Access to outdoor space is known to have significant benefits for people living with dementia, influencing both physical and emotional well-being. Although research and in-practice evidence of the benefits are well-known, residents in aged care often have limited access to outdoors.  

The incoming National Aged Care Design Principles and Guidelines specifically address the need for well-designed outdoor spaces that are easy to access, inviting, and encourage purposeful activity. 

Engaging with nature and fresh air can reduce the impact of behaviours such as agitation, anxiety, and depression. The sensory stimulation provided by the outdoors, such as the sight of greenery, the sound of birds chirping, or the feel of a gentle breeze, can evoke positive emotions and memories, promoting relaxation and reducing stress levels. 

Exposure to natural light is also important to maintain sufficient levels of Vitamin D, which plays an important role in bone strength, mood and energy. Exposure to natural sunlight in the morning or afternoon for 5-15 minutes a day helps maintain sufficient vitamin D. 

Outdoor spaces also provide opportunities for physical activity and social interaction. Activities like walking, gardening, or simply sitting outside with others can enhance mobility, coordination, and communication skills for people living with dementia. 

Even when the weather isn't ideal, there are still plenty of activities that can be enjoyed outdoors. Some tips within the guidelines for supporting outdoor activities include: 

• Equipping outdoor areas with shelters or covered seating directly outside the door to enable enjoyment of the outdoors regardless of weather conditions. 
• Planning activities outdoors and setting up spaces for activities that encourage going outdoors, such as BBQs or morning tea. 
• Ensuring visibility of the garden from inside areas and providing a clear path to encourage engagement with outdoor spaces. 

Getting outside helps Kelly 

Kelly's behaviours had changed over the past three weeks, particularly in the afternoons. She experienced pain due to chronic illness, disrupted sleep patterns, often waking up during the night, preferring to sleep in a chair in the lounge room. When Dementia Support Australia (DSA) assessed Kelly, these factors, as well as a lack of stimulation were identified as contributing factors to her distress and changing behaviours. 

Kelly’s history involved a long career as a nurse that involved shift work, including night shifts. Her aged care home was modern and well-appointed, but she rarely has access to outdoor spaces. 

DSA recommended sun exposure and melatonin supplementation to regulate Kelly's sleep pattern. Environmental modifications, such as facilitating access to outdoor spaces and enhancing engagement with activities, were proposed to address under-stimulation. 

Following these recommendations Kelly's sleep improved resulting in reduced care refusal and improved mood.  

Kelly’s case underscores the importance of addressing environmental factors, such as access to outdoor spaces, in dementia care and how DSA can recommend targeted support strategies that help. Contact us on 1800 699 799 or online at www.dementia.com.au.