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Happy Autumn! Stuck Indoors, No Fresh Air, Is it Time to Bring Care Outdoors?

Walking barefoot on a soft sand beach, hearing the waves crash along the shore, walking in a forest of changing seasons from summer to winter with red, purple, orange, and yellow leaves, inhaling the crisp and energizing breeze, gazing into a glorious sunrise of endless possibility. How do you feel?

Calm? Peaceful? Invigorated? Renewed? Joyful?

We all need fresh air and opportunities to connect with Nature.

Why don't we spend more time outdoors?

Why is most of the Care we provide indoors?

Research shows that our physical, social, and natural environments significantly affect longevity. Person-environment exchange (our experience of place), influences physical mobility, cognition, and sensory health.

Environmental gerontology seeks to understand, analyze, modify and optimize our natural, physical and social environments to promote aging well, living well. Housing, community characteristics, and accessibility, including accessible green and blue spaces, have a significant impact on our ability to maintain social connections, human and non-human.

Awareness of our environments' impact on our health and well-being enables the creation of social and environmental practices and policies for all ages to thrive throughout their lifespan in our climate-changing world.

All ages need accessibility to the outdoors, including parks, gardens, animals, orchards, forests, rivers, birds, lakes, and beaches. The Nature Experience has definite effects on our health and well-being, including stimulating physical activity, improving mood, and increasing life satisfaction while improving how we design and build the places we inhabit.

Nature immersion produces feelings of connectedness to Nature and a more profound sense of belonging to the natural world. Increasing and utilizing green and blue public spaces contributes to healthy lifestyles and buffers the effects of air pollution, heat waves, and floods.

Fresh Outdoor Air vs. Indoor Air

The average American spends 90%+ of their time indoors, and according to the Environmental Protection Agency, concentrations of some indoor air pollutants are up to five times greater than outdoor concentrations!

Apart from their indoor home environments, Americans spend 87% of their time in buildings, including offices, educational institutions, and health care facilities, 6% in vehicles, and just 7% outdoors.

Indoor pollutants are rising and include ozone from air cleaners, molds, synthetic building materials found in furnishings, personal care products, household cleaners, and the lack of mechanical ventilation found in energy-efficient building construction.

Quality ventilation with outdoor air can reduce airborne illnesses, including SARS-CoV-2, the respiratory virus that causes Covid-19.

Think for a moment about our most vulnerable neighbors, those who no longer drive, those who depend on their care partners to bring them outdoors to access fresh air, sunlight, and Nature.

Through the years, I have discovered the most nature-deprived people I know live or work in care facilities and people aging-in-place (at home) who lack transportation and accessible green or blue spaces.

Think about the places we practice 'Care.'

A growing body of literature indicates that skilled nursing facilities (nursing homes) have high indoor particulate and gaseous pollutants. Residents, and their care partners, spend most of their time indoors and are exposed to these indoor air pollutants for long periods. The Indoor air quality in nursing homes is not regulated and rarely monitored.

Even low concentrations of prolonged indoor air pollution exposure can adversely affect older adults' health, well-being, and quality of life while increasing medical expenditures due to frequent unscheduled hospitalizations due to severe episodes of illness.

I have known older adults who only go outside on their way to a doctor's appointment! I have known care teams who eat lunch at their desks, scroll on their iPhones, or sit in a break room with no windows or fresh air- if they are eating lunch at all.

It does not have to be this way.

Researchers propose an action plan for assessing Indoor Air Quality in nursing homes that will safeguard the health of nursing home residents and staff- this is imperative to ensure cleaner indoor air for our most vulnerable neighbors.

In addition, residents and staff will benefit by bringing Care Outdoors and start utilizing outdoor spaces as places for 'nature care.'

By denying those we care for access to the outdoors and quality immersion into the natural world, we are depriving ourselves of daily opportunities to gain the many benefits of Nature, improving our health and wellbeing.

The Care we give others is only as good as the Care we give ourselves.

Care Outdoors, Nature-Care, promotes Reciprocal-Shared Care; the caregiver becomes the care receiver.

Reciprocal-Shared Care can prevent caregiver burnout and guilt while providing opportunities for care receivers to connect with their environment meaningfully.

To bring the Care Outdoors, we must first discover our care culture as each is unique.

Understanding your care culture nurtures the way toward the care culture change needed to begin meaningfully engaging with outdoor spaces daily.

It starts with Awareness and Value. When we become aware of the benefits of fresh air and Nature Care and begin to experience these benefits ourselves, we begin to value being outdoors, which starts to seep into our home and work environments.

It will become natural to bring Care Outdoors; it will feel more unnatural

being inside all the time.

Are You Ready to bring Care Outdoors?

Home is where one starts from.

- T.S. Eliot


EPA. (n.d.). Indoor air in homes and coronavirus (Covid-19).

EPA. (n.d.). Indoor air quality. What are the trends in indoor air quality and their effects on human health?

Mannan, M., & Al-Ghamdi, S. G. (2021). Indoor air quality in buildings: a comprehensive review on the factors influencing air pollution in residential and commercial structure. International Journal of Environmental Research and Public Health, 18(6), 3276.

Reddy, M., Heidarinejad, M., Stephens, B., & Rubinstein, I. (2021). Adequate indoor air quality in nursing homes: An unmet medical need. Science of The Total Environment, 765, 144273.

Sánchez González, D. (2018). Natural landscape and environmental gerontology. Environmental Analysis & Ecology Studies.

Weir, K. (2020). Nurtured by nature. Psychological research is advancing our understanding of how time in nature can improve our mental health and sharpen our cognition. American Psychological Association.

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