Space, the final frontier: outdoor access for people living with dementia

Studies have consistently found that access to outdoor space has a positive impact on the mental and physical well-being of people with dementia (Mapes, 2010; Rappe & Topo, 2007). Benefits are often linked to an affinity with nature (Hendriks, van Vliet, Gerritsen, & Dr€ oes, 2016) and outdoor settings (Olsson, Lampic, Skovdahl, & Engstr€ om, 2013) with a government White Paper expressing the commitment to reconnect people with this natural environment (HM Government, 2011). The benefits of outdoor access can also arise from engagement in specific activities, helping to promote inclusion and occupation, with the Joseph Rowntree Foundation (2005) finding that older people regarded the ability to get out and keep active as being an important aspect of their life. Specific benefits of going outside expressed by people with dementia include interaction with others, aesthetic appreciation, exercise and a sense of freedom (Duggan, Blackman, Martyr, & Van Schaik, 2008). For those living in care homes, where privacy tends to be lacking, additional benefits of outdoor access can also potentially include the experience of being alone and in a peaceful place. Of course, these benefits are unlikely to be unique to people with dementia who just want to maintain an ordinary way of life (Fukushima, Nagahata, Ishibashi, Takahashi, & Moriyama, 2005). Nor are benefits confined to the promotion of individual well-being. As such, this editorial will suggest that access to the outdoors is central to the promotion of the human rights and social inclusion of people with dementia. It will also explore the barriers and facilitators to the achievement of this access.