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Lighting for Elders and the Aging Eye

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Lighting for Elders explores how health and safety can be improved for the elderly population through careful selection and placement of light fixtures and finishes.
Presented by: Lauren Roberts
Healthcare Market Development Manager, Visa Lighting

Published in: Technology
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Lighting for Elders and the Aging Eye

  1. 1. And the Aging Eye
  2. 2. Copyright Materials This presentation is protected by US and International Copyright laws. Reproduction, distribution, display and use of the presentation without written permission of the speaker is prohibited. © Visa Lighting 2015
  3. 3. Credit(s) earned on completion of this course will be reported to AIA CES for AIA members. Certificates of Completion for both AIA members and non-AIA members are available upon request. This course is registered with AIA CES for continuing professional education. As such, it does not include content that may be deemed or construed to be an approval or endorsement by the AIA of any material of construction or any method or manner of handling, using, distributing, or dealing in any material or product. ___________________________________________ Questions related to specific materials, methods, and services will be addressed at the conclusion of this presentation.
  4. 4. Credit(s) earned on completion of this course will be reported to AIA CES for AIA members. Certificates of Completion for both AIA members and non-AIA members are available upon request. This course is registered with AIA CES for continuing professional education. As such, it does not include content that may be deemed or construed to be an approval or endorsement by the AIA of any material of construction or any method or manner of handling, using, distributing, or dealing in any material or product. ___________________________________________________ Questions related to specific materials, methods, and services will be addressed at the conclusion of this presentation.
  5. 5. As our population continues to age so do our eyes. The visual requirements of older persons are much different than the younger population. Increased light levels, attention to contrast, detail and the healing attributes of lighting are all important factors in designing lighting for the elderly. This presentation will identify ways in which the eye ages, common diseases and what we can do with lighting as a tool in designing for the aging eye.
  6. 6. At the end of the this course, participants will be able to: 1. Understand the terminology and physical factors of the eye. 2. Describe the phases of the aging eye and common diseases. 3. Look at lighting solutions where lighting can be used as a tool when designing for the elderly. 4. Describe evidence based research on ighting that can improve human health.
  7. 7.  Baby boomers account for the largest percentage of acute care patients  In 2012, 22% of patients 65 and older made a trip to the emergency room  The healthcare industry is bracing for what’s been dubbed the “silver tsunami” http://www.healthcaredesignmagazine.com/article/generational-shift
  8. 8.  Apartments or units vs. large nursing homes  Smaller units add marketability to the community  Adds connectivity to the larger community by having seniors use neighborhood amenities and facilities  80 is the new 65! Communal Spaces Acute Care Settings
  9. 9.  Baby boomers will live longer, happier in their own homes
  10. 10.  Now that we know the trends, how do we light the spaces?
  11. 11. LENS
  12. 12. Cone of Light  Causes less ability to focus
  13. 13.  The lens is responsible for allowing your eyes to focus  The lens is in a constant state of adjustment  With age, the lens looses a lot of its elasticity  At roughly age 50, the lens can no longer change shape
  14. 14. 70 Years20 Years
  15. 15. Normal Diabetic Eye Disease Dry Eyes Cataracts Age Related Macular Degeneration Glaucoma
  16. 16. - PHOTORECEPTORS
  17. 17. Photopic Vision – Cones High Light Levels – Daytime
  18. 18. Peak Sensitivity – 555nm
  19. 19. Scotopic Vision – Rods Low Light Levels - Nighttime
  20. 20. Peak Sensitivity – 498 nm
  21. 21.  IPRGC- third photo-receptor discovered  Intrinsically photosensitive retinal ganglion cells  Turns light energy into brain signals that control the circadian clock  Intrinsically photo-sensitive retinal ganglion cells  Peak Sensitivity at 484 nm http://brown.edu/Administration/News_Bureau/2001-02/01-080.html
  22. 22.  Photopic Vision/Cones – Photopsin  R 564 nm  G 533 nm  B 437 nm  Scotopic Vision/Rods – Rhodopsin  G 533 nm  Circadian/Retinal Ganglion Cells (ipRGC’s) – Melanopsin  B 459-484.  Peak sensitivity at 484 nm
  23. 23.  Circadian Rhythm: A roughly 24 hour cycle in the physiological processes of living beings, including plants and animals.  Photoreceptors in the eye allow light and environmental cues to help regulate core body temperature and melatonin production.
  24. 24. Controls:  Temperature  Hunger  Thirst  Fatigue  Hormone levels  Circadian Cycles
  25. 25.  Brain  Liver  Lungs  Kidney  Heart  Pancreas  Gastro-Intestinal Tract
  26. 26. Light that mimics nature can improve:  Circadian system functions  Sleep  Mood  Performance  Health
  27. 27.  In elders less light reaches the back of the eye because the pupil size decreases with age  They lose retinal neurons that are needed to see light & dark patterns that keep our biological rhythms in line  Due to physical limitations they may be deprived of natural sunlight
  28. 28. So what can we do to help design for the aging eye?
  29. 29. GET OUTSIDE – Sunlight allows the body to maximally utilize calcium and optimize muscle function
  30. 30. Exposure Increases:  Seratonin (impulse control)  Cortisol (stress)  Gaba (calm)  Dopamine (alertness)  Follicle Stimulating Hormone (reproduction)  Gastrin Releasing Peptide (GRP)  Neuropeptide Y (hunger)  TSH (metabolism)  Suppresses melatonin
  31. 31. In the Northern Hemisphere there is insufficient UVB sunlight radiation/Vitamin D available in the months between November and March • 2% in Florida Vs. • 10% in New Hampshire
  32. 32.  Decreased Serotonin (Neurotransmitter)  Increased Melatonin (Hormone) Levels
  33. 33.  Light Treatments  Timing  Duration  Wavelength  Age dependent and individualistic  Sources must be UV filtered
  34. 34. Absence of Blue Increases:  Melatonin (sleep)  Vasointestinal peptide (lowers blood pressure)  Growth Hormone (metabolism and repair)
  35. 35.  Keep sleep disturbances to a minimum  Maintain sleep schedule, decrease naps as needed  Exposure to bright white light in the morning (2 hours when possible)  Amber/Red light at night only (650nm)  Blue light exposure in early evening (470nm)
  36. 36.  Alzheimer’s disease is the most common form of dementia – Damages the SCN part of the Brain  Memory loss  Sleep disorders  Impaired logic & cognition  Inappropriate social behavior  Agitation  Mood swings
  37. 37. Elderly and Alzheimer Facilities Sisters of St. Francis Study, 2010 – Stella Niagara Health Center, NY  Exposure to enhanced interior and outdoor daylight  Removed all white light from hallways at night  Utilized red, warmer wavelengths
  38. 38. Sisters of St. Francis Study Results of removal of white light in corridor  Slept through the night  Awake during the day  Reduced Insomnia  Lower incidence of flu & colds  Reduction and stabilization of blood pressure  Lower incidence of night wandering  Hallucinations ceased  Improved lucidity  Increased social participation
  39. 39. The IESNA Lighting Handbook 10th Edition Handbook (2011) Lighting and the Visual Environment for Senior Living RP-28-07 Location and Task Age 25 - 65 Age 65+ Senior Living Exterior Entry (Night) 10 20 10 Stairways (High Activity) 10 20 30 Elevator Interiors 5 10 30 Reading/Waiting Areas 30 60 30 waiting Group Dining 30 60 50 Bedroom 15 30 30 Bathroom (Fixtures) 15 30 30 Kitchen Area 30 60 30 Hallways (Active) 10 20 30 Hallways (Sleeping) 5 10 10 Nurse Stations 50 100 30 (10 at night) Physical Therapy 30 60 30 (50 task) Examination Rooms 100 200 30 (100 task) Laundry 30 60 30 (50 task)
  40. 40. Area Ambient Light Task Light Dining 50 Living 30 75 (Reading) Bedroom 30 75 (Reading) Bathroom 30 60 (Grooming) Kitchen 30 50 Halls (& path to bathroom**) 30 day/10 at night Entrance 30 Closet 30 Laundry 30
  41. 41. For healthcare you typically need 80 CRI +
  42. 42.  Falls account for 25% of all hospital admissions, and 40% of all nursing home admissions. 40% of those admitted do not return to independent living; 25% die within a year  Others have their quality of life greatly reduced
  43. 43. Light Reflectance Values Yes NoNo
  44. 44. Chromatic Contrast : When the color can produce contrast and enhance visibility  Use complimentary hues (those which lie directly opposite each other on the color wheel)
  45. 45.  Elders will perceive strips as steps or changes in elevations
  46. 46. Disability GlareReflective Glare
  47. 47. Use lensed fixtures over reflective surfaces
  48. 48. Reflections may be confusing for those with vision or mental health problems.
  49. 49.  Light path from bed to the bathroom  Provide amber lights at floor level all night  Provide amber ambient light from above that can be turned on when needed  Provide pre-set dimmers with fade
  50. 50. Adaptation: The ability of the eye to adjust to various light levels  As the eye ages there is a delay in this adjustment (30 min.) - Full light to dark adaptation in a 20 yr old (45 min.) - Full light to dark adaptation in a 50 +  Important at points of Egress to the outdoors  Lobbies and corridors should be dimmed according to time of day to allow for adaptation
  51. 51. Provide a pre-set dimmer with fade to allow eyes time to adjust between brightness levels.
  52. 52. Flicker: Noticeable periodic or irregular changes in source luminance  Can cause discomfort glare, migraines, Epilepsy triggers  Check age of lamp and Lamp/Ballast/Driver compatibility
  53. 53.  30 f.c.  Even light from above
  54. 54.  75 f.c.  Shade  Blue light  Even
  55. 55.  30 f.c. general  75 f.c. task  Dimming
  56. 56.  30 f.c. general  75 f.c. task  Amber night light
  57. 57.  75 f.c.  Close to task  Shielded source
  58. 58.  30 f.c.  Amber night light
  59. 59.  60 f.c.  Best 3 sides  2 sides  Top
  60. 60.  50 f.c.
  61. 61.  30 f.c.  50 f.c. task
  62. 62.  30 f.c.  Key hole  Wayfinding
  63. 63.  30 f.c. day  10 f.c. night  Amber night light
  64. 64. The Lighting Handbook – IES 10th Edition  Has recommended lighting levels by age ANSI/IESNA RP 28-07  Lighting and the Visual Environment for Senior Living ASHRAE  Energy and lighting power density code requirements  Check local code
  65. 65.  Increase light levels when designing for the elderly  Pay attention to source and color  Decrease white light and bright light sources at night  Maintain regular sleep patterns  Increase exposure to daylight
  66. 66.  Center of Design for an Aging Society  Institute for Patient Centered Design  The Center for Health Design  Research Department American Health Care Association  Lighting Research Center  Center for Human Centric Lighting
  67. 67. This concludes The American Institute of Architects Continuing Education Systems Course
  68. 68. Lauren Roberts, LC, EDAC, IES Healthcare Market Development Manager lroberts@visalighting.com

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