Environment and technology

Why is the physical environment important for people with dementia?

Dementia is associated with progressive impairments of memory, perception, orientation, information processing, planning, sequencing, performing and monitoring actions, and communication. Therefore, cues that built in or are produced by the physical environment are more important for people with dementia than for cognitively unimpaired older adults. Ideally, the environment should compensate for deficits, maximise independence and support personal identity. Environmental features that have a particular impact include lighting, noise level, temperature, clarity, stimulation, and orientation.

What are the effects of an appropriate environment?

An appropriate design of the physical environment has a number of beneficial effects on people with dementia:

  • Improving of quality of life
  • Facilitating spatial and temporal orientation
  • Supporting meaningful activities
  • Enhancing social interaction
  • Reducing changed behaviours such as anxiety and agitation

What is dementia-friendly architecture and design?

There are several principles of environmental architecture and design for people with dementia. A dementia-friendly building or flat should provide:

  • A structure that is self-explanatory and easy to understand
  • Controlled levels of background noise and visual stimulation
  • Appropriate lighting and color contrasts
  • Single rooms with individual and homelike character
  • Individual items of furniture and other objects
  • Specific, easily identifiable spaces for specific activities, e. g. cooking or leisure
  • Short corridors and few decision points
  • Well visible and easily accessible toilets
  • Easily accessible and safe exterior spaces

Suggestions for modifications inside the home

It is not advisable to make major changes to the home overnight, because the familiar environment is important for people with dementia to feel at home. However, there are simple things that can be done to help someone with dementia to continue living independently in their home.

  • Improve lighting, particularly on stairs and in the toilet
  • Automatic light sensors can make lights come on automatically when someone passes by
  • Reduce glare, shadows, and reflections – they may be misinterpreted as water or people in the house
  • Reduce excess noise, e. g. a radio or TV constantly playing
  • Remove clutter, e. g. stacks of newspapers or boxes
  • Allow manoeuvring with walker and wheelchair
  • Use safer flooring, avoid rugs or mats on the floor – they may be misinterpreted as objects that need to be stepped over, which could lead to trips or falls
  • Increase bathroom safety, e. g. by using a walk-in shower, a shower seat, or grab bars
  • Use contrasting colours, e. g. for furniture that contrasts from walls and floors, or the toilet seat
  • Remove troubling reflections, e. g. mirrors – they can cause confusion as people with dementia may not recognise themselves
  • Use labels and signs, e.g. on cupboards and doors; use words or appropriate pictures or photos; see-through cupboard doors may be a great help to someone with dementia, as they can then see what is inside
  • Provide information, e.g., using a large clock with LCD display – people with dementia may be able to read digital information about time better than traditional clock hands (see: assistive technology below)

We would like to thank Dr. Birgit Dietz, Dipl. Ing. Architekt, Director of the Bavarian Institute for Age and Dementia Sensitive Architecture (Bamberg) for important comments and suggestions on this section.


Suggestions for modifications outside the home

Technical aids are devices or systems that help people with dementia to maintain or improve their independence, safety and well-being. There are numerous technical aids for people with dementia and their relatives.

  • Facilitate entering the home, e. g. by safety railings on stairs
  • Make sure that walking surfaces are flat to prevent trips or falls
  • Outdoor spaces must be secure to prevent someone wandering off
  • Raise flower beds to help people with restricted mobility look after their garden
  • Provide sheltered seating areas to enable someone to stay outside for longer
  • Use adequate lighting, e. g. for the garden entrance
  • Automatic light sensors can make lights come on automatically when someone passes

Assistive technology

Assistive technology refers to devices or systems that support people with dementia to maintain or improve independence, safety, and wellbeing. Different kinds of assistive technology are available which address people with cognitive impairment or dementia and family carers.

The goals of assistive technology for people with dementia are:

  • Ensuring safety inside and outside the home
  • Supporting independent living, activity and quality of life
  • Facilitate communication and social interaction
  • Delivering treatment
  • Keeping people with dementia cognitively fit
  • Providing entertainment

Types of assistive devices for specific goals

Goal Type of device
Ensuring safety inside and outside the home • Alarms (e.g. bed detectors, mats, fall detectors, movement detectors, physiological monitoring)
• Fire, smoke, gas, flood detectors
• Door and window sensors
• Electronic door locks
• Automatic lighting
• Automatic shut-offs on household appliances
• Person locators
• Alarms (e.g. bed detectors, mats, fall detectors, movement detectors, physiological monitoring)
Supporting independent living, activity, and quality of life • Reminders
• Speaking objects, object finders
• Timers, calendars, clocks
• Remote controls
• Robots
Facilitating communication and social interaction • Simplified telephones, smart phones, telephone amplifiers
• Tablet computer applications
Delivering treatment • Medication dispensers
Keeping people with dementia cognitively fit • Cognitively stimulating exercises
• Exergaming
Providing entertainment • Computer games
• Digital photo frames
• Artificial animals (Paro)
• Reading devices
• Social robots


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  • Soril LJJ, Leggett LE, Lorenzetti DL, Silvius J, et al. Effective use of the built environment to manage behavioural and psychological symptoms of dementia: A systematic review. PLOS One 9: e115425, 2014
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