quality of life issues
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The second Earth Summit - scheduled for Rio in 2012 - holds the promise of a new commitment to cure the world's environmental ills.
Election hopefuls debate housing
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In bathrooms use shielded fluorescent lighting mounted on the wall on either side of the vanity or sink mirror spaced 30" apart. This will provide evenly distributed light with no glare on the face. If the bathroom is equipped with a long solid mirror, mount the lights on the mirror. Additional ceiling lighting should be provided throughout the bathroom to adequately illuminate all areas and provide good light for personal grooming and safety. Since older adults get up frequently in the night to use the bathroom, use amber colored nightlights to help them find their way safely. The amber color will not disturb the sleep cycle and interfere with their ability to return to sleep. While night lighting should be provided, it should be kept to as low a wattage as possible while still providing a safe path of light. In the bathroom provide a night light that can be left on all night or operated by a motion switch. Make sure this light is of a low wattage as well. Introducing bright light to soon can cause temporary blindness in older eyes and lead to disorientation. Older eyes take longer to adjust to changing light levels. There are low level LED's that can be installed in door frames or used at the floor to create a safe path of light throughout a living space.
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The resulting thickening of the lenses also causes the eyes to register more amber which changes the ability to perceive color correctly. Amber absorbs blueish and purple colors, so the older we get, the less blue we see. This makes it important for older people to have a light source strong in the blue range. Using cool fluorescent lamps and LED's will provide this blue light source. Select fluorescent bulbs at least 4100 k and LED's that have not been manufactured to achieve warmer colors. Use a good quality fluorescent bulb with a high color rendering index to aide in the color recognition. Using an inexpensive daylight bulb with a low CRI will only worsen the color recognition problem.
It is apparent from these studies that increasing the light levels in the living environments of the elderly can have a positive impact on their quality of life and perhaps reduce their dependency on expensive drugs. While striving to increase the light levels it is important to consider the type of lighting that will achieve the best result. Careful attention must be paid to creating high light levels without glare. Glare can be especially jarring to older eyes. The building up of layers of cells on the lenses causes a scattering of the light, increasing susceptibility to glare. Glasses and contacts also contribute to the glare problem.
Due to the advances in lighting technology and research, it is possible to enhance the quality of life of our senior adults by making simple changes in the lighting of their environments reducing the occurrence and severity of dementia. This is something we can all do for our elderly clients or loved ones.
As the Baby Boom Generation joins the ranks of our growing elderly population, we should consider how lighting their environment will affect their quality of life. By the time we reach age 65 we need three times the amount of light to see with the same acuity of a 20 to 30 year old. Each year a new layer of cells forms on the lens of the eye. As this layer becomes progressively thicker we require higher levels of light to penetrate to the back of the retina. According to new Dutch study published in the Journal of American Medicine, higher light levels can reduce the affects of dementia in older adults.
The Dutch study looked at 189 residents of 12 assisted living facilities, 87 percent of whom had been diagnosed with dementia over a five year period. In all the facilities, the lights were brightest between 9 a.m. and 6 p.m. In half of the facilities,new higher wattage lights were installed. The new lighting produced light of 1000 lux, a measurement of light output equivalent to 93 foot-candles, or about 50 percent more than the level recommended for open office lighting. In the remaining 6 facilities, indoor lighting produced 300 lux equivalent to 30 foot-candles or the amount of light recommended for residential living spaces. In addition, one group was given 2.5 milligrams of melatonin each evening, while the other group received a placebo. The study revealed the higher light levels alone were enough to cause positive effects in the patients. The 1000 lux lighting reduced cognitive decline by 5 percent, reduced symptoms of depression by 19 percent and reduced physical function decline by 53 percent. Of those who took the melatonin, 25 had more uninterrupted sleep, although those who just took the melatonin and weren't exposed to the higher lighting levels showed more signs of withdrawal and depression. The residents who experienced the higher light levels and took the melatonin increased their sleep efficiency by 3.5 percent, reduced nocturnal restlessness by 9 percent and reduced agitated behavior by 9 percent. This research revealed that the same results occurred in the residents exposed to the higher light levels as occurred in patients who are prescribed a popular class of drugs used to treat Alzheimer's.
Often an elderly person will have a favorite chandelier and lamps that they will want to use in their living space. These fixtures can be fitted with frosted light bulbs and soft fabric shades to eliminate glare and used as decorative accents in the room. Fit the table or floor lamps with compact fluorescent bulbs, the highest wattage they can physically hold. Replacement harps and shades can be used to allow for the larger size, higher wattage bulbs. These bulbs burn much cooler than their incandescent couterparts so you can use a higher wattage than recommended because heat is not an issue in the lamp.
When planning the lighting for the space, consider the different types of fluorescent lighting. One recommended application is to use linear fluorescent strips mounted in coves located near the ceiling. This in effect turns the entire ceiling into a light reflector creating glare free indirect, evenly distributed light. The ceiling must be white in order for this technique to be effective. Surface mounted fixtures may be used if covered by white diffusers to eliminate glare. The number of bulbs and wattage required is dependant on the room size, color of walls, floors and the reflective properties of those surfaces. Keep in mind that 3 times the recommended light level is the goal. Supplement the ceiling light with lighting over the cabinets and under the cabinets in kitchens. Use the same fluorescent color throughout. If possible the counter tops should be constructed from a light material finished in a matte finish. Avoid dark, high gloss counter-topsfor maximum lighting efficiency in areas occupied by the elderly.
A correlation exists between how much light we absorb and how much melatonin our body produces. Melatonin is a hormone that is produced while we are sleeping and is essential in the regulation of our circadian rhythm. The body uses light levels to differentiate between daytime and nighttime. When this light level is reduced by an absence of light during the daytime hours, the production of melatonin is affected and results in a disruption to the circadian rhythm. This causes a change in sleep patterns which has been shown to be a factor in early onset dementia. As we age, we tend to spend less time outdoors and more time indoors in artificial light, thus affecting melatonin production. At a time when the human body needs more light we effectively reduce the available light by spending more time indoors.
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