Masterchef
I love a good recipe book.
But, however vivid the description and detailed the pictures, if you’ve ever tried to cook a dish from scratch, especially one you’ve never tasted yourself, you’ll know there’s no substitute for talking to someone who’s done it before. Ideally, that’s someone you trust, who’s in the same position as you, so they know all the things that could go wrong.
So if you’ve been hearing about ‘circadian lighting’ and wondering if it’s all smoke and mirrors, you might be interested in a rare chance to learn directly from Jo Cheshire of WCS Care at a free half-day in-person half-day workshop at the Liverpool Social Care Test Bed on the 8th of July.
Jo will be talking through the ‘active ingredients’ of their successful implementation of circadian lighting in new build and retrofit facilities across their award-winning portfolio over the past five years.
She’ll share what’s worked and things to avoid, and how they calculate the return on investment and why they’ve decided it’s worth every penny,
She will review some of the remarkable results they’ve seen from recent installations – from elimination of sundowning and antipsychotic use, to a reduction in falls by around one-third, visitors who feel more confident visiting their loved ones and calmer, and happier staff. She’ll also explain how the management team now consider circadian lighting as part of their prevention strategy, complementing other innovations like acoustic monitoring to reduce long-lie falls and optimise night-time staffing without the risks posed by camera-based systems.
John Bullock will talk about the ‘nuts and bolts’ of these projects – how he makes sure the system delivers the right light at the right time while meeting Part L energy performance standards (and making sure the space still looks and feels like a comfortable home) – and how he chooses and configures the controls to balance biological, clinical and personal needs – we should all have the right to switch the lights off!
Hosted by the National Care Forum Digital Team, the event is made possible with the support of Commercial Lighting Systems.
Places are limited, so please message or email me if you’d like to come along.
Wounded knee
My dear Mum misjudged the bottom step in her garden a couple of weeks ago and went down hard, her knee catching the sharp edge of a paving slab, carving a deep gash across the joint, wide enough to warrant 13 neat stitches, skilfully woven her fragile skin in the small hours of the night in the emergency room of our loval hospital.
I am deeply grateful to the ressuring ambulance team and the duty nurse, Becky, red-eyed at the end of a punishing 12-hour shift in an airless and windowless room who still had the kindness and professionalism to wait for a second shot of painkillers to kick in before threading the final knot.
Mum’s recovering well.
But it got me thinking about wound healing – and light of course 😉
Although sunlight has traditionally been seen as the enemy of healthy skin, the infrared wavelengths in natural light could actually speed up accidental and post-operative wound healing and even reduce perception of pain, linked to the critical role of mitochondria in cell metabolism, repair and regeneration – Effects of Near Infrared Light on Surgical Wound Healing: A Systematic Review and Meta-Analysis.
I was surprised to discover another link between light and my mum’s bleeding knee,
The body clock,
It turns out that burns and cuts sustained during the night can take up to 60% longer to heal than injuries during the day. That’s thanks to the increased activity of cells associated with movement and repair and increased deposits of collagen at the site of the wound, an effect that is sustained over time – Circadian actin dynamics drive rhythmic fibroblast mobilization during wound healing.
The mechanisms that lead to chronic non-healing wounds like diabetic foot ulcers and pressure sores also seem to have a strong circadian connection, with growing understanding of the role of microRNA, an essential link in the clock signalling chain – A time to heal: microRNA and circadian dynamics in cutaneous wound repair.
While many wounds are accidental – my Mum didn’t choose what time of day to trip, and many people living with chronic illnesses are at high risk of pressure ulcers simply because of the time they spend in bed – others are an inevitable consequence of surgical procedures like knee and hip replacements.
Here, setting the body clock with patterns of light and darkness, and timing surgery to support recovery could really help.
One clinical trial found that, although patients undergoing surgery at night needed a lower dose of general anaesthetic, sleep, post-operative pain, nausea and dizziness were worse compared to those who went under the knife between 8am and noon – Comparison of Morning and Evening Operation Under General Anesthesia on Intraoperative Anesthetic Requirement, Postoperative Sleep Quality, and Pain: A Randomized Controlled Trial.
Becky was doing her best against all the odds – and I am so grateful she was there.
But perhaps it’s time we used light to give our remarkable healing response a helping hand?