Throwing light on dementia design

Oliver Buchan, head of innovation at Luxonic, argues that, while the lit environment is often an underestimated consideration when creating a dementia-friendly building, relatively simple lighting solutions can be very effective

When designing a facility with dementia sufferers in mind it’s very easy to talk exclusively about the provision of light in terms of practicalities – but good lighting addresses so much more.

In a dementia-friendly setting, the lit environment has the ability to reduce disorientation, confusion and falls by revealing forms within the space. It can also increase social interactions, optimism, attention span and independence by delivering a stimulating visual field.

These are all aspects that are highly desirable not only for those living with dementia, but also for the people that care for them. And yet, the lit environment is often an underestimated consideration when architects map out facilities used for dementia care.

Lighting design

The ageing process alone has a major impact on the eye, with suggested illumination levels are often two to four times greater for the elderly compared to a 20-year-old.

Increased light levels normally lead to better perception of detail, not just for functional tasks such as reading but also as a way of encouraging interactions when playing card games or helping with chores, for example. Such pools of light can be easily generated with strategically located downlighters or simple table lamps.

However, the distribution of light within a space is critical to its success. Glare from poorly located directional luminaires or reflections from specular surfaces, significantly reduces the ability to interpret the surrounding scene. At the same time a uniformly diffused illumination will struggle to generate the levels of contrast necessary to reveal three dimensional forms such as furniture. Glare in this context is not about unified glare ratings but inappropriate directionality and luminance.

Daylight and stimulation

Another area of active research preoccupying lighting designers at the moment is the way light can affect the body clock. A lot remains undiscovered, but it is indisputable that starting the day with high – but not oppressive – light levels and subsequently maintaining the normal pattern of day and night is very important in aligning circadian rhythms. This regulation of the body clock can have a major influence on quality of sleep, appetite, bowel functions and mood – all aspects of life that can be problematic for those living with dementia.

Bringing daylight into the living space or enabling residents to spend time outdoors,is a simple step to create this desirable link with the outside world and deliver a changing quality of light throughout the day. Additionally it gives many opportunities to automatically switch off artificial lighting and save considerable amounts of energy.

From the perspective of the lit environment, high daylight ingress can also bring issues associated with glare, extreme changes in light level that are often associated with falls and a distortion of the perceived shape of a space. The concept of daylight simulation can include many things such as light colour, directionality, quantity, and the changing of all these characteristics throughout the day.

Luminaires that can deliver a range of colour temperatures are a fairly simple and appropriate solution. In conjunction with a suitable control system, DALI or wireless for example, they can provide changeable light colour and quantity throughout the day. By delivering the two colour temperatures from different types of luminaire it is possible to provide a directional warm white and a diffuse – possibly uplit – cool white, further mimicking natural light throughout a clear sunny day. This relatively simple configuration can be remarkably effective.

Night-time illumination

An equally important part of simulating the natural daylight cycle is to ensure appropriately low levels of illumination are used during the night. Circadian rhythms are reinforced by a regular pattern of lower levels of warm light in the late evening, reducing to an amber night light during periods of sleep. Night lighting is clearly important for enabling care staff to move around the building and monitor residents as appropriate, and also for the safety and reassurance of any residents that may be awake.

These factors all go towards creating a dementia-friendly design where the patient is the focus but every occupant benefits.