Why is lighting in care homes important?
Lighting in any setting is important, but especially in the healthcare environment. It can aid with both physical and mental recovery, keep your circadian rhythm in sync, and on a more fundamental level, ensure the correct level of illumination is available for medical tasks.
Within the care home setting, traditionally, lighting has been static, low intensity, and often unfit for purpose.
Research has proven that there is a clear relationship between lighting and health. The right lighting can promote calmness, reduce lethargy feelings, maintain your sleep-wake cycle, and have even been linked to an improved immune system. ‘Circadian disruption dampens your immune system and makes a virus harder to defeat' (Lisa Health N/A). Also, a healthy circadian rhythm can aid with the rehabilitation of certain medical conditions, e.g. brain injuries (William D.S. K et al. 2020).
The conclusion of an investigation on 46 people living with Alzheimer’s and other dementias by the Lighting Research Center in New York is that the lighting in long-term care facilities is usually not bright enough during the day and ‘perhaps too bright’ during the evening.
Typical indoor lighting provides less than 100 lux at the eye, whereas being outside on a sunny day will provide anywhere from 1,000 to more than 10,000 lux at the eye.
Older adults in long-term care facilities often spend their days and nights in dimly-lit rooms with minimal time spent outdoors. Thus, they do not experience the robust daily patterns of light and dark that synchronise the body's circadian clock to local sunrise and sunset.
The 24-hour light and dark pattern strongly determine a person’s sleep-wake (circadian) cycle, telling the body when to sleep and wake up. Studies have demonstrated that daytime light exposure of CS > 0.3 (approx. 350–500 lux at the eyes) can improve nighttime sleep efficiency and increase daytime wakefulness by promoting circadian entrainment.
It is also widely noted that having a circadian rhythm that is in sync can reduce the risk of developing certain medical conditions (such as diabetes and depression).
Furthermore, a study by The Center For Health Design in California controlled the body’s circadian system with lighting. The lighting impacted the healthcare setting by reducing depression among patients, decreasing length of stay in hospitals, improving sleep and circadian rhythm, lessening agitation among dementia patients, easing pain, and improving adjustment to night- shift work among staff (Joseph 2006).
Another study at a Sacramento Municipal Utility care home in the US reported that a pilot installation of circadian lighting showed very positive results. There was a reduction in falls by residents and improvements in sleeping through the night, and a reduction in the use of psychotropic and sleep medications. They also recorded a reduction in resident behaviour episodes, with one dementia resident showing an improvement of 41% (Davis et al. 2016).
The body clock regulates many hormones, including cortisol and melatonin, which regulates how alert we feel and body temperature. The changes in intensity and colour temperature of natural daylight happen seamlessly across the day; however, we cannot fully reproduce this with artificial circadian light.
Though, we are much closer to this utopia than ever before as the evolution of LED has enabled light to be produced, which is significantly closer to natural daylight. Close enough, in fact, to affect the body’s response to light. We can now help address the balance between spending too much time indoors, and our bodies need light to set its clock. In implementing a circadian lighting design that spans the full spectral distribution, we can simulate daylight effects:
Starting in the morning with the highest light levels (a target of around 750 lux or greater) and using the strongest circadian activating light content delivered between 7 am and 10 am by precise spectral control, broadly equivalent to a CCT range of 6000k to 8000k, will improve residents alertness.
Then, gradually blending the colour mix to taper the blue light content towards the afternoon, as residents begin to wind down, fading it out while maintaining as close as possible to a white light in the region of 3000k. The intensity would then drop to around 600 lux.
After 4 pm, the design should shift towards an evening colour scene, equivalent to CCT of 3000k. Later in the evening, move into the night-time setting, at the warm end of the spectrum with reduced intensity levels, preparing residents for a good night’s sleep.
Many factors can influence our circadian rhythms, such as exercise/movement and food intake. However, we can achieve excellent results in the care home setting by combining them with new interactions with our non-image-forming light receptors. A recent install of spectrum-controlled lighting at Heanor Park care home has revealed amazing results, and the project has even won ‘Client of the Year’ at the Lux Awards 2020.
Check out the video below to learn more:
‘We’re seeing a greater level of engagement from the residents during the day because the lighting is helping their body clock become alert and ready for the day…we’re not seeing people falling asleep in their chair or not wanting to engage in activities’.
- David Poxton, Managing Director
‘We’ve only had a couple of falls within the last 3 months since we’ve been open which is great for residents wellbeing’.
- Catherine Bower, Care Home Manager
Getting the lighting design right is the key to a successful project that not only fulfils the client's objectives but also continuously provides outstanding benefits for residents throughout the lifetime of the building.
If you would like to find out more about amBX’s Circadian Plus solution, then click here to get in touch or to learn more on circadian lighting design contact it does lighting here.
About amBX
amBX develops software that is creating the future of lighting. They believe in a future for lighting that can transform human experience and wellbeing and their SmartCore system is designed to deliver that for buildings and projects of all sizes.
Originally formed as a spin-out from Philips, amBX has gone on to see their software at the heart of hundreds of lighting systems in over 16 countries worldwide.
About Lorraine Calcott
Lorraine Calcott is an experienced lighting designer who works closely with amBX to perfect the design of circadian lighting in each install. Lorraine specifies that full-spectrum lighting works not only with our emotional responses to light but also on our biological response, helping reset and maintain our body’s circadian rhythms.