Using Design to Empower People Facing Cognitive Decline in the Community and Healthcare Facilities

Cognitive decline in aging populations presents significant challenges, yet environmental design often overlooks specific cognitive and sensory needs beyond basic physical accommodations. This chapter explores how thoughtful design of built environments – from home to specialized care facilities – can empower individuals across the cognitive decline spectrum (mild cognitive impairment (MCI) to severe dementia) by supporting functional independence, well-being, and continuity of care. We present three distinct research-driven programs: (1) cognitive-aging-in-place (CAIP): A novel concept focusing on home interior design modifications (i.e. enhanced visual accessibility in the kitchen through open shelving and clear labeling) to support older adults with MCI by fostering environmental mastery, stimulation, and familiarity. (2) The Cognitive Empowerment Center (CEC): A co-designed living laboratory within Emory University's Cognitive Empowerment Program, offering therapeutic, educational, and social activities. The CEC leverages flexible, biophilic design and integrated technology to support individuals with MCI and their care partners. (3) An immersive experience room at Mayo Clinic: A retrofitted space in a memory care facility utilizes personalized sensory technologies (circadian lighting, music therapy, visual stimuli) to enhance identity, comfort, and orientation for individuals with advanced dementia. Key findings from these initiatives highlight the importance of environmental mastery, appropriate cognitive stimulation, reinforcing familiarity, promoting social engagement, and seamlessly integrating technology. These examples emphasize the critical need for evidence-based, person-centered environmental interventions. This chapter calls for further longitudinal research and greater collaboration between designers, healthcare providers, and researchers to develop and implement scalable solutions that improve quality of life for the growing number of individuals facing cognitive decline.