The role of lighting in senior care facility design

Anna Jaglarz, Szymon Chrzanowski

doi:10.37190/arc230209

Abstract

Shaping ergonomic lighting in spaces dedicated to seniors requires reliable knowledge from designers both in terms of health issues related to the aging of the eyesight and innovative lighting solutions. Design guidelines based on credible scientific results are also desirable. To complement the information in this field, the authors identified perceptual problems in the elderly due to the aging process of the visual system and analyzed the impact of lighting quality on the health, safety, comfort, and satisfaction of the elderly. Because eyesight deteriorates with age, older people have to deal with the effects of insufficient or inappropriate lighting. For this reason, there is a need to adapt lighting solutions to the requirements of seniors, taking into account the process of weakening of the visual system. Design strategies focused on three lighting effects were discussed: maintaining emotional balance, ensuring efficiency in everyday activities, and preventing falls. Lighting simulations were also made on selected examples of interiors in the senior care facility. They provided the basis for the analysis, comparison and evaluation of various lighting solutions and the development of conclusions and guidelines for multi-directional lighting strategies based on visualized design problems.

Keywords:
design-for-the-elderly
lighting-for-the-elderly
ergonomic-lighting
biodynamic-lighting
age-related-vision-and-perception-disorders

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Anna Jaglarz*, Szymon Chrzanowski**

The role of lighting in senior care facility design

Introduction

Allowedly, the population of most countries in the

world is aging. This phenomenon generates problems that

will be exacerbated in the future and already require spe-

cial attention. Aging can be accompanied by various types

of pathologies aecting the quality of life for several re-

asons. Seniors may experience uncertainty or frustration

in relation to daily activities, which can prove dicult to

perform. Visual and perceptual disorders and their asso-

ciated symptoms play a signicant role in the occurrence

of these inconveniences. Cognitive abnormalities lead to

spatial and temporal disorientation, disruption of a circa-

dian cycle, thus reinforcing feelings of anxiety, discom-

fort, and loss of autonomy. Diseases of old age, dementia,

depression, and visual impairments such as glaucoma,

cataracts, macular degeneration, and others lead to wor-

sened accommodation, visual acuity, and contrast percep-

tion, causing decits in the visual eld. Consequently, the

perception of the environment by the elderly is disturbed.

Conditions like disorientation, failure to recognize spaces,

or the inability to identify obstacles increase the risk of

falls, disabilities, or fear of impaired mobility and not be-

ing able to perform activities as before [1]–[3]. However,

it is possible to prevent or eliminate such situations by

modifying the environment and adapting it to potential

consequences of visual impairments, taking into account

the lifestyle and habits of seniors.

The authors of the studies presented in the references

demonstrate the importance of lighting in this regard.

The results obtained by them show that proper lighting

quality can improve the visual eciency of the elderly

and provide them with both physical and psychological

safety and comfort. By combining the quality and quanti-

ty of light, contrast levels, and colour temperature of the

illumination, tailored to the needs and health of seniors,

it is possible to achieve lighting design that meets their

expectations [1], [4], [5].

The design of ergonomic lighting for environments

intended for the elderly should be based on current and re-

liable scientic research ndings. To achieve this, it is ne-

cessary to examine the health issues related to aging eye-

sight and to identify the latest technological advancements

in the eld of lighting solutions. Precise design guideli-

nes are also needed to streamline the process of shaping

lighting in spaces intended for the elderly population.

Material and method

Bearing in mind the complexity of the issue concerning

the aging process of the eyes, changing demographic data

regarding the elderly population, and the limited number

of studies providing mature and reliable conclusions on

the impact of lighting on the visual abilities and motor

skills of seniors, it is desirable and promising to conduct

multidisciplinary research to enhance knowledge in this

eld [6]. The primary research method employed by the

authors was a literature review. Querying and reviewing

the subject literature allowed for the collection and analy-

sis of relevant information in the investigated area. The

actions undertaken by the authors included:

– recognition and analysis of perceptual problems in

elderly individuals resulting from the aging process of the

visual system,

– analysis of the impact of lighting quality on the

health, safety, comfort, and satisfaction of seniors,

– discussion of design strategies based on lighting re-

search for older people, aimed at three eects: maintaining

DOI: 10.37190/arc230209

Published in open access. CC BY NC ND license

* ORCID: 0000-0001-9869-2655, Faculty of Architecture, Wro -

cław University of Science and Technology, Poland, e-mail: anna.jaglarz

@pwr.edu.pl

** Design Studio, Grupa Verso Deltoid, Al. Wolności 27, Często-

chowa, Poland.

88 Anna Jaglarz, Szymon Chrzanowski

emotional balance, ensuring eciency and prociency in

daily activities, and preventing falls.

Another applied research method involved conducting

lighting simulations in selected spaces within a senior care

facility. These simulations served as the basis for analys-

ing, comparing, and evaluating various lighting solutions,

as well as for developing conclusions and guidelines for

multi-directional lighting strategies based on visualized

design issues and possibilities. The nal recommenda-

tions regarding lighting parameters, dening them as er-

gonomic and most optimal for seniors, were supported by

research ndings published in numerous scientic publi-

cations across various disciplines and elds [1]–[8].

Justification of the importance of the issue

of lighting in the context of the needs of the elderly

In the context of an aging population, it is essential

to consider the needs of the elderly in architectural and

interior design. Lighting is an area of particular signi-

cance in designing spaces for seniors – good lighting can

contribute to improving the quality of life for the elderly

through:

– a positive impact on their well-being,

– facilitating the activities of the elderly,

– ensuring health and safety, e.g., with adequate light-

ing seniors can avoid falls [4].

The key to achieving these objectives is the awareness

and knowledge of designers regarding both the health

issues associated with aging vision and the development

of the latest technological advancements in lighting so-

lutions. It is important to mention that lighting techno-

logies that have evolved in recent years oer extensive

possibilities for improving the quality of spatial usage.

However, the majority of spaces specically designed for

the elderly remain under-illuminated. Additionally, they

often perceive the lighting in their environment as “suf-

ciently adequate”. The improper assessment of lighting

by seniors can be attributed to the fact that age-related

vision loss generally occurs gradually. Older adults are

often unaware of changes in their perception, which leads

them to retain their habits and lighting solutions. Studies

indicate several reasons why architects and interior desi-

gners inadvertently incorporate inappropriate lighting in

spaces designed for the aging population. Designers typi-

cally determine lighting conditions based on the needs of

“young eyes”, stemming from a lack of familiarity with

the additional requirements of „elderly eyes”. The selec-

tion of appropriate lighting solutions to enhance the quali-

ty of facilities for seniors should be based on collaboration

between designers and scientists [4].

Recognition and analysis of perceptual issues

in the elderly resulting from the aging process

of the visual system

Architects and interior designers should understand the

limitations of the elderly and those with visual and percep-

tual impairments. This knowledge is essential for creating

an environment that can support functional independence

for an extended period. Academic design education pro-

grams provide limited information about the special needs

of seniors and those with cognitive impairments, despite

the crucial importance of raising awareness and education

in this regard [7].

One in six adults aged forty-ve and older suer from

some type of vision problem and the risk of vision loss in-

creases with age [7]. Visual impairment, dened as vision

loss that cannot be fully corrected with glasses or contact

lenses, intensies with age, potentially leading to unneces-

sary limitations in independence and reduced quality of

life for many seniors. The most common age-related cau-

ses of vision loss are macular degeneration, glaucoma, ca-

taracts, and diabetic retinopathy. Changes in the visual sys-

tem aect visual capabilities, and age-related eye diseases

can lead to further impairments, such as diculty adapting

to changes in brightness, increased sensitivity to glare, and

reduced contrast sensitivity. Decline in both visual acuity

and visual function is one of the most common and poten-

tially disabling conditions in late life, signicantly impac-

ting the quality of life for the elderly. Visual impairment

and other sensory disturbances also increase susceptibility

to hazards. Age-related changes in the eye, associated with

loss of visual acuity, hinder the performance of tasks, espe-

cially those requiring focus and concentration. They cause

diculties in driving at night and challenges in reading or

performing precision work under dim lighting conditions.

Visual problems interfere with everyday activities, such

as bathing, dressing, meal preparation, or even moving

around. They also hinder participation in social and recre-

ational activities, signicantly impacting emotional well

-being and social relationships, and potentially leading to

isolation and depression [2], [3], [7].

Visual capabilities can be signicantly increased thro-

ugh improvements in the living environment and certain

types of vision loss can be prevented or minimized by ad-

opting a lifestyle changes. The challenge lies in adapting

the environment to help compensate for visual changes.

Higher quality and quantity of appropriate lighting can as-

sist in minimizing the eects of normal age-related vision

changes and maximize the abilities of the elderly [7].

Analysis of the impact of lighting quality

on the health, safety, comfort, and satisfaction

of the elderly

The concept of good lighting is evolving along with

the latest research ndings in neurobiology, chronobio-

logy, and studies on vision and lighting. The science of

chronobiology elucidates the gift of daylight, investiga-

ting mechanisms through which light inuences humans

sleep, digestion, and immune responses. Chronobiology

also uncovers how biological rhythms can be harnessed

for health benets. Considering and controlling the fun-

damental properties of light for the circadian cycle, as

well as for the visual system, by scientists and designers,

can contribute to advancements in providing “healthy”

lighting, which supports human health [7]. In designing

spaces for the elderly architects make decisions that im-

pact the health, safety, activity, and well-being of seniors.

The role of lighting in senior care facility design 89

Lighting is considered an integral element in achieving

the goal of a healthy living and activity environment for

them. For individuals, such as the elderly, who spend most

of their time indoors, a lack of light can have far-reaching

consequences. The benets of lighting extend beyond

mere visibility and creating a pleasant atmosphere in the

space. Based on research, four eects resulting from the

implementation of ergonomic lighting can be observed:

– visual: enabling vision, perception of the environ-

ment, and coping with cognitive tasks,

– emotional: the mutual interaction of light and colour

triggering moods and emotions; particularly important in

interior design,

– biological: light uniquely aects the human circadian

cycle and inuences health and well-being,

– energy ecient: light should be supplemented where

necessary, e.g., in the absence of sucient natural light in

the room [8].

Light received by the eyes serves for vision and regu-

lation of human body functions – inuencing neurological

and metabolic processes. It has a signicant impact on the

production of melatonin, cortisol, and serotonin, the three

most important hormones controlling the biological rhythm:

– melatonin induces fatigue, slows down bodily func-

tions, and reduces activity in favour of well-deserved rest,

– cortisol is the stress hormone produced from around

3 am, stimulating metabolism and programming the body

for the daytime mode,

– serotonin: acts as a stimulant and motivator – while

cortisol levels decrease during the day, in a “counter-cy-

clical” manner to melatonin levels, serotonin helps in-

crease energy levels – in a 24/7 cycle [8].

Altered sleep and activity patterns, as well as the pro-

duction or suppression of hormones, are only a part of

a larger desynchronization of various rhythms in the el-

derly, caused by changes in the aging body. Many seniors

are more susceptible to sleep disorders, depression, and

weakened immune systems. Light proves to be a potent

regulator. Biologically eective ambient light can be the

main stimulus regulating their circadian cycle. By at-

tempting to mimic the action of natural light to balance

the human circadian cycle, a biodynamic lighting system

should have parameters similar to those found in nature.

Clinical studies have conrmed the eectiveness of light

therapy in treating winter depression and selected circa-

dian dysfunctions, including sleep disorders in the elderly,

even those with dementia and Alzheimer’s disease [5]–[9].

Research ndings reveal several important relation-

ships between lighting and the functioning and perfor-

mance of the elderly:

– regulated LED lamps are benecial not only for the

safe navigation of the elderly but also for maintaining

their circadian cycle,

– aging eyes poorly adapt to very bright or dim light-

ing; hence, appropriate lighting levels are necessary,

– poor lighting conditions can contribute to falls in the

elderly,

– visual cues providing a nighttime pathway from the

bed to the bathroom can enhance stability and prevent

falls, thus ensuring safety,

– increased exposure to daylight can also positively im-

pact the sleep quality of the elderly at night,

– with the development of tunable LED lamps, it is ex-

pected that innovative solutions will facilitate safe navigation

for the elderly at night and improve their circadian cycle [6].

Light is a design tool that has a tremendous impact

on many aspects of human behaviour and health. Visual

performance, atmosphere, safety and protection all de-

pend on lighting. Adequate lighting is the foundation of

a supportive environment that enhances the capabilities of

the elderly, promotes their well-being, and helps prevent

accidents. Weak or improper lighting reduces their inde-

pendence, jeopardizes their health and safety, and dimi-

nishes their quality of life. As such, design innovations in

lighting technology must not only support vision but also

consider the photo-biological eects of light on the body

and human circadian cycle [7], [9].

Strategies in lighting design for the elderly

The approach to designing and using lighting focused

on the healthcare of seniors should consider the perceptu-

al issues in the elderly resulting from the aging process of

the visual system. Undesirable conditions, such as under-

illumination in interior spaces, can occur due to lack of

sunlight resulting from the time of day and year, weather

conditions, inadequate window openings, or improper po-

sitioning of articial lighting sources in spaces dominated

by articial light. The level of lighting intensity should be

appropriately adjusted to the activities performed and the

individual needs of the elderly. Well-lit areas for visual ta-

sks, such as kitchen countertops, reading corners, worksta-

tions, personal care areas, encourage engagement and acti-

vity. Eective lighting in corridors and passageways aids

safe mobility. Due to anatomical and physiological changes

in the visual system of the elderly compared to young in-

dividuals, higher levels of lighting intensity are required.

In comparison to a twenty-year-old’s eye, only one-third

of the light reaches the interior of an older individual’s eye

due to a smaller pupil diameter and lens opacity, which sho-

uld be considered when selecting appropriate lighting [10].

Strategic, healthcare-focused approaches to planning, in-

stalling, and using lighting in the living environment of se-

niors are based on three eects that can be achieved through

light concerning the psycho-physical functioning of humans:

– emotional balance,

– eciency,

– fall prevention [4].

Emotional balance

Elderly requiring long-term care often have limited ac-

cess to natural daylight and the biological and emotional

balance it provides. By regulating the brightness and colo-

ur temperature of lighting, a positive impact can be made

on the mood of the elderly. Advanced lighting technolo-

gies allow designers to create a dynamic articial lighting

system that mimics the properties of natural daylight [4].

The concept of Tunable White biodynamic lighting

emerged from research on the impact of lighting on the

90 Anna Jaglarz, Szymon Chrzanowski

Certain design guidelines can be formulated to create

conditions that facilitate navigation for older people, en-

able reading of information from a distance, enhance de-

tail perception, and improve clarity and visual comfort.

These include:

– providing low glare (non-glare) lighting,

– oering indirect lighting (reected lighting),

– choosing a higher colour temperature of light (e.g.,

4100 K – cool white),

– ensuring higher colour rendering index (if Ra is

above 85, objects appear more natural)

– avoiding strong contrasts between surface nishes

(e.g., bright wall contrasting with the oor),

– selecting surfaces with low reectance, reducing

glare,

–

introducing high-contrast signage, where letters, signs,

and all information are easily distinguishable [4], [6].

Fall prevention

Limited lighting hinders seniors’ ability to move safely

in their surroundings, both indoors and outdoors. When

the light level is low, older people experience greater

diculties in mobility and balance, leading to unneces-

sary stops, which pose a threat to their health and safety.

Problems with mobility, such as bumping into objects,

groping with hands or feet, interrupting normal gait,

requiring constant contact with surrounding objects, ne-

eding observer intervention, and losing reference point,

increase by 121% when the light level in the room is too

low. The same mobility issues at night increase by 291%

when the outdoor light level is too low [4].

Appropriately increasing the amount of light in areas

with the highest likelihood of falls can impact the safety

of seniors, but lighting systems are recommended to be

placed in certain zones because:

– visual cues in low-lit surroundings assist seniors in

mobility,

– subtle night lighting illuminating walking paths,

which do not disrupt sleep like overhead lights, can po-

tentially reduce the risk of falls in the elderly,

– lighting around door frames helps reduce the transi-

tion time from a sitting to standing position

[2], [4], [6],

[16], [17].

Elderly people are very likely to fall during the night. The risk of

falling is also increased when seniors change positions, e.g., when they

rise from a sitting to standing position. Research conrms that low illu-

mination around the door frame is the most helpful feature in reducing

the transition time from sitting to standing. There are several reasons

why subtle illumination of the door frame is more eective than high

levels of ambient lighting. The luminous door frame provides visual

cues, using lighting to reduce the risk of falling for the elderly without

disrupting their sleep by turning on a bright overhead light. This solution

provides low-intensity ambient lighting with improved horizontal infor-

mation when walking. They can complement conventional night lamps

and light lines marking paths, as perceptual clues about the horizontal

plane of walking, also aecting the maintenance of balance [16], [17].

Door lighting can also have a psychological eect, motivating the el-

derly. It can encourage seniors to get out of bed quickly, take a standing

position, be brave and ready to “go outside, to other people” in order to

take up activity, despite various ailments and obstacles.

human body, well-being, and daily functioning. It mimics

daylight and its changing colour temperature throughout

the day. Utilizing the capabilities of tunable lighting tech-

nology in terms of colour temperature positively inuences

the body’s circadian cycle and melatonin production. By

adjusting the colour temperature of light, it is possible to

emulate daylight: in the morning, a higher concentration of

blue light with a cool white colour temperature of 4700 K

can provide stimulating properties, increasing alertness

and concentration while suppressing melatonin produc-

tion. In the evening, warmer light with a colour tempera-

ture of 2400 K and reduced blue content emulates sunset

light, providing relaxing and calming properties [11], [12].

A study was conducted at a senior care facility in Sa-

cramento, California, to investigate how tunable lighting

aects sleep patterns, nighttime safety, and lighting quali-

ty for sta. Research results related to elderly care suggest

that cool colour temperatures and brightness can help pre-

vent falls and improve visual acuity, while warmer colour

temperatures can enhance sleep and reduce agitation and

anxiety during late hours for patients with Alzheimer’s or

dementia [13], [14].

The benets of implementing the Tunable White Con-

cept:

– regulation of the circadian cycle,

– improved sleep quality and rest,

– enhanced productivity and eciency throughout the

day,

– ensuring safety during nighttime bathroom use,

– improved visual acuity,

– prevention of glare [15].

Brightness and colour temperature of lighting can be-

come supporting tools for emotional balance in the elder-

ly, counteracting stress and anxieties by increasing com-

fort and satisfaction with the environment and reinforcing

positive moods. To achieve this, it is important to consider

certain guidelines:

– for the elderly, a well-lit interior is perceived as

warmer and more friendly and comfortable,

– seniors are more satised when their surroundings

have a well-arranged lighting scheme that utilizes various

light sources – general ceiling lighting, wall lighting, and

accent or decorative lighting,

– light on multiple surfaces reduces shadows which can

help older people feel more comfortable and physically

stable while moving around in the space,

– the brightness and colour temperature of light shape

the emotional quality of lighting in senior care facilities

– e.g., they can prevent negative emotions related to ex-

periencing stress in a new territory, a new community, or

anxiety about medical care [4].

Efficiency

Weak lighting has a negative impact on the concentra-

tion of the elderly and causes diculties in performing

daily activities such as:

– determining their own location,

– reading labels and information,

– fullling personal needs.

The role of lighting in senior care facility design 91

Development of design guidelines

for multi-directional strategies of lighting

Practical applications of the previously discussed issu-

es aecting the comfort and eciency of older people in

care facilities can be identied. The considerations were

carried out on the example of two spaces where seniors

spend relatively the most time – on the example of the pa-

tient room and the general communication zone (Fig. 1).

Biodynamic lighting

The right amount and quality of lighting helps in the

daily synchronization of our internal clock. Due to insuf-

cient light or the negative impact of constant lighting,

problems with maintaining the circadian cycle, sleep di-

sorders or depression may occur. Seniors in nursing ho-

mes are particularly vulnerable to these inconveniences.

Appropriate biodynamic lighting systems, by imitating

the day cycle and changing the brightness and colour tem-

perature of light, have a positive eect on the functioning

of the elderly as well as the eectiveness of their acti-

vities. Special lighting control systems manage changes

in colour temperature from cool white with the addition of

blue in the morning (Fig. 2a, colour temperature of light:

5500 K, light intensity: 200–300 lux), through white at

noon (Fig. 2b, colour temperature of light: 5000 K, light

intensity: 200–300 lx), up to warm white with a red-oran-

ge tint of lighting in the evening (Fig. 2c, colour tempe-

rature of light: 3500 K, light intensity: 200–300 lx). This

solution has a positive eect on the hormonal balance of

the elderly [8], [11], [12].

Fig. 1. The baseline state for the conducted research: a) patient room, b) general communication zone (elaborated by S. Chrzanowski)

Il. 1. Stan wyjściowy dla przeprowadzonych badań: a) sala pacjentów, b) komunikacja ogólna (oprac. S. Chrzanowski)

a c

Fig. 2. Scheme of biodynamic lighting imitating the circadian cycle:

a) morning lighting, b) noon lighting, c) evening lighting (elaborated by S. Chrzanowski)

Il. 2. Schemat oświetlenia biodynamicznego naśladującego cykl dobowy:

a) oświetlenie poranne, b) oświetlenie dzienne, c) oświetlenie wieczorne (oprac. S. Chrzanowski)

92 Anna Jaglarz, Szymon Chrzanowski

Types of luminaires (direct/indirect lighting)

The type of luminaire and the direction of light are of

great importance for the physical and mental comfort of

seniors. Direct lighting, when the light beam is directed

down towards the oor, has denitely less advantages

than indirect lighting, when the light is reected from the

surface of the ceiling (a hybrid solution combining both

methods is also benecial). The exposure to direct light

causes great discomfort in the elderly (Fig. 3a, light colour

temperature: 5000 K, light intensity: 400–500 lx). In addi-

tion, overhead lighting creates dark and harsh shadows on

faces, interfering with non-verbal communication. Indirect

lighting signicantly minimizes glare (Fig. 3b, light colour

temperature: 5000 K, light intensity: 200–300 lx). This is

of particular importance in the patient room, especially

in the case of bedridden patients. Indirect lighting alson-

makes spaces appear brighter and larger (Fig. 3b) [2], [3].

Lighting balance (bright/dark lighting)

For adequate physical and mental comfort, uniformi-

ty of lighting is also necessary. Contrasting transitions of

light and dark spaces cause eye strain and discomfort in

older people (Fig. 4a, light colour temperature: 5000 K,

average light intensity: 100–150 lx, irregular lighting).

In addition, dark spaces in a new environment (nursing

home) in which seniors have to adapt, can lead to fears

and anxieties (Fig. 4a). It is recommended that the lighting

in rooms, especially elongated ones, should be uniform

throughout their space (Fig. 4b, light colour temperature:

5000 K, average light intensity: 200–300 lx, uniform light-

ing) [2], [3].

Light and floor finishing material (reflections)

Floors in facilities such as nursing homes should be

matt, non-reective for several reasons. First of all, oor

materials with a high-gloss nish can cause glare – visual

sensation with discomfort and loss of ability to recogni-

ze objects and shapes (Fig. 5a, light colour temperature:

5000 K, light intensity: 200–300 lx). Strong reections on

the oor may also suggest a wet surface (Fig. 5a). The

contrast between the oor and the walls allows for orien-

tation in space and ecient movement. Due to these ar-

guments, matt materials seem to be a much more favour-

able and safer solution (Fig. 5b, light colour temperature:

5000 K, light intensity: 200–300 lx), [2], [3].

Multifunctional lighting in patient rooms

Many luminaire manufacturers oer multifunctional

solutions for patient rooms. Creating several dierent

light ing scenarios for specic activities is possible thanks

to only one device. The lighting in the patient room should

create a friendly and safe environment – bright enough,

and at the same time warm and glare-free.

General lighting should interact with daylight to ensure

the right amount of light in the room (Fig. 6a, light colour

temperature: 3500 K, light intensity: 100–500 lx close to

oor). The diusion of direct and indirect light provides

the right conditions to clearly perceive objects near and

far without eye strain. In addition, adjusting the brightness

and colour temperature of the light is an eective solu-

tion. Intense cooler light can accompany activities during

the day, and subtle warmer light can create a pleasant and

cosy mood to rest in the evening [2], [3].

Fig. 3. Comparison of lighting quality on the example of luminaires used in the communication zone:

a) direct lighting, b) indirect lighting (elaborated by S. Chrzanowski)

Il. 3. Porównanie jakości oświetlenia na przykładzie opraw oświetleniowych zastosowanych w strefie komunikacyjnej:

a) oświetlenie bezpośrednie, b) oświetlenie pośrednie (oprac. S. Chrzanowski)

a b

The role of lighting in senior care facility design 93

The patient room is also a workplace for medical sta.

Adequate lighting during daily activities or examinations

is necessary for their proper performance (Fig. 6b, colour

temperature of light: 3500 K, light intensity: 300–500 lx

at the level of patient bed). There are situations when pa-

tients and sta are in their own shadows, so it is important

to use glare-free light with sucient brightness directed

at the patient. This solution greatly facilitates the work of

carers or medical sta and makes care more eective.

The correct combination of glare-free lighting and

a precise night lamp creates comfortable reading con-

ditions (Fig. 7a, light colour temperature: 3500 K, light

intensity: 300–500 lx at the level of patient’s bed). In

addition, due to the direct contact of the patient with the

Fig. 4. Comparison of lighting quality on the example of luminaires used in the communication zone:

a) irregular lighting, b) uniform lighting (elaborated by S. Chrzanowski)

Il. 4. Porównanie jakości oświetlenia na przykładzie opraw oświetleniowych zastosowanych w strefie komunikacyjnej:

a) oświetlenie nieregularne, b) oświetlenie równomierne (oprac. S. Chrzanowski)

Fig. 5. Comparison of lighting performance in the context of finishing materials used on the floor in the communication zone:

a) glossy floor finish, b) matt floor finish (elaborated by S. Chrzanowski)

Il. 5. Porównanie działania oświetlenia w kontekście materiałów wykończeniowych zastosowanych na posadzce w strefie komunikacyjnej:

a) błyszczące wykończenie posadzki, b) matowe wykończenie posadzki (oprac. S. Chrzanowski)

94 Anna Jaglarz, Szymon Chrzanowski

luminaire, safety is important – low heat emission, no risk

of burns, no glare and ease of use.

Subtle night lighting should guide staff to patients

during night check-ups without disruption by the glaring

light (Fig. 7b, light colour temperature: 3500 K, light in-

tensity: 50–100 lx close to oor). In addition, the lumi-

naires can create safe pathways for seniors in rooms or

corridors [2], [3].

Conclusions

The design approaches discussed in the article, inclu-

ding lighting for emotional balance, lighting for eciency

and lighting to prevent falls, can help to eectively solve

some of the health problems faced by older people. The

simulations carried out show the importance of taking

into account the features of “good lighting” in the process

Fig. 6. Examples of using a multifunctional adjustable luminaire in a patient room:

a) general lighting, b) examination lighting (elaborated by S. Chrzanowski)

Il. 6. Przykłady zastosowania oprawy wielofunkcyjnej regulowanej w sali dla pacjentów:

a) oświetlenie ogólne, b) oświetlenie do badań (oprac. S. Chrzanowski)

Fig. 7. Examples of using a multifunctional adjustable luminaire in a patient room:

a) reading lighting, b) night lighting (elaborated by S. Chrzanowski)

Il. 7. Przykłady zastosowania oprawy wielofunkcyjnej regulowanej w sali dla pacjentów:

a) oświetlenie do czytania, b) oświetlenie nocne (oprac. S. Chrzanowski)

The role of lighting in senior care facility design 95

of shaping the lighting conditions, e.g., in terms of the

type, location, quantity, intensity, level, diusion or colo-

ur temperature of light. Control of lighting eects such as

glare, reections, shadows, strong contrasts, can prevent

unfavourable lighting conditions. The application of the

biodynamic lighting concept is a benecial solution to

support design strategies focused on senior health care.

The adequate amount and quality of light are the basic

components of an eective lighting system, which should

also be “energy ecient”, combining the right quality of

light with the most ecient lighting system [7], [9].

Ensuring good lighting for the elderly is a complex

task that should take into account the ability of seniors to

perform normal activities of daily living as well as their

cognitive diculties and limited physical tness.

Design guidelines to balance changes in the aging eye

include:

– increasing the level of lighting due to loss of visual

acuity,

– ensuring a constant and uniform, even level of light-

ing, eliminating unnecessary shadows and optical illu-

sions,

– elimination or reduction of glare, taking into account

the greater sensitivity of older eyes,

– ensuring gradual changes in lighting levels, taking

into account transition areas between external and internal

parts (e.g., entrance halls, vestibules) and between die-

rent interiors (e.g., corridors, halls),

– providing access to natural daylight and controlling

the quality of light diusion depending on the exposure,

– balancing natural light and articial light, e.g., by

using various solutions regulating the access of sunlight

(shutters, blinds, curtains, etc.),

– increasing the level of lighting in the kitchen and

bathroom,

– use of indirect lighting to prevent eye fatigue,

– increasing the light intensity in the task area, ensuring

higher contrast,

– taking into account the interaction of light and colour

aecting spatial perception when choosing the colour of

lighting (day white or warm white),

–

increasing the colour rendering index of the light

source,

– application of biodynamic lighting technology,

– application of lighting control technology that is easy

and intuitive to use by the elderly,

– taking care of the control and maintenance of the

light ing installation [2], [3], [6]–[9], [18], [19].

Summary

Considering the aging population, architects and inte-

rior designers should be guided in their activities by the

prospective thought of the increasing need for senior care.

Technologies that have developed in recent years, including

lighting solutions, oer a wide range of opportunities to im-

prove the usable quality of spaces intended for the elderly.

The latest solutions make it possible to create a lighting

plan taking into account the expectations and requirements

of the elderly, which is a complex and multifaceted process.

The list of needs is long and varied – from balancing arti-

cial and natural light to ensuring adequate lighting in spe-

cic functional zones. Optimal use of innovative lighting

technologies and systems based on ergonomic design

guidelines can signicantly improve lighting conditions for

older people. The three strategic design approaches discus-

sed in the article, including lighting for emotional balance,

for eciency and preventing falls, are the steps to a multi-

directional lighting concept. The method can be eective in

olving health problems of the elderly and improving their

everyday living conditions. The issue of designing lighting

for seniors requires further, in-depth research, with parti-

cular emphasis on innovative energy-ecient systems.

Translated by

Anna Jaglarz

Szymon Chrzanowski

[1] Guerry E., Zissis G., Caumon C., Canale L., Bécheras E., Design

and survey of lighting and color ambiance for a suitable elderly’s

environment, “Light & Engineering” 2020, Vol. 28, No. 1, 79–89,

doi: 10.33383/2019-003.hal-02507321.

[2] Derungs, Light for people: Lighting for senior care. Good lighting

enriching life, 4/2016, https://www.pierlite.com.au/wp-content/up-

loads/2019/08/seniorenpege_en.pdf [accessed: 9.06.2022].

[3] Derungs, Medical lighting: Lighting solutions for elderly healthcare,

https://waldmannlighting.com/wp-content/uploads/pdfs/Light%20

for%20Senior%20Care/Light%20for%20Senior%20Care.pdf [ac-

cessed: 9.06.2022].

[4] Bell E., An Exploratory Lighting Study on the Eects of Correlat-

ed Color Temperature in Senior Living, Master’s Thesis, Ohio State

University 2018, https://etd.ohiolink.edu/acprod/odb_etd/ws/send_

file/send?accession=osu1523539636787946&disposition=inline

[accessed: 11.06.2023].

[5] Figueiro M.G., Saldo E., Rea M.S., Kubarek K., Cunningham J.,

Rea M.S., Developing Architectural Lighting Designs to Improve

Sleep in Older Adults, “The Open Sleep Journal” 2008, Vol. 1, 40–51,

doi: 10.2174/1874620900801010040.

[6] Lu X., Park N.K., Ahrentzen S., Lighting Eects on Older Adults’

Visual and Nonvisual Performance: A Systematic Review, “Journal

of Housing For the Elderly” 2019, Vol. 33, Iss. 3, 298–324, doi:

10.1080/02763893.2018.1562407.

[7] Brawley E.C., Design innovations for Aging and Alzheimer’s.

Creat ing Caring Environments, John Wiley & Sons, Hoboken

2006.

[8] Derungs, Light for people: Visual timing light. Biodynamic light

in elderly care, 2/2014, https://www.pierlite.com.au/wp-content/

uploads/2019/08/vtl_en.pdf [accessed: 11.06.2022]

[9] Collier L.M., Durmus D., Davis R.G., Lighting in Senior Care Cen-

ters: Comparing Tunable LED Systems to Conventional Lighting

Systems in Four Senior Care Centers, United States [n.p.] 2022,

doi: 10.2172/1859680.

[10] Janosik E., Zdrowotne aspekty oświetlenia stosowanego w miesz-

kaniach, “Medycyna Rodzinna” 2018, Vol. 21, No. 2, 185–195,

doi: 10.25121/MR.2018.21.2.185.

[11]

Feit J., Fact and ction of tunable lighting, “Buildings” 2018, April 3,

https://www.buildings.com/articles/28093/facts-and-ction-tun-

able-lighting [accessed: 17.10.2020].

References

96 Anna Jaglarz, Szymon Chrzanowski

Abstract

The role of lighting in senior care facility design

Shaping ergonomic lighting in spaces dedicated to seniors requires reliable knowledge from designers both in terms of health issues related to

the aging of the eyesight and innovative lighting solutions. Design guidelines based on credible scientic results are also desirable. To complement

the information in this eld, the authors identied perceptual problems in the elderly due to the aging process of the visual system and analyzed the

impact of lighting quality on the health, safety, comfort, and satisfaction of the elderly. Because eyesight deteriorates with age, older people have to

deal with the eects of insucient or inappropriate lighting. For this reason, there is a need to adapt lighting solutions to the requirements of seniors,

taking into account the process of weakening of the visual system. Design strategies focused on three lighting eects were discussed: maintaining

emotional balance, ensuring eciency in everyday activities, and preventing falls. Lighting simulations were also made on selected examples of inte-

riors in the senior care facility. They provided the basis for the analysis, comparison and evaluation of various lighting solutions and the development

of conclusions and guidelines for multi-directional lighting strategies based on visualized design problems.

Key words: design for the elderly, lighting for the elderly, ergonomic lighting, biodynamic lighting, age-related vision and perception disorders

Streszczenie

Rola oświetlenia w projektowaniu placówek opieki dla osób starszych

Kształtowanie ergonomicznego oświetlenia w przestrzeniach przeznaczonych dla seniorów wymaga od projektantów rzetelnej wiedzy zarówno

w zakresie problematyki zdrowotnej związanej ze starzeniem się wzroku, jak i innowacyjnych rozwiązań oświetleniowych. Pożądane są również

wytyczne projektowe oparte na wiarygodnych wynikach badań naukowych. Aby uzupełnić informacje w tej dziedzinie, autorzy rozpoznali problemy

percepcyjne osób w podeszłym wieku wynikające z procesu starzenia się układu wzrokowego oraz przeanalizowali jakość oświetlenia w kontekście

wpływu na zdrowie, bezpieczeństwo, komfort i satysfakcję osób starszych. Ponieważ wzrok pogarsza się wraz z wiekiem, osoby starsze muszą radzić

sobie ze skutkami niedostatecznego lub niewłaściwego oświetlenia. Z tego względu pojawia się potrzeba dostosowania rozwiązań oświetleniowych

do wymagań seniorów z uwzględnieniem procesu osłabiania się układu wzrokowego. Omówione zostały strategie projektowe ukierunkowane na

trzy efekty, jakie można uzyskać dzięki odpowiedniemu oświetleniu (utrzymanie równowagi emocjonalnej, zapewnienie wydajności i sprawności

w codziennych działaniach oraz zapobieganie upadkom). Przeprowadzono również symulacje oświetlenia na wybranych przykładach wnętrz w domu

opieki dla seniorów. Dały one podstawę do analizy, porównania i oceny różnych rozwiązań oświetleniowych oraz opracowania wniosków i wytycz-

nych do tworzenia wielokierunkowych strategii oświetleniowych opartych na zwizualizowanych problemach projektowych.

Słowa kluczowe: projektowanie dla osób starszych, oświetlenie dla osób starszych, oświetlenie ergonomiczne, oświetlenie biodynamiczne, zaburzenia

wzroku i percepcji w podeszłym wieku

[12] A world of lighting: What is color temperature?, 27.02.2017,

https://lumega.eu/blog/a-world-of-lighting-what-is-color-tempera-

ture/ [accessed: 17.10.2020].

[13] U.S. Department of Energy, Energy Eciency & Renewable Ener-

gy, Solid State Lighting, Tunable-White Lighting at the ACC Care

Center, 2016, https://www.energy.gov/sites/default/les/2016/09/

f33/2016_gateway-acc_brief.pdf [accessed: 14.10.2020].

[14] U.S. Department of Energy, Pacic Northwest National Laborato-

ry, Measuring Light Exposure and its Eects on Sleep and Behavior

in Care Center Residents ACC. Care Center – Sacramento, U.S.A.

[n.p.] 2019, https://www.energy.gov/sites/prod/les/2020/01/f70/

ssl-2019_acc-care-center_realistic-settings-report.pdf [accessed:

18.11.2020].

[15] Jaglarz A., The health role of smart home bathroom, “Builder”

2021, Vol. 284, Iss. 3, 48–51, doi: 10.5604/01.3001.0014.7422.

[16] Figueiro M.G., Plitnick B., Rea M.S., Gras L.Z., Rea M.S., Light-

ing and perceptual cues: Eects on gait measures of older adults

at high and low risk for falls, “BMC Geriatrics” 2011, No. 49, doi:

10.1186/1471-2318-11-49.

[17] Figueiro M.G., Gras L.Z., Rea M.S., Plitnick B., Rea M.S., Light-

ing for improving balance in older adults with and without risk

for falls, “Age and Ageing” 2012, Vol. 41, Iss. 3, 392–395, doi:

10.1093/ageing/afr166.

[18]

Bochnia A.K., Ruohonen S.M., Pajuste M., Hansen E.K., Eva luat ing

an integrative lighting design for elderly homes – a mixed methods

approach, “IOP Conference Series: Earth and Environmental Sci-

ence”, 2022, 1099, 012028, doi: 10.1088/1755-1315/1099/1/012028.

[19] Qiu J., Yang K., Application of lighting design in nursing home

design, “Highlights in Art and Design” 2023, Vol. 2, No. 1, 54–57.