Long term institutional care for people with dementia is estimated to cost the UK economy £20 billion. Global ageing populations predict an increase in dementia. This has highlighted the need to focus on the design of dementia care environments as an alternative means to alleviate some of the common symptoms associated with dementia. Traditionally community care for dementia had been the focus until recently. However, there is now a demand for dementia specific long-term institutional care facilities to provide greater support for the person with dementia, their carers, visitors and relatives. The perception of the physical environment alters with the onset of cognitive decline. Eyesight and hearing for instance are aspects which are often affected in older age and can further deplete wayfinding processes, especially for those with cognitive impairments. Other symptoms of the disease which are aggravated by poor design include aggression, stress, anxiety, incontinence and incidences of trips and falls. These all impact negatively on the psychological wellbeing of the person with dementia and can therefore affect other residents and staff members.The physical environment is widely recognised to influence the behaviour and wellbeing of people living with dementia. A well designed environment can improve the condition, alleviate carer burden and increase psychosocial interaction.There has been a shift in attitude towards design research. It should include the lived experiences of people with dementia and engage with them to provide a better understanding of the role of the environment on their perception of space. This paper examines the efficacy of particular strategies when engaging people with dementia in design and how to address inevitable ethical considerations of the research. Actively engaging with dementia residents in architectural design can provide an insight which could transfer to practitioners, influence policy makers and benefit human-environment interaction. Engaging with those under study in their environments can have a potential impact on professional practice and impact on policy. The formulation of policy comes with a caveat due to effect on professional practice and the potential for environmental determinism to become the norm. This study identifies the need to address issues of human dignity and non-discrimination when engaging in design research with older people. The paper also proposes that care should be taken when investigating the relationship between humans and their environment and that it should be reflective on the social environment also. The strategies suggested in this study aim to provide a richer outcome which may result by effectively working with designers, residents and their carers.