It’s long been understood that the right environment for a person with diagnosed dementia, or someone who we think may be developing dementia, can have a huge impact on their wellbeing and quality of life. These kinds of environments support people to keep doing the things they love – preparing meals, enjoying hobbies, and staying involved in their daily routines.
Most importantly, they help people stay connected to the place they call home.
But the person’s lived here for years – surely they know their way around?
It’s a common assumption that because a person has lived somewhere for a long time that they will always know where all of the rooms are and how to find everything they need. However, we know dementia can affect memory and orientation in ways that change how someone experiences even a familiar space. We’ve seen how small adaptations – like clearer signage, stronger colour contrasts, and simplifying visual patterns – can really help people feel more confident and comfortable moving around their home.
Our aim is simple: to support people to remain in their home for as long as they wish. A diagnosis of dementia shouldn’t change that – and making sure the environment works well for the person is a key part of how we help make that possible.
When an environment no longer works
When an environment no longer supports someone, it can have numerous negative effects, some of which aren’t often thought about, for example:
- Weight loss, because someone may no longer be able to find or prepare food.
- Frustration or distress, if they can’t find their way or locate what they need.
- Disengagement or apathy, because navigating their surroundings becomes too difficult.
- Increased risk of falls, where perception issues lead to hazards (for example trying to step over a mat on the floor which is now confused for a hole).
- Incontinence, due to confusion about where the toilet is or how to use it.
- Urinary tract infections, if someone avoids using the toilet because of uncertainty or confusion.
Our work so far
We’ve been thinking about dementia-friendly environments for many years. During our 2016–2018 Dementia Project, we explored the topic in detail, producing an eBook and developing staff training as part of our Wellbeing for Life Toolkit.
We’ve continued to build on that work. For over a year now, we’ve asked all homes supporting someone on our Dementia Pathway to carry out structured assessments using the University of Worcester’s Association for Dementia Studies Environmental Tools – covering both homes and gardens, following on from the work our external dementia consultant, Beth Britton, conducted prior to the Dementia Project.
We also signpost our teams to ‘Making your Garden Dementia-Friendly’ and the Alzheimer’s Society’s ‘Making your home dementia friendly’, both of which are really useful, accessible resources for staff and families.
Supporting teams through training
In 2024, we introduced a refreshed training offer to help teams carry out environmental audits confidently and thoughtfully. As part of this, Nicola Payne, our Best Practice Manager for Health and Families, supported one of our services by auditing a flat and using the experience to inform practical training for others. Nicky says:
“Auditing a home I already knew well was really interesting. Using the tool helped me to see the home through a different lens; not making assumptions and being guided by the questions was so helpful. Afterwards, I was able to share the results with the team and support them in making changes to keep the person’s home as safe, engaging and welcoming as possible.”
The training also uses real-life examples and images – including both helpful and unhelpful home layouts – so staff can better understand how certain features might impact someone living with dementia and can contribute to some common dementia symptoms.
Beth Britton, who supports Nicky with our dementia environments training, says:
“I’ve long been passionate about creating supportive environments. We know that 85% of people would prefer to remain at home if they developed dementia, and that is just as important for people with a learning disability. As things change with a person’s cognition, making sure staff teams know how to adapt their environment so it continues to work for them is rightly a top priority for MacIntyre.”
Important things to consider
In our training we stress the importance of the ‘whole’ environment. Gardens, outdoor spaces and even how someone gets from one room to another can all affect wellbeing. A walk outside, a moment in nature, or simply knowing how to get where you’re going – these small experiences make a big difference.
We always stress the importance of working collaboratively. Everyone who shares those spaces – peers, family and friends should be part of the conversation and feel confident in the changes and support
The next step?
Our Health Team are now asking every MacIntyre home or workplace supporting someone with diagnosed dementia, or a person we believe is developing dementia, to take part in our in-house training ahead of using the University of Worcester Association of Dementia Studies Environmental Assessment Tools in their place of work.
While these tools may not apply in full to every MacIntyre team, each contains helpful elements. The principles they’re based on – The King’s Fund’s OWL FM (Orientation, Wayfinding, Legibility, Familiarity, and Meaningful Activity) – offer practical ideas to make any space more supportive and easier to navigate..
We look forward to welcoming colleagues to our training sessions in July.
For the wider sector, if you’d like to know more about our upcoming training offer for social care staff, working with people who have a learning disability and dementia, please contact us: [javascript protected email address].
To keep up-to-date with our dementia work and the learning we share with the wider health and social care sector, sign up to our Dementia Special Interest Group. The next meeting is on 21 October 2025 and you can sign up – for free – here
