The proposal advocates for a national conference on lighting for the ageing population in the UK, addressing the adverse effects of inadequate lighting on older people's health, workplace efficiency, and quality of life. It highlights the need for improved lighting design in homes and care facilities, as well as the potential therapeutic benefits of light, particularly for sleep and mood disorders. The conference aims to connect the lighting community with health and social care sectors to explore design solutions that enhance the wellbeing of older adults.

1. Lighting & the Ageing Population
Proposal for a national conference, organised by the
Institution of Lighting Professionals

2. The Background
• The UK, in common with other industrialised countries has a
rapidly ageing population – every year our average age rises
by 5 weeks!
• In 2010, 16% of the population was over 65 – by 2035 that
figure will be almost a quarter of the population
• Currently there are 800,000 sufferers from Alzheimer’s and
other forms of dementia
• Huge knock-on effects in terms of health, housing and work
• On the basis of current research and technological
developments, we believe that lighting could have
significant positive effects on these areas of life
• Currently the elderly are very poorly served by lighting in the
UK – massive lack of awareness of the issues

3. Impacts of Lighting on Older People
The impacts of lighting on older people fall into two main
groups, as shown above

4. 1. Lighting for Visual Function
and Visual Comfort in Older
People

5. 1a. Workplace Lighting
• Due to the crisis in pensions,
many more people forced to remain
in work beyond 65
• Widening age range within the work-
force in offices and other workplaces
• 65-year olds require 3 times the amount
of light to achieve the same visual task
efficiency as 20 year olds
• Of the 9 million people over 64, some 2 million (22%) have some
degree of sight loss that affects their lives – many of these may
be forced to remain in work too
• Not just the amount of light that can have an effect on workplace
efficiency – also the lighting quality, in terms of its spectrum,
colour rendering capability and spatial distribution

6. Design Challenges
• This presents a considerable lighting design challenge –
most workplace lighting not catering for the older worker
• At the same time, current lighting design practice is
moving away from ergonomics towards energy savings –
may actually worsen the situation
• Older people in the workplace and the home will need
increased light levels – which might involve more energy,
not less
• IESNA in the USA has recognised this – lobbying for visual
needs for older people to over-ride existing energy codes.
• No such moves in the UK.

7. 1b. Lighting in Homes for Older
People
• The situation in institutions for older people is even
worse, with residents more vulnerable and less aware
of the issues -- in common with many care home
owners/managers.
Percentage of
different age
groups in
care homes
for older
people

8. Visual Afflictions of Older People
• Loss of visual acuity – growing inability to focus
• Loss of contrast sensitivity – inability to identify
objects’ edges
• Greater sensitivity
to glare
• Slower light-dark
adaptation
• Poorer depth
perception

9. Visual Afflictions of Older People
• As well as being the normal inconveniences of ageing, these
visual deficiencies can contribute to falls -- the most common
cause of accidental death or serious injury among older people
• Falls cost the NHS £4.6 million per day – projections for 2021
show the number of admissions through falls will increase by
33% for men and 16% for women
• In particular, as the most frail members of the population, 60%
of care home residents fall every year
• Better lighting in old people’s own homes and care homes – in
particular the creation of higher luminance contrast -- could help
reduce these problems

10. Innovative Design Solutions
 Originated at the Lighting
Research Centre in the USA,
this innovative LED door frame
lighting system, for night-time
use, is just one example of how
lighting design can help.
 A pressure pad under the rug
by the bed turns on the LEDs
to give horizontal and vertical
cues to the location of the
bathroom door
 UK lagging behind in terms of
innovation?

11. 1c. Design Guidelines
There are useful guidelines for lighting living spaces forThere are useful guidelines for lighting living spaces for
people with sight loss – e.g. Thomas Pocklington Trust’speople with sight loss – e.g. Thomas Pocklington Trust’s

12. Design Guidelines
Main TPT recommendations:
•Increased light levels for task and
ambient lighting + greater use of
daylight
•Minimisation of glare – low
specularity of finishes
•Balanced light levels within the
space to avoid excessive adaptation
•Increase of contrast between different
surfaces and objects (e.g. light switches and walls)
•Good colour light spectrum and CRI of light sources
High contrast step
edges for older people

13. Design Guidelines
• However, the guidelines are not being followed – a recent
TPT survey showed that only one out of 11 new buildings
for older people complied with specialist design guidance
• Nine lounges lit to only half the recommended minimum
• 30% of lounges, 50% of dining rooms and all the activity
rooms fell short of the minimum daylight level for buildings
recommended in the BS Code
• One important issue here – is there a conflict between
greater energy savings and the need for higher lighting
levels for older people?

14. 2. Therapeutic Benefits of
Lighting for Older People

15. Background: the Biological and
Psychological Effects of Light
• We have learnt in the last 15 years or so that the effects of
light go well beyond visual function and comfort
• There are non-visual pathways from the eyes to the brain
which via the suprachiasmatic nucleus (SCN) in the
hypothalamus, trigger the production of hormones at
different times of the day
Location of the ‘third eye’ or the
Suprachiasmatic Nucleus (SCN) in
the brain which responds to light levels
and controls the body’s hormone system
– and ultimately the circadian system

16. Biological and Psychological
Effects of Light
• This ‘body clock’ controls our circadian systems
• A robust 24-hour pattern of light-dark (preferably
provided by exposure to strong natural light) is vital to
maintaining our bodily health and well-being – and in
particular our patterns of sleep and alertness
• Circadian systems can be disrupted by too little light
during the day – or light at wrong time at night
• This can cause the disruption of sleep patterns – and is
often associated with other health problems.

17. Details of the Circadian System
A 48-hour cycle of the
body’s circadian system,
showing the relationship
between light-dark and
the production of
melatonin (sleep
hormone), cortisol
(which maintains
alertness during the day)
and growth hormones,
vital for cell production
and replacement. The
latter occurs almost
entirely during the hours
of sleep.

18. Circadian Patterns in Older People
• Disruption and impairment of the circadian system is
increasingly common in older people
• Their eyes are less efficient, so less light is available to
trigger the circadian system
• Also older people at home or in care institutions often
lack high levels of light, particularly natural daylight
• Most facilities have constant, relatively low levels of
artificial lighting – and constant lighting impairs sleep
ability
• 40-70% of people over 65 suffer from chronic sleep
disturbance – and Alzheimer’s sufferers are particularly
affected

19. Depression
• In addition to sleep disorders, depression can be
exacerbated by disrupted circadian rhythms (as it can be
with younger people who suffer from SAD syndrome)
• Studies show that when older people are exposed to
high circadian light levels during the day, and dim levels
at night, sleep duration and
efficiency are improved – and
the incidence of depression
reduced
• These simple, relatively in-
expensive therapies still
rarely used in care homes

20. The Importance of Blue Light
• Light with a high blue spectral content is most effective
in therapeutic terms
• Studies at Univ. of Surrey have shown that the use of
blue-saturated light with care home residents in the
afternoon increases sleep at night – and day-time
alertness
• These types of therapy have even greater effect on
Alzheimer’s patients.
• Dutch trials with blue light improved night-time sleep
patterns, slowed cognitive deterioration and reduced
depression, agitation and aggressiveness

21. Vitamin D Deficiency
• Vitamin D deficiency is widespread problem in northern
European countries
• Vitamin D only naturally available through exposure to
sunlight and the consumption of oily fish
• Vitamin D deficiency is linked to a whole range of
health risks, including low bone mineral levels + weak,
brittle bones, cognitive impairment, type 2 diabetes
and breast, colon and prostate cancer in the elderly
• More exposure of older people to regular low levels of
direct sunlight would help, but Vitamin D supplements
may also be required.

22. 3. Lighting Design Implications

23. Lighting Design Implications
Natural Lighting
•The design of old people’s living facilities should
incorporate access to natural daylight – on both
therapeutic and energy-saving grounds
•Sun rooms, patios, courtyards and heated
conservatories should be made easily available for all
residents
•Skylights, glass brick walls and light-transmissive glass
doors should also be used
•Rooms should be designed with interesting exterior
views onto natural environments, where possible

24. Design Implications
Artificial Lighting Systems
•Therapeutic daylight compensation lighting systems
should be incorporated into facilities
•These should offer higher, blue-enhanced light during
certain times of the day, using intelligent controls
•Incorporating such sophisticated lighting in a non-
intrusive way into a domestic environment is the biggest
design challenge
•Small, local light fittings + ‘fake’ skylights may be two
possible solutions

25. Artificial Daylight Systems

26. Real-life Trial: a Double Benefit
In this trial carried out by researchers at a residential/ nursing home in
Switzerland, higher light levels supplied by daylight + ceiling-mounted light
panels, both made the residents sleep better – and facilitated increased social
interaction and activity, as residents could see their co-residents more easily.

27. Custom-Designed System for Care Homes
Helios custom-designed lighting concept for the rooms of older people ( from
the Lighting Research Centre in the USA) is an automatic system
incorporating bright light therapy, blue LED therapy, dawn-to-dusk simulation
lighting and movement sensor to switch on the night-time light

28. 4. The Proposition:
National Conference on Lighting
for Older People

29. Conference
• There are clearly a large number of cost-effective lighting design
improvements that could enhance the lives of our ageing
population in the workplace, in their own homes and in residential
care facilities
• How can this potential be conveyed to the health sector,
charitable bodies, government departments, age-related quangos
and owners and managers of care homes?
• The ILP proposes a major national conference on the issue – and
follow-up campaign -- with the support of one or more lighting
sponsors.
• The conference could be an important way the health and care
sector to learn about lighting’s considerable potential – and for
the lighting community to make links with these important health
and social care services.

30. Conference
• Provisional title:
‘Lighting for Life’
Lighting and the Health and Wellbeing of Older People in the UK
Supporting Organisations
Support, marketing and conference branding to be sought from all
leading health organisations, research bodies and charities for the
elderly and those with impaired vision – Alzheimer’s Society, Age UK,
RNIB, Thomas Pocklington Trust, Dementia Research Trust, National
Care Association, Registered Nursing Home Association, the King’s
Fund, Care Home UK, BUPA Care etc.

31. Provisional Topics/ Speakers
• Intro from senior Health Minister?
• Lighting for an ageing workforce (Peter Boyce or speaker from Arup)
• Lighting to optimise old people’s vision and visibility in the home (Thomas
Pocklington Trust)
• Lighting for people with dementia (Univ. of Stirling)
• Older people, SAD syndrome and affordable lighting solutions (??)
• Circadian lighting systems for old people’s homes (Univ. of Surrey)
• Sunlight, its importance to Vitamin D production and the immune system (??)
• Designer of the US Helios and LED doorframe system (Mariana Figueiro,
Lighting Research Centre, Renssellaer Polytechnic, USA)
• The role of daylight in clinical and surgical recovery
• US Draft Standards for Residential Care Homes (IESNA speaker)
…………………………………………………………………………
• DESIGN WORKSHOP: collaboration between an architect and lighting
designer, to present a concept for a state-of-the-art residential home,
with ideal lighting conditions.

32. Target Audience/ Delegate Rates/Timescale
• Healthcare professionals, researchers and academics
in gerontology, Alzheimer’s etc, architects for the
health sector, lighting designers, social care
specialists, voluntary sector (special delegate rates),
owners and managers of care homes etc.
• Such a conference could easily attract 300-400
delegates – a percentage of profits to be invested in
some ongoing research work in this area.
• Delegate day rate £200-250 (lower rate for charity
representatives?) One/two free places for supporting
organisations
• Conference to be held in London in spring 2014.