A change of environment can be unsettling for someone with dementia but it isn't necessarily something that will have long term effects. Why you are considering moving him? Is he settled there and you are happy with the standard of care he is receiving? The fact that people in the home are worse than your husband isn't necessarily a bad thing as it will mean that he may not need to move again in future if his needs increase - some homes will only cope with a certain degree of dementia then ask the resident to leave if they become difficult to manage. The fact that some residents have been there for 20 years is also positive - the home must presumably be doing something right or they wouldn't still be there. My Mum lived in 3 different care homes last year (due to being placed in unsuitable homes by the LA) but is now happily settled in the third home, although it took a while for her to settle. Two were fairly small and the current home is much bigger but small isn't necessarily best - you need to make sure that any home meets your husband's needs now, and also consider whether they could continue to meet his needs in the future. Although some in Mum's home have serious mental health issues they are on a different unit to Mum so maybe a move to a different area of the current home, more suited to your husband's needs, may be possible?