Photo source: Canva
Bathing spaces in care homes are often treated as back‑of‑house infrastructure, yet they are where some of the most intimate, and distressing, moments of care happen for people living with dementia. This new scoping review asks a deceptively simple question: what would these spaces look like if they were truly designed around residents’ comfort, dignity, and cognitive needs?
What Did the Researchers Discover?
This scoping review pulled together 64 sources to answer a simple but neglected question: how should communal bathrooms in residential care be designed for people living with dementia and other cognitive impairments? The authors distilled 34 best practices, grouped into seven themes, covering everything from layout and lighting to sensory design and staff routines.
The Key Findings
The review highlights that assisted bathing is often frightening, embarrassing, and uncomfortable for residents, and a major trigger for agitation and “refusal of care.” Poorly designed bathrooms, cold rooms, noisy equipment, and unfamiliar fixtures amplify this distress for both residents and staff. In response, the authors propose best practices in planning, aesthetics, safety/accessibility, fixtures and assistive technology, indoor environment, sensory stimulation, and the bathing process and organisational environment.
Why Does This Matter for Dementia Inclusive Design?
Most existing standards focus on physical accessibility and minimum compliance, not cognitive accessibility or lived experience. This review shows that bathing spaces can either undermine or support personhood, privacy, dignity, and trust in care relationships, core aims of dementia inclusive design. It also makes clear that bathrooms must be understood as part of a wider care process, including pre‑ and post‑bathing routines and communication, not just tiles and taps.
What Can You Take Away? Implementation and Action
Facilities are encouraged to:
Prioritise privacy through visual barriers and careful room siting away from busy corridors.
Ensure enough space for wheelchairs, hoists, and access to three sides of the tub or shower area.
Warm the room in advance, use heat lamps or warmed towels, and avoid loud, echoing finishes and fans.
Offer choice of bath, shower, towel bath, or bed bath, and flexible timing based on resident preference.
Embed tools like Bathing Without a Battle or PRIDE to train staff in person‑centred bathing.
Caption: Rethinking bathroom design. Image source: Canva
Strategies for Healthcare Facilities and Aged Care Providers
The paper calls for bathrooms that look and feel domestic, not clinical. Designers are urged to use:
Non‑glare, sound‑absorbing, non‑slip materials, with strong colour contrast between floors, walls, toilets, grab rails, and seats.
Simple, familiar fixtures; clear wet/dry zones; threshold‑free showers with safe seating; and discreet storage to hide institutional clutter.
Flexible, intuitive controls for light, temperature, and ventilation, plus opportunities for daylight via frosted windows or skylights.
The Critical Messages
Three messages stand out. First, bathing environments must support autonomy, emotional safety, and dignity—not just hygiene. Second, multisensory strategies such as personalised music, pleasant scents, and calming visuals have some of the strongest evidence for reducing agitation. Third, residents’ own voices are largely missing from current research and tools, and this is a critical gap that future work must address.
Looking Forward
The authors call for more contemporary, empirical research on bathroom fixtures, technologies, and layout, including trauma‑informed and culturally responsive design. They also argue for new evaluation tools that centre resident experience (before, during, and after bathing), not just staff reports of agitation. For anyone involved in dementia inclusive design, this review offers a practical roadmap, and a clear mandate to co‑design better bathing spaces with residents, families, and frontline staff.
Reference
Konda, V., Arora, T., Kontos, P., Hinds, B., Desai, M., Arpiainen, L., ... & Iaboni, A. (2026). Best Practices for the Design and Evaluation of Bathing Spaces for Older Adults With Cognitive Impairment in Residential Care Settings: A Scoping Review. Journal of the American Medical Directors Association, 27(1), 105971. https://doi.org/10.1016/j.jamda.2025.105971
Want to learn more about dementia-inclusive environmental design? Explore our Resource Hub for practical examples and current research on creating supportive home and care environments: https://design.dementia.utas.edu.au/page/512/for-educators