Go Green: Adding Green Spaces to Skilled Nursing Offers Bouquet of Benefits

 Spending time in nature has been shown to benefit well-being; however, some older adults are unable to get outdoors. Researchers investigated how bringing the outdoors in affected the well-being of skilled nursing patients.

Green space was added to the public areas of a 22-bed skilled nursing wing in a Dutch hospital. “Green walls,” consisting of living plants or moss, were installed in the corridors, and potted plants placed in the living room and reception areas. A control group consisted of 28 patients who completed a stay in the four months prior to greening modifications, while the green group consisted of 26 patients who completed a stay in the four months after greening modifications. Average age for both was 83 (ages 66 to 97). Patients in both groups completed a measure of their activities of daily living when they arrived at the wing (intake) and when they departed (outtake). At outtake, a physician also rated patients’ functional decline, and staff members completed a survey regarding their own appreciation for the plants, job satisfaction, and perceptions of patient well-being.

Although the group sizes were relatively small and the intervention only took place at one location, the results were promising. Significantly fewer patients in the green group reported functional decline in activities of daily living, compared to the control group (11% and 32%, respectively). The physician-assessed functional decline showed similar results, with only 48% of green participants showing little to moderate functional decline, compared to 85% of control patients. Staff generally reported the addition of plants had a positive impact on aesthetics, social atmosphere, and stress reduction, as well as improved patient well-being. Job satisfaction, however, was mostly unaffected.

While there may be other explanations for these findings, such as changes in staff behavior after greening modifications or general aesthetic improvement, the findings merit further research. Adding a component of interaction with plants would be another avenue.


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van den Berg AE, Maas J, van den Hoven L, and Tanja-Dijkstra K. Greening a geriatric ward reduces functional decline in elderly patients and is positively evaluated by hospital staff. Journal of Aging and Environment (2021); 35(2), 125-144.

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