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Let there be (the right) light

Posted by: Paul Gibeault

What type of lighting is ‘right’ for a senior living space?  Answering that question involves understanding many variables affecting the quality of light including but not limited to brightness, contrast, glare and color temperature. Keeping up with technology advancements and building code changes adds yet another layer of complexity.  Overlay these variables with the continual desire to recreate home-like environments for senior living while also delivering regulated health care services at times and you have a complex and nuanced formula to calculate in trying to answer the question.

Through numerous studies on the subject of how we as humans receive, perceive and respond to light as we age, we have learned that an elders’ eye changes in definable ways.  Overall, the amount of light perceived is reduced in the aging eye, meaning that a higher quantity of light should be provided where appropriate, while at the same time not flooding an entire space with light for the sake of making it ‘bright’.  Flooding a space with light may likely exceed current energy codes but more importantly, the space overall may be rendered bland, monotonous and uninviting, or be simply too bright.  Just as looking directly at sunlight causes us to squint due to the excessive amount of light (read: glare), a space flooded with light in an uncontrolled and less than thoughtful design is not desirable.

The degeneration of the eye also brings on a continued loss of clarity as we age.  Further, the eye’s sensitivity to the above noted brightness, and its reduced ability to adapt quickly to changing lighting levels, puts the elder in an environment that becomes more and more difficult to live with.  Specifying the right light “for the task at hand” in the right location so as to avoid glare and enhance the features of a space is a successful design strategy.    This type of layering from general illumination to task lighting and highlighted areas is now more prevalent in newer, resident centered senior living environments.

The aging eye also begins to perceive less of the color spectrum.  The lighting strategy, and particularly the type of lighting source, can greatly enhance the perceived color and contrast if coordinated properly.  Correctly specifying variables such as CRI (color rendering index) and the color temperature of the lighting source (incandescent, fluorescent, LED) should lead to an enhanced environment for the senior eye.  Often this also leads to a debate about appropriate color palette and how much contrast to include within the finishes selected for a space.  The overall palette of a living room or a corridor floor may tend towards less contrast, while specific details like the lean rail against the wall, or the dishware of the dining room against the color of the table or linens may require more contrast to assist in visual acuity.

And what about LED’s?  This lighting technology utilizes light emitting diodes (LED) to create colored or white light in a wide array of fixture types.  The strength of LEDs is that they use much less energy to produce light than a residential incandescent bulb, and can be more easily dimmed than fluorescent sources.   Early shortcomings including heat management, consistency of color and other quality issues have largely gone away with better manufacturers now almost all including LED in their line cards.  The remaining challenge with LEDs is that conventional application strategies need to be rethought.  The LED itself can be physically configured appear much like a typical light bulb, a flood light, a downlight, a fluorescent tube or anything in between.  The issue is that LED technology is still young and developing, and the ever changing manufacturer offerings and advancements in the technology make for a moving target.

The lighting control package is also a key component in enhancing the senior care environment.  The ideas of a ‘warm dim’ or similar lighting control that could reinforce circadian rhythm patterns via the lighting are being debated as to their effectiveness in increasing positive resident outcomes.  This might include simply an LED fixture which has both bright white diodes (4000K color temperature or higher) and warm white diodes (2500K or less) in the same fixture.  The bright, cooler white color temperature stimulates us as a bright blue day lit sky might, while the warmer tones tend to calm and relax just as our small table lamp or fire light might.   Couple this technology with a controls package that includes a time clock function, and you now have a lighting system that could offer a generalized mood change throughout a facility from wake-up time in the morning, to a late afternoon or evening ‘sun downing’.

The end goal of course is positive patient/resident outcomes.  If the lighting is designed in such a way that seniors  feel safer and more comfortable in their ‘homes’, with resident’s families sharing in this positive perception of the facility, we can minimize agitation and anxiety; and  maximize enjoyment and engagement in the environment and their community.

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