Murdostoun Brain Injury Centre Therapy Garden

In early 2024 Gillian, Senior Occupational Therapist (OT) at the Centre, contacted Trellis. The staff were seeking support to turn a gloomy and disused courtyard back into a welcoming space that patients and family members could enjoy in addition to being a space that could be used by the multi-disciplinary team to support individuals’ physical and emotional rehabilitation plans through nature-based activities.

Participants: 14-20 service users at varying stages of recovery. The number using the gardening space as part of their agreed rehabilitation plan changes as patients are discharged and new patient rehab plans are agreed. The use of the garden as part of their scheduled rehabilitation work is determined by the individual’s interests and person-centred plan but the space is available as a relaxation area for patients and family members/visitors.

Activities: potting up, watering, weeding, seasonal tasks, and basic garden maintenance as well as simply being in the outdoors and taking time out in a quiet space in nature.

Staff Use: Integrated with occupational therapy and physiotherapy goals and used by the speech therapist and music therapist.

Outcomes

Improvements to the courtyard therapy garden were clearly visible. Whilst a simple space, it has been transformed from a dark and dreary unused garden to a welcoming hub used by the whole rehabilitation team, patients and family members.

Positive outcomes included:

• The creation of a calm, reflective space that helped improve mood
• More patients using the space in their own time to get outside and relax - with some even taking to creating chalk murals
• Patients and family members using the space more to enjoy visiting time
• Patients getting together more over a cuppa, creating a social hub with increased interaction and connection
• Members of the rehabilitation team using gardening activities with patients more to support improved manual dexterity and mobility
• Members of the rehabilitation team using the outdoor space for other therapies including music and speech therapy work.

Lorna noted that for one patient the garden now provides a reason to get out of bed when previously he was reluctant to get going – there are now plants that need watered, and cared for and this is his motivation to start the day.

Challenges and Learning

The centre staff know that accessibility still poses a problem – both from a security point of view but also the need for handrails to be installed to aid ramp use for some of their ambulant patients. The Scottish weather caused setbacks, with Storm Eowyn causing serious damage to the newly renovated courtyard in January 2025. The staff recognise that finding time for maintenance in their own schedule is difficult, particularly with no easily-accessible water supply to the courtyard area, something on their to-do list!

Next Steps

The initial transformation of the courtyard area has encouraged the staff team to do more. Whilst work continues to complete all the original concept ideas, a follow-up visit from Joan in May 2025, helped clarify next steps for the development of the garden space and greater integration of the use of nature-based activities across disciplines:

• The addition of wheelchair accessible raised beds for easier patient access to gardening activities (proposed in original plan)
• The addition of a sail shade or similar to provide a shaded seating area
• Provision of a water supply to the courtyard area to make watering (by staff and patients) much easier, thereby increasing physical activity opportunities
• Trellis will create an 8-week gardening programme which supports patient rehabilitation and encourages gardening activity, outside of rehabilitation work, which all patients can engage in
• Greater integration with other activities such as the weekly crafting group through thoughtful planting to provide resources for art therapy sessions and cooking activities – increasing the connection between indoors and out and giving patients the opportunity for increased nature connection. (Trellis will provide suggested plants and activities to support this)
• The use of planting, mirrors and art to brighten the areas which remain in shade throughout the day
• Explore partnerships with the local organisations (prisons or men’s shed groups) to support the creation of raised beds and other garden aids
• Create more visual interest and focal points with vertical range and planting at different levels