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BACKGROUND: The population of people with Alzheimer’s disease (AD) is rapidly increasing worldwide. While in Republic of Macedonia there is no formal special care for people with AD, developed countries are expanding on both the typology of their care homes and services they offer for people with AD. The Macedonian aging population is in need of long-term care (LTC) options tailored to meet the special needs of people with AD.AIM: The aims of this study are (i) to explore the Macedonian approach to the problem of creating LTC environments for people with AD, as compared to the approach of a developed country through the example of Canada, and (ii) to identify successful interior design characteristics that would meet the special needs of people with AD. METHODS: The study begins by reviewing existing literature with the purpose of obtaining knowledge about the common clinical symptoms of AD (i.e. memory problems and behavior) and how these changes have an impact on the interaction between AD individuals and the physical environment they live in. For the purposes of the study, a fieldtrip was conducted in two LTC homes in Toronto (Canada) offering special 24 hour care for people with AD, and one LTC home in Skopje (Macedonia) that includes people with AD in their care program. The interior design of LTC homes was described through photographs, plans, observations and a description of the spaces used by people with AD. For a controlled analysis of the recorded environments, the 'Evaluation of Older People's Living Environments (EVOLVE)' questionnaire was used. RESULTS: The identified qualities from the case studies, and the lessons learned throughout the analysis of the key design elements, were used towards developing a list of suggestions for modifying the interior of the Macedonian LTC home. The developed suggestions were classified into two groups: (1) proposals for minimal constructional modifications of the interior environment, and (2) proposals for major constructional modifications of the interior environment. CONCLUSION: While the suggested modifications are not final changes of the LTC environment, they are an important step towards developing a design strategy for providing 24 hour care for people with AD in Macedonia

Interior Design of Care Homes for People with Alzheimer's Disease: A Comparative Study