Research has shown that communication is affected by the environment and that modifications can improve communication skills in individuals with dementia. Poorly designed environmental features contribute to unsatisfactory responses or behaviors in individuals with cognitive impairment. Environmental modifications must be customized to the person, setting, and activity. Assessment provides a practical means of systematically acquiring that information, translating it into appropriate recommendations, and evaluating the success of those recommendations. This indicates the need for an environmental assessment that is individualized, not only to enhance clinical reasoning and judgment, but also to provide a basis for evidence-based, person-centered practice.