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.