Horticultural Therapy Plan of Care or Treatment Plan

Horticultural Therapy Plan of Care / Treatment Plan

Participant: [Name], [MRN or Facility ID]
DOB: [Date of birth]
Location/Program: [Unit / Facility / Program name]
Plan Date: [Date plan created]
Author: [Name, credentials]

Plan Type: [Initial / Update / Recertification / Transition]
Effective Dates: [Start date] through [End date or next review]
Setting: [Inpatient / Outpatient / Residential / Day Program / SNF / Community]
Environment: [Indoor greenhouse / Outdoor garden / Bedside/mobile cart / Other]

Referral Source: [Referring provider or service], [Referral date]
Reason for Referral: [Brief statement of why HT services requested]

Clinical Context

Diagnoses and Conditions: [Primary diagnoses and comorbidities impacting participation] (Document as provided in referral or medical record. Do not infer diagnoses. If not provided, state: "Diagnoses not provided; plan developed from referral reason and observed functional needs.")

Baseline Function:

• Participation tolerance: [Duration in minutes]
• Attention span: [Duration sustained, cue frequency and type needed]
• Mobility and positioning: [Transfer assistance level, seating/standing tolerance, terrain considerations]
• Upper extremity function: [Grip, reach, fine motor status; dominant hand if relevant]
• Cognitive/behavioral factors: [Sequencing, memory, insight, impulse control as relevant to safety and group participation]

Interests and Preferences: [Participant-stated interests, values, cultural/spiritual preferences related to plants, food, or nature] (Include brief direct quotes when available.)

(If clinical context details are not available, state: "Information will be obtained from referral and chart review prior to treatment initiation.")

Precautions and Limitations

(This section must never be left blank. For any domain without available information, state "[Domain] status: to be verified prior to participatory sessions.")

Participation Level: [Participatory / Observational / Blended approach]
Supervision Required: [Independent / Setup only / Verbal cues / Contact guard / 1:1 assistance / Constant observation]
Group Eligibility: [Yes / No / With modifications]

• Tool safety: [Restrictions on sharps or cutting tools; behavioral safety considerations]
• Skin and allergy precautions: [Glove requirements; plant/pollen/latex allergies; food allergies if edible gardening involved]
• Fall and mobility precautions: [Uneven terrain hazards; transfer assistance needs; wheelchair accessibility]
• Environmental precautions: [Heat/cold/UV exposure limits; hydration requirements]
• Infection control: [Isolation status; restrictions on soil or compost exposure; hand hygiene requirements] (For immunocompromised participants, specify restrictions on soil/compost/standing water and aerosol-generating activities.)
• Behavioral considerations: [Known triggers; elopement risk; de-escalation plan]
• Medical considerations: [Orthostasis; seizure precautions; anticoagulation/bruising risk; photosensitivity]

Treatment Approach

Format: [Individual / Group / Mixed]
Therapeutic Frame: [Rehabilitative / Psychosocial / Vocational / Leisure participation / Sensory regulation]
Seasonal Adaptation: [How services continue year-round] (Include only if applicable.)

Skilled Interventions: [List interventions selected and adapted to participant goals, such as plant propagation and planting, watering and plant care routines, pruning and harvesting, sensory garden engagement, task analysis with graded activity progression, adaptive equipment and tool modifications, social participation structures, vocational tasks]

Education/Training: [Topics for participant or caregiver education] (Include only if planned.)

Goals and Objectives

(Organize in problem-oriented format, listed by clinical priority. Each objective must specify what the participant will do, under what conditions, to what measurable standard, by when. If no specific goals are dictated, state: "Goals will be established following comprehensive assessment.")

Problem 1: [Current limitation or need in behavioral/functional terms]

Long-Term Goal: [Episode-level outcome with target timeframe]

• Short-Term Objective 1: [Objective statement with observable verb and conditions]
  • Baseline: [Current measurable status]
  • Target Criterion: [Measurable endpoint]
  • Target Date: [Date]
  • Interventions: [Specific HT interventions linked to this objective]
  • Measurement Method: [How progress will be tracked]
• Short-Term Objective 2: [Objective statement]
  • Baseline: [Current measurable status]
  • Target Criterion: [Measurable endpoint]
  • Target Date: [Date]
  • Interventions: [Linked HT interventions]
  • Measurement Method: [Tracking approach]

Problem 2: [Current limitation or need]

Long-Term Goal: [Outcome and timeframe]

• Short-Term Objective 1: [Objective statement]
  • Baseline: [Current measurable status]
  • Target Criterion: [Measurable endpoint]
  • Target Date: [Date]
  • Interventions: [Linked HT interventions]
  • Measurement Method: [Tracking approach]

(Add additional problems as needed.)

Service Schedule

Frequency: [Sessions per week]
Session Length: [Minutes per session]
Planned Duration: [Number of weeks or sessions]
Start Date: [Date services begin]

Pause Criteria: [Conditions that would pause services and criteria for resumption] (Include only if applicable.)

Care Coordination

(Include only if HT is part of a larger interdisciplinary plan; omit section entirely if no interdisciplinary involvement.)

Aligned Plan(s): [Rehabilitation plan / Behavioral health treatment plan / Facility care plan / Other]
Other Disciplines Involved: [List disciplines and roles]
Communication Plan: [Update frequency, method, shared goals]

Discharge and Transition Plan

Discharge Criteria: [Measurable thresholds for goal attainment, plateau definition, safety limitations, participant preference, or episode end]

Transition Goals: [Anticipated aftercare such as home container gardening, community garden referral, facility maintenance group, caregiver training completion]

Home Safety Considerations: [Tool storage; infection control; environmental safety] (Include only if home gardening is part of transition plan.)

Plan Review

Next Review Date: [Date or interval]
Triggers for Earlier Review: [Significant change in medical status; change in precautions; change between observational and participatory; significant goal revision]

Author Signature: _____________________________ [Credentials] [Date]

Referring Provider Certification: [Certification status / date sent / method] (Include only if required by facility or payer.)