Letting the light in: The impact on rehabilitation

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Hope Miller
Hope Miller

Believe it or not, looks do matter — at least when it comes to rehabilitation centers. The look and feel of a patient's environment has a clearly established effect on how quickly and how well a patient heals.

Research has shown that patients who are exposed to sunlight and nature — even if it's just a view of it — experience fewer post-surgical complications, have shorter hospital stays, need less pain medication, sleep better and feel less stress.

Short- and long-term rehabilitation patients confront a painful irony: By the time when they most need the comforts of home is the time when illness or injury keeps them from being there. When the 140-year-old Isabella, a provider of eldercare in Upper Manhattan, NY, had the opportunity to relocate and redesign its rehabilitation center in late 2014, the goal was to provide some of those comforts to help patients heal, return home more quickly and to avoid re-hospitalizations.

Careful design of the rehabilitation center at Isabella supports the effort to realize the goal of creating an uplifting therapeutic setting that gives patients access to sunlight and nature. Replacing the previous rehabilitation area (with its artificial lighting and tight quarters), the new center features a large, open central area with a soaring ceiling and three full walls of plate glass windows that drench the environs with sunlight and provide treetop “cityscape” views.

Isabella is a prime example of how a long-established nonprofit can evolve to incorporate evidence-based design, a new and growing field supporting person-centered care.

This field owes its start to one landmark study conducted in 1984 by Roger Ulrich, a professor of architecture and a behavioral scientist. His researched demonstrated the calming and positive effects of natural views and gardens in hospitals. He found that for patients, gazing at environments with greenery, flowers, or water for even just a few minutes served as a “positive distraction” that reduced stress and had restorative effects on health, as demonstrated by improved blood pressure, heart activity, muscle tension, and brain electrical activity. Ulrich also observed that patients given “positive distractions” experienced fewer post-surgical complications and shorter post-surgical hospital stays.

In another study, patients recovering from abdominal surgery recovered faster, had better emotional well-being, and required fewer strong pain medications if their rooms had windows with a view of nature rather than a brick wall. Also, a study in a Swedish hospital showed that heart-surgery patients in ICUs given even just a picture with a natural scene, such as a landscape with trees, reported less stress and needed fewer strong doses of pain drugs.[1]

Other research has shown that exposure to sunlight decreases length of stay in hospitals, improves sleep and circadian rhythms, lessens agitation among dementia patients, eases pain, decreases use of pain medication and increases staff satisfaction. That's quite a tally of side benefits.

Some aspects of evidence-based design can be incorporated only from the ground up, and new facilities are doing just that — but where does that leave institutions that date back decades, or even a century — institutions that are unable to completely overhaul their facilities? How do older facilities continue providing the highest standard of care and an optimal work environment for staff? How do they compete?

Light and nature are a key place to start. Letting in more light and incorporating nature into a patient's day has a significant and transformative effect, one that we are starting to witness here at Isabella. More often than not, light and nature are amenities that care providers can readily offer.

Hope Miller is the Vice President, Care Services for Isabella, a Manhattan, NY, non-profit organization that has pioneered the care of the elderly since 1875. Visit www.isabella.org for more inflation.

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