The deep yellow-orange petals of a coreopsis plant absorb the light and emit a color as rich as the early sunset.
The scent of geraniums and impatiens fills the summer air with a natural perfume.Monarch butterflies flutter in the bushes. Robins splash in the birdbath. Leaves dance in the dogwoods.
No, this is not the view from an idyllic vacation cabin tucked into a mountainside in a great national forest.
This is a glimpse into a specially designed therapeutic garden at an adult day-care center and nursing home complex in the midst of a modern American city.
The adult day-care center at the Keswick Home in Baltimore uses the garden to provide horticultural therapy to its often frail and demented participants. Residents of the adjoining nursing home often stroll to the garden to find peace, relaxation and a connection to nature.
The rectangular parcel of neat flower beds, wooden planters, shrubs, trees and white lawn furniture seems particularly beneficial to dementia patients, triggering deep memories of the fields of flowers many of them roamed as children.
The effect can be seen in the renewed spirit of people like Rebecca Smith, an upbeat 74-year-old who long ago picked cotton, tobacco and corn in rural North Carolina.
At times distant and forgetful, Smith seems to find memories and strength from working the soil. She describes how she can plant a perfectly straight row of onions and sink seeds to just the right depth, deep enough to protect them from the heat of the sun on the ground but shallow enough to give the sprouts a chance to surface.
"Honey, I was raised up on a farm so I know it ain't hard," she said with unmistakable clarity. "I really enjoy it out there. We all do."
The garden setting seems to calm the agitated fears that dementia patients experience by providing them with a safe place to wander, bound in only by the gentle border of neatly trimmed hedges.
Each day, a group from the adult day-care center treks up a small hill to the 2-year-old garden, where they weed planters, water flower beds and harvest vegetables. This seemingly simple activity starts a remarkable process that touches lives throughout the facility and into the larger community.
Flowers plucked from the garden are used in art therapy classes at the day-care center, providing material for creative floral arrangements or the inspiration for drawings. Even the metal gateway to the garden incorporates designs based on drawings from the art therapy classes.
Lettuce, tomatoes and cucumbers harvested from the garden are used to make salads for the center's lunch room. The pleasure of the harvest showed in the smile of Beatrice Baker, an adult day-care participant who recently gathered lettuce for the afternoon meal.
Last year, one bountiful harvest yielded the makings for 250 salads, which were delivered to a soup kitchen for the homeless.
Garden parties give the elderly, family members and staffers a chance to relax and chat in a peaceful natural setting.
"Even if they just sit there and listen to the birds sing, it is beneficial to them," said activities specialist Carol Jackson. "It lets them reminisce about things they have enjoyed their whole lives. It is a pleasant, nonthreatening environment."
Therapeutic gardening is just one among the innovative approaches that progressive facilities are using to link dementia patients to nature, often with results that enhance understanding, reduce depression and decrease the need for heavy medication.
One nursing home in West Virginia built a wooden walkway that meanders through a scenic area for residents to stroll. Another in upstate New York keeps a small menagerie on the grounds so residents can watch and pet animals.
Therapists report that putting dementia patients in closer contact with nature seems to ease the intense fears they often feel particularly around sundown, when a strong instinct to return to a safe place leaves many of them highly agitated.
But the nature programs stand out as exceptions in an industry built largely on the model of the hospital.
Most long-term-care facilities are staffed by doctors and nurses who dispense medication at appointed hours. Patient care is left to underpaid aides with little specialized training in dementia. Meals and activities are rigidly scheduled.
Recently, a four-month inquiry into the care of dementia patients in nursing homes by Maturity News Service and Newhouse News Service found that most facilities coerce patients into conformity. The rigid approach often aggravates patients' tendencies to become agitated. By contrast, gardens, trees and fields of flowers feel natural, not regimented.
On a recent afternoon, an elderly dementia patient from the Keswick nursing home walked into the garden with the help of an aide. Although she appeared a bit confused at times, insisting she was only 40 years old, she left no doubt how she felt about the garden.
"I can see it from my window," the woman said. "I get up in the morning, look at it and just give thanks. I love it."