Residential Healthcare Facilities 2014 Guidelines Revision Project: Access to Nature

Evidence-based research, as well as anecdotal information, has revealed that access to nature and natural light has a positive influence on the well-being of individuals. An added dimension to the focus on natural light is that of space that s either specifically adjacent to the facility or an interior space that has natural elements or designed components of nature, such as atriums, and is reminiscent of the outdoors.

Since the 2010 Guidelines for Design and Construction of Health Care Facilities provides requirements for different types of health care facilities, this workgroup has focused on each of the residential health, care, and support facility types. In support of proposals for the 2014 revision cycle, the following comments are provided by the workgroup:

• It has been demonstrated that the longer individuals remain inside of buildings, the less likely they are to venture outside. Their world becomes closed in and a fear of the outside represents the fear of the unknown.
• Evidence-based outcomes demonstrate that older individuals who stay indoors develop depression and/or depression that may be a co-morbidity of a physical disease/diagnosis, worsening their overall wellness.
• Contact with nature, both wild and designed and passive and active, results in improved health outcomes through stress reduction, sensory stimulation, exercise, exposure to natural light, and increased opportunities for social connection.
• Anecdotal information correlates outdoor experiences with playgrounds and passive and active gardens that result in improved behaviors and communication skills for children, adults, and older adults.
• Anecdotally, there is more effective communication among families that visit patients and residents when outdoor spaces are available for utilization. The outdoor environment creates a sense of harmony, therefore influencing how people speak with each other.
• Outcomes are documented on the positive effects of daylight, especially for people with depression and dementia related to re-setting circadian rhythms.
• There is both anecdotal and evidence-based information on the positive role that visual and physical access to nature has on decreasing stress, increasing alertness, and reducing turnover in residential health care staff.