The moment the assistant at USC Kyle Konis entered architecture, he was taught the importance of natural light.
When he continued to get his doctorate. at the University of California, in Berkeley, he studied with a daylighting laboratory, looking at energy-efficient windows. Natural light was not only a part of best design practices and a good use of resources, but he knew that daytime lighting had a significant effect on its inhabitants. In a nutshell, it makes them feel good.
Research shows that people who work in spaces with daytime exposure are happier and more productive, he said. The opposite can be said for people without much exposure to daylight. For example, studies show that night shift workers are more prone to obesity and type 2 diabetes.
It seemed a logical next step to think of groups that could be harder hit by "poorly functioning interiors", he said, as adults living in institutional settings. This is how he came out with his pilot study, which examined the impacts of daylight on elderly people with dementia and Alzheimer's.
Design for dementia: fewer drugs, more benefits
Looking at about 80 participants in eight dementia communities in the counties of Los Angeles and Orange, the study showed that morning exposure to natural light improved the mood of residents, reducing depression and psychoactive symptoms, which are common side effects of neurodegenerative diseases. He was a pilot, published with the hope of conducting further research on the topic, said Konis.
Konis's work is part of an international push to seek non-medical interventions for this population, six million in the United States, which research often shows can be overmedicated and underestimated. Those with early-stage Alzheimer's and dementia are often included in cholinesterase inhibitors, which can delay the symptoms of memory, learning and language. But often the disease comes with other conditions, such as depression, agitation and difficulty sleeping. The insufficient exposure to daylight, especially in the morning hours, can throw us off as "jet lag", leaving us lazy and moody. With these populations, it can often be treated pharmacologically, prescribe more drugs and influence their quality of life.
One-third of adults over the age of 60 report being in five or more drugs, according to the National Center for Health Statistics. The greater the amount of drugs taken by an elderly person, the greater the likelihood of adverse reactions and, in turn, an increase in hospitalization rates and mortality.
"We know that a lot of behavioral drugs lead to problems with falling and sedation," said Donna Benton, an associate researcher at the USC Leonard Davis School of Gerontology. "The more we are able to have environments that help us minimize pharmacological interventions, there is even total health savings."
Change the environment, improve the assistance
As Konis has seen, changing the environment is a way to mitigate cognitive delays and behavioral problems without the use of additional drugs. Others see it too.
In the Netherlands, Hogeweyk is a village-like community for dementia residents. They live in houses designed according to their previous lifestyle, stroll in the gardens and shop at the supermarket with special currency. Similarly, the Green House Project has communities throughout the United States, including in nearby Pomona. It also mimics the feeling of home with the appearance of a residential neighborhood. His "elders", not patients, can have pets and set their own meal times. One study showed that its residents had better health outcomes, working better on a daily basis than their peers in standard nursing homes.
"This is a disease or problem that has been almost totally focused on pharmaceutical care. There are many other things we can do to make a difference," said Victor Regnier, a professor who has two appointments in gerontology and architecture at USC . "If you can create a setting [like Hogeweyk or Green House] it's more normalized, less rules and more attitudes of improvisation, it's just better. "
In San Diego, a non-profit has built a memory care facility that looks like a movie set from the 50s, complete with a dinner and a 1959 Ford Thunderbird. The time period touches on reminiscence therapy , the idea that talking about past photographs, objects for the home or music can improve the mood. Most of their residents are around 80 years old, making them teenagers during that time.
While there is no abundant research on it, Regnier believes that giving residents a sense of purpose and a lifestyle that recalls their more independent past is probably useful. Research shows that exercise, intellectual stimulation and socialization improve the quality of life. Even the opposite turns out to be true, which if underestimated – whether from social isolation, lack of activity or bland food – cognitive decline can accelerate.
The USC alumna Gabriela Gomes piloted the virtual Healing Spaces experience, with the aim of calming adults with dementia and Alzheimer's disease in local memory care communities. It is his approach to multisensory experiences, which are common in Europe and pass through "Snoezelen". The idea is to tune in with our senses, like smell, touch and sight, to relax and reduce agitation. While those used in Europe could include elements of light, water and music, his experience is unique in that it is thematic. Run an app, it requires only an iPad, a TV, lights and Philips Hue speakers. The resident, perhaps in a nursing home, can enter a room and tell his assistant where they want to go: the beach or a forest. So the lights will dim to the correct level and tone, the music will start playing, and a video of the virtual position will play in front of them. There are also tactile and fragrant elements, a sandbox and a sunscreen for the beach and a pine-scented aromatherapy for the forest, which a caregiver can use to massage a resident's hands.
More research is needed on natural light, design and dementia
Konis hopes to be able to continue studying the impact of natural light. For one, it could have an impact on how developers and facilities approach the design of this population, which should reach 14 million by 2050, according to the Alzheimer Association.
"There is a huge demand now for people with dementia who live in homes," he said. "The treatment of dementia, in terms of the companies that manage them, is buying medical facilities or existing hotels and re-using those buildings, not always designed from scratch."
In his study, Konis discovered he was in a well-lit space with natural light (within 3 meters from a window) in the morning hours between 8 and 10 am, to reduce the symptoms of depression. He hopes that further studies on the positive results of daylighting will inspire standards supported by research for dementia communities and housing for the elderly in general, abandoning obscure institutionalized settings for sunny spaces that stimulate the body and the mind.
Exercise can reduce the risk of falling for elderly people with Alzheimer's
For Alzheimer's and dementia sufferers, thoughtful design can have a great impact (2019, April 9)
recovered on 9 April 2019
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