This page is part of PrimeCarers' guide to dementia care. It answers one question: what is worth changing in a house when somebody living in it has dementia. Equipment and adaptations in general sit on our guide to home adaptations that reduce the need for care, so this page keeps to what is particular to dementia.
The short answer
- Light is the single biggest changeOlder eyes take in much less light, and dark corners are where a coat on a door becomes a person.
- Contrast is what makes a thing findableA dark toilet seat on a white pan, and food on a plate that is not the colour of the food.
- Much of what gets called a hallucination is a misreadingThe Alzheimer's Society says people with dementia are often thought to be hallucinating when they are mistaken about what they have seen.
- Leave their own things where they areFamiliar surroundings are what a person navigates by. Change one thing at a time.
Checked against the NHS, the Alzheimer's Society, NHS England design guidance and the Care Act 2014, September 2026. Prices are what carers on PrimeCarers charge, with our fee included.
Where to start
Make the house easier to understand, not emptier
Much of the advice about dementia and the home is a list of things to remove, and a family who follow it end up with a bare house their relative recognises less than the one before. The Alzheimer's Society puts it the other way round: keeping the layout of a home familiar is helpful, because finding your way around is easier if you recognise your surroundings.
What helps
- Making one change at a time and giving it a fortnight before the next
- Keeping rooms in the layout your relative already knows
- Leaving their chair, their photographs and the things they use every day where they are
- Asking them what they are finding hard, for as long as they can tell you
- Writing down what you changed, so a carer or another relative can put it back
What tends to make things harder
- Clearing the house of ornaments and photographs in a single weekend
- Moving furniture to open a room up, which takes away the landmarks they steer by
- Buying equipment before anybody has watched them use the room
- Redecorating in soft matching tones, which removes the contrast they depend on
- Taking over a task they can still do because it would be quicker to do it for them
You will be doing this while your relative is still living there, and somebody who has always kept their own home may take a rearranged kitchen as an accusation. The changes that work are also not the ones that look like safety: painting a toilet seat a strong colour does more than a second grab rail.
Light
Light is the change that does the most
Vision changes with age whether or not somebody has dementia. Less light reaches the back of the eye, contrast is harder to pick out, and adjusting between a bright room and a dark one takes longer. Dementia then makes it harder to work out what has been seen. The Alzheimer's Society says it plainly: dark areas and shadows can be confusing, and you may need a lot more light.
Let the daylight in first
Free, this morning
Add lamps, and use the brightest bulb the fitting takes
Cheap, this week
Take the glare out while you add the light
The part people miss
Light the route to the toilet, not the bedroom
For the night
A house is not a hospital, and a professional standard still gives a sense of the gap. NHS England's design guidance for dementia-friendly health and social care buildings says lighting levels should be increased to give older people adequate vision, and that a minimum of 300 lux should be considered. A sitting room lit by one overhead bulb is well below that. If the difficulty is worst as the afternoon light goes, read what sundowning is and what helps. A dementia clock works better in a well-lit room.
Contrast
Contrast is what makes a thing findable
Contrast sensitivity, the ability to tell one surface from another when the colours are close, is one of the first parts of vision to weaken. A white toilet seat on a white pan in a white bathroom gives the eye almost nothing to catch. NHS England asks for more than 30 points of difference in light reflectance between adjacent critical surfaces in care buildings, which means the important things should stand out.
| What to change it to | What that makes possible | |
|---|---|---|
| A white toilet seat on a white pan | A seat in a strong colour, with towels and a roll holder that contrast with the wall | Using the toilet without having to ask, which people mind losing most |
| Food on a plate the same colour as the food | Coloured crockery that contrasts with the meal and with the tablecloth | Seeing where the food is and how much is left, so more of it gets eaten |
| A white light switch on a white wall | Switches and sockets in a colour that stands out from the wall behind them | Putting a light on without hunting along the wall in the dark |
| A handrail the same colour as the staircase | A handrail that stands out, and bright tape or nosing on every step edge | Seeing where one step ends and the next begins on the way down |
| A bathroom door that matches every other door | The doors they need made to stand out, the ones they do not left to blend in | Finding the bathroom at night, and not being drawn to the cellar door |
A white toilet seat on a white pan
- What to change it to
- A seat in a strong colour, with towels and a roll holder that contrast with the wall
- What that makes possible
- Using the toilet without having to ask, which people mind losing most
Food on a plate the same colour as the food
- What to change it to
- Coloured crockery that contrasts with the meal and with the tablecloth
- What that makes possible
- Seeing where the food is and how much is left, so more of it gets eaten
A white light switch on a white wall
- What to change it to
- Switches and sockets in a colour that stands out from the wall behind them
- What that makes possible
- Putting a light on without hunting along the wall in the dark
A handrail the same colour as the staircase
- What to change it to
- A handrail that stands out, and bright tape or nosing on every step edge
- What that makes possible
- Seeing where one step ends and the next begins on the way down
A bathroom door that matches every other door
- What to change it to
- The doors they need made to stand out, the ones they do not left to blend in
- What that makes possible
- Finding the bathroom at night, and not being drawn to the cellar door
Contrast advice from the NHS guidance on a dementia-friendly home and the Alzheimer's Society. The 30-point figure is from NHS England Health Building Note 08-02, written for care buildings rather than houses.
Plain beats patterned, so a strong colour is not the same as a busy one. The NHS also advises avoiding colours that can be mistaken for real things, naming green for grass and blue for water.
Floors, mirrors, noise
Floors that read as holes, mirrors at dusk, and a television nobody is watching
These three are rarely thought of, and all three are free to put right. Go round the house at the hour the trouble happens, and look at each room from your relative's chair rather than the doorway.
Walk the house and look for these
0 of 8 ticked
Floors and mats
Mirrors and reflections
Noise
If any of this is showing up as shouting or pushing away, aggression and agitation in dementia sets out what to rule out first, and how to deal with elderly falls covers what happens after a fall.
Room by room
What to change in each room, and what to leave alone
The third column is the one to read twice. Every room has something in it that should not be touched, because it tells your relative where they are and whose house this is.
The hall, the stairs and the front door
What can be misread here
A dark doormat can look like a hole in the floor, and stair edges that all look alike are hard to judge on the way down. A hall is often the darkest part of the house and the one nobody thinks to light.
The change worth making
Take up loose mats, mark every step edge with bright tape, paint or stair nosing, and fit a handrail in a colour that stands out from the wall. Put a lamp or a sensor light in the hall and keep a torch by the bed.
What to leave exactly as it is
The coat hooks, the hall table and whatever has always sat on it. These are the landmarks somebody uses to work out where they are when they come out of a room.
The living room
What can be misread here
Patterned carpets and striped upholstery can look textured or deeper than they are. At dusk, a window with the lamps on behind it turns into a mirror with a stranger in it.
The change worth making
Plain matt flooring in a colour that contrasts with the walls, a chair with arms in a colour that stands out, lamps on before the light goes, and the curtains closed at dusk. Turn the television off when nobody is watching it.
What to leave exactly as it is
The chair they always sit in, in the place it has always been, and the photographs and ornaments on the shelves. Familiar things in sight are what make a room theirs.
The kitchen
What can be misread here
Behind a cupboard door, a thing stops existing. Tins and packets in a cupboard are found by memory, and that is the memory going first.
The change worth making
Take the doors off one or two cupboards, or fit clear fronts, so the contents are in sight. Label cupboards and jars with a picture and a word. Use tea towels and cloths that stand out from the worktop, and coloured crockery that contrasts with the food.
What to leave exactly as it is
Where things live. Moving the tea and the kettle to a more sensible cupboard undoes years of knowing where they are, so light the cupboard rather than rearrange it.
The bathroom
What can be misread here
A white seat on a white pan in a white room has almost nothing to see. A bin or a laundry basket can be taken for a toilet, and a mirror over the basin can be taken for another person.
The change worth making
A toilet seat in a strong colour, with towels and a toilet roll holder that contrast with the wall. A sign on the door with the word and a picture of a toilet, and the door left open. A light left on or a sensor light for the night.
What to leave exactly as it is
Their own soap, flannel and towel. Bathing is the task people mind most about, and a bathroom that smells and feels like theirs makes accepting help easier.
The bedroom
What can be misread here
A wardrobe mirror facing the bed puts somebody in the room at three in the morning. Clothes in a closed wardrobe are as good as gone.
The change worth making
Cover or move the mirror if it causes distress. Bed linen in a plain colour that contrasts with the floor and the walls, one set of clothes left out in order, and a clock that says whether it is morning or night.
What to leave exactly as it is
The bed where it is, and the things on the bedside table. Dark enough to sleep matters here, so light the route to the bathroom rather than the bedroom itself.
Drawn from the Alzheimer’s Society booklet on keeping safe and independent at home and the NHS guidance on a dementia-friendly home. Make one change at a time and give it a fortnight, because the room your relative already knows is worth more than the room a checklist would produce.
Signs and labels deserve a word of their own. Use a word and a picture together rather than a word alone, because reading tends to go before recognising a picture does, and hang signs slightly lower than feels natural, as the NHS advises, because older people tend to look downwards. A sign saying toilet, with a picture, on the bathroom door, and the door left open, does more at three in the morning than anything you can buy. Bathing and toileting an elderly parent covers the washing.
The front door is the one change with rules attached. A lock your relative cannot open is not a do-it-yourself decision once they can no longer agree to it, because restricting somebody's freedom to leave their own home is a legal question, and the Alzheimer's Society is clear that a person with dementia should never be locked in on their own. What to do when someone with dementia keeps leaving the house goes through the gentler measures and what the law allows. Painting the front door a bright colour with a large number helps a person find their way back to it.
Who pays
The assessment to ask for, and what a council should provide free
Much of this costs nothing. For the rest there is a route through the council, and it starts with an assessment that is free to everybody whatever their savings.
- 1
Ask the council for a needs assessment
Free, and not means-testedUnder section 9 of the Care Act 2014 a council must assess an adult who appears to need care and support, whatever their income or savings. Ask for an occupational therapist to look at the house as part of it. They can visit, watch your relative use each room and recommend what would help. - 2
Take the aids and small adaptations that come free
Anything costing £1,000 or lessRegulation 3 of the Care and Support (Charging and Assessment of Resources) Regulations 2014 says a council must not charge for community equipment, meaning aids and minor adaptations, and defines a minor adaptation as one costing £1,000 or less. Grab rails, a raised toilet seat and stair rails sit inside that limit. - 3
Apply for a Disabled Facilities Grant for bigger jobs
Means-tested, through the councilA level-access shower, a downstairs toilet or a stairlift goes through a Disabled Facilities Grant, which the council administers and which takes account of household income and savings. The amounts are on our home adaptations guide. - 4
Work out whether you also need somebody in the house
Alongside the changesChanges to the house help a person manage what they can still do. They do not cover the morning wash or the hours somebody should not be alone. Visits are £18 to £25 an hour with our fee included, against £28 to £35 at an agency, and live-in care starts at £1,050 a week.
Funding for care is a separate question from funding for the house. Local authority funding explains the means test, and what care for dementia costs sets out the money over a longer period.
If you want somebody in the house while the changes bed in, you can search for carers near you and compare their rates, dementia experience and reviews without paying anything or booking anybody. Every carer has an online interview before they appear, and their identity, right to work and enhanced DBS on the Update Service are checked. Carers are self-employed and are insured while they work. Skills, training and the references on a profile are for you to check.
Tell a carer what you have changed and why, on the first day. Somebody who knows the mirror is covered on purpose and that the lamps go on at four will keep it going. Either side can end an hourly arrangement on 48 hours' notice, so two or three mornings a week is a reasonable start.
Questions
Questions families ask about the house
Start with light, then contrast, then the floors and the reflections. All of those add information rather than remove belongings. The Alzheimer's Society says keeping the layout of a home familiar is helpful, because finding your way around is easier if you recognise your surroundings. Change one thing at a time, and leave their chair and their photographs alone.
Any strong colour that stands out from the pan, the wall and the floor. Red and dark blue are common choices. The NHS lists a toilet seat in a contrasting colour to the rest of the bathroom among its recommendations, and the Alzheimer's Society suggests the same for towels and the toilet roll holder.
Look at what she may be seeing before you decide it is a hallucination. A mirror, a lit window that has turned into a mirror at dusk, a dark television screen or a coat on the back of a door will all do it. The Alzheimer's Society says people with dementia are often thought to be hallucinating when they are mistaken about what they have seen. Cover the mirror, close the curtains before the light goes, and light the dark corners. If it continues, tell the GP what you have ruled out.
If it is causing trouble, yes. Patterns and stripes can make a floor look textured or deeper than it is, which the Alzheimer's Society names as a cause of falls, and a busy pattern is a common reason somebody reports insects on the floor. Plain matt flooring in a colour that contrasts with the walls is what the NHS and the Alzheimer's Society both suggest. A plain runner laid over it is a cheap way to test that first.
Not as a routine, and not while he is on his own. The Alzheimer's Society says a person with dementia should never be locked in alone, because of fire and falls. Once somebody can no longer agree to it, a lock they cannot open restricts their liberty, and social services should be involved rather than the family deciding alone. Wandering and leaving the house covers what to try first.
A needs assessment from the council is free to everybody under section 9 of the Care Act 2014, whatever your relative's income or savings. Aids and minor adaptations costing £1,000 or less must be provided without charge under regulation 3 of the Care and Support (Charging and Assessment of Resources) Regulations 2014. Bigger work, such as a level-access shower, goes through a means-tested Disabled Facilities Grant. Home adaptations has the detail.