Bringing Design to Life: Virtual Reality as a tool for dementia-inclusive housing
Gibson, G. and Quirke, M. (2025) ‘Bringing Design to Life: Virtual Reality as a tool for dementia-inclusive housing’ Journal of Dementia Care, 33(6) pp. 35-39
Grant Gibson and Martin Quirke (L to R below) from the University of Stirling describe how virtual reality technology was used in research involving people with dementia to help design housing that would be dementia accessible and inclusive.
Why housing design for cognitive ageing matters
Many people assume that “dementia-inclusive” design only matters in care homes. In reality, most people with dementia live within, want – and need – to remain at home. Housing that supports this should be a priority for both policy and practice, as seen in the UK Government’s Our Future Homes report (UK Government, 2024) and the Scottish Government’s Housing to 2040, strategy (McCall et al., 2019; Scottish Government, 2021).
Housing design for ageing still focuses mainly on physical health – for examples ramps, level access, or adaptations for mobility (Peace, 2022). While there are valuable resources such as the Environments for Ageing and Dementia Design Audit Tool (Henry et al., 2021), most guidance on cognitively supportive design is focused on institutional settings such as care homes (Fleming and Purandare, 2010).
Modifications to the home environment can improve everyday life for people living with dementia, but the evidence base on which changes matter most remains limited. Key housing providers – from developers to social landlords – have also given little priority to cognitive ageing (Bowes et al., 2023). As a result, most mainstream housing remains poorly suited to the growing number of older people living with cognitive change and dementia.
The three-year UK Research and Innovation (UKRI) funded Designing Homes for Healthy Cognitive Ageing (DesHCA) project (www.deshca.co.uk), based at the University of Stirling, set out to change this. The aim of DesHCA was to create scalable, research-informed housing designs that enable people with cognitive change and dementia to remain at home for as long as possible. This article reports on one aspect of the project: the use of virtual reality (VR) to explore design solutions and involve older people directly in shaping them.
Summary
Enabling older people living with dementia and cognitive change to live at home for longer is a key policy priority. Yet mainstream housing design rarely considers their needs, nor involves them directly in the design process. Reporting findings from the Designing Homes for Healthy Cognitive Ageing (DesHCA) project, this article explores the use of Virtual Reality (VR) in co-design workshops with older people living wand housing professionals.
VR made it possible to test design ideas in immersive, realistic environments and refine them through real-time feedback. Key outcomes included flexible layouts, practical and aesthetic solutions, and spaces that enable meaningful activity. We conclude with lessons for practice and the potential of VR to make housing more inclusive of cognitive ageing at scale.
Methods: Using VR to bring ideas to life
One DesHCA workstream focused on creating exemplar model homes that demonstrated inclusive housing features to support cognitive ageing. The exemplar model comprised new information collected from research activities within the DesHCA project, as well as wider design principles generated, regarding the development of ‘dementia-inclusive’ home environments (e.g. Henry et al., 2021). These were tested and refined through a series of VR-based co-design workshops. VR, originally developed for gaming, was used to enhance the housing design process by creating immersive design simulations where layouts and features of the model homes could be tested ‘as if real’, by people with lived experience of various age-related conditions, including dementia. Their feedback on what worked or what needed changing could be collected immediately (Palmer et al., 2024).
Author Details
Grant Gibson is a Senior Lecturer in Dementia Studies at the University of Stirling. Grant’s research focuses on the use of technology to support person-centred dementia care.
Martin Quirke is a Lecturer in Dementia, Ageing, and Design, at the University of Stirling, as well as Senior Architect at the university’s Dementia Services Development Centre (DSDC).
The process involved 13 workshops with 46 older people (including 10 people with dementia, and 15 older people with past or current experience of caring for a person with dementia), and 48 housing professionals such as architects, housing managers, major housebuilders, occupational therapists, and local authority planners. Over three rounds of iterative design, using VR headsets, video walkthroughs, print-outs, and a web-based there dimensional (3D) viewer, participants were supported by the DesHCA team, to explore and critique the designs for two evolving housing design models.
Feedback from each session was incorporated into successive versions of the housing designs, with suggested features usually discussed and validated by other participants to build a degree of consensus. By the final round, the team had produced a semi-interactive VR environment that reflected many of the agreed design elements.
Some features that were mutually exclusive – for example, using a room as a spare bedroom versus a home gym – were included as options within the model. Inevitably, not all views could be represented (such as contrasting preferences for carpet or vinyl flooring), but the model provides a practical synthesis of the priorities most strongly supported by participants. This final model is available online at: https://www.deshca.co.uk/explore-deshcas-designs/.
Key points
- Research using Virtual Reality (VR) led the University of Stirling, can support housing organisations to actively involve people living with dementia when designing new, dementiainclusive housing schemes.
- VR enables genuine co-design with older people living with dementia, giving people with dementia a stronger voice in the housing design process.
- Flexible, future-proof housing designs support changing physical and cognitive needs over time.
- Accessible layouts, generous space, and familiar cues make homes easier to use.
- Practical design includes tonal contrast, and adaptable fixtures, and space for equipment.
What older people and housing professionals told us
The VR co-design workshops allowed older people (including those living with cognitive change) the opportunity to share practical and achievable ways to make homes more supportive with housing design professionals.
The suggested design ideas were then grouped into common themes and principles. We identified seven design principles for housing that support cognitive ageing, each arising from participants’ interactions with the VR environment:
1. Layout and circulation
Movement around the home should be easy, intuitive, and free from visual or physical barriers. Open sight lines to key rooms such as kitchens and bathrooms reduced confusion and encouraged independence (Photo 1). Avoiding unnecessary physical steps at thresholds was important, but equally critical was avoiding contrasting flooring materials that could look like a step and create a falls risk. Structural adaptations, that included sliding doors enhanced ease of access and provided additional manoeuvring space. In some layouts, participants confidently navigated straight to the kitchen or bathroom; in others, they hesitated or took longer. This behavioural cue told us how well visual access was working without it needing to be voiced. Practice takeaways included designing single-level homes where possible, with visible routes between frequently used spaces. Enabling this depends on careful planning, along with generous, well-placed storage to keep these routes clear, making storage a factor for circulation as much as a convenience.
2. Lighting
For people living with cognitive change, significantly stronger overhead lighting than is typically standard, supplemented with additional illumination in darker recesses such as storage areas, and targeted to the activities undertaken in each space, is essential (Goudriaan et al., 2021). Participants highly valued brighter lighting, especially in areas where fine visual discrimination was needed – such as when cooking and preparing meals, enjoying hobbies, or reading. Lighting, without shadow spots, supported confidence and safety. Older participants preferred brighter light levels – around two to three times stronger than younger participants. Practice takeaways included using strong, even lighting in activity zones, and adding targeted lighting for spaces such as worktops desks, or places for reading. Lighting should also be positioned to minimise shadows and glare.
Photo 2 (left, above): Tonally contrasting WCs can aid recognition,, whilst visually and physically accessible grab rails can support users experiencing challenges with mobility, balance, or awareness of the wider environment; Photo 3 (right, above): glazed kitchen cupboards provide visual and cognitive access to the contents.
3. Kitchens and bathrooms
Kitchens and bathrooms are often the most challenging spaces for people living with cognitive changes, and where sensitive and inclusive design can enable people to live independently. The essential functions of these spaces should be visible, intuitive, and adaptable. For ensuite bathrooms, being able to see the toilet from the bed (with the ensuite door open) aided orientation. Contrasting tone (i.e. light/dark), rather than colour, on toilets, showers, tiling and worktops, and for mobility aids such as grab rails, can improve recognition (Photo 2) above. Ideally, appliances should be visible rather than concealed, and participants wanted the option to add signage or labels to appliances or cupboards if needed, without these being permanent default features.
The VR environment meant participants could test direct lines of sight from bed to bathroom or quickly gauge if an appliance was recognisable. The immersive 3D nature of VR made it possible to “reach” for handles or taps, giving realistic impressions of ergonomics and ease of use – feedback that can be hard to get from 2D drawings or still images. Tonal contrasts can be used to highlight essential fixtures. Spaces should allow for retrofittable signage, and plan for the installation of future adaptations from the start, such as incorporating reinforced or load bearing structures or joists where grab rails or hoists can be installed, during the building phase. Ensure labelling and tonal contrasts, including colour coding for appliances such as taps and hobs.
4. Storage and equipment
The need for everyday items does not diminish with cognitive change or dementia. Houses should therefore provide accessible, generous storage spaces that can adapt to changing lifestyles and needs. Visible storage through the use of glass in cupboard/wardrobe doors can aid people with accessing clothes or kitchen items, by making them visible at all times (Photo 3-4). Ample storage supported a wider range of lifestyles – from active hobbies to later-stage care needs – while keeping living areas clear. For example, mobility aids, scooters, or hospital-at-home equipment could be stored discreetly yet remain easy to access (Photo 5). Seeing full-size equipment in the virtual rooms revealed how little space standard designs often leave, prompting calls for more generous, strategically located storage areas. Building in more storage than the minimum standard, strategically placed near points of use, was therefore an essential feature of both age-friendly and dementia-inclusive housing. Storage should be positioned so that spaces can remain uncluttered and accessible, protecting both mobility and visual clarity. Allowing aids and equipment to be hidden away was also highlighted as an important means of sustaining a person’s dignity.
5. Flexibility and Futureproofing
A key consideration was the ability of homes to adapt as a person’s needs and lifestyles change. Such changes should not just be applied to care scenarios but should include aspects of homes that can support an enriching or participatory lifestyle. Participants noted that spare rooms were seen not only as potential carer accommodation but also as hobby rooms, home offices, or gyms. To accommodate greater flexibility in the face of future care needs, more generous space standards such as a slightly larger main bedroom could accommodate hospital-at-home care (e.g. hoists) if and when needed.
In the VR model, being able to move or replace furniture helped participants picture multiple configurations for the same space. This reinforced the importance of building in adaptability to the core of the building, not just in the form of loose furnishings. Spaces should therefore be planned with enough floor area and service points (e.g. power, plumbing) to allow future conversion. Living spaces should not be locked into one use, and demonstrating alternative layouts early can encourage more flexible thinking by designers.
Photo 4 (left, above): Selective use of glazed elements, for example on wardrobes, can help sustain independent self-care and dressing routines.
Photo 5 (middle, above): Ample storage space could be used to store everyday items, as well as providing enough space for any mobility or other aids (e.g. scooters/wheelchairs) needed in the future.
Photo 6 (right, above): colour coded taps and physical controls on appliances make them easier to recognise and use.
6. Familiarity and Comfort
Homes which support cognitive change offer ample opportunity for innovation, but these innovations should be grounded in familiarity. Overly novel fittings could be disorienting, but simple and recognisable solutions – like separate hot and cold taps with colour-coded markings could inspire more confidence, while their familiarity sustained their use for longer (Photo 6). The VR model revealed which fittings were less intuitive, sometimes indicated by participants’ hesitation when trying to use them. Whilst it is possible for new technologies and environmental features to enhance people’s lives (Gibson et al., 2019) innovations should be grounded in familiar cues, such as separate hot and cold taps with colour-coded markings
7. Technology and Everyday Convenience
Reliable and simple technologies can and should be integrated into housing designs where they bring an obvious benefit to the user. Features such as power sockets with built-in USB charging, smart heating controls, and discreet safety devices (e.g. low level sensor lights) were welcomed when they were straightforward to operate, unobtrusive, and provided clear benefits in terms of comfort or safety. Touch-screen controls could be problematic for some users, and manual knob controls providing tactile feedback were generally felt to be more intuitive to use. Overly complex systems or those requiring multiple steps to use were viewed less favourably. The ability to see how various equipment and technology fit into the home via the VR home designs helped participants assess their accessibility, visibility, and ease of use. This prompted discussion about where controls should be located for maximum convenience and whether their design felt intuitive. Technologies should be selected for their clarity, reliability, and tangible benefits to the resident. Where possible, control interfaces should be simple, familiar, provide clear tactile or visual feedback, and should not add visual clutter or unnecessary complexity.
Using VR as a tool for engagement
The VR workshops generated exemplars of housing adaptations and design principles that can be scaled up across dementia inclusive housing schemes. VR also enhanced empathy by simulating everyday challenges and supported inclusive co-design through real-time feedback. Participants highlighted wider challenges for housing design – including the use of minimum space standards as the norm, limited attention to the effects of aesthetic matters, and a lack of genuine co-production. These issues often contribute to resistance to traditional adaptations, which can appear institutional or prioritise provider convenience over residents’ preferences. The VR process offered a way to overcome these barriers by involving those who will ultimately live in the homes.
In DesHCA, most participants – including both older people and housing professionals – had little prior experience of VR. With appropriate support, they engaged meaningfully with both the technology and the broader design process. VR brought design changes to life, allowing participants to simulate everyday tasks, such as navigating to the bathroom or using a kitchen, and to see how individual adaptations worked together as a whole.
By removing barriers common to traditional design methods (such as paper-based plans or static visualisations), VR enabled more collaborative and iterative co-design. This approach allowed stakeholders to test and refine ideas at multiple scales, from adapting an individual home to planning larger housing schemes. The DesHCA model demonstrates how immersive, participatory processes can strengthen housing provision for people living with cognitive change.
Conclusion: what this means in practice
The DesHCA project shows the value of VR in making housing design more inclusive of people living with cognitive change and dementia. With appropriate support, older people engaged confidently with the technology and contributed insights that might otherwise have been missed.
For practitioners, the key lesson is that design decisions benefit from being tested in realistic, immersive environments. VR made it possible to identify barriers, simulate everyday activities, and demonstrate how individual adaptations combine to support independence.
Embedding VR into co-design ensures that the lived experience of cognitive ageing shapes housing from the outset. Architects, housing providers, and policy-makers should consider VR-supported co-design as a practical way to deliver homes that are flexible, future-proof, and responsive to real needs.
Funding Statement & Acknowledgements
Designing homes for healthy cognitive ageing (DesHCA) was funded by UK Research and Innovation (UKRI) via the Healthy Ageing Social Behavioural and Design Research Programme (SBDRP) grant number: ES/V016059/1 from the Economic and Social Research Council (ESRC).
Professor Alison Bowes, University of Stirling was Principal investigator for the project. DesHCA project team members who contributed to this research also included: Lesley Palmer, Vikki McCall, Junjie Huang, Cate Pemble, and Sadhana Jagannath.
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