Senior Care GooD LiGHTinG enriCHeS Senior LiVinG 2 LiGHTinG SoLUTionS For eLDerLY HeaLTHCare THe iMPorTanCe oF GooD LiGHT The statistics on aging show us the challenges ahead in caring for the elderly. There is an increase in life expectancy, which is affecting the way we think about healthcare and the importance of quality in elderly care facilities. The lighting design of these facilities can have a great impact on the overall effectiveness for the staff, patients/residents and visitors. Derungs Licht AG has been addressing the needs of the healthcare industry for over 65 years. Experience and education has made us experts in the specific needs of elderly care facility lighting. Lighting for the elderly Lighting for healthcare staff Lighting for healthcare facility owners Light can stimulate the mind, emotions and Caring for the elderly and for people who High-performance, quality materials, energy- the circadian rhythm. It enables us to de- are ill can be a challenging task for the health- saving and durable luminaires along with cipher when things start and end, colors as care staff. It can push care providers to superior engineering and workmanship are well as shapes. As vision deteriorates with their physical and psychological limits. Our all reasons why our lighting solutions help increasing age, the elderly have to cope custom lighting solutions provide the best facility owners feel confident they chose with the effects of inadequate lighting. possible visual conditions for the staff. By Derungs. Age-related hearing problems are often enabling efficiency, quality and productivity offset by visual speech interpretation like through lighting, healthcare providers can lipreading. An 80-year-old person requires feel their own sense of well-being in the Derungs lighting solutions: on average ten times the illumination level workplace. Creating great environments of a young adult. Age-related illnesses such as dementia also need to be taken into Inconspicuous but highly effective—that’s account. The effective use of light helps Lighting for visitors what we demand of our lighting designs. people who are suffering from an illness Everybody has to feel accommodated in the to better cope with symptoms, and it pro- Light affects the way we perceive space same way: residents, care providers, and motes independence and mobility. Thus, in terms of dimension, color, material, and owners. Our state-of-the-art lighting solu- a custom lighting design that addresses atmosphere. It should convey a sense of tions provide homelike comfort and safety. these needs is important to a successful well-being and safety to enhance the vis- Our lighting design systems are adaptable and effective interior design of elderly care ual perception of the establishment. In this and they create an environment conducive facilities. Proper and adequate light can also way, the lighting design can actually help to to communication. Derungs’ luminaires are promote the best in quality of life despite promote the facility. inconspicuous yet effective. the circumstances. The combination of different light effects produced by high intensity lights, care lights, reading or work lights, general lights, exam- ination lights, nightlights and guide lights enables us to provide lighting solutions tail- ored to meet the demands of every target group. We use indirect and direct lighting on ceilings, walls and floors as well as multi- purpose reading lights to produce different light effects. 3 TaBLe oF ConTenTS LiGHTinG SoLUTionS For eLDerLY HeaLTHCare Seni oo rBROCHURE GUIDE 4 Icons to help organize information oo oHEALTH CONCERNS OF THE ELDERLY 5 Visual impairments 6 Dementia oo CEFFECTS OF AGE-RELATED HEALTH ISSUES 7 Issues: Falling and slipping / Anxieties 8 Issues: Passiveness / Disorientation 9 Issues: The disruption of the circadian rhythm aG HOW LIGHT AFFECTS THE QUALITY OF LIFE Custom lighting is a solution-key factors in adequate lighting 10 Illumination level, Cylindrical illumination 11 Light diffusion 12 Color of light, Color rendition 13 Glare control, Environment, Light distribution Reflection control, Shadow control ar PREPARING A LIGHTING DESIGN 14 Important basics for planning a SPECIFIC LIGHTING 15 Recreation room, corridor and staircase lighting aD DERUNGS PRODUCTS: CORRIDOR AND STAIRCASE LIGHTING 16 Ceiling lights 18 Wall lights LG DERUNGS PRODUCTS: RECREATION ROOM LIGHTING 20 Ceiling lights / Reading lights LL SPECIFIC LIGHTING 22 Healthcare room lighting Lr DERUNGS PRODUCTS / HEALTHCARE ROOM LIGHTING 24 Wall lights 26 Reading lights LH SPECIFIC LIGHTING 28 Restroom lighting TG DERUNGS PRODUCTS / RESTROOM LIGHTING 30 Wall lights TL DERUNGS OFFERS ADDITIONAL BENEFITS 32 Safety, quality, ergonomics, economics Tr THANK YOU FOR YOUR ATTENTION 34 We are at your service as a reliable partner T LIST OF REFERENCES 35 Copy, graphic images 4 BroCHUre GUiDe iConS To HeLP orGaniZe inForMaTion Lighting solutions in elderly care facilities are extensive and multi-faceted. There are many factors to consider regarding each and every custom lighting solution. The icons below are used throughout this brochure to organize information and help give you clarity on the importance of lighting in elderly care facilities. organization of the brochure This brochure will start with the definition Derungs is dedicated to the education of of terms and an explanation of factors that lighting in the healthcare industry, as well may affect professional lighting systems for as providing outstanding products and ser- healthcare facilities. First, several elderly vice as solutions. health issues will be defined. Then, overall solutions for good lighting, basics for plan- The icons below represent three separate ning, high-performance lighting systems sections in this brochure to help clearly il- will be discussed. Finally, this brochure lustrate its purpose. will conclude with the benefits in using Derungs as your elderly healthcare lighting expert and a listing of product lines. issue Solution Products ?? !! 5 ?? HeaLTH ConCernS oF THe eLDerLY ViSUaL iMPairMenTS The elderly and people afflicted with dementia often suffer from vision and perception issues. Studies have shown that adequate lighting provides the key to maximizing self-sufficient and accident-free living as much as possible. A professional lighting design can offset these issues and add to the quality of life for the patient. Macular degeneration Cataracts Diabetic retinopathy Impairment of central vision; affects read- Clouding in the variable lens; vision beco- Vision becomes blurred and distorted; dark ing ability, objects appear blurry, difficulty mes foggy or blurred spots, complete loss of vision in discriminating colors Glaucoma retinitis pigmentosa Increased fluid pressure in the eye, optic Difficulties adjusting to brightness/dark- nerve fibers die due to lack of blood, he- ness, night blindness, sensitivity to glare, mianopsia tunnel vision 6 ?? HeaLTH ConCernS oF THe eLDerLY DeMenTia Fifty percent of all adults will need long-term care at some time according to research, and the trend is growing. Dementia is an enormous challenge for patients, care providers and relatives. The patient environment needs to be professionally designed to compensate for the changes in abilities like cognition and perception. Professional lighting significantly contributes to a successful environment in elderly care facilities. It helps ensure the highest level possible of patient independence as well as the physical and mental health of patients. Proper lighting solutions can also allow the healthcare professional to clearly and accurately handle tasks. Understanding dementia Imagine all of your memories were chro- Secondary symptoms may involve anxiety, nologically kept in a book. You can only flight rather than fight, depression, passive- remember what is recorded on these ness, aggressive behavior, and manic delusi- pages. Suddenly ‘dementia’ comes along ons. and starts to tear pages out of your book, beginning with the last pages. Patients with dementia require intensive support and care, often around the clock. Dementia involves the progressive decline Keeping this population of patients as self- of mental abilities accompanied by changes sufficient and mobile as possible is not only in personality. Carrying out daily activities in line with common social values but also without help becomes difficult and some- the decisive factor in reducing the workload times impossible. Symptoms that further of care providers. burden daily life include memory loss, loss of speech, difficulties with recognition and Customized lighting solutions can motiv- perception, difficulties with time and place ate the elderly to stay self-sufficient and orientation, and changes in behavior. The can also help facilitate the daily routines of environment becomes more and more con- healthcare providers. fusing to the dementia patient. It becomes more difficult to adequately process and re- act to environmental stimuli. 7 ?? eFFeCTS oF aGe-reLaTeD HeaLTH iSSUeS iSSUeS: FaLLinG anD SLiPPinG / anXieTieS Falls, feelings of insecurity and anxiety can be significantly decreased by providing adequate lighting. This in turn results in a higher degree of independence, safety, comfort and contentment. Falls Common causes of falling due to poor lighting: Falls and possible fractures like femoral neck fractures, may involve major surgery • O bstacles are not recognized in time and an extensive recovery period. Compli- due to glare cations during treatment may even mean • B right/dark transitions cause eye strain in 1a) Poor lighting 1b) Good lighting immobility and no longer being able to carry older people out daily activities. • H ard shadows / Shiny spots are in- terpreted as obstacles and lead to false 1a) Unfavorable illumination levels and light conditions steps 2a) Refections on foor caused by one direct light • S hadow of door handle is thought to be the door handle itself 2a) Poor lighting 2b) Good lighting 1a) Negative 1b) Positive anxieties Residents often interpret passing shadows Dark ceilings without indirect lighting feel or other optical illusions as a threat. This restrictive and unsafe. in turn causes anxiety and fear which may lead to aggression. Shadows on peoples’ 1a) D ark shadows on various facial features (images: reproduction and/or publication 1a) Poor lighting 1b) Good lighting faces may cause angst, especially if vision with permission from Verwaltungs- is impaired. Berufsgenossenschaft, Deelbögenkamp 4, 22297 Hamburg) 2a) Negative 2b) Negative Reflections are often the cause of irritabi- 2a,b) Passing shadows, door handle with shadow lity and insecurity. Patients with dementia often interpret these as obstacles or as optical illusions. Floor reflections are often thought to be water. 2a) Poor lighting 2b) Good lighting 8 eFFeCTS oF aGe-reLaTeD HeaLTH iSSUeS iSSUeS: PaSSiVeneSS / DiSorienTaTion The need to actively engage in daily activities and in social life continues to exist even after moving to a private or public senior care facility. Adequate lighting helps seniors to manage their daily routines more independently. Passiveness Disorientation People in need of care still need to main- Disoriented patients often feel worse in tain their own level of independence. Being poorly lit rooms. This is because objects able to move freely helps them better un- throughout the room lack contrast, therefore derstand the environment they live in and it making it difficult to see shapes and de- promotes social behavior with other people tails clearly. The perception of depth can be in the healthcare facility. Poor lighting may severely limited which makes it difficult for trigger fear and discourage the elderly from the patient to see the beginning and the end carrying out daily activities independently. of objects. The result is passiveness, discontentment, depression or even aggressive behavior. Corridors, staircases and recreation areas can become hazard zones with poor lighting Adequate lighting assists the elderly in bet- because the patients may lose their bea- ter finding their way around safely and inde- rings out of confusion. The ability to move pendently. They feel encouraged to move about independently decreases drastically; about and they are more likely to participate almost every step requires the assistance in social activities. Therefore, the overall at- of a care provider. mosphere throughout the facility is signifi- cantly enhanced. The systematic use of light substantially contributes to optimizing the general sense of spatial perception. Dark with shadows and glare Clear, bright environment Clear, bright environment Dlite® amadea Dlite® amadea 9 eFFeCTS oF aGe-reLaTeD HeaLTH iSSUeS iSSUe: THe DiSrUPTion oF THe CirCaDian rHYTHM The circadian rhythm helps the human body adjust to the patterns of daily processes. It controls everyday human physiological processes like metabolism and hormone production and the awake/ sleep cycle with remarkable accuracy. Light acts as the body‘s “timer” in the process. If natural light is not available to regulate our inner clock, then a lighting solution that provides an adequate substitute for natural daylight is required. The disruption of the circadian rhythm • Twenty-four hour cycle of light to orga- nize daily course of activity Patients with dementia have difficulties • P ositively affects the day / night cycle with spatiotemporal orientation. This leads • H elps balance hormone production to implications of inactivity, confusion and • R egular sleeping and eating habits Early morning Morning depression. • P ositively affects mood and sense of Morning Forenoon well-being; invigorates the senses “Visual Timing Light”, the innovative light • C ompensates for mood fluctuations management system from Derungs Licht and depressions AG uses artificial light to simulate the • E nhances overall performance twenty-four hour cycle, from sunrise to • S ignificantly improves articulation of sundown and night-time. patients with dementia Afternoon Afternoon Evening Evening A sophisticated light control system is used to define the different light effects from morning until night. As the time of the day progresses, this lighting system features a different illumination level and light tem- perature. The control system repeats the different light effects over a twenty-four hour period. As each hour passes, corre- sponding color temperature and brightness is automatically simulated. “Visual Timing Light” has become an indispensable way to assist circadian rhythm health concerns. 10 HoW LiGHT aFFeCTS THe QUaLiTY oF LiFe CUSToM LiGHTinG iS a SoLUTion − KeY FaCTorS in aDeQUaTe LiGHTinG This section describes the factors needed for adequate lighting. Derungs Licht AG combines and adapts these to meet the specific needs of adult care facilities. Effects of age-related deficiencies can consequently be substantially reduced. illumination level One of the most significant factors for room Adequate illumination levels reduce feelings illumination is the illumination level mea- of insecurity, the risk of accidents, anxiety, sured in “lux” or “footcandle”. It defines the and passiveness among other things. intensity of light emitted over a given area. Due to the deterioration of vision, the el- See page 14 for specifics on illumination re- derly need a higher illumination level to be commendations for different rooms. able to cope with daily tasks. The threshold areas between light and dark such as entry- ways have to be kept brightly lit, especially on the inside, to help the eye better adjust to the inside when entering from the brighter outside. Cylindrical illumination Cylindrical illumination is the quantifying Quality components along with innovative parameter for the lighting level of vertical reflector and prism technology allow De- or virtually vertical object surfaces in a rungs Licht AG solutions to achieve opti- room. It is also applied as a standard for mal cylindrical illumination. determining the brightness in a room and, in particular, the brightness of faces. Ideal cylindrical illumination enhances the reco- gnition of faces, door handles, light swit- ches, colors, and more. This diagram represents the various ap- proximate illumination levels in every- day life. O10v0e0rc0a sLtu sxk y 2 At5 0th0e L wuxin dow 0Fu.2ll Lmuoxo n at midnight inside the room 300 Lux In the middle 100 000 Lux of the room Clear, sunny day 10 Lux 10 000 Lux Streetlighting In the shade 6 000 Lux Under an awning 1 Lux 10 Lux Candlelight In the basement