10 Summer Outdoor Treatment Ideas for the Blossoming OT

By Lanie Hefferly, MS, OTR/L
Occupational Therapist

As a child, my grandmother never let me play indoors. She would always say, “Go get some fresh air, it’s good for you.” Inherently, we all know time spent outdoors is good for us, but how good? Turns out it’s not just something our parents did to get some peace and quiet. 

There is real physiological data on the correlation of time spent outdoors to decreased cortisol levels, heart rate, blood pressure, blood glucose levels, and cholesterol. In addition, several studies have found the psychological impact of time spent outdoors includes decreased anxiety, depression, chronic pain, improved sleep, and increased attention. Sensory impacts have also been well documented including improved vision! 

So, how do we provide services outdoors? Here are ten ways you can make the most out of your sessions while giving your patients the opportunity to enjoy some fresh air and sunshine. 

1. Gardening

Let’s take the low-hanging fruit here. So many of our older adult patients love gardening, and many senior living facilities have garden beds outdoors. Gardening is so easily graded and can work on a variety of deficits. 

In memory care, I have my patients pull out the dead debris from wheelchair level and rake the dirt. Watering plants can involve lifting and carrying a water jug with dynamic balance and functional reach. For more advanced patients, maybe you actually get down on the ground and transplant a plant!

2. Nature Walks

As an OT, I love a good nature walk to make my functional mobility, well, functional. Try to incorporate the patient’s senses: What do you hear, smell, feel, or see? Play “I Spy” to incorporate scanning the environment. Challenge dynamic balance by picking up trash or picking flowers along the way. 

3. Pet Care

Does your patient have a dog? Take them for a walk, work on picking up after them, brushing them, washing them, and playing fetch. Honestly, everyone wins in this situation!

4. Using Sidewalk Chalk

The possibilities are endless. I love using sidewalk chalk for motor planning. I draw out visual targets for stride length and J turns to simulate toilet transfers. I make targets to bounce a tennis ball on the ground or on a brick wall. My favorite is my rendition of Dance Dance Revolution where I write 4 numbers and have them step to a sequence. 

5. Washing Cars

Activity tolerance, anyone? If you want to grade it down, you could also have patients simply hose down their car. We could all use some de-pollenation. 

6. Yard Games 

Break out the corn hole, horseshoe, golf putter, or just a simple ball toss. For those with little or no resources, get creative. I have been known to use a broom handle like a baseball bat or golf putter with a beach ball or tennis ball. 

7. IADL Tasks

You can’t go wrong with actual yard work, cleaning the grill, or repetitive task-specific training of carrying the garbage can to the road or the mail to the mailbox.

8. Fishing

Any outdoorsmen out there? If you have a pond or swimming pool at your disposal, wonderful! If not, I learned a fun game from the BassMaster Classic this year (thanks, hubby!). You set out a couple of targets and have the patient work on casting their lure to hit the targets. You can even have them rig their baits via knot tying for bonus fine motor control. 

9. Clothespins on the Clothesline

Quite a few of my patients still make use of actual clotheslines in their yards. If they don’t have one, it’s fairly easy to rig up with a string between trees or on a porch. I carry around a set of clothespins for tripod pinch strength, but most patients have clothespins or chip clips at their house, too.

10. Literally Any Therapeutic Exercise

Even if none of these activities interest your patients, you can still encourage them to enjoy the nice weather. Take that resistance band outdoors, wrap it around a tree or pole and do some UE strengthening.