Dementia-Friendly Spokane & Its Built Environment

January 27, 2023

Caring for People Living With Dementia (PLWD) is as much a helping hand as an appropriately designed built environment.

Evidence from Australia, New Zealand, Scotland, Norway, and the United Kingdom show that the appropriate form, character, and content of residential, neighborhood, government and commercial areas, and residential aged-care facilities can positively impact behavior and quality of life for PLWD, their caregivers, and the greater community. In-home services when complemented by accessible, useful environments enable PLWD to remain in their community much longer. British studies also show that dementia-friendly built environments reduce government, insurance, and out-of-pocket costs.

In 2022, 65 million Americans 65 and older lived with dementia, 200,000 of which have younger (under 65) onset dementia. In 2017, 81% of PLWD lived in their homes, 19% in residential care settings and nursing homes. Of those living in private homes, 70% lived with someone, while 30% lived alone. Many were basically home-bound due to unfriendly outdoor environments.

Being dementia friendly goes beyond providing services. It encompasses a community’s social attitudes toward dementia, aging, and calls for environmental features that help PLWD interact without discrimination, fear, or disadvantaging others. Dementia-related design is a non-pharmacological form of intervention, to be included in personal, neighborhood, institutional, governmental, and broader community environments.

Environments that speak to PLWD allows them to enjoy greater independence and security as they carry out daily activities in their community. To do so, PLWD should be participants in and contributors to the planning and design of all built environments.

When the ten environmental design principles below are combined with The World Health Organization’s (WHO) eight Domains of Age-friendly Cities, you have a foundation on which to build a dementia-friendly neighborhood, village, town, or city: 

WHO Domains for Age-friendly Cities: Click Here

  • Outdoor Spaces & Buildings
  • Transportation
  • Housing
  • Civic Participation & Employment
  • Respect & Social Inclusion
  • Social Participation
  • Communication & Information
  • Community & Health services

Ten design principles derived from the The World’s Alzheimer’s Report 2020 (Click Here) are provided below as a means of heightening people’s awareness of built environments’ influences on PLWD:

  1. Unobtrusively Reduce Risks — Enable PLWD to safely move about indoors and outdoors
  2. Provide a Human Scale — Personal scale in places and space
  3. Visual Access – Allow people to see and be seen
  4. Reduce Unhelpful Environmental Stimulation — Minimize competing noises and sights
  5. Optimize Helpful Stimulation major & minor landmarks to guide wayfinding
  6. Support Movement and Engagement — Easy, ready access to green spaces and visit ability
  7. Create a Familiar Place — Familiar form, character, and content to outdoor spaces/places
  8. Provide Opportunities to be Alone or with Others — Places that suit alone and time/activities
  9. Links to the Community “Nothing About Us Without Us,” include PLWD in all planning and deign
  10. Design in Response to Citywide Vision for Way of Life — Recognize lifestyle of neighborhoods & districts

You can help us improve upon the design and planning of Spokane’s environments for those living with dementia. When you become aware of dementia-friendly environments please take photos and send them to us along with any descriptions on the setting or how it was dementia friendly at

*Interested in discussing any of these resources further? Contact Bob Scarfo at 509.220.5113;