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Care in the outdoors
Care providers in the UK are increasingly using the outdoors environment to help people to gain, or regain, personal and social skills, good health and self-esteem. It is used in care for all age groups, from kindergarten to care of the elderly, supporting learning difficulty, and as part of a full educational program provided by residential schools.
The Care Inspectorate website in Scotland describes some initiatives in outdoors care. Most recently it commends a playgroup which successfully supports children once a week to have an outdoors, forest school day. The manager stated that the trips outdoors were “all about discovery” and allowing the children to explore, lead, revisit and evaluate their own learning, with obvious extra benefits through being active outdoors and liking indoor work to the outside world.
Other outdoor early education initiatives in Scotland appear to be working well, after some initial opposition when this approach was first introduced in the 90s. I remember the irony of reading that one service might have been refused permission as there were no hand washing facilities in the woods! But I think that objection was overcome.
Outdoor kindergartens are common now in Scandinavia, where they were introduced in the 1950s after the first forest schools were implemented in Wisconsin, in the United States.
Increasing self-esteem; promoting pride
I experienced encouraging outdoors approaches to care and support in my previous work as an inspector. One residential school for young people had a convenient local forest space, where they held outdoor sessions. These proved to be one of the most popular sessions in the curriculum, and staff showed me how the young people, and their families, benefited greatly from the experience.
In another situation, a care home had supported young people with personal difficulties through landscaping and reconstructing part of the garden. A stream had been diverted to form a garden pool, and the benefit to wildlife and the environment was matched by the progress the young people made in their development and self-confidence. Another service had supported young people to set up and maintain a vegetable garden, and this supplied the cook regularly with vegetables. The benefit to the young people was clear in their self-esteem and pride in their outdoor work as they showed me around the garden.
Older people benefit greatly from outdoor experience also. Research has shown that regularly being outdoors, and among or close to trees, has helped people to maintain their health and, indeed, to recover more quickly from illness or medical operations. While we often associate old age with declining ability and motivation, there are many examples where people have regained skills, or taken up new ones, in outdoor activities. A service was recently highlighted by the Care Inspectorate as helping people to take up, or continue playing golf. This was part of a care home activity network, supported in part by the health services.
In a service I visited some residents had been encouraged to bring the plants from their gardens in the community into the care home garden, where they were able to maintain a flower plot with their familiar plants. This eased the transition to the care home and was very welcome by the residents.
A meaningful purpose in life
There are many ways to involve older people in outdoor experience and activities: setting up a putting green in the grounds of the care home is an example, and involving people in planning and maintaining the garden (where they choose!) is another. Walks in the grounds, or to a local landmark or shops, give other opportunities. I worked with one person who took great delight in going for people's daily messages, which gave him meaningful purpose in his day, as well as the benefits of exercise and being outdoors.
A basic human need
One manager neatly turned around the concept of the risks of outdoor work by pointing out the risks of not going outdoors, rather than the too frequently raised objection of increased risk in the wider environment. Good outdoor work manages risk rather than minimising it, and can reassure participants and families about safety. The attachment and affection we have for pets and our gardens are seen by some as a basic human need to relate to other living things and, of course, outdoor experiences enable this. To live mostly indoors is perhaps to cut us off from more opportunities than we know: one author, Richard Louv, wrote about nature deficit disorder, in his 2005 book Last Child in the Woods. He recognised that the basic need to be in touch with nature was being eroded by our increasingly urban living, suggesting that this brought with it many of the health issues we encounter today.
It is good to see increased awareness of our need to be outdoors and to be in active touch with nature. To summarise the advantages of outdoor experience in care work:
- People's confidence, health and wellbeing is enhanced through activity and being in touch with nature
- Personal skills and development can be progressed, with people taking their own lead in this.
- In education, there can be a transfer of skills from classroom learning to the 'real' world of our natural environment.
- Practical applications of maths, history, geography and biology can be used.
- Personal competence, resilience, creativity and social skills can be gained through working with others on challenging tasks.
How to start outdoor work in care?
- A change of mind set or attitude may be needed: I saw a nursery where the children got outside on 'good days': the staff were afraid that the children – or they - would get wet! Protective clothes and wellies were needed, but also a change of viewpoint.
- Guidance documents are readily available, see for example Go Outdoors!
- There may be a network of care or other services which already support outdoor activities. Either join them, or start one yourself!
- Employ, or support a staff member to train as an accredited outdoors worker, e.g. in the Forest School approach.
- Involve people or organisations who may help: healthcare professionals, volunteers, families and relatives.
I hope these suggestions are useful and that the benefits of outdoor work in care continue to be recognised.
Tony Clarke – QCS Expert Scottish Care Contributor