Dementia Care Environments and Person-Environment Fit: A Review.

Abstract

AimTo critically review the development and application of Person-Environment Fit theory in dementia care environment evaluation and to assess how existing instruments capture multidimensional fit between residents' needs and environmental supports.BackgroundDementia is a major cause of disability, dependency, and long-term care use worldwide. As the dementia population grows, care settings must provide environments that support safety, orientation, autonomy, social interaction, and quality of life.MethodsThis critical review synthesized theoretical and methodological literature on Person-Environment Fit in dementia care and compared major environmental assessment instruments in terms of theoretical foundation, dimensional coverage, psychometric evidence, and practical utility.ResultsDementia care environment assessment has shifted from safety- and risk-oriented approaches toward broader person-centered and household-model perspectives. Existing instruments provide relatively strong coverage of physical safety, wayfinding, and orientation support. However, they assess psychosocial interaction, emotional support, cultural adaptation, continuity of family roles, and staff well-being less consistently. Overall, current tools only partially capture the multidimensional need-supply fit required for dementia-sensitive care.ConclusionsFuture assessment frameworks should move beyond physical safety and architectural auditing to incorporate psychosocial, cultural, and organizational dimensions. More contextually adapted and person-centered instruments are needed, particularly for non-Western long-term care settings such as China.