Let There Be Light

As we age, the structure of our eye changes as well — our pupils reduce in size, our lenses become cloudy and less pliable, and our susceptibility to common eye conditions increases. These changes make it challenging to read small print, distinguish between colours, and transition between bright and dim spaces.

In fact, adults over the age of 60 need roughly three times the amount of light to perform a task compared to the average 25-year-old. A poorly lit environment also increases our risk of falls, anxiety, depression and disruptive sleep-wake cycles.

                          Photo Courtesy of Canva

People living with dementia also experience significant changes in vision.

The brain interprets the visual information delivered along our optic nerve, and studies show that neurodegenerative conditions can result in a loss of depth perception and a difficulty distinguishing between two- and three-dimensional objects.

What you might see as an impeccably polished wood floor may appear wet, slippery and dangerous to someone living with dementia.

Or, shadows cast by a flickering streetlight can mimic menacing flames. Misperceptions like these can provoke fear, agitation and eventually a loss of independence.

Deb Bryson is co-lead for brainXchange’s Design and Dementia Community of Practice (CoP), which has researched and developed recommendations for dementia-inclusive lighting environments.

“When I go into a home [as a geriatric consultant], it’s quite often very dark,” says Bryson. “I’m always saying to families, ‘Can you make sure that the lights get left on until bedtime?’ Families are puzzled when you bring that up. We don’t often think about lighting.”

Addressing lighting in our homes can have dramatic effects on quality of life for minimal cost. Here are a few easy and effective ways to achieve dementia-inclusive lighting in your home.

NATURAL LIGHT

Bryson says daily exposure to natural light regulates our circadian rhythm (the internal clock that regulates sleep and wakefulness) and dictates our melatonin production. Even a few minutes a day outside is beneficial.

Indoors, Bryson suggests making use of large windows, atriums and skylights by positioning sitting areas and points of interest (like activity tables or aquariums) nearby.

AMBIENT LIGHTING

Larger rooms need more light sources, and lighting should vary in height (for example overhead lights, cove lights, wall-washers, task lights and baseboard lights at night) and direction. When shopping for bulbs, look for “cooler” lights for daytime use and warmer, red or orange tones later in the day to promote better sleep/wake cycles.

Also, use bulbs with an appropriate level of lux for the area you’re trying to light. Lux is a measurement of how much light is projected onto a given space. (One lux equals one lumen, a measure of brightness, per square metre.) For older adults, the recommended ambient lighting of general living spaces is 200-500 lx.

TASK LIGHTING

Bryson says adequate task lighting has a significant impact on independence and even appetite. “Eating in a place that has good overhead light can improve eating habits,” she says. Areas where we perform visual tasks — like eating, preparing food or reading — require a lux level of at least 500 lx. Areas with low contrast, for example, a blue puzzle on a dark tablecloth, need up to 1,000 lx for aging eyes to properly distinguish colours and finer details.

Portable lamps or dimmable switches allow you to adjust and direct lighting, depending on the activity and the time of day.

Photo Courtesy of BrainXchange

NAVIGATIONAL LIGHTING

Adding lights to your hallways and stairs helps with safety and wayfinding, especially at nighttime. Plan to angle the lights to illuminate places like the edges of the floor, doorframes and handles. But use only what is necessary as too much light can impede vision.

TRANSITIONAL SPACES

Anyone who’s emerged from a dark building on a bright day, or flipped off a switch to cause sudden darkness, has experienced the adaptation our eyes undergo when confronted with lighting change. This adjustment takes much longer in aging eyes and can lead to falls, injury and confusion.

To avoid this, make sure your lighting is uniform from room to room. In transitional areas, such as entrances and mudrooms, make sure the lighting is even and adequate to illuminate both spaces.

                               Photo Courtesy of BrainXchange

GLARE

Glare, shadows and pooled lighting can create illusions that result in increased stress, anxiety and responsive behaviours in people living with dementia. Reposition lamps and light sources, cover highly reflective surfaces and adjust your home’s curtains, blinds or shades throughout the day.

CONTROLLING YOUR LIGHT SOURCE

• DIMMABLE LIGHT SWITCHES allow you to customize brightness levels to the task.
• ADJUSTABLE TASK LIGHTS help you control the location, direction and intensity of your lighting.
• BIODYNAMIC LIGHTING mimics the natural progression of daylight by changing colour and intensity throughout the day.