The Impact of the Physical Environment on Depressive Symptoms of Older Residents Living in Care Homes: A Mixed Methods Study

Abstract Background and Objectives Forty percent of residents living in care homes in the United Kingdom have significant depressive symptoms. Care homes can appear to be depressing places, but whether the physical environment of homes directly affects depression in care home residents is unknown. T...

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Bibliographic Details
Published in:The Gerontologist 2018-05, Vol.58 (3), p.438-447
Main Authors: Potter, Rachel, Sheehan, Bart, Cain, Rebecca, Griffin, James, Jennings, Paul A
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Built environment
Cohort Studies
Dementia
Depression - psychology
Emotions
Environmental assessment
Female
Gerontology
Health Facility Environment
Humans
Interior Design and Furnishings
Male
Mental depression
Mixed methods research
Multilevel Analysis
Nursing Homes
Older people
Prospective Studies
Qualitative Research
Research design
Social research
Symptoms
United Kingdom
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Summary:Abstract Background and Objectives Forty percent of residents living in care homes in the United Kingdom have significant depressive symptoms. Care homes can appear to be depressing places, but whether the physical environment of homes directly affects depression in care home residents is unknown. This study explores the relationship between the physical environment and depressive symptoms of older people living in care homes. Research Design and Methods In a prospective cohort study the physical environment of 50 care homes were measured using the Sheffield Care Environment Assessment Matrix (SCEAM) and depressive symptoms of 510 residents measured using the Geriatric Depression Scale (GDS-15). The study was supplemented with semi-structured interviews with residents living in the care homes. Quantitative data were analyzed using multi-level modeling, and qualitative data analyzed using a thematic framework approach. Results The overall physical environment of care homes (overall SCEAM score) did not predict depressive symptoms. Controlling for dependency, social engagement, and home type, having access to outdoor space was the only environmental variable to significantly predict depressive symptoms. Residents interviewed reported that access to outdoor space was restricted in many ways: locked doors, uneven foot paths, steep steps, and needing permission or assistance to go outside. Discussion and Implications We provide new evidence to suggest that access to outdoor space predicts depressive symptoms in older people living in care home. Interventions aimed at increasing access to outdoor spaces could positively affect depressive symptoms in older people.
ISSN:0016-9013
1758-5341
DOI:10.1093/geront/gnx041