Mooney, P. and P.L. Nicell, CHE. 1992. The importance of exterior environment for Alzheimer's residents: Effective care and risk management. Health Care Forum 5(2):23-29.

Evidence shows that environments especially designed for cognitively impaired seniors can maintain or increase their levels of functioning. Little emphasis has so far been placed on the prosthetic role that May be played by exterior environments. This study attempted to determine the value that specially designed exterior spaces May have in reducing undesired behaviors, thereby minimizing risks to the patients and potential liability to the institution.

The researchers tested that (a) poor environments increase residentsí frustrations and can precipitate catastrophic behavior and (b) freedom of movement and opportunities to avoid crowding, noise and excess stimulation minimize the frequency of aggressive behavior.

The researchers found that the use of exterior environments reduced incidents of aggressive behavior, and contributed significantly to a risk management program