There is little specific information pertaining to the design requirements of the physical home environment for people who experience problems with cognition who display aggressive or self-injurious behaviour. A systematic review, guided by the Protocol guidelines for systematic reviews of home modification information to inform best practice (Bridge & Phibbs, 2003) was implemented in this study. An initial literature review was conducted pertaining to the needs of and current design of homes of people who experience problems with cognition who display aggressive or self-injurious behaviour. Nine guidelines have been highlighted to assist in the design of optimum home environments for this population.