The Impact of the Physical Environment on Depressive Symptoms of Older Residents Living in Care Homes: A Mixed Methods Study

Potter, Rachel; Sheehan, Bart; Cain, Rebecca; Griffin, James M.; Jennings, Paul

doi:10.1093/geront/gnx041

Cited by 27 publications

(35 citation statements)

References 31 publications

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“…Care home residents place a high value on outdoor spaces being accessible, with the need to be around greenery of particular importance (Kearney & Winterbottom, 2008). Lack of access to outdoor spaces has also been reported as the main environmental variable predicting depressive symptoms in care home residents (Potter et al, 2018). Despite this, there are several barriers such as physical limitations, lack of assistance and design issues that can prevent care home residents from enjoying the outdoor environment.…”

Section: Introductionmentioning

confidence: 99%

Cycling Without Age: Assessing the Impact of a Cycling-Based Initiative on Mood and Wellbeing

Gray

Gow

2020

Gerontology and Geriatric Medicine

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Objective: Cycling Without Age is a global initiative in which trained volunteers take adults living in care homes or supported housing environments out on specially designed trishaws. Despite its global success, there is limited research on the effect the initiative has on the older adults taking part. The current study therefore assessed changes in mood and wellbeing to determine whether there were short-term benefits of participation. Methods: Forty-nine older adults (69% female; 67–100 years old ( M = 84.1, SD = 7.6)) living in care homes and supported housing environments were recruited; 35 participants completed all measures and comprise the analytical sample. Participants completed the Warwick-Edinburgh Mental Wellbeing Scale and UWIST Mood Adjective Checklist immediately before a ride (baseline); they repeated the measures on completion of the ride (follow-up). Participants also completed baseline and follow-up measures on a day in which they did not go on a ride. Mixed ANOVA compared differences in baseline and follow-up mood and wellbeing scores on ride and no ride days. Results: For all mood and wellbeing measures, there were significant interactions between day (ride or no ride) and measurement occasion (baseline or follow-up). Analyses revealed significant improvement in mood and wellbeing at follow-up on ride days versus no ride days. Conclusion: Short-term positive changes in mood and wellbeing were reported as a result of participation in the Cycling Without Age initiative for older adults in care home and supported living environments. Further research is needed to explore the longevity of benefits and longer-term changes.

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Section: Introductionmentioning

confidence: 99%

Cycling Without Age: Assessing the Impact of a Cycling-Based Initiative on Mood and Wellbeing

Gray

Gow

2020

Gerontology and Geriatric Medicine

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“…Empirical studies show that a good fit between the elderly and their home environments has significant effects on healthy aging (Iwarsson 2005). The goal in good design for the elderly is supporting their functional and cognitive abilities (Potter et al 2018). Satisfaction with housing environments is also an important factor in mental and psychological health (Oswald et al 2007).…”

Section: Introductionmentioning

confidence: 99%

Extending the importance–performance analysis (IPA) approach to Turkish elderly people’s self-rated home accessibility

Afacan

2019

J Hous and the Built Environ

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Designers are still struggling to make good and fair home designs for elderly people. Although there are a lot of studies on accessibility in homes, there are few methodologies to rate the importance of accessible home attributes, or address the relationships between the most important and most satisfactory attributes (in terms of creating a good fit between the elderly and their homes). This study suggests using the importance-performance analysis (IPA) approach to set accessibility priorities and identify the critical performance factors that determine the elderly's satisfaction with accessible homes. A self-assessment questionnaire instrument was developed based on housing accessibility literature and conducted with 342 Turkish elderly people chosen through stratified sampling among neighborhood clusters in Ankara, Turkey. The descriptive results and factor analysis of the study are significant in that they indicate significant differences among dwelling types. There were differences in importance and performance priority levels of home accessibility factors associated with each dwelling type. Moreover, the study found that safety and ease of use are the key indicators of home accessibility. According to the results, the IPA could be an effective tool to overcome the messy character of evaluating home accessibility for the elderly. By extending the accessibility attributes with the IPA analysis, it is possible to identify specific accessibility attributes, establish highest and lower priorities for intervention and decide which attributes should be maintained and/or ignored. Thus, this study contributes to the literature on aging by being the first study to explore the applicability of the IPA technique while eliciting elderly people's accessibility requirements for healthy aging.

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“…Frequently going outdoors may increase the QoL of residents through interaction with nature, the activities undertaken whilst outside, such as walking or other physical activities, or possibly by elevating vitamin D [2,[23][24][25][26]. For people living with dementia in residential aged care in the UK, restricted access to outdoor areas has been associated with depressive symptoms [7], but only a relatively short duration of outdoor exposure may be needed to show an association with improved mood [9]. Residents of care facilities frequently have low serum vitamin D which has been associated with depression, so increased time spent outdoors may improve mood by increasing vitamin D [23,27].…”

Section: Discussionmentioning

confidence: 99%

“…Even if facilities offer independent access to outdoor spaces there may be barriers to the residents using these areas, explaining the lack of benefit on quality of life. Whilst dependencies due to physical health and mobility issues are possible barriers [5,7], this analysis has adjusted for differences in function and cognition between the residents. A recent systematic review has found that key barriers and enablers relate to the design of outdoor areas and the main building in terms of providing doors that are easy to open and close access points, weather (which can be addressed in part by providing adequate and appropriate shade, shelter and clothing), staffing factors and provision of social activities outdoors [33].…”

Section: Discussionmentioning

confidence: 99%

“…However, upon admission to residential aged care, the opportunity to venture outdoors is often limited for many residents [5,6]. Residents with dementia, in particular, may be unable to venture outdoors unaccompanied and doors to outdoor areas may be locked [4,7,8]. For people living with dementia, agitation, mood and behaviour may be improved by increased access to outdoor spaces, exposure to nature and use of garden spaces [2,3,9].…”

Section: Introductionmentioning

confidence: 99%

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People living in residential aged care need to BE outside not just SEE outside: associations between quality of life and outdoor access: a cross-sectional study

Dyer¹,

Liu²,

Gnanamanickam³

et al. 2019

Preprint

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Background The value of providing access to outdoor areas for people living in residential aged care, including those living with dementia, in terms of mood, behaviour and well-being is increasingly acknowledged. This study examines associations between provision of independent access to outdoor areas and frequency of residents going outdoors with the quality of life (QoL) of nursing home residents and compares use of outdoor areas between alternative models of residential aged care. Methods A cross-sectional study was conducted including 541 participants from 17 residential aged care homes in four states in Australia, mean age 85 years, 84% with cognitive impairment. Associations between having independent access to outdoors and the frequency of going outdoors and QoL (EQ-5D-5L) were examined using multi-level models. The odds of going outdoors in a small-scale home-like model of care compared to standard Australian models of care were examined. Results After adjustment for potential confounders (including comorbidities and facility level variables), living in an aged care home with independent access to the outdoors was not significantly associated with QoL (β=-0.01, 95% Confidence Interval (CI) -0.09 to 0.07, P=0.80). However, going outdoors daily (β=0.13 95%CI 0.06 to 0.21), but not multiple times a week (β=0.03, 95%CI -0.03 to 0.09), was associated with a better QoL. Residents living in a home-like model of care had greater odds of going outdoors daily (odds ratio 15.1, 95%CI 6.3 to 36.2). Conclusions Going outdoors frequently is associated with higher QoL for residents of aged care homes and residents are more likely to get outside daily if they live in a small-scale home-like model of care. However, provision of independent access to outdoor areas alone may be insufficient to achieve these benefits. Increased availability of models of residential aged care with staffing structures, training and design which increases support for residents to venture outdoors frequently is needed to maximise resident quality of life.

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The Impact of the Physical Environment on Depressive Symptoms of Older Residents Living in Care Homes: A Mixed Methods Study

Abstract: We provide new evidence to suggest that access to outdoor space predicts depressive symptoms in older people living in care home. Interventions aimed at increasing access to outdoor spaces could positively affect depressive symptoms in older people.

Cited by 27 publications

References 31 publications

Cycling Without Age: Assessing the Impact of a Cycling-Based Initiative on Mood and Wellbeing

Cycling Without Age: Assessing the Impact of a Cycling-Based Initiative on Mood and Wellbeing

Extending the importance–performance analysis (IPA) approach to Turkish elderly people’s self-rated home accessibility

People living in residential aged care need to BE outside not just SEE outside: associations between quality of life and outdoor access: a cross-sectional study

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