{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T17:05:53Z","timestamp":1784048753977,"version":"3.55.0"},"reference-count":44,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institute for Health and Care Research (NIHR) under its Research for Patient Benefit (RfPB) Programme","award":["Grant Reference Number NIHR205173"],"award-info":[{"award-number":["Grant Reference Number NIHR205173"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Dementia"],"abstract":"<jats:p>Up to 60% of people living with dementia \u2018wander\u2019 in care homes. Previously perceived negatively, wandering is increasingly recognised as a meaningful activity, driven by enjoyment, routine, and social connection. Care home environments can support or hinder wandering and orientation, influencing autonomy and wellbeing. This study aimed to describe environmental features that can influence orientation and wandering within care homes. This study developed and employed an evidence-based environmental mapping tool within care homes, recruited to ensure representativeness across ownership, funding, and location. The bespoke tool integrated design criteria from existing literature, such as scale and domesticity and expert experience, addressing orientation and wandering. Visual floor plans were created, and findings were presented in alignment with environmental strategies from a realist review. The 80-item \u2018Wayfinding Environmental Mapping Tool for Care Homes\u2019 was developed and used in seven care homes in England (Midlands and the North). Size, layout, and design varied across care homes. Some closely resembled domestic settings, while others had a clinical appearance. Modifiable and non-modifiable features shaped care home environments. In some homes, residents could independently access kitchens, laundry rooms and gardens; whilst others restricted access. Clear signage, natural lighting, and visible routes were observed and have the potential to support wandering and orientation. This study applied the novel \u2018Wayfind Tool\u2019, revealing significant heterogeneity in care home environments. We found that modifiable features like personalisation and accessible seating offer cost-effective ways to create supportive, \u201chome-like\u201d settings, aiding orientation and wandering. Given the observed heterogeneity and the crucial environment-behaviour interaction in dementia, future care home research should increasingly integrate environmental mapping methods. Our freely available \u2018Wayfind Tool\u2019 serves descriptive purposes and has potential as an audit instrument to identify areas for improvement, highlighting the environment\u2019s role in supporting wandering and orientation.<\/jats:p>","DOI":"10.1177\/14713012261469998","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T16:50:46Z","timestamp":1783788646000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Designing for Dementia: A Multiple Case Study Approach to Explore How Care Home Environments May Influence Wandering"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1615-1817","authenticated-orcid":false,"given":"Rosie","family":"Bamber","sequence":"first","affiliation":[{"name":"School of Medicine and Population Health, University of Sheffield, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Fisher","sequence":"additional","affiliation":[{"name":"School of Medicine and Population Health, University of Sheffield, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1216-0867","authenticated-orcid":false,"given":"Bryony","family":"Waters-Harvey","sequence":"additional","affiliation":[{"name":"School of Medicine and Population Health, University of Sheffield, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8194-4174","authenticated-orcid":false,"given":"Tamara","family":"Backhouse","sequence":"additional","affiliation":[{"name":"School of Health Sciences, University of East Anglia, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iria","family":"Cunha","sequence":"additional","affiliation":[{"name":"School of Healthcare, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liz","family":"Jones","sequence":"additional","affiliation":[{"name":"School of Medicine and Population Health, University of Sheffield, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Gemma","family":"Cherry","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sion","family":"Scott","sequence":"additional","affiliation":[{"name":"School of Health Sciences, University of East Anglia, Norwich, UK"},{"name":"School of Healthcare, University of Leicester, Leicester, England"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Hock","sequence":"additional","affiliation":[{"name":"School of Medicine and Population Health, University of Sheffield, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reena","family":"Devi","sequence":"additional","affiliation":[{"name":"School of Healthcare, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6908-0032","authenticated-orcid":false,"given":"Karen","family":"Spilsbury","sequence":"additional","affiliation":[{"name":"School of Healthcare, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jignasa","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0746-0566","authenticated-orcid":false,"given":"Clarissa","family":"Giebel","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK"},{"name":"NIHR ARC North West Coast, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9388-9168","authenticated-orcid":false,"given":"Alys Wyn","family":"Griffiths","sequence":"additional","affiliation":[{"name":"School of Medicine and Population Health, University of Sheffield, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"issue":"5","key":"e_1_3_9_2_1","first-page":"239","article-title":"Wandering behavior from the perspectives of older adults with mild to moderate dementia in long-term care","volume":"12","author":"Adekoya A.","year":"2019","unstructured":"Adekoya A., Guse L. (2019). Wandering behavior from the perspectives of older adults with mild to moderate dementia in long-term care. Empirical Research, 12(5), 239\u2013247. https:\/\/doi.org\/10.3928\/19404921-20190522-01","journal-title":"Empirical Research"},{"key":"e_1_3_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/19375867231185851"},{"key":"e_1_3_9_4_1","unstructured":"Alzheimer\u2019s Society. (2026). Walking about. https:\/\/www.alzheimers.org.uk\/categories\/symptoms\/walking-about"},{"key":"e_1_3_9_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0144686X17000368"},{"key":"e_1_3_9_6_1","doi-asserted-by":"publisher","DOI":"10.1108\/9781787699717"},{"key":"e_1_3_9_7_1","doi-asserted-by":"crossref","unstructured":"Calkins M. P. Kaup M. Abushousheh A. (2022). Evaluation of environmental assessment tools for settings for individuals living with dementia (8 1 p. e12353). Alzheimer\u2019s & Dementia: Translational Research & Clinical Interventions. https:\/\/doi.org\/10.1002\/trc2.12353","DOI":"10.1002\/trc2.12353"},{"key":"e_1_3_9_8_1","unstructured":"Care UK. (2025). Walking with purpose. https:\/\/www.careuk.com\/help-advice\/walking-with-purpose"},{"key":"e_1_3_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-4943(01)00127-3"},{"key":"e_1_3_9_10_1","volume-title":"Dementia-friendly health and social care environments (Health Building Note 08-02)","author":"Department of Health and Social Care","year":"2021","unstructured":"Department of Health and Social Care. (2021). Dementia-friendly health and social care environments (Health Building Note 08-02). NHS England. https:\/\/www.england.nhs.uk\/publication\/dementia-friendly-health-and-social-care-environments-hbn-08-02-2\/."},{"key":"e_1_3_9_11_1","doi-asserted-by":"publisher","DOI":"10.12968\/nrec.2011.13.10.494"},{"key":"e_1_3_9_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1463423618000105"},{"key":"e_1_3_9_13_1","volume-title":"Designing for dementia: An assessment of the impact of the physical environment on wayfinding success for residents in long-term care settings","author":"Faith V.","year":"2014","unstructured":"Faith V. (2014). Designing for dementia: An assessment of the impact of the physical environment on wayfinding success for residents in long-term care settings. Doctoral dissertation, Queen\u2019s University Belfast."},{"key":"e_1_3_9_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2024.2338204"},{"key":"e_1_3_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/aft077"},{"key":"e_1_3_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1471301215614572"},{"key":"e_1_3_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnu.2015.06.003"},{"key":"e_1_3_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-6712.2011.00932.x"},{"key":"e_1_3_9_19_1","article-title":"Strategies to support safe wandering in care homes for older adults: What works, for whom, and in which circumstances? A realist synthesis","author":"Hock E. S.","year":"2025","unstructured":"Hock E. S., Waters-Harvey B., Griffiths A. W., Fisher E., Backhouse T., Cunha I., Scott S., Giebel C., Jones L., Mehta J., Spilsbury K., Booth A., Devi R., Cherry M. G. (2025). Strategies to support safe wandering in care homes for older adults: What works, for whom, and in which circumstances? A realist synthesis. medRxiv. https:\/\/doi.org\/10.1101\/2025.07.18.25331765","journal-title":"medRxiv"},{"key":"e_1_3_9_20_1","volume-title":"Dementia: Wandering evidence-based summaries","author":"Jayasekara R.","year":"2009","unstructured":"Jayasekara R. (2009). Dementia: Wandering evidence-based summaries. Joanna Briggs Institute."},{"key":"e_1_3_9_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1976.00500040001001"},{"key":"e_1_3_9_22_1","volume-title":"Dementia reconsidered: The person comes first","author":"Kitwood T.","year":"1997","unstructured":"Kitwood T. (1997). Dementia reconsidered: The person comes first. Open University Press."},{"key":"e_1_3_9_23_1","doi-asserted-by":"publisher","DOI":"10.12779\/dnd.2015.14.3.99"},{"key":"e_1_3_9_24_1","volume-title":"Care homes for older people UK market report","author":"LaingBuisson","year":"2025","unstructured":"LaingBuisson. (2025). Care homes for older people UK market report (35th ed.). Author. https:\/\/go.laingbuisson.com\/care-home-report-35","edition":"35"},{"key":"e_1_3_9_25_1","doi-asserted-by":"publisher","DOI":"10.1037\/10044-020"},{"key":"e_1_3_9_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/8.2.108"},{"key":"e_1_3_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijlp.2020.101649"},{"key":"e_1_3_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2019.06.011"},{"key":"e_1_3_9_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/030802260006300604"},{"key":"e_1_3_9_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/193758671100400207"},{"key":"e_1_3_9_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/1533317513517033"},{"key":"e_1_3_9_32_1","volume-title":"Meaningful wandering for residents with Alzheimer\u2019s disease in memory care facilities","author":"McQuilkin J. C.","year":"2016","unstructured":"McQuilkin J. C. (2016). Meaningful wandering for residents with Alzheimer\u2019s disease in memory care facilities (Master\u2019s thesis, University at Buffalo, State University of New York)."},{"key":"e_1_3_9_33_1","volume-title":"Dementia","author":"Mikhaylova-O'Connell Y.","year":"2025","unstructured":"Mikhaylova-O'Connell Y., Griffiths A. W., Cunha I., Devi R., Spilsbury K., Cherry M. G. (2025). \u201cThere is always a reason why someone is doing something\u201d: The importance of life history and personhood when supporting people with dementia to \u201cwander\u201d in care homes. In: Dementia. Advance online publication. https:\/\/doi.org\/10.1177\/14713012251316679"},{"key":"e_1_3_9_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/02763890903327135"},{"key":"e_1_3_9_35_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-2327.168636"},{"issue":"4","key":"e_1_3_9_36_1","article-title":"Subjective barriers to prevent wandering of cognitively impaired people","volume":"2001","author":"Price J. D.","year":"2000","unstructured":"Price J. D., Hermans D. G., Grimley Evans J. (2000). Subjective barriers to prevent wandering of cognitively impaired people. Cochrane Database of Systematic Reviews, 2001(4). https:\/\/doi.org\/10.1002\/14651858.CD001932","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_3_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2012.08.007"},{"key":"e_1_3_9_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/19375867221100210"},{"key":"e_1_3_9_39_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610211002377"},{"key":"e_1_3_9_40_1","volume-title":"Fix dementia care: NHS and care homes","author":"Thraves L.","year":"2016","unstructured":"Thraves L. (2016). Fix dementia care: NHS and care homes.Alzheimer\u2019s Society."},{"key":"e_1_3_9_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/19375867211043546"},{"key":"e_1_3_9_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/1471301216648670"},{"key":"e_1_3_9_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/01376517-200804000-00010"},{"key":"e_1_3_9_44_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2023.1213379"},{"key":"e_1_3_9_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-03581-8"}],"container-title":["Dementia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14713012261469998","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14713012261469998","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14713012261469998","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T16:18:23Z","timestamp":1784045903000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14713012261469998"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,11]]},"references-count":44,"alternative-id":["10.1177\/14713012261469998"],"URL":"https:\/\/doi.org\/10.1177\/14713012261469998","relation":{},"ISSN":["1471-3012","1741-2684"],"issn-type":[{"value":"1471-3012","type":"print"},{"value":"1741-2684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,11]]},"article-number":"14713012261469998"}}