By Sara Hayball and Michael Buser
The relationship between ageing, lived experience, and the built environment is increasingly recognised as a critical concern for planners, designers, and public health practitioners. Yet the ways in which places are imagined and designed often continue to reflect narrow assumptions about who uses the space, how they move, and what they need to feel connected, safe, and included. For people living with dementia, these assumptions can translate into environments that unintentionally restrict independence, limit participation, and contribute to social isolation.
Despite growing commitments to inclusive design, many dominant planning frameworks and built environment design responses still centre on an idealised user. This risks overlooking the diverse sensory, emotional, and spatial realities that shape everyday life across the life course. At the World Health Organisation Healthy Cities Conference in Viana do Castelo, Portugal, conversations about healthy ageing, intergenerational connection, and the role of neighbourhoods in supporting wellbeing highlighted the urgent need to rethink how we design places so that older adults, including those living with dementia, are not positioned as passive recipients of care, but as active participants in public life.
Co‑leading a Workshop at the Conference
The question of how people living with dementia participate in the shaping of place remains deeply entangled with broader debates about inclusion, agency, and the politics of representation. Too often, engagement is framed as an invitation to “fit into” pre‑existing spatial norms, implicitly positioning cognitive difference as a deviation to be accommodated rather than a form of knowledge that can actively reshape design practice.
It was within this context that we developed our workshop approach, Engaging People Living with Dementia in Place‑Based Research, at the World Health Organisation Healthy Cities Conference. Sharing insights from our work, shaped directly by people with lived experience of dementia, was both humbling and energising. The enthusiasm, openness, and generosity of participants were accompanied by a shared desire to rethink how cities can support connection, independence, and dignity for people with lived experience of dementia.
In listening to colleagues from across the world, we learned from the initiatives emerging within their own countries, each offering a different way of imagining what healthy, inclusive environments might look like. As part of the workshop discussion, we heard about inspiring programmes such as those in Portugal, where students support older adults with everyday tasks, creating mutually beneficial arrangements that strengthen intergenerational relationships and reframe ageing as a shared social responsibility rather than an individual challenge. These models challenge the assumption that care flows in a single direction and instead emphasise dignity and the everyday infrastructures of social connection. Further inspiring examples include immersive training being used to cultivate empathy towards people living with dementia. By enabling participants to experience the sensory and cognitive challenges that shape daily life, these initiatives move beyond abstract awareness‑raising and invite a deeper, embodied understanding of difference. Such approaches demonstrate how shifts in attitude and perception can complement design interventions, creating the cultural conditions necessary for more inclusive environments.
Learning from the Conference
Alongside presenting our workshop, we had the opportunity to take part in a number of conference presentations and workshops. A central theme was the importance of social connectedness and the role of the built environment in enabling or restricting it. Conversations highlighted how design can either support independence or contribute to isolation, particularly for older adults and people living with dementia. The discussions emphasised the need for people‑centred, integrated approaches that support individuals across the life course, recognising that designing for independence is ultimately designing for everyday life.
We explored how neighbourhood settings, including ideas such as the 15‑minute city, can reduce inequalities by ensuring essential facilities are accessible within a short distance. This aligns closely with the challenges faced by people with dementia, where, in our research, we have heard just how much poor design can lead to a loss of independence and social isolation.
What Comes Next
We were excited to contribute to this collective effort and to continue learning from colleagues working across generations, sectors, and disciplines. The discussions in Viana do Castelo highlighted not only the urgency of designing places that enable connection and independence, but also the transformative potential of research co-designed with those with lived experience of dementia. The next phase of our work will continue to centre their voices, not as contributors on the margins but as essential partners in shaping the environments that support everyday life.
Featured image at the top: Participants at the Workshop Engaging People Living with Dementia in Place‑Based Research, WHO Healthy Cities Conference