Designers and care practitioners are often frustrated by the underuse of outdoor areas by residents of dementia care facilities, in spite of the clear intention to design outdoor spaces that meet residents' needs. Even though many residents express enjoyment from contact with nature, and interdisciplinary research evidence strongly supports such interaction, investment in outdoor resources is often a gamble. Evidence-based design is the accepted norm, although gathering evidence and applying it to design requires creative strategies. This article suggests taking an ecological approach to research and design by engaging people, plants, and place in ways that stimulate curiosity and provide opportunities for normal life. Case studies illustrate how listening to the residents directly, and research by immersion rather than intervention, affords integrated design solutions that are embedded in day-to-day life. Suggestions are given for place making at the building's edge, to encourage enjoyment and human relationships, through which the use of outdoor environments by people with dementia and care staff is a happy consequence instead of a primary aim.
Garuth Eliot Chalfont, BM, MA, ASLA is a research assistant in the School of Architecture, University of Sheffield, UK, and is currently working on the INDEPENDENT Project (Investigating Enabling Environment for People With Dementia), which explores the potential for technology to improve quality of life.
Susan D. Rodiek, PhD, NCARB is assistant professor in the Department of Architecture, Texas A&M University, where she is also Associate Director of the Center of Health Systems and Design. Dr Rodiek's work is concerned primarily with the behavioral and psychological implications of environmental design, with an emphasis on residential facilities for older adults and particularly their usage of outdoor spaces.
Address correspondence to: Garuth Eliot Chalfont, BM, MA, ASLA, School of Architecture, Arts Tower, Western Bank, University of Sheffield, Sheffield UK S10 5BD. E-mail: g.chalfont.sheffield.ac.uk.
Garuth Eliot Chalfont thanks the people with dementia and their families, and the management and staff of the care homes for their warmth and wisdom, and their willingness to share both.