Dementia design
loss. At the time, these design choices made sense as residents were typically in the earlier stages of dementia and more cognitively able. Today, the profile of care home residents has changed significantly. Evidence suggests that when caring for
those living with more advanced dementia this approach is not only ineffective but can be a source of stress because of prolonged exposure to copious amounts of redundant stimulation. In the past, colour-coding may have
supported orientation with many residents living with advanced dementia impaired, learning capacity inevitably means a blue door is simply a blue door, not the colour that identifies, for example, ‘this is the toilet’. However, the cognitive impairments they
experience go far beyond memory loss. Reasoning and perception also become affected, making it increasingly difficult for residents to understand even the simplest of signs or symbols. As a result of severe dementia, a picture of a knife and fork may no longer signify a dining room, instead the symbol may be misinterpreted, ignored or might in some cases even cause distress. The question we must ask is not whether
signage has value, but who it benefits, for how long, and at what stage in the progression of dementia it should be retired. Even murals, intended to create interest
or familiarity, can backfire. A painted shopfront with no goods to buy, or a window mural where the sun never sets, can confuse and frustrate. These are not just design flaws, but they are missed opportunities to create environments that meaningfully support the wellbeing of residents. Overall, research shows that traditional
approaches to interior design often fail to support people with advanced dementia and instead contribute to ‘environmental noise’ – a cluttered, overstimulating space that overwhelms rather than supports. It is evident then that the innovative
approach to design must seek to build an environment that is low arousal, calming and designed for the purpose of living and not deceiving. As a person living with dementia once said to me, ‘why is it when we are at our most vulnerable, you make us more confused by making us believe we are somewhere we are not’? Creating an imaginary world has the potential to cause confusion and offers little in the present to enhance wellbeing, which can set those living with dementia further back as they adjust to living in a care home.
A new look for dementia care We have responded to this challenge by developing Specialist Dementia Care Communities (SDCCs) at Darnley Court Care Home in Glasgow and Meadow Bank Care Home in Lancashire. These environments are designed around the principle of low arousal, and these spaces are intentionally calm, familiar, and free from unnecessary sensory stimulation. The SDCC living environment meets the
needs of those with advanced dementia and complex needs by having lower occupancy to create a calmer atmosphere, enhanced lighting, and low-arousal interiors to reduce sensory overload, and custom-designed living spaces along with dedicated therapy rooms to promote comfort. Offices, sluices, and treatment rooms
are visually ‘designed out’ by painting the doors the same colours as the adjacent walls
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www.thecarehomeenvironment.com October 2025
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