Description
The project aims to increase knowledge about outdoor environments at day care facilities in relation to the health and well-being of older adults with dementia. This knowledge may serve as guidance for service development for authorities, decision-makers, and staff at all day care centers in Sweden.
Background
Outdoor environments with access to nature and animals have documented positive health effects and are described in previous research as a fundamental human need. This need also applies to older people with dementia and staff at day care facilities. Currently, day care is mainly offered indoors, meaning individuals do not benefit from the health-promoting effects. Moreover, there are currently no national recommendations or routines for how outdoor environments can be used in day care.
Aim
To explore how older people with dementia, their relatives, and staff experience day care in farm and urban environments in terms of health and well-being, and to identify physiological responses arising from being in these environments. The project also aims to highlight and propose ways to ensure the use of outdoor environments in day care at a national level to promote the health and well-being of both older adults with dementia and staff.
Research questions
- How is day care in various types of outdoor environments such as farm and urban/community settings (including animals) perceived by older adults with dementia and staff, in relation to health and well-being? Additionally, how do relatives perceive that outdoor environments affect the health and well-being of their loved ones?
- What physiological responses are observed in older adults with dementia and staff when spending time in farm and urban environments?
- How can the use of outdoor environments in day care be ensured at a national level?
Theoretical Perspective
The project is based on two theoretical perspectives: One Health and the Four Zones of Outdoor Contact model. One Health refers to the interaction between humans, (outdoor) environments, and animals ‘One’ emphasizes the need for interdisciplinary research involving collaboration between disciplines and societal stakeholders. ‘Health’ refers to health in a broad sense, focusing on the interaction between people, the environment, and animals. In this project, One Health provides an overarching framework, incorporating people, day care outdoor environments, and animals.
The Four Zones of Outdoor Contact model forms the theoretical foundation of the project. The model outlines four zones, each offering health-promoting potential based on body positions and cognitive status:
- Zone 1: Contact with the outdoor environment from inside the building through windows.
- Zone 2: Transitional spaces between indoors and outdoors, such as entrances, patios, and balconies.
- Zone 3: Gardens belonging to the facility.
- Zone 4: The surrounding environment where the building is located.
- (Zone 0: Indoor spaces without windows, with no contact with the outdoor environment.)
Method
Data collection includes both qualitative and quantitative methods to provide a broad knowledge base. It takes place in farm and urban environments at the private ‘Gärdets dagverksamhet’ in Laholm municipality and the municipal day care centers in Falu and Boden municipalities. The methods include:
- Walking interviews in Zones 1–4 with persons with dementia and staff.
- Measurement of health data in connection with the walking interviews.
- Interviews with the older individuals’ relatives.
Expected Results
Increased knowledge about outdoor environments in day care in relation to the health and well-being of older people with dementia and staff, as well as a national proposal for ensuring the use of outdoor environments in day care. The knowledge may serve as guidance for service development for authorities, decision-makers, and staff at all day care centers in Sweden.
Reference Group
A reference group consisting of various societal stakeholders is associated with the project. The group serves as a hub for knowledge and experience sharing, benefiting the project, practice, and policy. The following organizations are involved: Laholm municipality (staff and politicians), Karlskrona municipality, the Alzheimer’s Association in Halmstad, Silviahemmet, Sjöbrisen dagverksamhet, Good Garden, the Swedish Alzheimer’s Association, the BPSD Registry, the Swedish Dementia Centre, Queen Silvia Nursing Award, and the National Board of Health and Welfare (Socialstyrelsen).
Are you also interested in the project and would like to join the reference group?
Please contact the research leader Susanna Nordin.