Living well with dementia at home: understanding the role of the home environment

This project aimed to explore the role of the home environment in dementia care and support, and it consists of two parts. The research starts with a systematic synthesis of international qualitative studies exploring the role of the home environment, architectural elements and strategies. From 11824 citations found in 12 databases, 40 qualitative studies representing nine countries, 653 informal carers, 372 people with dementia and 120 professionals were analysed using thematic synthesis. Findings indicated that: (a) Home, although an important place, can also be a place of tensions. (b) Home needs to remain individualised and flexible to accommodate life and health challenges and changes. (c) Adapting the physical space, objects and behaviour is necessary to facilitate quality of life. These findings offer evidence on a number of important architectural and design aspects that need to be taken into consideration to support community dementia care. The second part involved walking interviews with thirteen co-resident family carers to explore (a) the subjective and (b) the objective impact of their home, and were analysed thematically. Findings revealed that ‘home is everything’ for carers and has different meanings (‘home as a secure haven’, ‘home as a prison’) and great impact on carers (relocation versus staying in place but redefining their home). Data also revealed the impact of home as a site of care provision and highlighted important aspects of the architectural and interior environment, that when adapted can encourage independence and comfort at home. The unique challenges of dementia and the important home components (e.g. size, layout and accessibility) need to be taken under consideration to ensure future housing is dementia and caring friendly to correspond to the needs of our ageing society. Future carers will clearly benefit from the adaptability and hybridity of their homes.