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This paper presents the results of a study evaluating a complete autonomous smart home installation in an apartment in a care home, and the impact it had on the behaviour and independence of someone with quite severe dementia (Mini Mental State Examination, or MMSE, of 10). It describes the technology that has been evolved for this purpose, and how the apartment was configured. The evaluation compared the behaviour of the resident before and after the switching on of a wide range of autonomous support technology, by analysing the logged sensor data, through a questionnaire‐based outcome measure, and through transcribed interviews. The technology enabled the client to retain a lot of independence. It helped him to regain urinary continence, improved his sleep from around 3.5 hours per night to 5.5, and halved the number of night‐time wanderings. The paper concludes with a series of recommendations for future work in this area.

Two projects in the EQUAL programme explore aspects of the influence of building design on the quality of life of people with dementia. Design in Caring Environments (DICE) examined the quality of life of people in residential care homes in relation to building design features. INDEPENDENT (Investigating Enabling Environments for People with Dementia) is a current project with the aim of developing technologies to enhance quality of life by supporting enjoyable activities. One aspect of INDEPENDENT is an exploration of the interaction between spatial settings and meaningful activity, to highlight factors that support and enable activity and to identify barriers. Findings from both projects suggest that a more creative approach to the management of buildings would enhance the well‐being of residents; under‐use of facilities is common. Meaningful space that supports activity is therapeutic but spaces that give confused messages are common in buildings used by older people. Tools to evaluate buildings have a potential role in the long‐term management of facilities to help identify underused spaces, spatial confusion and barriers to activity. Quality of life was shown to be poorer in buildings that prioritise safety and health; buildings that support activity positively by providing good assistive devices, giving people control of their environment and affording good links with the community have a positive association with well‐being.

Research ethics and integrity stipulates that research must be conducted with responsibility towards the research community and should benefit the intended population. This chapter will share insights from an ongoing research programme to reduce family conflict in the context of dementia care while discussing the accompanying ethical considerations. Research into dementia care has primarily focused on improving outcomes for the care dyad, leaving the influence and input of the wider family unit under investigated. Family conflict can detrimentally impact the quality of care provided and leave caregivers vulnerable to psychosocial difficulties. Family conflict occurs in the context of dementia care but there is little research on how to reduce, or prevent, such conflict occurring. In this research programme, a systematic review investigated the effectiveness of interventions that include the wider family unit to reduce family conflict; only one study was included which evidenced the lack of interventions in this area. A qualitative scoping review was then conducted to explore the lived experiences of caregiving families with experience of family conflict and reported solutions. It was found that conflict occurred due to factors including care decisions and role transitions which impacted relationships and affected care provision. Solutions to conflict were less often reported, indicating an important gap in the literature. Interviews with Alzheimer's Society staff and volunteers revealed that stigma and denial surrounding dementia were prevalent, and families were often reluctant to seek external help. This research programme is currently establishing public patient involvement (PPI) to develop the research methodology and interview questions for people with dementia (PWD) and their family caregivers to explore their lived experiences and potential solutions to family conflict. To conclude, this research programme will propose a family-focused intervention aimed at systemic family conflict for those caring for someone with dementia.

Assistive living technologies provide support for specific activities, transforming a home into a smart home. The purpose of this paper is to present how to design, implement, deploy and install a personalized ambient support system for the elderly suffering from Alzheimer’s disease (AD) and nighttime wandering.

The intervention presented in this paper proceeds in two phases. During the monitoring phase, the system determines the profile of the person with AD, based on nighttime routines. Data are gathered from sensors dispatched in the smart home, coupled with physiological data obtained from sensors worn by the person. Data are then classified to determine engine rules that will provide assistance to the resident to satisfy their needs. During the second phase, smart assistance is provided to the person via environmental cues by triggering rules based on the person’s habits and the activities occurring during night.

The paper develops the architecture of a non-intrusive system that integrates heterogeneous technologies to provide a calm environment during night and limit wandering periods.

The goal is to help people age well at home as long as possible and recover a regular circadian cycle while providing more comfort to the caregiver.

The system presented in this paper offers a calm and personalized environment with music and visual icons to soothe persons with AD and encourage them to go back to bed. It is installed at the patient’s home using wireless technologies.