Review Article| Volume 128, P10-16, October 2019

Download started.


Environmental design for dementia care - towards more meaningful experiences through design


      • (Systematic) reviews from the fields of assistive technology for dementia care and healing environments research show opportunities for environmental design for dementia care.
      • Insights from both fields could better inform the designers of dementia care environments.
      • A multidisciplinary and user-centred design approach might broaden opportunities for more meaningful environmental design for dementia care.


      Dementia is generally considered to be one of the most pressing societal issues now and in the years to come. Although insights from different disciplines have contributed to a better understanding of dementia and the development of interventions targeting dementia symptoms, there is a lack of integration of insights from these different perspectives for the purposes of design for dementia. The aim of this paper is to show how insights from environmental psychology and advances in technology can inform a user-centred multidisciplinary design approach. To this end, first a brief meta-review of (systematic) reviews from the fields of assistive technology for dementia care and healing environments research is presented, after which gaps and opportunities for a multidisciplinary design approach are identified. To illustrate what such an approach could look like, two exploratory case studies are presented in which technology-enhanced prototypes of an experience handrail (aimed at facilitating wayfinding by providing meaningful sensory experiences) and a virtual nature installation (aimed at providing relaxation and stimulating social engagement) were implemented at a Dutch care centre for people with dementia. Preliminary evaluations indicate that these designs contribute to the wellbeing of people with dementia and confirm the fruitfulness of the design approach presented in this paper. Furthermore, this approach may not only provide a means to optimize existing environments and enhance ease of living, but may also lead to novel solutions to the challenges people with dementia face on a day-to-day basis, and improve their quality of life.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Maturitas
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Prince M.
        • Bryce R.
        • Albanese E.
        • Wimo A.
        • Ribeiro W.
        • Ferri C.P.
        The global prevalence of dementia: a systematic review and meta-analysis.
        Alzheimer’s Dement. J. Alzheimer’s Assoc. 2013; 9: 63-75
        • American Psychiatric association
        Practice Guideline for the Treatment of Patients With Alzheimer’s Disease and Other Dementias.
        American Psychiatric Publishing, Washington, DC2007
        • Evans J.
        • Brown M.
        • Coughlan T.
        • Lawson G.
        • Craven M.P.
        A systematic review of dementia focused assistive technology.
        in: Kurosu M. Human-Computer Interaction: Interaction Technologies. Lecture Notes in Computer Science. Springer, 2015: 406-417
        • Ienca M.
        • Fabrice J.
        • Elger B.
        • Caon M.
        • Pappagallo A.
        • Kressig R.W.
        • Wangmo T.
        Intelligent assistive technology for Alzheimer’s disease and other dementias: a systematic review.
        J. Alzheimer Dis. 2017; 56: 1301-1340
        • Fleming R.
        • Sum S.
        Empirical studies on the effectiveness of assistive technology in the care of people with dementia: a systematic review.
        J. Assist. Technol. 2014; 8: 14-34
        • D’Onofrio G.
        • Sancarlo D.
        • Ricciardi F.
        • Panza F.
        • Seripa D.
        • Cavallo F.
        • Giuliani F.
        • Greco A.
        Information and communication technologies for the activities of daily living in older patients with dementia: a systematic review.
        J. Alzheimer Dis. 2017; 57: 927-935
        • Daly Lynn J.
        • Rondón-Sulbarán J.
        • Quinn E.
        • Ryan A.
        • McCormack B.
        • Martin S.
        A systematic review of electronic assistive technology within supporting living environments for people with dementia.
        Dementia. 2017; : 1
        • Marquardt G.
        • Büter K.
        • Motzek T.
        Impact of the design of the built environment on people with dementia: an evidence-based review.
        Health Environ. Res. Des. J. 2014; 9: 127-157
        • Soril L.J.J.
        • Leggett L.E.
        • Lorenzetti D.L.
        • Silvius J.
        • Robertson D.
        • Mansell L.
        • Holroyd-Leduc J.
        • Noseworthy T.W.
        • Clement F.M.
        Effective use of the built environment to manage behavioural and psychological symptoms of dementia: a systematic review.
        PLoS One. 2014; 9 (art. no. e115425)
        • Anderiesen H.
        • Scherder E.J.
        • Goossens R.H.
        • Sonneveld M.H.
        A systematic review – physical activity in dementia: the influence of the nursing home environment.
        Appl. Ergon. 2014; 45: 1678-1686
        • Chaudhury H.
        • Cooke H.A.
        • Cowie H.
        • Razaghi L.
        The influence of the physical environment on residents with dementia in long-term care settings: a review of the empirical literature.
        Gerontologist. 2018; 58
      1. LAUGH Project.
        2019 ((Accessed April 17 2019)
        • Schelle
        • Gomez Naranjo C.
        • ten Bhömer M.
        • Tomico O.
        • Wensveen S.
        Tactile dialogues: personalization of vibrotactile behavior to trigger interpersonal communication.
        Proceedings of the Ninth International Conference on Tangible, Embedded, and Embodied Interaction (TEI '15). 2015; : 637-642
        • Keng S.L.
        • Smoki M.J.
        • Robins C.S.
        Effects of mindfulness on psychological health: a review of empirical studies.
        Clin. Psychol. Rev. 2011; 31: 1041-1056
        • Rejeski W.J.
        • Gauvin L.
        The embodied and relational nature of the mind: implications for clinical interventions in aging individuals and populations.
        Clin. Interv. Aging. 2013; 8: 657-665
        • Lin Q.
        • Zhang D.
        • Chen L.
        • Ni H.
        • Zhou X.
        Managing elders’ wandering behavior using sensors-based solutions: a survey.
        Int. J. Gerontol. 2014; 8: 49-55
        • Algase D.L.
        • Son G.R.
        • Beattie E.
        • Song J.A.
        • Leitsch S.
        • Yao L.
        The interrelatedness of wandering and wayfinding in a community sample of persons with dementia.
        Dement. Geriatr. Cogn. Disord. 2004; 17: 231-239
        • Marquardt G.
        Wayfinding for people with dementia: a review of the role of architectural design.
        Health Environ. Res. Des. J. 2011; 4: 75-90
        • Namazi K.H.
        • Johnson B.D.
        Physical environmental cues to reduce the problems of incontinence in Alzheimer’s disease units.
        Am. J. Alzheimers Dis. Other Demen. 1991; 6: 22-28
        • Day K.
        • Carreon D.
        • Stump C.
        The therapeutic design of environments for people with dementia: a review of the empirical research.
        Gerontologist. 2000; 40: 397-416
        • Marquardt G.
        • Schmieg P.
        Dementia-friendly architecture: environments that facilitate wayfinding in nursing homes.
        Am. J. Alzheimers Dis. Other Demen. 2009; 24: 333-340
        • Motzek T.
        • Bueter K.
        • Marquardt G.
        Investigation of eligible picture categories for use as Environmental cues in dementia-sensitive environments.
        Health Environ. Res. Des. J. 2017; 10: 64-73
        • Baker R.
        • Bell S.
        • Baker E.
        • Gibson S.
        • Holloway J.
        • Pearce R.
        • Dowling Z.
        • Thomas P.
        • Assey J.
        • Wareing L.
        A randomized controlled trial of the effects of multi-sensory stimulation (MSS) for people with Dementia.
        Br. J. Clin. Psychol. 2001; 40: 81-96
        • Freiherr J.
        • Lundström J.N.
        • Habel U.
        • Reetz K.
        Multisensory integration mechanisms during aging.
        Front. Hum. Neurosci. 2013; 7: 1-5
        • Keniger L.E.
        • Gaston K.J.
        • Irvine K.N.
        • Fuller R.A.
        What are the benefits of interacting with nature.
        Int. J. Environ. Res. Public Health. 2013; 10: 913-935
        • Flynn D.
        • Schaik P.V.
        • Blackman T.
        • Femcott C.
        • Hobbs B.
        • Calderon C.
        Developing a virtual reality-based methodology for people with dementia: a feasibility study.
        Cyberpsychol. Behav. 2003; 6: 591-611
        • Garcia L.
        • Kartolo A.
        • Methot-Curtis E.
        A discussion of the use of virtual reality in dementia.
        in: Eichenberg Christiane Virtual Reality in Psychological, Medical and Pedagogical Applications. InTech, 2012
        • Moyle W.
        • Jones C.
        • Dwan T.
        • Petrovich T.
        Effectiveness of a virtual reality forest on people with dementia: a mixed methods pilot study.
        Gerontologist. 2018; 58: 478-487
        • Whear R.
        • Thompson Coon J.
        • Bethel A.
        • Abbott R.
        • Stein K.
        • Garside R.
        What is the impact of using outdoor spaces such as gardens on the physical and mental well-being of those with dementia? A systematic review of quantitative and qualitative evidence.
        JAMDA – J. Am. Med. Directors Assoc. 2014; 15: 697-705
        • Kaplan R.
        • Kaplan S.
        The Experience of Nature: a Psychological Perspective.
        Cambridge University Press, New York1989
        • Fredrickson L.M.
        • Anderson D.H.
        A qualitative exploration of the wilderness experience as a source of spiritual inspiration.
        J. Environ. Psychol. 1999; 19: 21-39
        • Okken V.S.
        • Van Rompay T.J.L.
        • Pruyn A.
        • van Rompay Thomas
        Room to move: on spatial constraints and self-disclosure during intimate conversations.
        Environ. Behav. 2013; 45: 737-760
        • Okken V.S.
        • Van Rompay T.J.L.
        • Pruyn A.T.H.
        When the world is closing in. Effects of perceived room brightness and communicated threat during patient-physician interaction.
        Health Environ. Res. Des. J. 2013; 7: 35-51
        • Van Rompay T.J.L.
        • Jol T.
        Wild and free: unpredictability and spaciousness as predictors of creative performance.
        J. Environ. Psychol. 2016; 48: 140-148
        • Piff P.K.
        • Dietze P.
        • Feinberg M.
        • Stancato D.M.
        • Keltner D.
        Awe, the small self, and prosocial behavior.
        J. Pers. Soc. Psychol. 2015; 108: 883-899
        • Campo M.
        • Chaudhury H.
        Informal social interaction among residents with dementia in special care units: exploring the role of the physical and social environments.
        Dementia. 2011; 11: 401-423
        • Greenberg S.
        • Marquardt N.
        • Ballendat T.
        • Diaz-Marino R.
        • Wang M.
        Proxemic interactions: the new ubicomp?.
        Interactions. 2011; 18: 42-50