FluxPlus converts scientific findings in the field of light and health into concrete lighting designs and lighting scenarios. People with dementia and their carers in residential care homes have been helped with this.

In residential care home ’t Landleven in Lelystad (Woonzorg Flevoland), people were looking for a way to make the daily life of residents with dementia more pleasant. The facilities manager of ’t Landleven, Bram Bergsma, approached Waldmann Engineers of Light. This light supplier mapped out the customer’s needs and made a light study. Waldmann Engineers of Light then contacted Fluxplus. Erik Swillens of Waldmann: ‘In the role of project manager, we had already collaborated constructively several times on projects with an integrative lighting design. So we knew that that way we could provide the best lighting solution for this very specific environment. Together, in ’t Landleven, we ensured a result with positive effects, both for the well-being and quality of life of the residents, as well as for the work schedule and job satisfaction of the staff members.’

Scientifically based lighting design

As a research and consultancy firm, Fluxplus forms the link between research and practice. “From contacts with various educational and research institutions, we translate scientific insights into lighting plans and help light suppliers such as Waldmann to realize effective lighting solutions together,” says Esther Groenhuijzen, lighting designer and specialist in integrative lighting at Fluxplus.

Numerous scientific studies indicate that a sufficient dose of daylight is essential to perform well and to increase alertness and concentration. Based on these findings, Fluxplus applies solutions for a disturbed sleep/wake rhythm in various domains.

Striking results were achieved in top sports, among others, by the controlled shifting of the sleep-wake rhythm via light therapy and chrono coaching. Anyone who stays for a long time in rooms where there is little or no daylight – for example control rooms or control rooms where people work day and night – benefits from lighting plans that provide simulated daylight. Because the function of good light is not limited to ‘seeing’, light can positively influence our biorhythm and our overall well-being. This is especially true in elderly care.

Dispel the winter blues and support mental well-being; these are aspects of light that can make the difference in elderly care between sinking into gloomy thoughts and getting back into activity, says Esther Groenhuijzen.

Daylight consumption

We all need daylight, light that we experience as white and which is a combination of all visible wavelengths. When the sun rises, daylight has a higher proportion of short wavelengths, with more blue, making us active and alert. In the evening when the sun sets, the longer wavelengths predominate. Daylight becomes warmer in color so that we can relax.

This daylight cycle is important because it supports our biorhythm. Daylight increases the release of the nighttime hormone melatonin, so that we not only fall asleep better, but also sleep better. A good night’s sleep determines how energetic we are and how good we feel about ourselves.

Some facts mean that older people absorb less daylight and as a result sleep less well and are at risk of fatigue and listlessness.

For example, some elderly people tend to go outside less: they are deterred by the cold or by ailments, they can no longer walk or cycle well, do not do their shopping themselves…

In addition to the reduced consumption of daylight, less light also reaches the retina of the aging eye due to the yellowing of the lens, partly blocking blue light.

Keeping an eye on the aging eye

Esther Groenhuijzen designs lighting concepts for this target group, in particular for elderly people with dementia: ‘Since the older eye absorbs less light, a higher light intensity is required. In doing so, we must bear in mind that the older eye is extremely sensitive to glare: the light must be calm to the eye. The older eye also perceives fewer contrasts and it is more difficult to adapt to the transition from light to dark and vice versa: it needs more time to make that transition.’

Esther explains how integrative lighting can have a positive influence on the quality of life of the elderly: ‘Integrated lighting is lighting that provides good vision, but also a feeling of well-being and a support for the biorhythm. The extent to which light influences these three objectives depends on the illuminance, the duration of exposure to the lighting, the timing – at which point you apply which type of light – and the spectral distribution.’

These various factors are translated into lighting designs, tailored to the wishes of clients in the elderly care sector.

From project analysis to specific lighting plan

Every lighting scenario that Fluxplus draws is preceded by an extensive project analysis. The requirements, wishes, opportunities and expectations of the location are mapped out. The results are tested against the applicable standards and recommendations for healthy lighting, after which a lighting design is made that also fits within the budget, as far as possible.

In projects relating to places where the elderly reside, scientific knowledge relating to this target group is converted into concrete solutions. We always start from the needs of the user of the building. The target group can still be refined: older people can suffer from dementia, as a result of which specific lighting choices are made. In residential care home ’t Landleven in Lelystad, for example, where elderly people with dementia reside, both residents and staff experience the benefits of integrative light.

Light scenario for elderly people with dementia

Elderly people with dementia lose their sleep and wake rhythm. By applying cool artificial light, these people can be prevented from taking regular naps during the day and then wandering around at night. In addition, cool light makes people more active and less prone to gloominess. Esther Groenhuijzen: ‘We imitate daylight and we provide enough intensive light. We prefer to use a mix of direct and indirect light to reduce glare as much as possible.’ Fluxplus opts for light that feels comfortable, has a low brightness and is atmospheric. Light should always provide good vision, a stable biorhythm and well-being. In consultation with (interior) architects, walls are lightly colored for maximum reflection. In ’t Landleven, pendant luminaires were chosen with a lower percentage of direct light and a higher percentage of indirect light, which gives a calmer light image than direct lighting alone.

Since the older eye finds it more difficult to distinguish contrasts between light and dark, FluxPlus always pays a lot of attention to corridors adjacent to the bedrooms. Esther Groenhuijzen: ‘Adequate and evenly lit corridors also ensure that residents with dementia do not become anxious about leaving their bedroom. Corridors are often not provided with daylight. Residents come from a bedroom with daylight into a dark corridor where there are often no windows. The older eye takes longer to adapt to the difference in light level.”

In order to provide residents with sufficient lighting that promotes well-being, Fluxplus prefers to opt for a ‘boost’ in light: for a relatively short period of time – for example during breakfast – the light intensity in the cool white activating light is increased and then dimmed. Esther Groenhuijzen: ‘In the project analysis, we include the residents’ daily schedule as a determining factor, as well as the duty rosters of the care staff. For example, we dim the light back around the time of the afternoon nap to give a boost of cool white light again in the afternoon. We respond to the desired day and work schedule.’

Positive Effects

It is essential that healthcare personnel is involved and understands the benefits of the applied lighting. In order not to turn the lighting back to warm white out of habit, a lot of attention was also paid in ’t Landleven to the transfer of knowledge. Bram Bergsma, facility manager at Woonzorg Flevoland: ‘Everyone received a presentation that made clear the added value and increased support. The collaboration with both Waldmann Engineers of Light and Fluxplus paid off: the first was responsible for project management from the first discussions to the installation and programming of the lighting control, while Fluxplus made a very focused lighting design and communicated clearly about the how and why. The positive effects are noticeable, both among our residents and our employees. There is much more light in the building than before. Residents are visibly more active during the day and participate more in activities. We also experience that residents are happier. Employees are now really noticing how little light there used to be on location.