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In the years after her return from the Crimea, Florence Nightingale essentially lived the life of an invalid, writing extensively on many important subjects. In particular, one letter stands out (it is housed in the Nursing History Archives, Special Collections at Mugar Library, Boston University). It is a fascinating 12-page letter to the editor of Collier's Magazine at the time, criticizing his editorial that denigrated women who volunteer. In it, she deftly points out the crucial roles that volunteers fulfill-their selfless gifts of time and expertise-and how these acts enhance the lives of others. She explained, in great detail, why volunteerism is important for a society. Indeed, volunteering in Victorian times was almost the only way in which women could fulfill their potential and honor their special talents all the while contributing to the betterment of their communities.


In our present day, volunteers remain crucial to the health and welfare of countless people. The devotion of volunteers to important causes and to those in need is remarkable. Therefore, as this column is being written in December, it seems fitting to highlight, in particular, the spirit of volunteerism of one such individual. Her name is Mary Moore; she is connected with the Covenant Senior Day Program in Portage, Mich, which is a day respite program whose mission is to enhance the quality of life of older adults experiencing limitations. Although not a horticultural therapist per se, Mary Moore is an accomplished gardener who regularly attends Horticultural Therapy Conferences. She also admittedly truly enjoys working with older people.


In nearby Kalamazoo, a long-term care facility's residents were without access to nature unless there was a planned outdoor meal or activity. Many of these residents, in their past lives, were avid gardeners and have fond memories of working with the soil and plants. Their descriptions of favorite gardens no longer accessible to them are poignant. We have always known that access to nature is essential to health and healing. Now, it is a major point in the Health Consumer's Bill of Environmental Rights.1 Indeed, one could argue, there are few patient populations where access to nature is more crucial, for without assistance and attendance, residents cannot even go outdoors when they feel so inclined. Freeing staff from personal care responsibilities to accompany a resident outdoors is rarely possible.


When Mary Moore learned of the situation in this long-term care facility, she called the director of activities and asked if she could bring the outdoor connection to the residents on a volunteer basis. Her offer was happily accepted. Over the summer, self-selected residents and Mary met 1 afternoon a week to plant container tomatoes, herbs, and hanging baskets of impatiens. They spiced up the courtyard with colorful annuals and perennials, planted a shoe garden, potted baby spider plants, and made dish gardens with wine goblets and croton plants. They even had a garden party, during which they drizzled homemade vinegar over their own homegrown tomatoes. They wore garden hats that they had designed in a previous session. Everyone enjoyed being outside in the courtyard on the perfect days and being inside looking out on days that were less than perfect. Imagine the spontaneous conversations, laughter, and reminisces that these activities engendered.2 Think of the lasting positive effects and continued conversations about the gardening sessions between the residents during the intervening days.


Here is an excerpt of the garden diary describing the session during which the residents planted shoe gardens-filling shoes with soil, moss rose, and sedum. "We planted a dozen shoes. We had lots of ladies dress shoes (bright red and blue, a black boot) and a sneaker, a child's boot, and a pair of infant shoes. We had a couple of men's shoes, one a dress shoe and another casual shoe. After we had all the shoes planted up, one of the ladies said, 'and they say we can't fill a man's shoes!' (That brought a lot of laughter) and then I suggested the ladies name their planters. I held up the man's dress shoe (which actually was a loafer, but I didn't say that). I described the shoe as a very large man's brown dress shoe and asked if anyone had an idea of what we could call this shoe. A lady said 'Let's call it Loafer.' We stayed outside for an hour and 45 minutes. It was perfect day[horizontal ellipsis]sunshine, a shady area and a nice breeze" (M. Moore, [email protected], June 29, 2006).


It is such ordinary events that become extraordinary in long-term care where individual's comforting daily rituals are no longer possible. The habit of keeping to one's personal daily schedule, writing, managing a home, carrying out a hobby, cooking, and gardening are a major part of what makes life reasonable. Mary Moore's contribution to these resident's lives cannot be measured in concrete terms. Giving her time and sharing the art of gardening, her very presence becomes a grace to those who need her the most. And, of course, this is what Nightingale knew long ago.




1. Center for Health Design. Health Consumer's Bill of Environmental Rights. Available at: Accessed December 16, 2006. [Context Link]


2. Moore M. People-Plant Interactions. Atlas, Michigan Horticultural Therapy Association. 2006(3). [Context Link]


3. E-mail message. Mary Moore. June 29, 2006.