Elizabeth Brawley was set to pursue her fortune as an interior designer for the rich and famous.Then her mother was diagnosed with Alzheimer’s disease, and confined to a nursing home. That was 20 years ago, and her life and work since then has taken a radically different course.

“I had never been in a nursing home before then. When it became necessary to put my mother in a home I was stunned by what I saw,” she said.

What Brawley saw, in a mid-80’s nursing home, were aging adults with little chance to get outside, often staring at the same painting on the wall, the same view through a window or the television. Since then, she has devoted her professional life to “designing for Alzheimer’s” — everything from handrails and chairs to lights and entire rooms that fit the needs of adults with dementia, a fatal condition most commonly caused by Alzheimer’s.

Her most recent project is the American Landscape Society of America Alzheimer’s Garden Project — a series of nine gardens designed to accommodate those with Alzheimer’s.

“We know that just getting outside is good for you. For Alzheimer’s patients it can help reduce anxiety, improve sleep patterns and give the caregiver a break,” says Jack Carman, a landscape architect who is Brawley's partner in the garden project.

First World Alzheimer's Congress

Carman and Brawley will make a presentation on the therapeutic benefits of Alzheimer’s memory gardens at the first World Alzheimer’s Congress in Washington D.C., which begins today and runs through July 18.

With 4,500 researchers, physicians and caregivers from the United States, Canada and around the world attending, the Congress is one of Carman and Brawley’s best opportunities yet to encourage a renewed focus on quality of life overall rather than just the quality of medical care.

The Congress is the first time the world’s three major Alzheimer’s conferences have come together at one time to share their research and ideas. In the past, each conference would meet separately and at different times of year. The lack of communication often meant wasted resources as scientists duplicated the same research in different countries.

Alzheimer’s is an irreversible neurological disorder that destroys brain cells and is most common in people past age 65. Researchers are still struggling to understand what triggers the disease and develop a cure — a major impetus behind this year’s Congress.

Alzheimer’s is the most common form of senile dementia and is characterized by a buildup of plaques deposited in the brain. It affects up to 10 percent of adults over the age of 65 and 50 percent of those over 80.

Nationwide more than 4 million people have the disease. The Chicago-based Alzheimer’s Association that is sponsoring the congress estimates more than 12 million Americans will have Alzheimer’s by 2025 as baby boomers move onto their 70s and 80s.

“A cure is probably a long way off. We have to do something now for the millions of people who already have Alzheimer’s,” Brawley said.

Power of Sunlight

Research has shown that sick and elderly people who were able to view trees and sky recovered faster — with fewer painkillers and complaints — than those left staring at brick walls. Numerous studies have also shown reductions in blood pressure, anxiety, pain and other symptoms of stress when patients were offered just a videotape or a photograph of a natural scene.

But so far there is very little research on how sunlight and being in a natural environment affect people with Alzheimer’s in particular. So Brawley, Carman and the Alzheimer’s Association are currently applying for government and private funding to study the five memory gardens they have completed in Oklahoma City, Muskegon, Mich., Hastings, Minn., New York City and Macon, Ga.

The first memory garden opened in July 1999 on a half acre park in Macon, Ga.

“So far, it’s been hugely successful because everyone from the community uses it. It’s not just for people with Alzheimer’s but it does provide them with a sanctuary,” said Mary Gatti, executive director of the Central Georgia chapter.

Not Just Any Garden

The Alzheimer’s Memory Garden may look like just a pretty park at first glance, but every square foot is carefully planned to make a person with dementia feel safe and willing to explore the enclosed world around them.

People with advanced dementia often wander off and get lost, they have a tendency to put things in their mouth, are easily confused when given too many choices, easily spooked by shadows and have diminished vision, said Dr. Nancy Chapman, a gerontologist at the School of Urban Studies and Planning at Portland State University who specializes in environmental psychology.

The garden is designed to meet all these needs. It has only one entrance, one circular path instead of a network of paths. It is packed with benches, non-toxic plants and raised beds of plants with bright flowers and fuzzy leaves to lean on and to touch. The benches are placed some distance from trees so shadows from the swaying branches won’t appear threatening. The garden is also near a restroom and a parking lot while being far from speeding traffic.

Although healing gardens are hardly a new idea, said Chapman — they’ve been discussed for the past 40 years by some researchers — the importance of an outdoor environment has been ignored to practitioners and nursing homes for too long.

The ancients recognized nature’s healing powers by retreating to sacred springs and mountains when they were injured or ill. The Egyptians and Greeks built labyrinths for walking meditations, the Persians made paradise gardens, and by the Middle Ages, cloistered gardens with flowering trees and water fountains soothed the sick.

In later centuries, monasteries that were used as hospitals offered shady courtyards and airy rooms with views of greenery. But with the development of surgery, radiation therapy and the miracle drugs of the 20th century, hospitals turned from nature to machines, laboratories and surgical wings.

“The concept behind the gardens is really so simple and it can make such a big difference,” Brawley said.

Her mother died in 1989 from Alzheimer’s as Brawley’s grandmother had years before.

“I think everything I do is a tribute to her. She never saw the benefit of these changes but I hope families in the future will be able to offer a better quality of life to their loved one with Alzheimer’s.”