How to do it ... lighting

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Lighting is an overlooked design element in many long-term care environments. Good quality illumination will make a big difference in your residents' quality of life, and in many ways that you might not at  first realize. Experts give their tips here on achieving better lighting.

1 - Interior lighting is equal parts science and art, and the best designers do both well.

“Lighting  ... is an area many interior designers and architects aren't fully educated about,” says Betsy Brawley, a senior living interior designer, independent consultant and founder of Design Concepts Unlimited.

Karyn Gayle, a vice president at Acuity Brands, agrees professionals are needed.

“If at all possible, engage a professional lighting designer or engineer who is familiar with the distinct needs of long-term care facilities,” Gayle says. Improper or inadequate lighting could aggravate disorientation among dementia residents or increase the prevalence of falls with frail elderly. New kinds of lighting, meanwhile, can mitigate issues like “Sundowner Syndrome,” an affliction that disrupts sleep cycles.

Experts also advise tapping into the resources of the Illuminating Engineering Society.

2 - Focus on function over form. The quality of light is far more important than the beauty of the fixture it emanates from. Far too many long-term care facilities choose dramatic lighting solutions that create dimly lit environments. 

A 2007 study published in the Journal of the American Medical Directors Association concluded that the amount of light in nursing homes was seldom sufficient to meet the visual needs of older people.

“I care less about current trends and more about getting the light levels raised considerably,” says Brawley. 

Emerging technologies are now focusing on the role of light in seniors' circadian rhythms, according to Lucas Bassin, WalaLight Director, uSave LED.

“Bright sunlight is rich in blue light and triggers circadian rhythm,” says Bassin. “In the evening, however, we need warmer light temperatures that trigger the brain to begin secreting melatonin to encourage the sleep cycle.”

3 - There is a flip side: too much light. Many facilities have “hot spots,” or areas of near-blinding glare, such as outside light pouring into the end of a long, dimly lit hallway. 

“Higher light levels are often necessary for the aging eye. However, it is critical that we manage glare as we increase light intensity,” Gayle cautions. 

Choosing sources with diffusing lenses or indirect light distributions can help to minimize glare.

“Buyers should closely evaluate lighting fixtures to ensure that they will not be perceived as overly bright from various viewing angles for residents,” Gayle adds. 

Problematic angles may include direct view from a prone or reclined position, seated in a wheelchair, standing unassisted or with the help of mobility aids. 

4 - Don't be too tempted by inexpensive lighting. It might be cheap to implement, but it could be more expensive in the long run.

“Energy efficient technologies dramatically increase the ROI on lighting investments,” says James Feeney, managing director at Improved Illumination. “You don't want to be switching out lighting systems every two years. Be mindful that good suppliers are just like you: They want to provide the highest quality ‘product' while offering a sustainable cost structure.” 

Gayle adds that a less expensive system with problems may be a worse deal over time.

5 - The best lighting solutions address both the physical environment and residents' needs. 

“There's no silver bullet,” says Feeney. “It depends on what you're trying to accomplish, how the space will be used, your budget and timeline.”

Precious little attention is devoted to the dramatic effects of aging on eyesight, and good, quality lighting can change that. 

“Whether you're living at home, an assisted living facility or skilled nursing home,” Brawley says, “your eyes are not seeing the same things they did when you were even 40.”

Mistakes to avoid

Choosing style over substance. Beautifully designed fixtures are worthless if they don't produce high enough quality light.

Failing to consult the experts. Lighting is a complex science.

Taking the overly thrifty route. Inexpensive lighting could mean more frequent replacements or upgrades.