We tend to take it for granted that we are free to go outside and enjoy fresh air, whether it be walking, jogging in the morning or relaxing sunbathing. Being outside generally makes us feel much better, relieving stresses of everyday living. It has even been proven that being outside can make you feel more relaxed and healthy within a short amount of time.
Getting outside also allows us to exercise in fresh air at the same time as benefit from sunshine and daylight. Walks outside can reduce stress levels and increase people’s self-esteem, allowing for activity and sociability as well as contact with nature. Yet we often forget that those in health care settings such as hospitals, care homes and other buildings are not always able to do this. It seems that the benefits of being able to go outside are not always recognised and taken seriously in many establishments.
A recent study at the University of Warwick has been examining the impact that access to the outdoors has on the mental health of residents. Recent research has shown that nearly half of all UK care home residents have some kind of depression. Although it is easy to associate this statistic with the interior and environment of a care home, recent studies have shown that it is not necessarily the poor design of a care home that is the cause of this, but rather inadequate access to outdoor spaces. The paper, entitled “The Impact of the Physical Environment on Depressive Symptoms of Older Residents Living in Care Homes: A Mixed Methods Study”, aimed to find any association with the depressive symptoms of 510 residents. The paper contains new research encompassing the physical environment of 50 care homes in Coventry and Warwickshire, and northeast London. Interestingly, the study found an individual’s perception of autonomy and personal freedom appear to be the main concern. The lead author of the study, Dr Rachel Potter, asserts, “Residents may appear to have access to outdoor space but are prevented from using the outdoor space independently due to poor physical or cognitive function”. In visiting a large number of care homes, the leaders of the study have discovered that the need to have the permission of staff to use the outdoors is the main factor damaging an individual’s autonomy and consequently affecting their mood. The findings of the study suggest that interventions that increase access to outdoor spaces could positively affect depressive symptoms in older people.
Dr Rebecca Cain, one of the researchers working on the paper at the University of Warwick, said: “Residents expressed little interest in the décor of the care homes; and appreciated features of the care home that increased opportunity for social interaction, promoting independence and function”. The study by the University of Warwick concluded that the quality of design for indoor and outdoor spaces is of secondary concern for residents of care homes, who were more concerned with easily accessible outdoor spaces in which they can relax and communicate with their peers. More independence could easily be provided through having increased trust in residents and allowing residents to go outside providing the environment is safe. Even allowing residents to stay in a room which overlooks the outside surroundings and countryside can have a positive impact on mood, with an early study finding that hospital patients staying in rooms overlooking a rural area had shorter hospital stays.
Many of the reasons for the obstruction of outdoor space have proven to be varied, including procedural, lack of staffing and physical barriers. Higher levels of aerobic fitness are associated with greater hippocampal volumes in elderly humans and larger hippocampal volumes translate to better spatial memory function Studies have shown that planned walking three times a week for people with Alzheimer’s disease resulted in significant benefits in their ability to communicate. In addition, being in bright light has a modest benefit in improving one’s cognitive and non-cognitive symptoms of dementia.
How can you increase outdoor activity for residents?
Before you encourage residents to go outdoors more, ensure you have a safe and private landscaped garden that residents will not feel enclosed in. As well as encouraging social interaction outside, it is useful to provide garden activities for gentle exercise, stimulation and relaxation. Wheelchair accessible sensory garden areas are useful in ensuring all residents feel welcome to explore the outdoors.
Here are some ideas you may want to try to encourage residents to go outdoors:
- Encourage simple and familiar games such as bat and ball and throw and catch-
Although some residents may require assistance with accessories for games, it is a good idea to make your residents aware that they are free to use the games when they wish.
- Bespoke a wellness care plan for each resident-
Make sure you make residents aware of the importance of good health and physical movement. A wellness plan can simply include ensuring each resident is spending a healthy amount of time outdoors per week. If you notice that a resident is often indoors, remind them of the freedom they have to go outside and enjoy the fresh air.
- Creating innovative, caring, creative and fun activities and events-
Residents may wish to have an input in the kinds of activities they take part in. Therefore, ensure everyone in your care home feels autonomous by asking them about the activities they are interested in. You should encourage residents to feel creative, sociable and competitive.
- Ensure there is clear and easy to access to the outdoors-
It is a good idea to put yourself in the shoes of a resident when considering outdoors access. Ask yourself the following questions:
– Is there anything that would put you off going outside if you had physical or mental disabilities?
– Are there any dangerous obstacles that could prevent people from getting outdoors safely?
– Are you encouraging residents to go outdoors regularly enough?
– Is there anything you could add to the outdoors area to make it more inviting for elderly residents?
If you require more ideas on encouraging residents to go outside, the Golden Carers website contains a list of interesting outdoor activities for the elderly here.