The power of nature

It’s no coincidence that we find peaceful nature scenes in waiting rooms where nerves are on edge. In the healthcare arena, artwork has an important role to play by offering momentary escape from a stressful situation. In a long-term care community, residents are prone to anxiety and disorientation that accompanies illness. Familiar scenes from nature have been shown to have a soothing effect on agitated elders, and potentially minimize dependence on psychotropic intervention.


The decision to use depictions of nature in the senior living home is the first step, selecting the right scene is the next. To that end, evidence-based guidelines exist for choosing art for the healthcare setting. Warm, fresh scenes inspire feelings of happiness, which radiate on to the viewer. Cold, dark images could evoke sadness or worry, so are not recommended. Regionally familiar flowers and landscapes are ideal to orient the viewer and offer a window to happy memories. For example, scenes of bluebonnets in a community in the Texas Hill Country would certainly inspire glad recollections of springtime. A familiar landscape could make the difference in a day for a person suffering from the disorienting effects of dementia.


Selecting the ideal art for a community means understanding the populations who will ultimately benefit. Residents are the primary beneficiaries, but staff and visitors will also enjoy positive distraction from art. Positive distraction, is the “direction of attention to a non-toxious event or stimulus in the immediate environment.”1,6 A study conducted on mental health patients found that art from nature could help to save an estimated $30,000 per year on PRN medications.2 For an individual with Alzheimer’s disease, the right artwork could reduce anxiety by creating a diversion from a moment of acute distress. In turn, visitors and staff caring for ailing residents will themselves experience periods of tension. A staff area, such as a break room, is an ideal space to consider the stress-relieving effects of art.


Not every scene from nature is ideal. It’s important to understand the qualities that make artwork supportive to good outcomes, as well as the risks posed by melancholy scenes or non-representational art. In senior living, abstract art can do more harm than good, noted Dr. Robert Ulrich, a pioneer of EBD research. His studies documented several incidents of patients physically attacking and damaging abstract works of art.4 Interpretive qualities popular in other settings have proved to be problematic, uncertainty only contributed to patients’ anxiety. There is a major risk to placing art which is subject to interpretation in a healthcare setting due to the viewers’ high emotional state.3

Characteristics of EBD artwork

  • Images of calm water
  • Open foreground
  • Trees with broad canopies
  • Familiar flowers and gardens
  • Emotionally positive faces

Source: Ulrich and Gilpin5

Conversely, ideal scenes from nature are straightforward and representational. Evidence demonstrates that these images have the power to conjure happy memories and assist in managing pain, as was shown in Ulrich’s groundbreaking study of post-surgical recuperation among patients with a view to nature, versus a view to a brick wall. The results are evidence that representations of the natural world possess healing qualities for the human condition.


For the potential benefit it offers, artwork selection and placement deserves as much consideration as the design of the building. Beautiful courtyards, planting gardens and walking paths are life-enriching amenities, but not all residents will be able to enjoy them as much as they might like. Artwork that brings the natural world inside the home has the potential to make a profound impact, alleviating stress for the viewers and minimizing the amount of medication needed for many residents.

Emily Ronck is an interior designer at Pi Architects, a multidisciplinary design firm specializing in long-term care communities. She can be reached at



1. Fernandez, E. (1986). A classification system of cognitive coping strategies for pain. Pain, 26(2), 141-151.

2. Nanda, U. & Eisen, SL; Owen, D and Zadeh, R (2010). Effect of visual art on patient anxiety and agitation in a mental health facility and implications for the business case. Journal of Psychiatric and Mental Health Nursing doi: 10.1111/j.1365-2850.2010.01682.x

3. Nanda, U. & Hathorn, K. (2008). A guide to evidence-based art. The Center for Health Design, 1-18

4. Ulrich, R. (1984). View through a window may influence recovery from surgery. Science, 4647, 420-421.

5. Ulrich R. S., Gilpin, L. (2003). Healing arts: Nutrition for the soul. In S. B. Frampton, L. Gilpin, & P.A. Charmel (Eds.), Putting patients first: Designing and practicing patient-centered care (pp. 117-146). San Francisco, CA: John Wiley and Sons

6. Vessey, J.A., Carlson, K.L., & McGill, J. (1994). Use of distraction with children during an acute pain experience. Nursing Research, 43(6), 369-372.



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