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Is circadian lighting really worth the money?

piggy bank
 

Every lighting catalogue boasts a ‘circadian’ option. But examples of successful businesses investing in a truly ‘human centred’ lighting solution are vanishingly rare. Perhaps not surprising. None of the standards demand it.

Evidence is patchy and inconsistent. And a tunable light source is just an expensive gadget if it’s stuck in the same place as the old one, the controls don’t work and the rest of the environment is as dingy and stressful as it always was.

I’m lucky enough to be working with two remarkable teams who are bucking the trend. Both in the Residential Care sector, both facing a perfect storm of rising demand, staff shortages and tight budgets. Both passionate about the human and financial benefits of offering supported living at a human scale in local communities where friends and families can stay in touch. They’re just 12 times zones apart!

I’m currently the guest of the Northern Health Authority in Canada (where I saw a real live bear on the way to work…) We’re working together on a truly human-centred supported living facility in a rural town called Vanderhoof, the geographical heart of British Columbia.

The ground floor of this affordable housing block right in the centre of town is dedicated to those living with early stage dementia. The other two floors are designed to welcome older people on low incomes. This integrated model has led to a budding romance and to some other unexpected consequences: as these senior citizens are more visible in the town, other facilities are being upgraded to welcome them – from repairing the pavements and ramps to access the weekly farmer’s market to investing in a disabled swing in the park next door.What’s special about this place is that the human-centred lighting is part of a truly human-centred approach. There is light at the end of the tunnel after all!

Can circadian lighting really cut falls by 43%!?
According to this remarkable study by Shadab Rahman et al, at Brigham Women’s Hospital, yes it really can – Impact of Upgraded Lighting on Falls in Care Home Residents
 
And that really could add up. Every year, around $34 billion is spent in the USA alone on the direct costs of non-fatal falls in the elderly – ARTICLE: Falls Cost U.S. Hospitals $34 billion in Direct Medical Costs
 
Rahman’s team studied two pairs of care homes in Wisconsin over two years, with a total of 758 residents (average age 81, 57% female; 31% with dementia. In one pair of homes. they upgraded the lighting to deliver bright, blue-enriched light during the day ((6am-6pm) and dim, blue-depleted at night (6pm to 6am). Before the experiment, the rate of falls were similar between the two homes (6.94 vs 6.62 falls per 1000 resident-days). Following upgrade, falls were reduced by 43% compared with the control.  That’s something to stand up for!
Do tunable lights (cool to warm) really make a difference?
Yes – according to this study at least. The team at Arizona State University took 21 healthy older adults (78 y/o average). Exposed half to different light levels across the day (500 lux in the morning to 100 lux in the evening) at a constant 2700k. The other condition saw the same illumination levels but with colour changing (6500k morning to 2700k evening) – Lighting up living spaces to improve mood and cognitive performance in older adults
Social distancing…
As we head back to school and to work after the break with COVID still on the radar, I am acutely aware of social distancing and what seems appropriate – or not!. This classic paper by Adams & Zuckerman looked at the influence of light on the appropriate personal distance of standing females: under lower lighting, they chose to stand further away, especially when standing behind or to the sides because of a sense of inappropriate intimacy – The effect of lighting conditions on personal space requirements

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