One of the consequences of an ageing demographic is the increase in the incidence of illnesses such as dementia. Dementia affects visuo-spatial perception, causing difficulty with wayfinding, even during the early stages of the disease. The role of the physical environment as part of a holistic approach to caring for people with dementia is widely recognised. There is a need for specialist support and care, placing a greater impetus on the need for a person-centred approach to tackle issues related to wayfinding and dementia. This thesis aims to improve design for dementia in long term care settings in Northern Ireland. The purpose of this was to provide a better understanding of how people with dementia experience the physical environment and to highlight features of the design that assist with wayfinding. The outcome is intended to improve quality of life, wellbeing, independence and uphold the dignity of people with dementia living in nursing or residential care homes. Ethical issues were considered throughout the thesis and in the research design which used a mixed methods approach. This involved an initial questionnaire to home managers (based on leading design recommendations), semi-structured interviews with the staff in the long term care settings and the resident's next of kin and a wayfinding task (which employed ethnographic methods). Additionally, Space Syntax methodologies were used to examine the physical properties of the architectural layout. Results indicate that particular environmental features are associated with improved performance on the wayfinding tasks. By enhancing design for dementia, through identifying the attributes, challenges with wayfinding may be overcome and the benefits of the physical environment can be seen to promote wellbeing. There were limitations due to the available resources, time and funding. Future research would involve testing the identified environmental features within a specific environment to enable measured observation of improvements.