Contrary to public perception, residents in seniors housing communities like to spend time outdoors, but often the design of facilities hampers the mobility of older adults, according to Susan Rodiek, a professor of health facilities design at Texas A&M University.

The National Investment Center for the Seniors Housing & Care Industry recently honored Rodiek for her research in evaluating seniors living environments. An architect by training, Rodiek studied seniors who are not able to choose their environment but who are still interested in spending time outdoors. Rodiek, who also is developing a series of DVDs that sum up her research, talked to NREI about her findings and the implications for operators.

NREI: You say that the quality of the physical environment has a major impact on residents’ quality of life. How so exactly?

Rodiek: When I first started researching quality-of-life issues at seniors housing facilities about 10 years ago, I would notice that the indoor environment at most of the places I visited was pretty well designed. But I noticed that the facilities almost never utilized the outdoors. Interestingly enough, when I first started asking seniors about the senior community they lived in, many of the overall comments were about the outdoors even though I had not asked them directly about the outdoor environment.

The outdoors is something that has been partly forgotten by people designing long-term care. What I found in a study is that people who spent time outdoors have better moods and cortisol levels [cortisol is a hormone that the body releases to fight stress], and the cortisol level in the saliva is a pretty good indicator of stress. Older people tend to say they feel alive, refreshed, connected to the world again.

NREI: What do you think makes for a good senior living environment for residents and staff?

Rodiek: Outdoor areas should be safe, convenient and comfortable for older people and very well connected with the indoors, so that the outdoor areas are inviting to people. Staff members at a seniors facility are sometimes afraid of residents being outdoors because they know that they are a little frail. Keeping them indoors day and night is not the answer. The best answer is to have an outdoor environment that is very safe, very comfortable and can be viewed very well from the indoors. It helps staff feel more relaxed and also saves them time.

NREI: How did you measure the quality of the environment?

Rodiek: “Affordances” is a term coined by psychologist James Gibson that refers to what the environment allows you to do. We feel that when the weather permits and health conditions permit, older people should have a place where they could go out outdoors briefly, maybe once a day for 10 minutes or so.

We measured activities based on whether a person, say with great frailty and low physical strength, could perform the activities without fear and with great comfort. So we looked at every single aspect starting with the places indoors. I’ve been to beautiful places that had a nice sitting room looking to the outdoors, but to actually get there you had to go into a hall and down a little side hallway and around a corner to reach the door. We look at seven principles and break it down into components about what people are concerned about outdoors. We have taken their responses and created an instrument from it.

NREI: How can senior housing operators use your findings to improve their environment?

Rodiek: An operator could use our checklist to assess its environment and see what parts need to be improved and what parts are doing well. Many older people tend to be much more frail than a younger person. When we conducted the assessments, we did so with that kind of person in mind. That’s what often goes wrong when you have a young architect, or strong and healthy staff. When they are designing facilities, they don’t always consider that a door that is easy for them to open is very difficult for a resident to open.