THE CHALLENGE

Despite the benefits of outdoor spaces, prior studies have shown that the outdoor spaces of long-term care (LTC) homes are often underused, such as in the case of Saint-Louis Long-Term Care (LTC). LTC homes are also vulnerable to design project limitations such as resources, time, expertise, and space constraints, making the realization of ‘ideal’ outdoor space designs difficult. Research is needed to examine how community-based participatory research (CBPR) and strategic design approaches can help target these challenge areas and support the design, implementation, and optimization of outdoor spaces in LTC.

Outcome

This research project seeks to create an evidenced-based framework, followed by design concepts that will inform future planning of an accessible and interactive intergenerational space at Saint-Louis LTC. The goal is to improve the quality of life of long-term care home residents/tenants and engage families, staff, and the community. This project serves as a case study to inform a broader design framework, grounded in a human-centred design and a strategic design approach for outdoor spaces in LTC settings.

Design Project Overview

The opportunity to conduct this research project came from a project initiated by Saint-Louis Long-Term Care (LTC) in the Bruyère Health Village (BHV) in Ottawa, Ontario. The long-term care home was seeking a design plan for their large, green outdoor space located on the Ottawa River. While the area is spacious and has a gorgeous view, it has been noted that the space is not used regularly by many of the residents, staff, and families, and is largely inaccessible. With these factors in mind, the home has a goal to redesign the space in a way that maximizes its potential and provides benefit to its visitors. Along with the goal to simply encourage more usage, a mission of the home was to foster intergenerational interactions with younger visitors as a way to improve resident experience.

This project is unique in that it presents not only a design challenge, but also the chance to incorporate research into the design process, exploring the issues presented at a broader scale. This hybrid of practice and study stemmed from the identification of key gaps in current practices and knowledge, and opportunities to address them.

Methods & Participants

Community-Based Participatory Research (CBPR)

A CBPR approach has facilitated a collaborative understanding of the context, gaps, and opportunities as well as design development.

Participant Groups

1. Residents of Saint-Louis LTC

2. Neighbouring tenants of the Senior Living Apartments

3. Staff and volunteers of the Bruyère Health Village

4. Family, friends and care partners of residents and tenants

Pre-Research Activities

1. Literature Review (March 2024 - ongoing)

2. Informal Observation (July - September 2024)

3. Site Survey & Environmental Analysis (August - October 2024)

Research Activities

1. Focus Groups (January 2025)

2. Co-Design Workshops (May 2025 - ongoing)

Preliminary Findings

Literature Review & Focus Groups

The literature review uncovered existing considerations proposed for the design of therapeutic gardens and outdoor spaces in LTC as well as intergenerational outdoor spaces. Structured group discussions with each of the 4 participant groups provided insights into their needs, preferences, and expectations for the redesigned outdoor space, as well as current limitations.

Themes

Six dominant themes were developed through the literature review and were further elaborated on with the focus group data.

Download the report of findings shared back to participants here: English / French.

NEXT STEPS

Co-Design Workshops - in progress

The input from the focus groups has been used to inform the design of the in-person workshops at the Saint-Louis LTC site. For example, identifying areas of the outdoor space that are most important to individuals helped to develop probes and activities they can work on during the session. These workshops will involve all participant groups to gather input and collaborate on components of the proposed design.

Community Partnerships

Continued efforts to build community partnerships, particularly with local schools, will identify opportunities for shared engagement within the outdoor space and will further define design requirements (e.g., garden beds for students to plant seeds and maintain).

Masterplan Proposal

I will use all the input, idea generation, and concept development from the data collection phases to create a design proposal for the redesign of the Saint-Louis LTC outdoor space. This will involve creating a 2D masterplan and 3D digital model of the proposed design. Design recommendations, and specific design details/requirements of importance (e.g., ergonomic features) will supplement the proposal.

Illustrated site plan of current Saint-Louis LTC outdoor space with target areas highlighted

APPLICATION OF Strategic Design PRINCIPLES

Through multidisciplinary collaboration, LTC homes can prioritize barriers and opportunities and co-formulate a design and implementation plan. Further project development, based on the learnings of this case study, will inform the creation of a roadmap for LTC homes seeking to rethink their outdoor spaces strategically.

Future Impact

The resulting design framework and concepts are intended to be scalable and adaptable to unique LTC contexts. Using a strategic design approach, LTC homes will be able to apply the framework and concepts to co-develop outdoor spaces that meet their needs, align with their available resources, foster intergenerational relationships, and enhance resident quality of life.

Knowledge Dissemination

This project and its preliminary findings were presented as a poster at the HFES International Symposium on Human Factors and Ergonomics in Health Care 2025. The Proceedings publication is coming soon.

Please reach out to me at alesyamskaya@gmail.com if you’d like to learn more about this project.