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The purpose of this paper is to explore the concept of homelikeness from the perspective of family members and friends of nursing home residents across different models of nursing homes.

This mixed-methods study examined survey data collected from 397 family members and friends of residents living in 23 nursing homes representing three models of care (traditional, new augmented, and full scope). Participants completed a homelikeness scale and a measure of the importance of nursing home spaces to family members and friends. This study also involved conducting three focus groups with 20 family members and friends to provide further insights into the findings.

Analysis of survey data indicated quite high levels of homelikeness overall. Significant differences did emerge between traditional model nursing homes compared to new full-scope and new augmented models for all items in the homelikeness scale and for many items about nursing home spaces. Qualitative results provided insights into how homelikeness can be fostered through public and private spaces and through care and relationships.

As this study was conducted in one Canadian province, the results may not be applicable to other geographic areas. In addition, there are limitations in survey response rate.

Homelikeness can be supported across models of care by fostering relationships between residents and staff, ensuring that that family and friends feel welcome, and creating public and private physical spaces that are conducive to new and ongoing relationships.

The results provide evidence to nursing home decision makers about how to foster a homelike environment in various models of nursing homes.

The independence and well-being of people with dementia can be significantly influenced by the design of the physical environments around them. Several assessment tools exist to evaluate the dementia design quality of existing residential aged care facilities but, to date, none have been formally identified as suitable for use during the design process. This paper aims to examine the feasibility of re-purposing existing post-occupancy tools for use during the design process, while mapping the influence of design stages on resulting dementia design quality.

Literature searches identified audit tools for residential aged care settings. After reliability screening, three tools were analysed in-depth, mapping their suitability for use during the design process.

The study confirmed that existing tools can be re-purposed for design stage use and identified that early design stages have a larger influence on overall dementia design quality than previously thought.

Non-English language publications were not reviewed. Searches may not have identified other existing audit tools for residential care environments.

The ability to assess proposals at key stages of design may help improve the dementia design quality of future residential aged care environments – potentially enhancing the lives of ever-larger numbers of people with dementia.

According to the authors’ knowledge, this is the first known paper to consider formal design-stage evaluation of dementia design quality and the first to identify the relative influence of key stages of design on the resulting dementia design quality.

Recent international experiences of community inclusion have produced a major change in residential care for people with intellectual disability (ID). Assignment and outcome assessment through new person‐centred measures are raising increasing interest; however, the information on quality of life and accommodation is still limited. This paper aims to provide an overview of the application of quality of life models and the size of the provision of different living arrangements.

A systematic mapping of the literature of the last decade was followed by an expert guided review of the available evidence.

QoL outcomes measures of living arrangements in people with ID show conceptual and methodological challenges. The following key topics were identified: individual level: issues related to health status, behavioural problems and other personal factors (ageing, choice and empowerment); family and peers; local level: accommodation, architecture and urbanization, and economic aspects (deprivation and costs); macro level: social participation (community inclusion). The residential solutions that are currently considered of highest efficiency are small apartments in the community and “cluster centers”.

The level of quality of life is very relevant in the assessment of living arrangements in people with ID although its assessment still shows significant limitations. Some accommodation typologies seem more effective than others. New conceptual models of inclusive residential care support the convenience of a wide range of accommodation alternatives that may fit the individual needs of a highly heterogeneous population group. A unique residential alternative, albeit optimal from a community care perspective, may not be adequate for all persons with ID.