While most senior care centers are understandably focused on enlarging and enhancing their interior rehabilitation spaces, many miss a great opportunity by not thinking outside the box, or at least outside the walls of their building.

If you are lucky enough to have an exterior area abutting your physical/occupational therapy suite, you can visually and operationally extend your program to the great outdoors, during periods of favorable weather.

The physical benefits of outdoor exercise are well known. In the case of a senior "rehabbing" short term, outdoor activity can also provide a psychological boost, making them feel "closer to going home". This is especially true if the focus of the outdoor therapy suite is on Activities of Daily Living (ADL)

Our Senior Care project experience has taught us that the key to a successful outdoor therapy space is to use "the real world" as a therapeutic tool.

The heart of any outdoor therapy space is its ambulation area. We always try to treat this area as a "destination" with various ADL "stops" along the way. Introducing a number of changes-of-level into that route makes it both interesting and therapeutic.

Introducing a 4 to 6 inch curb in several locations is a simple way to introduce a change-in-level and has the practical benefits of channeling storm water and making transitions between paving materials. Lengths of curb should also include a wheelchair ramp (carriage drop) to introduce a steep pitched element that can be a significant challenge for someone with a cane, walker or wheelchair.

Along our ambulation paths, we also introduce more conventional ramps and short flights of steps. It is important to introduce stairs at several locations. One flight of steps should have indoor risers and tread proportions (7" risers and 11" treads). The other flight of steps should have the 4" risers and 18" threads normally associated with outdoor elements such as stepped walks.

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