Designing External Space for Elderly Wellbeing
Healthcare and lifestyle improvements have greatly increased life expectancy and as a result, more people require some form of continuing care during the latter years of their lives. Consequently, care environments are increasingly under pressure to support a complex range of user needs, including access to fresh air and outdoor space.
A study conducted in the United States and published by the international journal, World Health Design, explores how the quality of the external environment can positively influence the readiness of elderly residents in long-term healthcare settings to spend time outdoors. As designers, it’s thus particularly important that we include a wide range of stimulating, high quality outdoor facilities that encourage elderly patients to enjoy such therapeutic spaces independently and safely.
The Dementia Centre at Stirling University reports that for people with dementia, an outdoor space provides a place for familiar activities such as watering plants, or playing games, as well as providing vitamin D through exposure to natural light. Access to external space also provides opportunities to mix and reminisce with others, helping to trigger memories.
The Centre also advocates that spaces should provide opportunities to exercise through the provision of well thought out activity spaces, and sensory stimulation through planting carefully selected plants for their smell, touch and sound. Residents provided with regular access to fresh air and exercise, as well as quiet reflection areas, are much less likely to become distressed and aggravated, especially if they are accustomed to being outdoors and taking part in active pursuits.
Any outdoor space needs to embrace a range of mobility and sensory issues, while taking into account the changing needs of users, without making the space feel institutional. For example, objects and pictures can help dementia sufferers with wayfinding – e.g. door mats and hanging baskets to mark an entrance, sculptural trees or sensory planting to help distinguish between various spaces, and visual markers to help guide them along a route. This approach is supported in an article by The Dementia Society, which states that dementia patients better recognize and recall landmarks than spatial layouts.
For this reason, it is important that external pathways always loop back to the starting point whilst avoiding sudden directional changes or dead ends. Surfacing should be uniformly finished avoiding colour changes and patterns that could be mistaken for changes in level or objects on the ground. Where mobility is an issue, handrails can encourage individuals to explore external spaces unaided while raised seating with armrests provides less mobile users with places to rest.
Planting not only provides sensory benefits and aids group activities, it also provides seasonal interest and encourages wildlife. In a healthcare setting, planting can be used to help screen views into residents’ bedrooms, and also create attractive views from inside the building for those less able to access outdoor spaces.
Woodland View, an award winning adult mental health facility designed by IBI Group, adopts many of these approaches to dementia design. Public and private spaces are defined through the use of structured planting and carefully located pedestrian routes, sensitively linked to the local natural and built environment. Through the incorporation of well-considered spaces and planting, the development’s twenty two courtyard spaces respond to the specific physical and emotional needs of differing service groups including elderly mental health, acute mental health, addictions and rehabilitation. This encourages a range of activities such as gardening whilst at the same time, providing contemplative spaces for staff and visitors.
The designs of the elderly persons’ courtyards priorities safe user passage through the provision of footpaths with handrails and a range of seating at regular intervals. Raised planters address the physical limitations of users, facilitating participation in group activities. Particular species of plants and familiar objects have been selected to help evoke memories of past seaside holidays or cottage gardens, whilst feature shrubs and trees are used to mark spaces along the route to create a reassuring external environment.
The overall non-institutional design, inspired by the surrounding coastal and woodland environment, supports the service user journey to recovery; building confidence, offering choice and paving the way for transition home and back into the community.
Image by Daniele Da Luz from Pixabay