A chance observation of an elderly woman gazing wistfully out the window of a nursing home has blossomed into a whole new avenue of research for a Texas A&M University architect, leading to a soon-to-be-released book on the subject.

"As part of my research focus on designing healthcare facilities, I spend a lot of time in long-term care residences like nursing homes and assisted living complexes," says Susan Rodiek, who is associate director of the Center for Health Systems & Design (CHSD), a joint research center of the College of Architecture and the Texas A&M System Health Science Center. "After noticing that people tended to congregate near outside doorways or to sit looking out windows, I decided to find out why they were doing so and whether they wanted more opportunities to go outside."

Rodiek's curiosity led to conducting focus groups and photo-surveys with residents at 14 facilities randomly selected from a 12-county region.

"I found that most people equated being able to go outdoors with a higher quality of life," she notes. "And surprisingly, those who needed the highest level of care because they were confined to wheelchairs or otherwise had difficulty walking told me 'we need to go outside more than anyone else'."

Participants in Rodiek's study indicated that their use of their residence's outdoor facilities depended on how easy those facilities were for them to access, the aesthetic appeal of the outdoor environment, and specific features such as shade, places to sit, plants and scenic views. She found that their background produced no significant differences in opinions voiced by residents; former urban and rural dwellers seemed to feel much the same.

Being able to go outdoors is not just about raising the spirits of the elderly. But; other research has shown that people's physical health improves when they can go outdoors, Rodiek notes.

"The health benefits seem to result from greater physical activity and from access to bright light," she says. "The benefits of Vitamin D from sunlight have been known for a long time, but exposure to bright outdoor light may also balance hormones and improve mood. These effects may be related to the fact that outdoor light can be at least 10 times brighter than indoor light and that outdoor light is full-spectrum."

Rodiek has published studies on these topics, and several other researchers are also working in this area. The publisher of Journal of Housing for the Elderly has had so many submissions on the topic that Rodiek was invited to produce an edited book on it, Role of the Outdoors in Residential Environments for Aging, to be released by Haworth Press in May 2006.

"This work lets architects see what contribution they can make to improving long-term care facilities," Rodiek says. "It was somewhat of a surprise to find out how much the residents were missing contact with nature, but now that we know this, we can do something to help them get outdoors more."