Table 1.

Needs and/or impairments of people with dementia and relative recommendations of DDCCs design

Needs and/or impairments of people with dementia	Design recommendations
Safety
Reduced awareness of environmental risks [35]	Eliminate physical and psychological barriers, both in indoor and outdoor spaces. Forbid or hide non-controlled areas or spaces that could represent a source of potential danger [35]
Usability and space–time orientation
Inability to use space properly, resulting in anxiety, agitation and aberrant behaviours [36]	Eliminate physical and perceptual barriers that may limit the use of spaces and objects. Use implicit and explicit signage to ease orientation and identification of spaces and objects [36]
Familiarity, comfort
Worsening social interaction associated with impersonal environment and furnishings [36–38]	Design spaces with domestic appearance and size [36–38]
Environmental well-being, sensory aspects
Orientation, autonomy and mood affected by environmental characteristics (lighting, noise, temperature and odour) [28, 36, 39]	Provide suitable lighting levels for the type of activity carried out, allow for the regulation of temperature, the dispensation of aromas and the presence of environmental stimuli, such as music, images and colours. Reduce noise level [28, 36, 39]
Flexibility
Time-dependent variations of needs of people with dementia and caregivers [40]	Flexibility and adaptability of spaces, according to the degree of disability, type of activities carried out and daily organization [40]
Occupational well-being
Increasing work and psychological burden of care team due to environmental characteristics [40]	Provide spaces for the exclusive use of staff that allow visual control of care recipients’ spaces. The configuration of the space and the type of furnishings must facilitate care and therapeutic activities, indoor and outdoor [26, 40]
Outdoor spaces (therapeutic garden)
Psychological and behavioural well-being associated with the contact of natural elements and physical activity [31–33]	Provide safe spaces, which facilitate physical activity, orientation and control by the staff. Seed native plants to facilitate recognition of the seasons and sensory stimulation (sight, smell, hearing, touch, aromas and fountain with running water) [31–33]
Emergency and health care services
First aid for acute injuries and illnesses	An infirmary must be provided, with adequate equipment (examination bed; sphygmomanometer; stethoscope; thermometer; pulse oximeter; glucometer; bladder catheter kit; portable oxygen tanks; BLS-D kit; AED; EKG unit)

DDCCs dementia day care centres, BLS-D  basic life support defibrillation; AED automated external defibrillator, EKG electrocardiogram