Proceedings of: Workshop on Improving Building Design for Persons with Low Vision

Introduction

Before I start in, I’d like to kind of pick up where Robert ended relative to energy focus. Right now people are designing buildings for security reasons, although they are not on top of the energy savings that we can have by controls; not having to light buildings when they aren’t occupied is also a factor. So we need to start shifting the view as to how we use energy.

For those of you who may not know the lighting power density that Robert referred to, or the LPD as we use for shorthand, and just being how much energy we can use for the connected load for our lighting. It’s very easy from a code official standpoint to say, “Uh oh, the total has exceeded the loss per square foot that you can have.” However, [the LPD] really discriminates against people with low vision, and also doesn’t take into consideration the amount of energy that’s used over the day. We need a different formula and the Department of Energy needs a different formula to start regulating energy use, and then I don’t think we’ll be handicapping people quite as significantly as we are now.

Low Vision Standards (slide 2)

ANSI/IES RP 28-07: Lighting and the Visual Environment for Senior Living

Several times I’ve heard the reference for this document that I’m going to hold up. It’s an ANSI standard developed by the Illuminating Engineering Society of North America, the lighting for the aged and partially sighted committee. Robert, Jeanne Halloin and I serve on that committee but it was first formed back in 1992, to give you a sense of how long we’ve been dealing with that. Then Mariana has joined the committee later on. This is actually the second publication. It was first published in ‘98, then it became an ANSI standard in 2001, and in order to keep the ANSI [status], [it was updated in 2007]. I have one copy here with me. I will put it in whoever’s hands will make the best use of it.

[This standard] was developed for the senior housing market, where we have a lot of people with low vision. In your own home you can make whatever modifications you want. But in a care environment you are not free to add lighting, take lighting out, whatever it was. So what we needed to do is come up with a general standard that would apply to most people who are low vision, living in these care facilities, from nursing homes, assisted living, [and] residential care.

It should be noted that it’s more of a function of age. The average age for living in care facilities is like 85, and you have people who are 85 living in independent living and you have people who are 85 living in nursing homes and assisted living. So it’s not the level of care. It’s based on age of the end user, not the adult children of the aging parents.

And so, you know, I offer this up to you. It’s been fully vetted as an ANSI standard. It’s a consensus document. And we do go a lot into low vision, glare, [and] contrast. All that kind of stuff is already in here, so if there’s parts of it that can be gleaned for this next step of the group here. It’s not my document, I can’t give it away, but you can certainly talk with the IES about incorporating some of the findings that we have here.

Need for Additional Standards

I strongly urge both the VA and Centers for Medicare and Medicaid Services to start looking at [ANSI/IES RP 28-07] because it does talk about light levels. It [states]: this is desired light level[s] measured at 30 inches [above the floor], on the floor, in corridors, how much light you need on a dining table, and how much light you might need on the face for shaving and make-up. It goes through, task by task, selecting clothes [and] all those different things. There is a section on circadian rhythms, to play into what Mariana was talking about.

One of my biggest frustrations is that the Center for Medicare and Medicaid Services does not have a lighting recommendation that is measurable in nursing homes. And they’re writing the code for nursing homes all across the country. [The visual environment] should be comfortable. But who makes the judgment of what’s comfortable? The administrator who’s 24 years old, who’s been trained for six weeks? I don’t think so

So it’s just that there’s a big disconnect between the understanding of age-related changes in general on the part of the people who manage these facilities. So we need to stand up for them as a subgroup. And, you know, when we came here, I thought we were going to be talking about office environments, so I’d say, yes, the principles that are in here could apply to low vision in the workplace and in public buildings. But we also need to stand up for the older people.

The way I got to this, and Jeanne and Robert too, we were all facing similar kinds of situations where we were very interested in the lighting of care facilities and there really wasn’t a document like [ANSI/IES RP 28-07]. And actually one of the engineers from Robert’s own office was the one that drove me over the edge, and I was trying to talk about how he needed to be doing his lighting. I was doing interior designing and he was the lighting administrator, so I was kind of explaining how we had done it before. I was working with their company, that engineer, and he was saying, finally, “Well, until it’s written where an architect, a lighting designer or lighting engineer can find it, I’m going to ignore you.” I did not take that lightly.

But I mean, as much as I hated the guy, wanted to strangle him, try to get him fired, it was a good statement because until this was published. So when we first published in ‘98, I thought, done. Well, we’re still fighting it today. Robert and I advised the state of Oregon on what was needed for people in memory care. Here you have the most disadvantaged people possible. There are special conditions relative to their vision. They kind of have tunnel vision. They don’t have the peripheral vision, and a lot of different things like this, and yet it was coming back to us by the for-profit administrators that there’s not enough evidence to state that older people need higher light levels than young people. Not enough evidence.

I encourage you to get a copy of this if you don’t have it. See what can be applied. It’s already here, already vetted.

Design Issues

Glare and Shadows (slides 3 and 4)

Okay, these are some of the problems that I see. Shadows in the foyer (slide 3). This happens to be an Alzheimer’s care facility; I didn’t intentionally bring senior care facilities, but I have a lot of good examples of [glare and shadows]. So we’ve got clear glass, we’ve got glare, we’ve got heat. But then what is that pattern on the floor? And here these people have [difficulty in deciding] ‘is that a beam that I’m supposed to step over on the floor, or what is it?’

The other thing that I see is uneven light distribution, where Mariana says ‘cave light,’ you know, lights the lower part of the wall that doesn’t hit on the side, or gets you that kind of cave environment. Again, the glare coming in from the daylight, highly polished floor, the light just on one side bouncing up. It isn’t being distributed very much down the wall. So these are problems that we see.

Adaptation: Transition from Daylight to Interior (slide 5)

[Another] thing that I think is a problem is this adaptation, which has been raised several times. [In slide 5], you can see how bright it is outside and how dark that intersecting vestibule is that you have to go through. The glass doors have a chrome bottom so you can’t really tell where they are. [The] front doors don’t align with the next [interior] row of doors, so you have to know that you have to jog over a whole door panel, and the handle is chrome. So it’s like this is all reflected. Your eyes [have to adjust to] this transition; a real hazardous situation trying to go from the outside to the inside.

Direct – Indirect Lighting: High Light Levels without Glare (slide 6)

Since we are talking about lighting, I just took some photos in Robert’s office of indirect-direct lighting fixtures. What we have found with older folks is that if we want to get a higher light level, we have to have the indirect or the general illumination bouncing off the ceiling and the upper walls to kind of light the space, and then have more light coming down.

Stairwell Lighting (slides 7 and 8)

So we need the NFPA at this table. We need to get them to understand that not everyone has perfect young eyesight (slide 7). Currently they allow an average of one foot-candle – and that’s an average, so that’s not a minimum – of one foot-candle in stairways like that. And the ratios they will accept, you can’t exceed the 40 to 1 ratio. Well, you know, the 40 is going to be on the landing where there’s no hazards, but there’s a lot of hazards going down to that. Low-contrast definition for the handrails or the – (inaudible) – from the stair.

Another [issue for] stair lighting [is] pattern (slide 8). Here’s the pattern going down (left photo). This happens to be a theater. So you’re going down, you can’t see, but then if you turn and look up, you will see that every third step is lighted (right photo). So what are you supposed to do – trip over the two in between?