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. 2025 Sep 1;24(1):1141.
doi: 10.1186/s12912-025-03771-w.

Finding the way - nursing staff's perceptions and experiences of outdoor walks with residents in dementia care homes: a qualitative study

Cecilia Sjöholm  1 , Kirsti Skavberg Roaldsen  2 , Paul A Gardiner  3 , Ing-Mari Dohrn  4
Affiliations

Finding the way - nursing staff's perceptions and experiences of outdoor walks with residents in dementia care homes: a qualitative study

Cecilia Sjöholm et al. BMC Nurs. .

Abstract

Background: Outdoor walks have been shown to provide physical and cognitive benefits and may help reduce behavioral and psychological symptoms of dementia (BPSD) in care home residents. However, little is known about how nursing staff perceive and integrate these walks into daily care. This study aimed to explore staff perceptions and experiences of outdoor walks, focusing on their benefits and how to integrate them into routine care.

Methods: Semi-structured interviews were conducted with seven informants, all nursing staff, from six dementia care homes located in different residential areas in Sweden. Data were analyzed using qualitative content analysis.

Results: Three main categories were identified: 'Walks with purpose and meaning', 'Challenges with outdoor walks and ways to deal with them', and 'Emotional, physical and relational responses to outdoor walks'. Outdoor walks were perceived valuable for residents, staff, and relatives from multiple perspectives. Informants consistently described outdoor walks as meaningful and beneficial for residents, contributing to improvements in physical, psychological, cognitive, social, and existential well-being, both during and after the walks. However, walks could occasionally increase anxiety afterward. Challenges were described both in the preparation process and during the walk, such as stressful environments, weather conditions, and varying individual health conditions and needs. Insufficient staffing, competing tasks, differing views among staff regarding the importance of walking, and the absence of established routines for walks were also mentioned. The informants had developed various a person-centered strategies to manage many of these challenges and risks, based on their knowledge and experience in dementia care.

Conclusion: Outdoor walks were highly valued by staff and could be integrated into daily dementia care with appropriate planning. A wide range of health benefits were described, including reduced BPSD, suggesting that walks may help reduce the need for medication. Moreover, outdoor walks were viewed as meaningful activities that fostered social connection and offered residents a way to engage with nature and the surrounding community.

Trial registration: Not applicable.

Keywords: Dementia; Nursing care; Physical activity; Qualitative; Walking.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki. Prior to participation, each informant signed an informed consent form. Both oral and written information regarding the study’s purpose and the right to withdraw at any time without providing a reason were provided to the informants during recruitment and again before the interview. The confidentiality of the recorded conversations was assured, and informants were informed that their identities would remain anonymous in the final report and analysis. Research projects that require approval from the Swedish Ethical Review Authority are defined as “medical research including biological materials, personal health data, or a physical intervention”. Ethical approval was waived by the Swedish Ethical Review Authority, as the current study was not considered to require approval, given that the data collected related only to the informants’ work routines. Participation in the study was approved by the managers of the dementia care homes. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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References

    1. Nichols E, Steinmetz JD, Vollset SE, Fukutaki K, Chalek J, Abd-Allah F, et al. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the global burden of disease study 2019. Lancet Public Health. 2022;7(2):e105–25. - PMC - PubMed
    1. Frisell O, Jönsson L, Wimo A. Demenssjukdomarnas Samhällskostnader i Sverige 2019. Karolinska Institutet; 2019.
    1. Budson A. Kowall, N. The handbook of alzheimer´s disease and other dementias. Wiley Blackwell; 2014.
    1. Sverdrup K, Selbæk G, Bergh S, Strand BH, Thingstad P, Skjellegrind HK, et al. Physical performance across the cognitive spectrum and between dementia subtypes in a population-based sample of older adults: the HUNT study. Arch Gerontol Geriatr. 2021;95:104400. - PubMed
    1. Van Doorn C, Gruber-Baldini AL, Zimmerman S, Richard Hebel J, Port CL, Baumgarten M, et al. Dementia as a risk factor for falls and fall injuries among nursing home residents. J Am Geriatr Soc. 2003;51(9):1213–8. - PubMed

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