The physical environment is important for someone with dementia. It can help them stay safe, comfortable and as independent as possible. A dementia-friendly environment can support the person in getting their bearings at home and help them to participate in and enjoy everyday activities.

Modifications to a personal living space can help the person with problems like memory loss, disorientation, coordination and mobility. Aids are also available to improve their safety and security.

Changes are often very simple, but it’s important to remember that dementia affects everyone in different ways. Only make changes that help with the person’s individual challenges — any unnecessary changes may add to their confusion.

Creating a calm and safe environment

Indoor areas

A soothing, calming atmosphere is helpful for everybody. For a person with dementia, it can minimise confusion and help them to concentrate and rest. Ideally, the environment should also bring back happy memories.

Consider the household routine, the noise levels, the lighting, the effects of mirrors, the state of the bedroom, and even the colours and patterns used through the house.

Many people with dementia find noise annoying, so you might need to turn the television and radio off more often. Try to eliminate shadows, glare and reflections that a person with dementia may find frightening.

Some safety tips to consider include:

• making sure the floors are not slippery, avoiding loose carpets and other trip hazards and not having too much clutter. A well-lit house will also reduce the risk of falls.
• checking the safety of locks, floors, doors, windows, stairs, verandahs and balconies to see if they need modifying
• thinking about heating, cooling, lighting, electricity and gas — are they safe and easy to use?
• putting signs on taps to show which is hot and which is cold
• installing sensor lights or lights with built-in timers if the person wanders at night
• installing handrails on both sides of stairs
• marking glass doors and windows with masking tape

It is also important to keep the home at a comfortable temperature because the person with dementia might not be able to judge the temperature themselves, or remember how to adjust their clothes if they are too hot or too cold.

Outdoor areas

Outdoor areas should also be calming, relaxing and safe for a person with dementia to walk around in. For example, you could put in a raised garden bed which they could plant out and tend to. Put timers on hoses to water the garden without the person needing to remember to turn the tap off when they are finished.

Pets are an important source of comfort and companionship for many people with dementia, but it is very important to ensure the animal is being cared for properly and cannot escape.

You may need to fix and lock gates. You may even need to put up fences, although do this carefully since a new fence can make a person with dementia feel trapped.

Consider removing obstacles from paths, hiding garbage or compost bins, removing poisonous or spiky plants, and lock away any dangerous chemicals in the garden shed or garage, if there is one.

Managing everyday activities

Kitchens

Kitchens should be safe and allow the person to use it as independently as possible for as long as possible.

Try to keep everything familiar — do not rearrange too many things. If an appliance needs replacing, try to get the same make and model if it is safe to do so. Appliances with built-in safety features, such as a kettle with an automatic cut-off switch, are a good idea. Make sure electrical cords are away from water or heating sources.

It may help to label cupboards to make it easy to find things, or keep commonly used items on the bench.

If the person can no longer use the kitchen safely, you may need to install a master cut-off switch for the stove, and take away any sharp knives, medicines and toxic products. Reduce the temperature of water from the hot water tap and keep a list of contact names and numbers in large print placed by the telephone.

Living rooms

Living rooms are a good place to show photos and ornaments that trigger happy memories and reinforce the person’s sense of identity.

You might need to remove some clutter and rearrange furniture to create walkways. Keep in mind that some people with dementia use furnishings for support to help them walk.

It is important to have a sturdy and comfortable armchair that is easy for the person with dementia to get in and out of. It also needs to be easy and safe for family and carers who might need to lift the person in and out of the chair. Ideally, the chair should be waterproof in case of incontinence.

You may need to remove any unstable furniture, such as rocking chairs or chairs on wheels. You might also need to cover sharp edges and stick down loose floor coverings and rugs.

Low coffee tables and other protruding furniture are easy to trip over and may need to be removed. You might also need to lock some cupboards and drawers and put covers on the power points.

Sharp objects such as scissors or letter openers, and any precious but breakable ornaments, should be removed. You may need to remove or cover wallpaper, curtains or upholstery if the person with dementia mistakes the patterns for objects or insects.

Bedrooms

Bedrooms should be set up to support a person with dementia to get in and out of their own bed, and to sleep there for as long as possible. It should also be as familiar as possible.

You might need to raise the bed height and use a firm mattress to help the person get on and off their bed by themselves. If you want to use lights to make it easy to find the toilet at night, try soft night lights.

Remove any loose rugs and mats as these are easy to trip on. You may need to rearrange furniture to make sure there is a clear walking path to and from the bed.

Bathrooms

Any changes you make to bathrooms and toilets should make those rooms safe and should help the person be as independent as they can.

It is important to respect the person’s privacy as much as possible. You might also have to make it easy to attend to their needs for them.

Consider labelling the toilet and bathroom doors, installing grab rails by the bath and using non-slip rubber mats. You might also need to lock away toilet cleaning products, personal care products, shavers and hair dryers.

You may need to remove locks so the person with dementia cannot lock themself in, or modify the toilet door so it can be opened outwards for easy carer access.

Personal comfort is also important. You might consider installing a safe heater in the bathroom to make it more comfortable in winter.

Laundries

Laundries should be as simple and as familiar as possible. If you need to make changes, you might keep the benches uncluttered or label the cupboards to make it easy to find things.

If the person with dementia can no longer use the laundry safely, consider taking away cleaning products and any poisons, storing the iron in a locked cupboard and keeping the washing machine and drier turned off at the wall. Make sure electrical connections are away from possible contact with water or heating sources.

Supporting memory

Memory loss is common in people with dementia, and can be one of the most distressing symptoms. There are many ways you can assist someone to remember things and find their way around.

Think about what types of things the person with dementia usually forgets. This will help you decide what memory aids to use.

For example, if they have trouble remembering to do jobs, then place a whiteboard in a central location, such as near the fridge, and write daily task lists on it. If they lose their keys often, put the keys in the same place each day, and put reminders up in other parts of the house.

Putting photos and familiar objects around the home helps the person with dementia stay connected with their past.

Using easy-to-read clocks or large calendars around the house helps them stay connected with the present.

Supportive aids

Supportive aids are technology or devices that can help someone with dementia to manage their symptoms. They range from simple equipment, such as a touch lamp, to sophisticated technology.

Supportive aids can reduce the risk of accidents, support a person’s independence and help to keep them at home for longer.

Some supportive aids to consider are:

• medication reminders and blister packs
• phone reminders, alarms and audio messages
• item finders (alarms attached to items such as keys)
• sensory and therapeutic supports, such as dolls or mechanical pets
• monitoring systems that use satellite positioning to locate someone when they are lost

Resources and support

• Call the National Dementia Helpline on 1800 100 500.
• Dementia Australia has help sheets that address the most commonly raised issues in preparing a dementia-friendly environment.
• The Dementia Enabling Environments website provides information on orientation and wayfinding.