Source: University of Auckland (UoA)
Monday 28 September 2026
For a person with dementia, patterned carpet can look like a floor full of holes – a space that’s terrifying to cross, says University of Auckland Professor Ngaire Kerse.
A GP and co-director of the University’s Centre for Co-Created Ageing Research, Kerse is leading a new dementia-friendly design project. It aims to make homes and aged-care facilities feel safer for people with dementia.
An umbrella term for memory and thinking decline from degenerative brain conditions, dementia causes changes to spatial perception, says Kerse.
“With dementia, there’s degradation along all the pathways in the brain associated with processing visual information.
“That reduces their ability to judge depths and distances, and to recognise objects,” says Kerse, who is the Joyce Cook Chair in Ageing Well.
It’s reasonably common for people with dementia to perceive dark doormats on light coloured flooring as holes in the floor, she says.
“With patterned carpets, the dark parts might appear to be a series of holes, so rather than seeing a flat floor that you can confidently walk across, they would see it as hazardous.”
She says plain coloured flooring and mats in similar shades make walking through a house easier for people with dementia.
Kerse has worked with Alzheimer’s New Zealand, The Village Architect, aged-care professionals, and people with dementia to design two new three-hour courses on dementia-friendly design.
The courses are for people with dementia, their whānau, caregivers, aged-care workers in the community and in residential care, and people involved in building and design who want to learn how to create housing that meets the needs of people with dementia.
The first course, Introduction to Dementia Design Aotearoa, includes a checklist to help identify potential problems that people with dementia might face in a home or aged care facility.
The second course, Dementia Design Aotearoa: Design Essentials, has practical information about each room and space in the home or aged-care facility.
Simple, affordable alterations can make navigating at home easier for people with dementia, says Kerse.
“Small changes can make a huge difference, helping to maintain their dignity and allowing them to stay at home longer.”
Dementia sufferers often lose the ability to differentiate between similar colours and tones, she says.
“Painting walls a contrasting colour to flooring can help highlight where to walk and where a room ends.
“There should be a strong contrast between the chair and the floor, because then the chair will be instantly visible and easy to sit in.”
Putting a picture of a toilet on the toilet door and installing a coloured toilet seat that contrasts with the floor and walls can help people with dementia know where to go when nature calls, she says.
When it comes to fittings and appliances, old-fashioned knobs can be less confusing than new touch technologies.
“Black taps are easier to see in a white bathroom than silver taps.
“If light switches are a contrasting colour to the walls or are framed by a contrasting colour, they’re easier to find.”
Falls are more common in people with dementia, who lose the ability to spot objects at low levels, says Kerse.
“It’s recommended to clear anything from the knee down that’s sticking out, so people don’t trip over so much.”
Mirrors are another common source of distress for people with dementia, she says.
“If their self-image is of a younger person and they suddenly see an older person reflected back at them, they can get quite agitated, thinking there are always strange people in the house.”
Keisha Rawiri, an architectural designer and researcher at the Centre for Co-Created Ageing Research, has helped develop kaupapa Māori design principles that address the needs of people with mate wareware (dementia).
These principles include creating homes and care facilities to enable wairuatanga (spirituality), whanaungatanga (relationships), māramatanga (understanding), manaakitanga (care and hospitality), mauri ora o te whare (living essence of the building) and mauri ora o te whenua (the life force of the land).
“It’s important to consider how well homes in Aotearoa connect older people to the natural environment, because that connection helps them feel calmer and enjoy life more,” says Rawiri.
“People with mate wareware can lose the concept of time, so being able to observe natural rhythms, like changes of the light each day and different weather and seasons, can help them to orientate themselves in time.”
More information about the new short courses on dementia friendly design is available here. Two in-depth courses are also available.