Lighting

An artificial circadian rhythm can be implemented with the use of LED lights that fluctuate over a 24-hour cycle, mimicking the gradual change of sunlight from sunrise through nighttime. These effects involve both intensity and wavelength variations in perceived lighting (Ellis, Gonzalez & McEachron, 2013).

Patients should be exposed to:

  • Bright white light at 2,500 – 8,000 lux at the cornea for at least one hour in the morning;
  • Followed by bright white light at >1,000 lux at the cornea.
  • In the evening, patients should be exposed to short- wavelength light at 30 lux at the cornea for approximately two hours.
  • Nighttime should be spent in complete darkness (Figuerora, Plitnick, Lok, et al., 2014).

Light box therapy can also be used during the day in the form of 300–400 lux
of a bluish-white light, which has proven to significantly improve sleep efficiency, Pittsburgh Sleep Quality Index (PSQI) scores, decreased depression (CSDD), and agitation (CMAI) scores (Figuerora, Plitnick, Lok, et al., 2014).

In keeping with the concept of the institutionalized circadian rhythm, Torrington & Tregenza have recommended the implementation of scenes from nature (2016). These natural themes help people feel connected to the outside which helps create a pleasant and relaxing atmosphere, for both patient and staff. The reduction of a hectic atmosphere also lends to faster recovery times as it helps calm them (Phillips, n.d.).

Sources:
Ellis, E.V., Gonzalez, E.W., & McEachron, D. L. (2013). Chronobioengineering indoor lighting to enhance facilities for aging and Alzheimer’s disorder. Retrieved from http://www.tandfonline.com/doi/abs/10.1080/17508975.2013.807764
Figueiro, Mariana G., Barbara A. Plitnick, Anna Lok, Geoffrey E. Jones, Patricia Higgins, Thomas R. Hornick & Mark S. Rea. (2014). Tailored Lighting Intervention Improves Measures of Sleep, Depression, and Agitation in Persons with Alzheimer’s Disease and Related Dementia Living in Long-term Care Facilities. Retrieved from https://www.ncbi.nim.nih.gov/pmc/articles/PMC4168854
Torrington, J. M., & P. R. Tregenza. (2016). Lighting for People with Dementia. Retrieved from http://journal.sagepub.com/doi/pdf/10.1177/1365782806074484
Philips. Philips Large Luminous Surfaces. Retrieved from http://www. largeluminoussurfaces.com/
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