I’ve always believed that the spaces we create have profound effects on our wellbeing. It wasn’t until I visited my Uncle Richard at Pinewood Gardens Memory Care that this belief solidified into something I couldn’t ignore. The facility was only five years old—a beige, rectangular building with fluorescent lighting that hummed overhead like an unwelcome guest.
The windows were small, the corridors long and disorienting. Plants? A few sad pothos in plastic pots at the nurses’ station.
The residents seemed… well, lost is the only word I can think of. Uncle Richard, once the life of family gatherings, sat slumped in a chair facing a wall-mounted TV nobody was watching.
Two months later, I visited a different memory care facility where my friend’s mother lived. The contrast hit me like a physical force. Meadowbrook had been designed with nature at its core—large windows overlooking courtyard gardens, indoor plants thriving in strategic locations, natural materials and textures everywhere, and lighting that shifted throughout the day to mirror natural rhythms.
The residents seemed more present, more engaged. My friend’s mum, whose dementia had progressed further than Uncle Richard’s, recognized her daughter that day. Small miracle?
Perhaps. Coincidence? I don’t think so.
The difference between these spaces wasn’t just aesthetic—it was fundamental. One acknowledged the residents as biological beings with innate connections to natural environments; the other treated them as medical conditions to be managed in a sterile setting. I’ve spent the last seven years exploring how biophilic design—design that connects humans to nature—can transform the experience of people with memory impairments.
What I’ve found has convinced me that this approach isn’t a luxury or a trend—it’s essential care. Let’s be real about what we’re facing. The numbers are staggering—over 55 million people worldwide living with dementia, expected to nearly triple by 2050.
Behind each number is a person experiencing a progressive loss of cognitive function that affects memory, thinking, orientation, language, and eventually, physical capabilities. What doesn’t diminish, though, is their humanity—their need for dignity, comfort, engagement, and joy. Traditional memory care environments have focused primarily on safety and efficiency—both critically important, but insufficient on their own.
These clinical settings often inadvertently increase confusion, agitation, and the sense of disconnection that already plagues those with cognitive impairment. They’re designed for the disease, not the person living with it. Biophilic design offers a different path.
I remember watching Mrs. Callahan (my friend’s mum) at Meadowbrook. She couldn’t tell you what day it was or sometimes even her daughter’s name, but when seated in the sunroom overlooking the garden, she would point out birds at the feeder and comment on the weather.
“Those little ones, they’re always so busy,” she’d say, tracking chickadees with her eyes. These moments of connection and awareness—fleeting though they may be—matter enormously. The evidence supporting nature-based environments for memory care goes well beyond my personal observations.
Research consistently shows reduced agitation, improved sleep patterns, decreased need for pain medication, and enhanced overall wellbeing when people with dementia have access to natural elements. One study I’m particularly fond of found that exposure to outdoor garden spaces reduced aggressive behavior by 19% and use of PRN (as-needed) medications by nearly 30%. That’s not incremental improvement—that’s transformative care.
So what does biophilic design for memory care actually look like in practice? It’s not just slapping some plants around and calling it a day (though plants are brilliant and I’ll talk about them more in a minute). It’s a comprehensive approach addressing multiple sensory pathways and cognitive needs.
Visual connections to nature are foundational. Windows offering views of gardens, courtyard spaces, or even distant landscapes provide changing scenery that stimulates without overwhelming. I worked with a facility in Colorado that installed floor-to-ceiling windows in their common areas—carefully designed with proper glazing to prevent glare, which can cause visual confusion for people with dementia.
Within weeks, staff noticed residents naturally gravitating toward these areas, often sitting quietly for extended periods watching seasonal changes outside. But what if exterior views aren’t possible? That’s where interior plantings, nature-themed artwork, and even digital nature scenes can play a role.
Not ideal substitutes, but still valuable. The key is authenticity—realistic representations rather than cartoonish or highly stylized depictions that may not be recognized by individuals with perceptual challenges. Direct physical access to nature takes the benefits further.
Secure outdoor gardens with circular pathways (eliminating dead ends that can cause frustration) give residents freedom to move while staying safe. These spaces should include familiar plants that might trigger memories—lavender, roses, tomato plants—things many older adults would have encountered in their earlier lives. I’ll never forget watching a gentleman who rarely spoke suddenly become animated when he discovered tomato plants in his care home’s garden.
“Need to stake these better,” he muttered, gently touching the stems. His daughter later told me he’d been an avid gardener his whole life. That muscle memory and procedural knowledge remained intact even as other cognitive functions diminished.
Light is another critical element, though often overlooked. Our bodies evolved with circadian rhythms governed by sunlight. Dementia frequently disrupts these patterns, leading to “sundowning”—increased confusion and agitation in late afternoon and evening.
Lighting systems that mimic natural patterns—brighter, bluer light in morning, shifting to warmer, dimmer light in evening—have shown remarkable success in regulating sleep-wake cycles. I worked with an electrician whose mother had severe sundowning symptoms. After installing a circadian lighting system in her room, they saw dramatic improvements within days.
“For the first time in months, she’s sleeping through the night,” he told me, his voice cracking slightly. “And so am I.” Natural materials add another dimension through non-visual sensory pathways. Wood handrails that warm to the touch, stone surfaces with varied textures, fabrics that mimic natural fibers—these elements engage the tactile system, which often remains responsive even in advanced dementia.
One memory care unit I consulted for incorporated a “touch wall” with different natural materials at various heights. Residents would often pause there, running their hands across the different textures without prompting. Sound deserves special attention.
Institutional settings are notorious for harsh acoustics—hard surfaces reflecting noise, creating a chaotic auditory environment that increases stress and confusion. Biophilic design addresses this through natural sound absorption (plants, textiles, cork) and the introduction of gentle nature sounds—rainfall, birdsong, rustling leaves—to mask less pleasant mechanical noises. Water features can be particularly effective when designed appropriately.
The sound of moving water seems to resonate with something primal in us. I’ve observed residents who were pacing anxiously pause and visibly relax near a small water wall. However—important caveat—these features must be designed with specific consideration for the cognitive challenges of the population.
The sound should be gentle, the visual movement subtle, and safety paramount. Smell is our most directly emotional sense, bypassing cognitive processing to trigger memories and feelings immediately. Fragrant plants like jasmine, lavender, and herbs can create sensory anchors throughout a space.
One innovative program I visited used seasonal scents intentionally—baking apple pie in autumn, bringing in pine boughs in winter—creating temporal orientation through olfactory cues. Temperature variation is another natural element that institutional settings often eliminate. While extreme temperatures are obviously problematic, slight variations can provide sensory interest and temporal cues.
Sunrooms that warm during day and cool slightly at night, outdoor porches with overhead coverage that allow feeling a gentle breeze—these features reconnect residents to the rhythms of the natural world. I should address the practical concerns that often arise. Maintenance, cost, and safety are legitimate considerations.
Plants need care, natural materials may require more frequent replacement, and outdoor spaces demand ongoing attention. But these challenges aren’t insurmountable. For maintenance, many facilities partner with master gardener programs or garden clubs for volunteer support.
Some have found that involving higher-functioning residents in simple plant care activities provides meaningful engagement while distributing the workload. As for costs, while initial investment may be higher, the operational savings from reduced medication use, fewer behavioral incidents requiring staff intervention, and improved sleep patterns (reducing nighttime staffing needs) often offset these expenses over time. Safety requires thoughtful design rather than elimination of natural elements.
Plants must be non-toxic, water features secured, outdoor spaces properly contained. These considerations add complexity to the design process but don’t negate the benefits. When I think about Uncle Richard in that beige, windowless common room, I feel a particular sadness knowing that his final years could have been different.
The progression of his dementia couldn’t have been stopped, but his experience of it—his day-to-day reality—could have been gentler, more connected, more human. The most profound aspect of biophilic design for memory care isn’t measurable in research studies. It’s about dignity.
It’s recognizing that people with dementia remain part of the natural world—biological beings responding to light, sound, texture, and living things. By designing environments that acknowledge this fundamental connection, we affirm their humanity in ways that medical interventions alone cannot. I’m now working with a coalition of memory care providers to develop accessible biophilic design standards that can be implemented even in facilities with modest budgets.
The goal isn’t perfection—it’s progress. Every natural element introduced, every connection to the living world restored, represents an opportunity for a moment of peace, recognition, or joy for someone navigating the difficult journey of dementia. After all, isn’t that what we all want?
Not just to be cared for, but to feel connected—to each other, to our surroundings, to the natural rhythms that have surrounded humanity throughout our existence. For those with memory impairments, these connections become not just comforting, but anchoring—rare constants in an increasingly confusing world.
