Alberta Cancer Foundation

Outdoor Experiences Can Play An Important Role in the Well-Being of Cancer Patients

Sonya Jakubec at Glenbow Park Ranch. Photograph by Aiden James.

It’s common sense that a little fresh air does us good, but does going outside actually provide medical benefits? If so, should we make a greater effort to engage people, especially those with serious health conditions, in outdoor experiences? Sonya Jakubec, a professor with the school of nursing and midwifery at Mount Royal University, believes so.

Jakubec spent her 20s as a community nurse and nursing teacher in West Africa, where most of her work took place outside. After moving to Calgary in 2003, she volunteered for an Alberta Parks group that helped to facilitate outdoor experiences for people with disabilities. These experiences taught her to think differently about what types of activities were possible indoors and outdoors, and even about who stood to benefit from being in nature.

“What we found was that volunteers and caregivers get as much out of those experiences as the official participants,” she says.

Over the past decade, Jakubec has studied the connection between natural spaces and well-being. Working with Mount Royal University, the University of Alberta and Alberta Parks, she led a province-wide survey in 2015 on the role of parks and outdoor spaces in palliative care, which includes pain management, end-of-life care and more. The survey found that over 90 per cent of participants wanted to include nature in their end-of-life experience.

Jakubec has been involved in other investigations that suggest outdoor experiences have a positive effect on well-being and quality of life for people in cancer recovery, people with disabilities and (as she observed as a volunteer) caregivers.

Outdoor experiences offer broad mental, emotional, spiritual and even physiological benefits. Jakubec’s research found that being in nature can help a person calm anxiety, build social connections, spark happy memories and temporarily shed their “sick person” or “care partner” identity. It also connects people with the seasons and cycles of the natural world, which can help them reframe their circumstances in positive ways.

Jakubec says people with serious illnesses (and members of their care teams) tend to get caught in a cycle where life seems to revolve around appointments and recuperation and outdoor experiences aren’t a priority. At the same time, care facilities focus on treating and protecting patients, which is easiest to do in a controlled environment, and outdoor experiences can seem unfeasibly risky. Jakubec tells the story of a hospice resident who told her nurse she hadn’t seen the moon for an entire year. Another hospitalized patient longed to eat a meal outside.

Jakubec’s research found that being in nature can help a person calm anxiety, build social connections, spark happy memories and temporarily shed their “sick person’ or care partner” identity.

The relationship of parks departments to health-care departments is evolving. Jakubec says many people, from Alberta Parks leaders and palliative care workers to policy-makers, researchers and kinesiologists, have shown eagerness to shift the mindset on nature and health care.

They’re beginning to infiltrate each other’s worlds. Jakubec regularly presents at Alberta Parks conferences and sees Parks people exploring health-care contexts like palliative care conferences. “There’s a growing inter-sector group of people keen on moving this kind of work forward,” she says.

Alberta Parks has already implemented innovative programs focused on well-being. Push to Open Nature, for example, is an Alberta-based non-profit that increases access for people of all ability levels and stages of life through barrier-free trails, accessible facilities and offers reduced fees for caregivers. In 2017, Friends of Fish Creek Provincial Park Society in Calgary, along with Mount Royal University and Alberta Parks, launched Good Grief, a program that helps people process grief and loss by participating in eight weeks of group walks. The program has proven so popular that other organizations, including the Palliative Care Society of the Bow Valley, have expressed interest in implementing similar events.

What about the health-care world? Should going outside be considered a medical intervention and prescribed as a treatment? Jakubec thinks not. “Do we view this as a health program and a prescription? That’s how health care works, and maybe it’s not the right relationship,” she says. Outdoor experiences are personal and based on individual histories, priorities and desires. As such, perhaps what’s needed is not a formal medical framework, but simply an openness to facilitating natural experiences in health care in some way, whether it’s a trip to a provincial park, a meal outside or even installing a bird feeder outside a hospice window.

“It’s a mindset. It’s an invitation to what’s already there,” Jakubec says. “The limitations are really of our own making.”