practical living
day on hands and arms. This allows the body to manufacture
vitamin D, which again is very important for bodily health,
particularly with regard to bone strength and muscles. And if
the muscles and bones are better, there’s usually less damage if
someone falls.
Other things that come into play include seasonal affective
disorder, which up to 5 per cent of people in Australia and New
Zealand suffer from. Light can make a big impact in relieving the
symptoms of that.
Another benefit of exposure to direct sunlight is that the body
also manufactures nitric oxide. This is very good for cardiovascular
benefits, as it increases the rate of blood flow through the body.
We have benefits from sunlight, the vitamin D and the nitric
oxide. Generally, you can’t get these through windows, so you
have to get outside.
The benefit of daylight and circadian rhythm is you don’t need
direct sun. Generally, you can achieve the benefits by sitting
close to a window inside, although getting outside is obviously so
much better.
On the sunlight safety issue, Cancer Council Australia
cautions that when the UV index is 3 or above, extended and
deliberate sun exposure without any form of sun protection is not
recommended. On the other hand, however, they caution against
excessive protection, saying that sunscreen use should not put
people at risk of vitamin D deficiency.
Darkness overnight is also very important. Firstly, light at night
is annoying and disturbs sleep. Secondly, light exposure overnight
suppresses melatonin production. Melatonin production is a by-
process of the circadian rhythm mechanism. It’s very important
for cleaning out the body’s inefficient radical scavenger. It cleans
out toxins from the body overnight. If you expose people to light
overnight, the melatonin production is suppressed, and they’re
more susceptible to dise ase.
Another thing to consider in dementia, and this isn’t solely
related to light level, is perception. The visual construct is formed
by the brain. The eye has input, but the brain does all the hard
work. In dementia, the communications in the brain are beginning
to break down. People are more likely to make misinterpretations
– for instance, thinking that a black rug is a hole, and trying to
walk around it. They may also think that the floor extends further
than it does, and they walk into the wall. That’s one reason we
recommend clear contrast between the floor and the wall.
In a care home, it was found that there were two sets of
people taking action about a paisley-patterned rug. One set was
sitting looking at it. The other set was walking around it, taking
great care. When the researchers got to the bottom of this, they
found that both sets thought the rug was a fish pond. Confusing
patterns are easily mistaken and can cause problems for people
with dementia.
In what other ways might aged care facilities be getting it
wrong when it comes to light and lighting?
A range of issues continually come up: insufficient corridor
lighting; using high powered LEDs, which can produce too much
glare; the confusing patterns we’ve talked about; and the lack
of contrast between, say, food on a table and the table. People
have been known not to find a glass of water sitting on a white
tablecloth, or maybe some fish in a white sauce sitting on a white
plate, on a white tablecloth.
Some people think that shadows outside don’t have sufficient
light. That’s not the case. Outside is very bright compared to
indoors. Even in a shadow, people will pick up significantly
more light exposure than they will indoors.
Getting people outside for their light exposure, for a little
exercise, to enjoy the sights and the sounds outdoors is
very important.
Care has to be taken not to light care homes like an office
or a library. You have to have sufficient domestic-style luminaires
in the environment to contribute to an overall feeling of being
in a home.
What are some of the key considerations when it comes to
light and lighting that aged care providers should consider
before a build or refurbishment?
People should be aiming to get twice as much light in the
interiors as they first thought of, or as the standards specify. Every
site is different. What you want to do is maximise your daylight
penetration, while at the same time minimising unwanted heat
gain, a problem from that daylight.
Easy access to a garden is also important. And design a nice
garden based on activities, seats, bird tables, perhaps whatever the
locals used to do. I know one care home in a farming community
has an old tractor in the garden. That’s really good for the men to
tinker about with.
Another key issue is direct viewing lines to key points. You
should always have a toilet in view for ease of access. When
people emerge from their rooms, they should have some idea of
where they’re going by that direct access to the kitchen, lounge or
the sitting area.
Say a facility has been built without lighting in mind, and there
isn’t the budget for a major refurb. What can managers or
staff do to get some of the same benefits that a site built with
lighting in mind would offer?
That’s a tricky question. There are so many little things that can
be done. In fact, in our new book we’ve actually got several pages
devoted to effectively answering this question.
One that springs to mind is to extend curtain rails beyond
windows, so that the curtains can be freely drawn and let as much
daylight in as possible.
Make sure you wash your windows occasionally. It’s amazing
how much dirt can be trapped and prevent light coming through
if windows aren’t washed.
If there are any trees or shrubs directly outside windows, you
can cut them back and let in more daylight. There are loads more
tips in the book.
To sum up, what would you say are your top lighting tips?
I’ve got five key points. Most importantly, light indoors at twice the
levels in the standards for middle-aged people.
Expose people to the 24-hour cycle of light and dark. That will
have great benefits for their circadian rhythms and their health,
and it will help prevent falls.
Consider surfaces. You see by reflection from surfaces. Have
contrast for your objects to be found. Don’t have contrast where
you don’t want them to be found. Think about the perception.
Think about the funny patterns and how they will be perceived.
Use daylight wherever possible, because it’s a very high quality
of light. After you’ve done your initial design, effectively it’s free.
Use sufficient domestic-style fittings to help promote a
recognition of place. Don’t have people thinking they’re trapped in
an office, a library or a restaurant. ■
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