Dementia


providers today, particularly as the sector supports increasing numbers of people living with more complex presentations of dementia alongside mental health or neurological conditions and behaviours that may previously have resulted in placement breakdowns. Guidance from the National Institute for


Health and Care Excellence (NICHR) also supports non-pharmacological approaches as a first response to distress wherever possible, recognising the importance of understanding what may sit behind a person’s behaviour rather than relying solely on medication-based interventions. For care providers, this often means


reconsidering not only how care is delivered, but how environments themselves may either contribute to or reduce distress. This is an approach strongly reflected within the philosophy at North Devon Heanton Nursing Home


The yellow wall In practice, relatively small environmental changes can have a significant impact. Colour, for example, can support orientation and recognition. Contrasting doors, memory points, personalised bedrooms and familiar objects help to navigate surroundings. Reducing excessive noise and creating household-style living areas can lessen sensory overload, while access to gardens, natural light and purposeful occupation supports emotional wellbeing. The impact environmental


changes can have become particularly evident through something as seemingly simple as the colour yellow.


A gentleman living at one home has always loved the colour yellow and, during time spent outside in the garden, he expressed that he wanted to paint a wall in his beloved colour. Rather than dismissing the idea or viewing it as impractical or costly, the team supported him to realise his ambition. Paint and brushes were bought, and the


resident was encouraged to lead the project himself. Being involved in this project gave him a sense of independence and purpose, and helped him to reconnect with his environment while reducing some of the frustration and distress he had previously experienced at other placements. What initially appeared to be a simple decorating hobby quickly became something far more important. There was visible purpose inin the activity, meaning he was not being occupied for the sake of it; he was actively engaged in something that reflected identity. He also decided he wanted


more yellow and chose to paint his bedroom door as well! Importantly, the team felt empowered to support this without needing to seek permission. Their training


and autonomy allowed them to respond in a person-led way, recognising the value the experience held for him rather than focusing on restriction or task-based care. This reflects the importance of bespoke social care training that supports teams to think beyond process alone and confidently respond to the individual person in front of them. The door later became an important


40 www.thecarehomeenvironment.com October 2026


orientation point for him and at times when confusion increased, the bright yellow door helped him identify his room more independently. While simple, the adaptation reflected key


principles within dementia care: identity, purpose and supportive design over control. Environment can have a huge impact on


how someone experiences their day. Small details that may not appear significant to others can help reduce confusion and avoid unnecessary triggers and support a person to feel more independent and connected to who they are, ultimately resulting in a safer and more supportive environment.


Increasing complexity across the sector For providers supporting people with complex needs, these approaches are no longer viewed as optional additions to care, but as an essential part of it. Across the sector, homes are increasingly


supporting people with needs once considered too complex for traditional residential environments. At the same time, there remains a shortage of care settings specifically equipped for more complex cognitive and behavioural needs. As people enter care later in life with increasingly advanced presentations, providers are under growing pressure to adapt environments, with some individuals moving between multiple homes or even out of county due to a lack of suitable placements.


Household models As a result, some providers are moving toward smaller household models and more adaptable living environments. Rather than expecting people to fit around the building,


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