Dementia special care units (SCU) and freestanding special care facilities (SCF) for people with dementia are built using design principles that have been shown to enhance quality of life and reduce responsive behaviours that often occur when residents are disoriented or overstimulated by their surroundings. More supportive environments in these facilities are created through smaller unit sizes, homelike ambience, increased wayfinding, smaller activity spaces, and access to safe and secure wandering paths. Architectural planning and design features can improve the physical context where programmed activities such as music therapy, exercise sessions, creative arts, and therapy gardening occur. However, these specially designed spaces offer few therapeutic benefits without appropriate staff resources and family involvement to make the programs succeed, and consideration must be given to the combined effects of physical design, programs and policies, and staffing issues. Few studies have systematically assessed how modifications to the physical environment work in concert with social and organizational factors to enhance opportunities for residents to engage in positive social interactions through meaningful programmed activities. Krista Frazee is exploring the impact of the physical and social environments of care settings on residents’ social engagement during programmed activities in SCUs and SCFs, versus traditional integrated care facilities. She will also assess staff and family caregiver perceptions of activity spaces in helping them provide meaningful planned activities for residents. The findings from this study will be used to inform architects, interior designers, facility administrators and staff in various ways they can support the care and quality of life of residents with dementia through the integration of physical design and programmed activities.