In this thesis, innovative housing concepts for people with dementia are analysed in terms of their outcomes and the preferences of the German population for the design of small, home-like living units are elicited.

In chapter 1, a general introduction is given. 

Chapter 2 begins by presenting the results of a scoping review. The aim of this review was to analyze published preference surveys on long-term care considerations in people with dementia. In addition to the inherent research interest, the results were also intended to provide a basis for the design of the preference assessment as part of the written survey. Ten studies were included, nine of which used a discrete choice experiment (DCE). The results show that preference elicitation methods have been successfully used and despite different objectives, strong preferences for continuity of care by the same person, organizational aspects, and caregiver expertise were found across studies.

Chapter 3 reports on a systematic review which aimed to analyze small-scale homelike living units regarding residents' quality of life, behavioral aspects, as well as functional, cognitive and emotional aspects. Included studies reported on 11 different concepts, which are broadly similar with regard to care philosophy, but differ in some aspects such as group size, staff qualification, responsibilities, and organizational structures. Small-scale homelike living units showed beneficial effects when compared to traditional care settings, including preservation of activity performance and positive influences on emotional status and social behavior. However, some studies also showed an increase in behavioral and psychological symptoms of dementia (BPSD).

Chapter 4 reports on a DCE which was conducted to elicit preferences for living arrangements in dementia in urban and rural regions in Germany. On the basis of the two literature reviews and additional focus groups, seven attributes were included in the final design. Individuals between the ages of 50 and 65 were identified through population registration offices and approached via postal survey. A total of 840 returned questionnaires were included in the analysis. Access to a garden was perceived as the most important attribute, followed by consideration of food preferences, and staff qualification, care organization, group size, range of activities, and support of religious practice. Heterogeneous preferences according to gender, age, religiousness, migrant background, and experience as informal caregiver were detected.

In Chapter 5, a best-worst scaling experiment is presented, which was part of the postal survey and aimed to gather insights on preferred activities in small-scale living arrangements for dementia. Out of ten activities, respondents perceived walks and excursions, sport activities, gardening, and interaction with animals as most important, while household activities and practicing religion were of lowest importance. Importance ranks differed between subgroups.

Finally, Chapter 6 offers concluding remarks on the essays presented.