Creating restorative outdoor environments by meeting informational needs: applying the Supportive Environments for Effectiveness framework to long-term care design

Abstract

Supporting health and well-being in long-term care facilities has long been a pressing issue that has only increased in significance due to rising mental health concerns for residents and staff in response to the COVID-19 pandemic. While outdoor environments have been demonstrated to support well-being, these environments in long-term care, if well designed, are typically only designed for the functional needs of residents. These spaces are rarely designed to offer restorative support for staff, as design recommendations are usually in relation to meeting specific needs required as caregivers rather than as individuals. This suggests that outdoor environments in long-term care are unlikely to meet the needs of staff and are, therefore, less likely to be utilized by this user group and less likely to provide any restorative benefit. This study utilized the principles from the environmental psychology framework Supportive Environments for Effectiveness to address this issue (reDirect, 2022). A quantitative study at Meadowlark Hills Retirement Community in Manhattan, Kansas examined the needs and preferences of outdoor environments by both residents and staff in long-term care facilities. Data collection involved photo-surveys of 11 existing outdoor environments inquiring about use patterns, preferences for proposed elements, and satisfaction with existing elements. The surveys also inquired about general outdoor preferences, self-reported well-being, and the impact of the COVID-19 pandemic on well-being and use of outdoor spaces. Survey data from 155 residents and direct care staff revealed significant differences in resident versus staff perceptions and preferences for 10 spaces, indicating a need to create custom outdoor spaces that meet the physical and psychological needs for each user group. This need is further supported by the disparity in well-being between both user groups, with staff reporting a higher frequency of negative affects consistent with mental fatigue and burnout. These findings demonstrate the need to re-evaluate long-term care design to create more supportive outdoor environments for both resident and staff and present the Supportive Environments for Effectiveness framework as a novel application to contextualize psychological needs through contact with nature. The broader outcomes of this study relate to its implications in supporting well-being in residents and staff in long-term care facilities.