Spending time within green spaces has positive effects on the physical and mental health of all and especially for the elderly and people living with dementia being outdoors can support stress relief and boost mental and emotional well-being. Visiting the outdoors and undertaking physical activities can further enhance functional capacity among older people, and can help to maintain quality of life and independence.
In order to make use of these benefits, outdoor spaces need to be created that attract people to actually use them. For existing as well as newly built outdoor environments this can be achieved by the following design principles.
1. Make the outdoors accessible
Naturally, the access to the outdoors should be barrier-free, accessible at all times and visually and physically connected to the indoors. Generally speaking the layout and elements within the outdoors should suit older people and people living with dementia. A well-structured and easy to overlook outdoor space makes it more apparent as to how to use the space and where to go. Paths which connect different spaces should always lead back to the indoors, any dead ends or noticeable locked gates should be avoided. As for the elements within, they should be well integrated, again in order to understand their use easily. Where required handrails should be fitted to provide support and can help people with dementia feel more secure when exploring the outdoors.. Sufficient and varied seating opportunities should be offered with furniture that is ergonomically formed, has a continuous back, armrests, and timber surfaces. Tables to put down a cup of tea or a book adjacent to the seat or bench will encourage activity and increase the likelihood of the person staying outside for longer. Blankets, cushions or jackets placed at the exist to the outdoors reduce the need to return to your bedroom or apartment and subsequent time taken to get outside. This has been noted, increases the likelihood of people going outside. Accessories such as blanketsmake the outdoors inviting, comfortable and attractive to use. Knowing that toilets are close by and can be easily found can make it more likely for older people and people living with dementia to use the outdoors.
2. Diversify the outdoor spaces
To make the outdoors interesting and attractive the question ‘Which meaningful activities can be offered?’ needs to be considered. Meaningful activities could range from eating lunch, drinking a cup of tea, reading a book, having a conversation with a friend, observing flowers, wildlife or playing with children, gardening, eating fruit, going for a walk to using plant material for art activities or decoration. Once activities have been identified which would be suitable for the users' needs, interests and abilities, different spaces can be created that foster this wide range of uses: Larger communal areas, quiet areas, small seating spaces, pathways offering different lengths of walks, areas to observe or perhaps even age and ability appropriate ‘difficulties’ by allowing a slight change in level (however avoiding trip hazards).
3. Enhance the planting
Planting can be used as elements creating different spaces, atmospheres or features with special interest. Through the positioning and choice of plants varied qualities can be created: calm, contrasting, open, confined or views into the wider surrounding. Using plants with different heights, texture, scents and colour can give structure, provide all year interest and offer an attractive environment throughout the year. In addition biodiversity should be enhanced. This is not only crucial for environmental benefits but also attracts wildlife offering opportunities to observe or talking points.
4. Stimulate all senses
For people living with dementia, it is important to support and stimulate the senses. Environments should be created that address all senses: sound, sight, touch, smell and taste. This can be achieved by providing plants that sound and move differently within the wind, plants that give scent during different times of the year, that produce fruit which can be picked while walking by or raised planting beds with different textured and scented plants that can be easily touched and explored. The use of different materials such as timber, metal or stone can also add different qualities: warm / cold, smooth / rough.
5. Future proofing
When providing well designed outdoor spaces, good quality maintenance needs to be guaranteed ensuring that the spaces can be safely used but also stay attractive over the years. Furthermore it is crucial to train staff of the benefits using the outdoor spaces ensuring their use is being encouraged but also to promote and integrate outdoor activities as part of the everyday. Changing conditions, such as mobile and active users or the use of digital equipment need to be considered to ensure the outdoor spaces are attractive or can be modified for future users to come.
Providing successful outdoor spaces within care environments as well as within our public open spaces is key to environments that benefit elderly and people living with dementia and to ensure that they are being used by this demographic. Following the above design principles and considering each of the points carefully can offer spaces that allow activities which create opportunities to be part of the wider community, to give purpose and retain a notion of one-self.
Marion Preez is a qualified landscape architect and artist. As an Associate of the DSDC she brings her knowledge on designing outdoor spaces. Marion has been engaged in research and developing best guidance practice designing outdoor spaces for elderly and people living with dementia. As part of her practice work she undertakes the design and improvement of better access to outdoor spaces within existing elderly housing developments.