By providing access to outdoor environments, exterior doors can enhance the sense of freedom in residential environments for aging. However, doorways may also present barriers to outdoor access. Using environmental audits, this study examined doorway problems at 68 assisted living facilities in three geographic regions. Results were compared with resident surveys (n = 1,128), staff surveys (n = 432), and resident focus groups (n = 76). Specific doorway issues were found to be associated with residents' weekly minutes of walking, outdoor usage, and perceived ease of reaching outdoor areas. The main problems were door opening/closing, thresholds and landings, and self-locking doors. The findings indicate that exterior doorways often present barriers to assisted living residents, resulting in lower levels of walking and outdoor use. By discouraging these health-related behaviors, doorway problems may negatively affect residents' health and well-being. Practice implications suggest that many existing doorway problems, such as high thresholds or excessive opening force, are easily remedied.
