We found that using photographs strengthened recollections of good memories, stories and the feeling of identity, which is of considerable importance in geriatric care (34). Drageset, Normann and Elstad (35) emphasise that nursing home residents with dementia disorders also ‘appear strengthened’ when they relate recollections linked to nature experiences.
In various ways, the residents indicated that their relationship to nature and outdoor activities had become different in old age, and that fellowship and social interaction were more associated with being outdoors than previously. If this is interpreted as part of the process of adaptation in later years, the findings are in line with Bergland’s study (5), in which it is reported that elderly people adjust their expectations in line with the reality of their situation.
The findings can also be understood as a desire for more social activity and outdoor life than what they experience in their everyday lives in the nursing home. These are significant factors in enabling them to regard the nursing home as a real home (36). In addition, next of kin value these factors as important qualities in the nursing home (37).
Experiences linked to the connection between the life course and the course of nature can help to create meaning and support a sense of coherence and wholeness, as Takkinen and Ruoppila (38) have reported. These existential reflections can contribute to the important work of reflecting on peace and reconciliation when facing death, as Andersson, Halberg and Edberg (39) have described.
The study’s strengths and limitations
It is considered a strength of the study that we have conducted two interviews with eight residents in two different contexts, and that we have used photographs to elicit the residents’ memories. The outdoor interviews helped us to acquire good and spontaneous descriptions of here and now experiences. The use of photographs also allowed for activating reflections and memories of residents’ earlier lives in connection with nature, and they constituted a helpful tool as described by Chao et al. (20). The interviewer himself had a strong commitment and a close relationship with nature as well as considerable clinical experience with nursing home residents, which was also considered to strengthen the study.
Limitations of the study are that the interviewer was inexperienced, and that all the interviews were conducted prior to transcription and analysis (22).
When asking nursing home residents about their experiences and memories related to contact with nature, this study shows that they acquired a change of environment, beneficial sensory experiences, meaningful activities, social interaction and good memories. They also got in touch with feelings such as sadness at impaired functional ability and the loss of childhood landscapes and geographical affiliation. Conversations inspired by photographs of different kinds of landscape activated memories and stories linked to their roots and identity. The findings are in line with research and relevant theories.
Based on the findings, we recommend a practice that makes it easy for elderly people to spend time outdoors regularly. Moreover, we recommend that being outdoors is established as a regular and natural component of the therapeutic environment at nursing homes, based on the individual resident’s preferences and resources (40).
Research communities in this field are challenged to explore and describe further relations between ageing and experiences of the natural environment. In addition, research should address how experiencing nature on a regular basis can promote well-being, quality of life, improved functioning and greater satisfaction of the basic needs of elderly people. We also encourage researchers to identify similarities and differences between residents’ needs and wishes for good days at the nursing home and the staff’s expectations and priorities in the everyday life of the nursing home.
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