Beyond the Walls: A Mixed Methods Study on Assessing Outdoor Spaces in Long-Term Care Settings for Older People

Outdoor environments are an integral part of long-term care (LTC) settings. This study examined the extent to which the assessed quality of outdoor environments in LTC corresponds with older residents’ perceptions of those spaces. A convergent mixed methods design was employed, combining structured observations of outdoor physical environments in 30 LTC settings with walk-along interviews exploring residents’ reflections and experiences. The integrated findings demonstrate that outdoor spaces play a meaningful role in residents’ everyday lives. Observational assessments indicated generally good environmental quality. Residents valued outdoor spaces for their aesthetic qualities, familiarity, and opportunities to maintain habitual activities. Walking paths were especially important for supporting mobility. Overall, the findings suggest a strong correspondence between assessed environmental quality and residents’ perceptions while identifying features that could further enrich outdoor engagement in LTC settings.