At home with dementia
This Help Sheet discusses the importance of ensuring that the home environment of
a person with dementia is as useful and safe as possible. It includes information
about ways to approach problems that may arise in the environment when caring
for someone with dementia.
It is widely recognised that a building and an
environment can have a significant effect on a
person with dementia. It can support them or
it can hasten their deterioration.
A person’s home, because it is their home, can
usually provide a far greater level of
environmental support to a person with
dementia than even the newest and best
designed nursing home or hostel. But
sometimes the layout, appliances and
amenities of a person’s own home may have to
be modified to make them useable or safe for
a person with dementia.
The whole reason for making changes to an
environment to support someone with
dementia is different from modifying an
environment for someone with a physical
disability. Whereas a person with a physical
disability needs modifications to gain physical
access to their environment, a person with
dementia often needs modifications to help
them understand their environment. The
purpose of home modifications for someone
with dementia is usually to compensate for
cognitive deterioration. They may also
become frail or they may have a co-existing
physical or sensory disability, and
modifications relating to physical access will
also then become relevant.
Another characteristic of modifying the
environment for people with dementia is that
the modifications will often be temporary. A
solution today may not work tomorrow as the
person’s dementia progresses. It is necessary
to continually assess the environmental needs
Your Alzheimer’s Association can
be contacted directly on the:
Dementia Helpline
Freecall 1800 639 331
the environment and dementia
of the person with dementia and to make
changes accordingly to support them.
The best living environment
The best living environment for a person with
dementia is one which helps them to be as
independent and happy as possible. Home
should:
• Be familiar
• Be orientating - helping the person to
know where they are or find where they
want to go
• Support independence - by compensating
for skills which are deteriorating or lost
• Engage participation in tasks and activities
rather than promoting passivity and
dependence
• Promote confidence and self esteem - by
helping them to succeed rather than fail
with the everyday tasks of living
• Reinforce the person’s sense of identity -
by stimulating their memory
• Be physically and psychologically
comfortable - with a comfortable
temperature, good lighting, the right level
of stimulation and minimal stress
• Promote safety for the person with
dementia and make caring tasks safer and
easier for the carer - achieving a balance
between safety, security and independence
The overall aim of home modifications for
someone with dementia is to make it possible
for them to remain living at home.
Each Australian State and Territory has an
Alzheimer’s Association which can provide
further information, counselling and support for
carers of people with dementia.
Principles of problem solving Steps to problem solving
Solving problems involves continual Many carers get to be very good at
assessment and planning. The following approaching problems in a creative and
principles should guide any changes to the flexible way. But some problems are complex
environment of a person with dementia: and it can be difficult to decide what is the
actual problem and what is an effect of the
• Involve the person with dementia in problem. Working through the following
identifying problems and deciding on sequence may help carers to understand and
changes to their environment, if at all solve a particular problem.
possible
• Ensure that modifications suit each • What is the problem?
individual • Whose problem is it?
• Respond to specific problems. Don’t • What are the likely causes of the problem?
introduce standard modifications • What skills has the person lost in relation
• Change as little as possible. Retain the to this problem?
familiar • Don’t rush in to solve the problem
• Build on strengths and maximise • What are the possible solutions?
autonomy
• Assess each possible solution
• Try simple solutions first
• Do you need outside help with problem
• Recycle ideas. Keep trying and even solving?
retrying old strategies
• Do you need outside help with equipment
• Ensure that modifications are home-like or modifications?
and dignified
• Use trial and error
• Changes should be era and culture-
• Recycle ideas
appropriate
• Start again if needed
• Weigh up the risks and try to achieve a
balance between safety and autonomy
• Ensure that carers and service providers Further help
have a safe working environment
This Help Sheet is one of a series of
sheets that summarises some of the
information in the manual At home with
dementia. The manual also contains
product information. It is available by
contacting the NSW Ageing and
Disability Department (ADD) on (02)
9367 6822 or from ADD’s website at
www.add.nsw.gov.au
A range of books, videos and Help
Sheets are available through your State
or Territory Alzheimer’s Association by
contacting the Dementia Helpline on
1800 639 331
These Help Sheets can be obtained on
the internet at www.alzvic.asn.au

The content and funding for the production of this sheet were provided by the NSW Ageing and Disability
Department under the NSW Action Plan on Dementia.

This publication provides a general summary only of the subject matter covered. Any person with
dementia or a carer for a person with dementia should seek professional advice about the specific case. Sheet 1
The Alzheimer’s Associations in Australia are not liable for any error or omission in this publication, April 2000
even if negligent.

© 2000 Alzheimer’s Association Australia