Dementia
Supporting dementia and complex needs through environment
Thoughtful, person-centred environments can reduce distress, support independence and help people living with complex dementia stay connected to their identity and everyday life, writes Rafaella Faccio.
For people living with a dementia or more complex cognitive and emotional needs, the environment around them can significantly influence how they feel, communicate and experience daily life. Noise levels, lighting, colour, layout, activity, smells and familiarity all shape how a person responds to the world around them, particularly as verbal communication becomes more difficult. Within dementia and social care, there is
increasing recognition that the environment plays an active role in supporting wellbeing. More providers are rethinking how care settings are designed and adapted to support orientation, reduce distress, encourage meaningful engagement and help people maintain a sense of identity and familiarity. This shift reflects a broader movement away from institutional models of care
and toward approaches that are more person-led, sensory-aware and grounded in continuation of life.
Moving away from institutional models of care Historically, care environments were often built primarily around operational efficiency and risk management. In many settings, this resulted in spaces that could feel clinical, overstimulating or disorientating for people living with dementia or cognitive impairment. Long institutional-style corridors, centralised routines, bright clinical lighting and limited access to meaningful activities were common features across many settings. While these environments may have
supported oversight and task-based care delivery, they did not always support the
emotional and psychological wellbeing of people living with a dementia.
Behaviour as communication Research and practice within dementia care increasingly recognise that behaviour is often a form of communication rather than something to be controlled. Distress, agitation, repetitive movement, withdrawal or attempts to leave a building may all represent an unmet need, confusion, fear, boredom, or a loss of familiarity and purpose. The work of British psychologist and
gerentologist Thomas Kitwood during the 1990s helped shape modern person- centred dementia care by emphasising the importance of identity, attachment, inclusion, occupation and comfort. This philosophy continues to influence many care
October 2026
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