)

FEEDBACK III Hospice Nurse, MM.pdf

Feedback III - July 28, 2016 - Prototype Brochure shared with Hospice Nurse from Mt. Sinai Hospital. Feedback obtained on brochure and the program as described.

Feedback II Dr. Nelson.pdf

Feedback II - July 25, 2016 Meeting with palliative care physician, Jacobi Medical Center, Bronx, NY. Prototype/Brochure presented. Program discussed. Feedback obtained.

Brochure Mock Up July 27.pdf

PROTOTYPE - Gardening Connection Program Brochure (Initial Prototype)

FEEDBACK I Meeting, Mt. Sinai Hospice Nurses.pdf

Feedback I - Meeting with Mt. Sinai hospice nurses, July 14, 2016. Presented original idea using a rough diagram.

Rough Sketch_Process Diagram.jpg

Rough Sketch/ Process Diagram of Original Idea - Shared with hospice nurses, Mt. Sinai, July 14


Join the conversation:

Photo of Lee-Jung Kim

Bettina, I love the fact that you were able to gain insights from both the patient/caregiver side and the community involvement via community garden. It would be wonderful if we can pilot test this idea with some organizations willing to give this a try!

Photo of Bettina Fliegel

Thanks Lee.  I learned a lot from visiting and speaking with a few gardeners.   Plus they were incredibly nice!  There is potential as there are 47 community gardens on the Lower East Side of Manhattan!  Apparently Fall is a busy season in the gardens.  There is a big festival - The Harvest Arts Festival.  Might be an opportunity to see several gardens.  
(I just posted the feedback and learnings from the garden visits.)

Photo of Pearl Sequeira

Bettina Fliegel - I agree with Lee-Jung Kim 's comments. I really love the insights you were able to gather from many perspectives, and look forward to hearing more about pilot(s) you can test! 

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