BOOK REVIEW: The Role of the Outdoors in Residential Environments for Aging
by Henry Szymanski, ASLA and Lyn Geboy
Susan Rodiek and Benyamin Schwarz, Editors. Binghamton, NY: Haworth Press, 2007.

Rodiek and Schwarz’s edited book, a collection of recent studies that support the benefits of the outdoors in the lives of older adults, is an excellent read for academics and practitioners alike. For the researcher, the studies, authored by a mix of top tier and rising generation environmental design researchers, offer an interesting variety of topics, epistemological perspectives, and research methods. Acknowledging the programmatic needs of the practitioner and administrators of residential settings for aging, a number of the studies go beyond reporting results, and describe the implications of the findings in terms of design recommendations. The usefulness of the book is enhanced through the studies’ well-articulated theoretical groundings and effective literature reviews.

While each of the studies offers something of interest, several stand out. In their study of 40 nursing homes in five states, Cutler and Kane found that, although the majority of nursing homes had designated outdoor spaces, roughly a third of residents got outside less than once a month. Usage of outdoor areas is hampered by a lack of proximity to their rooms, lack of staff assistance, and poor design, such as no continuous hard surface paths. All of these barriers to use of outdoor space are supported by the results reported by Kearney and Winterbottom, as well.

In their study of outdoor areas and Swedish nursing home residents, Bengstsson and Carlsson use their results to implicitly advance Stigsdotter and Grahn’s promising concept of “instorativeness,” a complementary dimension to restorativeness. Thus, while restorativeness refers to experiences that facilitate recovery from stress, instorativeness promotes wellbeing through recognition of identity and fostering selfesteem. Rodiek found that accessibility, aesthetics, and “magnet” features such as shade, seating, plants, and views influenced assisted living residents’ use of outdoors spaces.

The interplay of culture as it relates to outdoor spaces is highlighted in a study by Alves, Gulwadi, and Cohen, who found that elderly U.S. Hispanic respondents had a distinct preference for outdoor settings that supported social interaction, in contrast to Anglo-American respondents, who preferred more natural outdoor settings for personal, quiet engagement.

In a large-scale survey of residential communities (n=398), Joseph, Zimring, Harris-Kojetin, and Kiefer identified positive relationships between the presence, numbers, and visibility of activities resources (e.g., swimming pools, walking paths, gardens) and residents’ participation in outdoor physical activities.

The value of nature, even when direct and active use of the outdoors may not be possible, is emphasized in the study from Tang and Brown. They reported lower blood pressure and heart rates among elderly women after the women viewed natural landscapes versus built landscapes or no views.

This compilation of metrics and thoughtful interpretation acknowledges the multifaceted resource of nature, and affirms the importance of outdoor settings in designed environments. The researchers emphasize the need for purposeful and deliberate creation of natural spaces that foster restoration and contemplative focus. The chapters provide a wealth of documented evidence of the relationship between natural landscapes, and health and well-being. In sum, this book is a terrific resource for environmental design researchers, design professionals, and administrators of facilities for the aged who are looking for solid evidence that nature contributes to the positive quality of life of older adults.

Note: Rodiek and Schwartz’s book was also published as a special volume of the Journal of Housing for the Elderly, 19, 3-4, 2005.

This book review was excerpted with permission from the authors. The full review was published in Design Research News (vol.38, #3, 2007), the member newsletter of the Environmental Design Research Association.

Henry P. Szymanski, ASLA is Associate Principal Landscape Architect, and Lyn Geboy, PH.D. is Director of Research and Education. Both work at Kahler Slater Architects. Henry Szymanski can be reached at:, and Lyn Geboy can be reached at
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