See Seniors Housing in a New Light

The quality and quantity of lighting in a community has a subtle but crucial effect.

By Russ Garber

While many design elements in senior living facilities have been carefully vetted and refined over many iterations — even generations — to determine what works best, one elements that is all-too-often overlooked or underemphasized is lighting.

This is unfortunate, because the right lighting can have a significant (and even dramatic) impact on residents. Insufficient or poorly chosen lighting design can have a correspondingly noticeable negative effect.

The surprising size and scope of that effect was made plain in a recent study we commissioned, conducted by design research consultants. The study consolidated and conducted a comprehensive review of academic journals, scientific studies and published literature on the topic of lighting in senior living facilities and found that the three main areas that lighting affects in residence living in senior living facilities are mood, risk of falls and overall resident performance.

The team set out to understand the fundamental question of how much, if at all, the quality of interior lighting affects conditions related to aging, specifically reduced visual acuity, impaired depth perception, reduced mobility and increased fall risk.

The results not only paint a picture of the overall lighting landscape in senior living facilities — the research strongly suggests that current lighting levels across the board are too low for older adults — they reveal some eye-opening conclusions about the health and wellness impact of lighting on the residents in those facilities. The report concludes with a series of key takeaways and actionable items that can help designers, developers and facilities managers make informed decisions about how to improve the lighting design in their own senior living facilities. 

Mood

At the start of this study, we could see that mood was a big topic in the articles we researched.

We all know that lighting can affect mood. Think of the multitude of lighting levels in restaurants and how each one of those makes you feel.

Through our studies we found that dynamic lighting can help a person’s perception of the space, and in general make them feel more comfortable. This is important because anxiety can be harmful to residents, as it causes mental and physical health issues. Additionally, lighting cannot only improve a person's perception of a space, but can also counteract negative moods in older adults by using layered lighting or varying color temperatures.

Other key mood-related takeaways learned throughout the include:

  • Luminance levels that rapidly increase and slowly decrease may produce more positive responses and performance accuracy in older adults.
  • Using cool colored lighting may reduce the chance of amplifying negative moods in older adults. This strategy could be especially beneficial in high-stress areas or when dealing with dementia patients, where mood management is particularly critical.

Layering different types of lighting (ceiling, wall and table lamps) is most comfortable for older adults. Bright spaces are generally perceived to be warmer, more comfortable and understandable by older adults. Be cognizant of lighting color temperatures throughout varying types of spaces in the senior living facility, dependent on activity.

Performance

On issues of physical and mental performance, we learned that older adults tend to prefer lighting that is brighter than they expect. And, consequently, when older adults place their own furniture, generally the bedside is the only place that is provided with the correct lighting level.

However, when lighting is corrected, older adults liked it better. This is important to consider because it means that unless lighting is specifically designed for the resident, they may have to strain their eyes or other faculties to perform general day-to-day tasks.

We also found that, in signage, indirect lighting is more important than contrast with regard to reading capabilities in older adults. Even for something so basic as a sign that points to the dining area, lighting should be taken into consideration so that residents can easily navigate their way throughout the facility.

The following conclusions regarding performance were also reached:

  • 50 percent contrast and overcast performed better than
90 percent contrast with in-house lighting.
  • Individual results with respect to personal preference, visual performance (the speed and accuracy of the task) and visual acuity (the ability to discriminate fine detail) varied significantly. Consequently, the best approach to providing lighting for older people is to investigate, on an individual basis, the effect of different light levels. It might be a good idea to have an on-site “test room” where the light level can be varied in order to find the optimal setting for each individual.

We suggest that if a person doesn't know what lighting is best for themselves, help him or her by giving the ability to see the differential. Consider what lighting is appropriate for each and every normal-day task.

Fall prevention

Because falling is such an enormous health and safety risk for older adults, we wanted to know how lighting affected a residents’ risk of fall. What we found is that the amount of light in nursing homes is seldom sufficient to meet the visual needs of older adults.

Lack of illumination may induce
a higher risk of accidental falls for residents, especially dementia patients. In a continuing care environment, a lighting plan should be created to increase lighting as the resident grows older.

Other findings to take into consideration include:

  • When navigating in more challenging environments, such as in low-level ambient illumination, the addition of perceptual cues that define the horizontal walking plane (ambient, nightlight or pathway lighting) can potentially reduce falls risks in older adults.
  • Bright lighting prevents or reduces the following in seniors: contact with objects, gait change, searching with hands and feet, loss of balance, veering off path, trailing (using furniture as guides), stopping, and spotter intervention. Facilities managers and other senior living facilities employees are encouraged to look for those cues during observations or include them in staff audits as indicators of potentially poor lighting.

These findings not only reveal some important insights into how lighting impacts the emotional state, mental acuity and physical performance of seniors, they provide a good place to start for anyone involved in the design and operation of senior living facilities who wants to get a better understanding of these issues.

 

Russ Garber serves as an associate and senior project manager at M+A Architects, a Columbus, Ohio-based architecture firm.

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