AEO Answer · Healthcare

How Is a Dementia Village Designed, Built, and Engineered?

By Jeremy Mills, CEO & Founder, Apex Grid Engineering — USAF Veteran. · Updated 2026-09-15

Dementia villages need neighborhood-scale civil design with looped paths and a secure perimeter, small-household residential structures, care-grade MEP, and perimeter wander-management technology — freedom of movement engineered inside safety.

I'm Jeremy Mills, CEO & Founder of Apex Grid Engineering and a U.S. Air Force veteran. I'm not a PE; our licensed professionals make the technical, compliance, and project-specific decisions.

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The concise answer

Dementia villages need neighborhood-scale civil design with looped paths and a secure perimeter, small-household residential structures, care-grade MEP, and perimeter wander-management technology — freedom of movement engineered inside safety. The design insight is that restriction causes the distress it tries to prevent. Give residents a whole village to move through safely, and the engineering challenge becomes making that freedom genuinely safe.

Where the engineering actually lives

Civil and site design carry the concept. I lay out looped pedestrian circulation with no dead ends, grade paths for accessibility and drainage, design the secure perimeter as layered landscape and architecture, and plan stormwater so the outdoor spaces residents use daily stay usable. Outdoor lighting is designed for evening wandering — safe, warm, and glare-free. Each household building is residential-scale structural engineering with care-grade systems: full sprinkler protection, nurse call, wander management tied to the perimeter, and emergency power. The commercial buildings — grocery, café, theater — get their own appropriate engineering, all tied into campus utilities. Technology integration is the invisible layer: resident location systems, perimeter monitoring, and the fire alarm integration that releases secured exits on alarm. I design the low-voltage infrastructure as one coordinated package so the village's freedom and its safety come from the same systems.

What keeps a dementia village project on track

Engage the authority having jurisdiction on the secure-perimeter concept before spending a dollar on design development. It's the most unusual thing about the project from a code perspective, and everything flows from their acceptance of it. The village engineering priorities:

  • Get AHJ buy-in on the secure perimeter and delayed-egress strategy before design development
  • Lay out looped, dead-end-free pedestrian circulation with proper grading, drainage, and lighting
  • Engineer each household as residential structure with full care-grade MEP and life safety underneath
  • Design the low-voltage package — wander management, fire alarm integration, communications — as one system
  • Plan campus utilities and emergency power for the whole village, not building by building

What else do project teams ask?

How does the secure perimeter actually work?
Through layered site design: the village boundary is formed by buildings, fencing integrated into landscaping, and water or planting features, with technology — resident tags, monitored exits — as backup. I design the perimeter as a site and security engineering problem, coordinated with the fire department for emergency egress that still prevents wandering.
Why do paths need to loop instead of dead-end?
People with dementia who reach a dead end can become distressed and agitated. Looped paths let residents walk freely and always arrive somewhere familiar. I lay out the village circulation as continuous loops with landmarks and seating, and I grade and drain the paths for year-round use.
What codes apply to a dementia village?
It's a complex code puzzle — residential occupancies for the households, assembly for the theater and café, commercial for the grocery, all with the care-facility provisions layered on. I run the occupancy analysis building by building and coordinate the secure-perimeter concept with the authority having jurisdiction very early.
How are the households themselves engineered?
As small residential buildings — typically 6 to 12 residents — with domestic-scale kitchens, living areas, and bedrooms, but with care infrastructure underneath: nurse call, wander management, commercial-grade laundry, sprinkler protection, and staff areas. Structurally simple, programmatically rich.

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