1. Good interior lighting facilitates the performance of daily activities (ADL) of the visually impaired elderly in their homes York, June 23th Frouck de Boer, Occupational Therapist, the Netherlands

2. Overview  Visual functioning of the elderly  Experience the need of light  Recommendations for lighting design  Case study elderly home ‘Bernardus’ 17 augustus 2015

3. Introduction Light has a positive influence on the quality of life of the elderly Usually: High focus on impairments, participation and activity, not on the environment 25% of the elderly residents are visually impaired 17 augustus 2015

4. Visual Functioning The aging eye needs more and more light Elderly adapt to a changing environment instead of the environment is being adapted to the elderly Why? 17 augustus 2015

5. Common things elderly say “I am not able to read the newspaper anymore” “I bumped into the table” “I can’t prepare dinner anymore, without making a mess of the kitchen” 17 augustus 2015

6. ICF model Health Condition (disorder/disease) Body Function and Structure (Impairment) Activities (Limitation) Participation (Restriction) Environmental Factors Personal Factors Contextual Factors

7. Quality of life Visual impairment can lead to reduced participation in activities of daily living and mobility  Safety – safety in their environment  Participating in activities of daily living  Independency 17 augustus 2015

8. Visual functioning of the elderly The diameter of the pupil, the light transmission of the lens of the eye and the quality of the retina decreases with age. 17 augustus 2015

9. How many lux do you think there is in the next room? 17 augustus 2015

12. Elderly, what do they see? 17 augustus 2015

21. Light and vision. What do you see? 17 augustus 2015

24. Relationship between light and age 17 augustus 2015 At ages above 50, the required illumination level is higher. Increase can reach a factor of 10 in the 70’s or 80’s! 10 20 30 40 50 60 Age in years

25. Reflection / Glare reflection light Part of the light absorbs  Light from a light source reflects on an object.  Part of the light is absorbed. This part is converted into heat.  The rest of the light is reflected. If this reflected light reaches our eyes, we see the object.

26. Glare / Straylight 17 augustus 2015 Source; T. v.d. Berg (VU, Netherlands)

27. Example of Glare

29. 17 augustus 2015

31. General recommendations  Use natural light whenever possible  Areas where elderly stay for a longer time need a combination of daylight and artificial light around 1000 lux  Use indirect light (uplight) for general light and direct light for task light.  Avoid reflections  Avoid big contrast differences  dimmable lighting increases flexibility 17 augustus 2015

32. Recommendations for lighting design GeneralActivity Living room200 – 300 lux500 – 1000 lux Kitchen300 – 500 lux1000 lux Bed room300 lux1000 lux Bath room / toilet200 lux Corridor300 lux Stairs200 lux Orientation night5 lux 17 augustus 2015

33. Case study elderly home, Royal Dutch Visio 17 augustus 2015

39. Message! The physical environment of the older generation is underexposed! There is a lack of standards for lighting specifically, for the elderly We need to come together to assist government regulators developing strategies 17 augustus 2015

40. Discussion  How are the light conditions in the living environment of the elderly in your country?  What do we need in the future? 17 augustus 2015