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

Student thesis: Doctoral Thesis


The research presented in this thesis aims to explore the role of the home
environment in dementia care and support, drawing on two complementary
approaches. The thesis consists of three papers to offer evidence of the various
environmental aspects and strategies that explore environmental aspects in living with dementia at home. The first approach and paper presents a systematic review of international qualitative studies exploring people’s experiences and perceptions on the role of the home environment, environmental home elements and strategies. The second approach involved conducting in-depth walking interviews with thirteen co-resident carers. The interviews were analysed thematically and are presented in two papers reporting on (a) the subjective and (b) the objective impact of their home environment. Exploring both subjective and objective aspects provided a holistic way to synthesise the literature and understand participants’ experiences of their home environment. The main findings offer evidence on potential environmental barriers and facilitators and a number of important architectural and design aspects that need to be taken into consideration to support community dementia care. There is no universal solution in addressing dementia care. Family carers implemented a plethora of strategies and often adapted their home through trial and error. Barriers to implementing adaptations were around the carers’ scepticism about the use and need of environmental interventions, mistrust towards practitioners, financial difficulties, timing and property restrictions. The present study highlighted the need for educating carers on the dementia trajectory and available environmental strategies. The findings offer guidance to professionals in many areas (health and social care, architecture, interior design, policy making) and bring more light into areas that require further research. New strategies support carers in their own homes and design future housing solutions are needed. The walking interviews were helpful as the main data collection method in order to understand the interplay between the family carers and their home situation. It was also useful to draw upon a number of theories in order to interpret and refine the findings. Future research and services should be directed to enhance dementia and caring friendly home environments.
Date of AwardAug 2017
Original languageEnglish
SupervisorAlan Costall (Supervisor), John Crossland (Supervisor) & Rebecca Stores (Supervisor)

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