An Insight from Gibraltar Nursing Home on How Environment Plays an Important Role in Dementia Care

While approaches to dementia care have evolved significantly, in many care settings, when someone living with a Dementia or on a cognitive journey becomes distressed, the response can still focus on removing the person from the situation or redirecting them to a quieter environment. Sometimes, when behaviours escalate significantly, medication may also be used to help manage the distress.

However, modern dementia care places greater importance on understanding why a person may be feeling distressed and what may be leading them to express that distress through anger, aggression, anxiety or withdrawal. It begins by exploring personalised, non-pharmacological approaches first, recognising that behaviour is often a form of communication rather than something to simply manage.

This is something the team at Gibraltar Nursing Home see every day when supporting family members living with a Dementia. There is no single approach that works for everyone because every person, every life story and every moment is different. Rather than immediately changing the person, the team first considers what might be happening around them. What are they seeing, hearing or experiencing? Is there too much stimulation, or perhaps not enough? Is there something familiar that reflects who they are and the life they have lived? Something the team knows holds meaning through their identity or attachment to the people, places and experiences that matter to them? Only then do they ask: what might this person need right now?

Often, the answer can be found in the environment around them.

Why the Environment Matters

For people living with a Dementia, the spaces they move through every day can have a significant impact on how they feel. Rather than simply being places to walk from one room to another, hallways at Gibraltar Nursing Home are viewed as opportunities to support identity, strengthen attachment to familiar people, places and experiences, and encourage conversation.

Small details can make a meaningful difference. One example in Gibraltar Nursing Home is the way hallways are referred to as “streets”, helping create a more familiar environment when people step outside their own “front door”. Even something as simple as bunting along the streets may remind someone of community celebrations, street parties or neighbourhood events from earlier in life. Rather than simply decorating the space, these features encourage people to pause, notice, reminisce and engage with the world around them, turning everyday journeys through the home into meaningful moments.

This approach reflects the work of dementia care pioneer Thomas Kitwood, who identified identity as one of the fundamental psychological needs of people living with a Dementia. By creating surroundings that reflect a person’s life, interests and experiences, the environment can help support that identity and strengthen connections with the people, places and memories that remain meaningful.

Supporting Connection Through Everyday Spaces

It can also make everyday visits feel different. Imagine a grandchild who finds a traditional care home environment overwhelming or struggles to know how to interact during visits. Walking together through a hallway filled with interesting objects, familiar images or conversation prompts gives them something to notice, talk about and explore together. Instead of the focus being on sitting in one place, the environment itself becomes part of the shared experience.

Creating Meaningful Environments

Creating a supportive environment is about much more than how the home looks. It is about recognising that every picture, object and shared space has the potential to help someone feel more connected and more engaged with the world around them.

After all, good dementia care is not only about how people are supported. It is also about the environment that supports them every day.

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