Ageing in Place with Dementia: Modifications and Design Innovations for the Home — A Scoping Review

Background: Most people living with dementia prefer to remain in their own homes for as long as possible. The domestic environment plays a critical role in supporting safety, independence, and wellbeing, yet cognitive and functional changes associated with dementia can make ordinary homes increasingly challenging. Design innovations—including architectural modifications, environmental design strategies, and assistive technologies—have the potential to support ageing in place, but the evidence base is diverse and fragmented across disciplines. Objective: To map and synthesise existing evidence on home-based design innovations that support ageing in place for people living with dementia, and to identify key themes, barriers, and gaps to inform practice, policy, and future research. Methods: A scoping review was conducted using pre-specified Population–Concept–Context criteria (Population: people living with dementia; Concept: environmental, architectural, and design-related interventions, including assistive technologies; Context: private domestic dwellings). Thirty-five full-text publications were reviewed in full. Data were charted into a structured extraction table and analysed using design-focused thematic synthesis. Results: Twenty-three studies met the inclusion criteria, comprising empirical intervention studies, qualitative and mixed-methods research, scoping and systematic reviews, and design-led research. The strongest and most consistent evidence related to low-cost home modifications were associated with reduced falls risk and improved usability, in particular bathroom adaptations, grab rails, lighting improvements, and circulation safety.. Assistive and smart-home technologies showed potential benefits for safety and daily functioning, but evidence was heterogeneous and highly dependent on usability, personalisation, and support. Cross-cutting themes included balancing safety with autonomy, preserving familiarity and “home-ness”, cognitive accessibility, professional involvement, and implementation barriers such as cost, access to services, and workforce capacity. Conclusions: Evidence supports prioritising practical, low-cost, and adaptable home modifications to enable people with dementia to age in place safely and with dignity. While digital and smart-home technologies are promising, further standardised evaluation and economic analysis are required. Policy and practice should focus on improving early access to home assessment, embedding dementia-inclusive design in housing systems, and supporting scalable demonstration and implementation initiatives.