An Exploratory Lighting Study on the Effects of Correlated Color Temperature in Senior Living

Home , Color temperature, Glare (vision), Lighting

Thesis

Presented in Partial Fulfillment of the Requirements for the Degree Master of Fine Arts in the

Graduate School of The Ohio State University

Emily Bell

Graduate Program in Design

The Ohio State University

2018

Thesis Committee:

Rebekah Matheny, Adviser

Jeffery Haase

Monica Robinson, OTD, OT/L, FAOTA

Mary Anne Beecher, Ph.D.

Emily L. Bell

2018

Abstract

Aging is an inevitable process and people are living longer than ever before. Currently, there are about 50 million people over 65 years old in the United States, which is expected to grow to over 72 million by 2030 (Ortman & Velkoff, 2014). This rapidly increasing population has elevated the significance of designing environments that not only meet needs of the larger aged population, but also establish healthier and more desirable living conditions. Functional declines are a normal part of aging, therefore, environments designed for older adults must establish features that support the specific needs of the aging population.

As an element of design that is all around us, light, whether natural or artificial, provides both functional and emotional supports. In senior living facilities, since resident rooms are often around the exterior, many community spaces are pushed to the core and have limited or no daylight access. Therefore, it is not only important to ensure that artificial light is of sufficient brightness, but it is also important to understand what effects qualities of light may have on older adults as past research indicates that light has both functional and emotional effects on people

(Martyniuk et al., 1973). The rise of LED lighting has provided an opportunity to explore qualities and application of artificial light in interior environments. LED lamps can range from

2700K (warm) to over 6000K (cool) color temperature, providing an opportunity to better understand the impact color temperature may have on older adults.

This exploratory research evaluates older adults’ impressions of their interior environment when illuminated by different correlated color temperatures of light. Through four

sessions, older adults evaluated the facility’s existing light (2700K CFL) and three replacement

LEDs (3000K, 4000K, 5000K) that had similar CRI and brightness, providing their subjective impressions of the session’s lighting. As senior living and long-term care facilities are designed to function as a support for older adults as they experience aging changes, an older adult’s impression of lighting within their community spaces is significant to helping develop a supportive environment.

Research results may help improve general lighting conditions for public spaces within senior living facilities. Through an understanding of priorities and what current older adults respond to and view as important, designers have an opportunity to improve qualities of current senior living facilities. While this research focuses on perceptions from the current aged population, these methods and results can inform research focused on the future aged population.

Dedication

In memory of my dad, Wilson Bell, for starting me on the journey of design. In dedication to my mom, Janet Bell, for always believing in me and my fiancé Jeremy Valentine for being such an incredible support throughout this process.

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Acknowledgements

To my adviser and each committee member, thank you for your thoughtful feedback and support over the past few years.

Rebekah, thank you for not only advising through the thesis work, but for also becoming a mentor in teaching and presenting. I have gained so much valuable experience from not only guest lecturing in your classes, but also through our other research endeavors. From your mentorship and advising, I feel so much more prepared for my future in academia.

Jeff, thank you for pushing the in-person perspective for research which greatly enriched the conversations and information gathered from the older adults. Thank you also for the opportunity to integrate this research and my experience with older adults into your human factors class.

Monica, thank you for your health-oriented perspective, experience with older adults, and scientific perspective that enriched my design perspective. I have gained so much by dissecting and connecting data with you.

Mary Anne, thank you for your guidance in academic writing and in ways to further communicate this research to practicing designers. You have helped me better understand how to frame my research, explain significance, and determine ways to make this research and process more tangible to professionals.

Adam, thank you for so much help in understanding presentation quality, diagramming, and talking through research problems.

To all of my peers: these past years would have been so much more boring if it wasn’t for our conversations in studio.

Jeremy, thank you for being the best cheerleader ever throughout these years, for seeing the finish line when I couldn’t, and for all the cooking and cleaning you’ve done so that I could work longer.

Vita

2011 ...... Design Intern, Garrow Kedigian Interior Design, New York, NY

2012 ...... Design & Office Assistant, Garrow Kedigian Interior Design, New York, NY

2013 ...... B.S. summa cum laude, Interior Design, Business Administration Minor

High Point University, High Point, NC

2013-2015 ..... Interior Designer/CAD Drafter, Küche-Cucina, Paramus, NJ

2017 - 2018 ... Research Consultant, Columbus, OH

2018 ...... MFA (pending), Design, Graduate Interdisciplinary Specialization in Aging

The Ohio State University, Columbus, OH

Publications

Bell, E. (2018). Lighting for senior living: a study of older adults’ perceptions of color temperature. In 2018 IDEC Annual Conference Proceedings.

Matheny, R. L., & Bell, E. (2018). Understanding LED’s Color Temperature Preferences Amongst Millennials and Baby Boomers. In 2018 IDEC Annual Conference Proceedings.

Fields of Study

Major Field: Design

Concentration: Design Research and Development

Specialization: Aging

Table of Contents

Abstract ...... i Dedication ...... iii Acknowledgements ...... iv Vita ...... vi Table of Contents ...... vii List of Figures ...... x List of Tables ...... xii Chapter 1: Introduction ...... 1 Problem Statement ...... 5 Research Questions ...... 6 Aim & Scope ...... 6 Research Plan ...... 7 Audience ...... 7 Definition of Terms ...... 7 Chapter 2: Literature Review...... 10 Design’s Effects on Function ...... 10 Changes in Aging...... 10 Long-Term Care Models...... 11 Person-Environment Relationship...... 12 Design’s Effects on Emotions ...... 14 Supportive Design...... 14 Emotional Connections to Place...... 15 Light’s Effects on Health ...... 17 Insufficient Light in LTC...... 17 Light’s Effects on Emotion ...... 19 Light, Environment, Behavior, and Preferences...... 19 Light and Mood...... 21 Literature Review Summary ...... 24

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Chapter 3: Methods ...... 26 Methodological Approach ...... 26 Research Design ...... 27 Pilot Testing ...... 28 Testing Space Selection ...... 28 Research Setting ...... 29 Process ...... 32 Research Sessions...... 32 Light Measurements...... 34 Photographic Documentation...... 34 Subjects ...... 35 Lighting Conditions...... 36 Data Collection ...... 37 Research Sessions...... 37 Data Processing ...... 39 Analysis...... 39 Chapter 4: Results ...... 40 Quantitative Data ...... 40 Session 1 (2700K CFL lamps)...... 40 Session 2 (3000K LED lamps)...... 41 Session 3 (4000K LED lamps)...... 42 Session 4 (5000K LED lamps)...... 43 Qualitative Data ...... 44 Functional theme...... 44 Distribution of light...... 45 Feelings...... 47 Chapter 5: Discussion ...... 49 Quantitative Data ...... 49 Calm – Anxious...... 49 Safe – At-Risk...... 51 Warm – Cool...... 52 Too Dark – Too Bright...... 53 Excessive – Inadequate and Glaring – Non-Glaring...... 55 Session 3: 4000K LED lamps...... 57

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Quantitative Summary...... 59 Qualitative Data ...... 60 Positive & Negative Discussions...... 60 Functional Theme...... 62 Distribution of light...... 64 Feelings...... 71 Chapter 6: Conclusion ...... 74 Limitations ...... 76 Future Work ...... 77 References ...... 79 Appendix A: MatLab Code ...... 86 Appendix B: Room Images ...... 87 Appendix C: Lamp Specification Sheets...... 96 Appendix D: Foot Candle Measurements ...... 100 Appendix E: Participant Demographics and Community Space Visits ...... 113 Appendix F: Survey Questions ...... 115 Appendix G: Positive and Negative Qualitative Code Distributions ...... 119

List of Figures

Figure 1: Research Cross-section ...... 5 Figure 2: Behavior Setting, from Martyniuk et al., 1973 ...... 20 Figure 3: Photos of testing space ...... 29 Figure 4: Floor Plan ...... 31 Figure 5: Reflected Ceiling Plan ...... 32 Figure 6: Horizontal Foot Candle Measurements ...... 37 Figure 7: Calm to Anxious Responses for All Sessions ...... 50 Figure 8: Safe to At Risk Responses for All Sessions ...... 51 Figure 9: Warm to Cool Responses for All Sessions ...... 52 Figure 10: Too Dark to Too Bright Responses for All Sessions...... 54 Figure 11: Excessive to Inadequate Responses for All Sessions...... 55 Figure 12: Glaring and Non-Glaring Responses for All Sessions ...... 56 Figure 13: Session 1 and Session 3 Mean Responses ...... 58 Figure 14: Mean Responses for All Sessions ...... 59 Figure 15: Positive and Negative Qualitative Code Distribution ...... 61 Figure 16: Session 3 Positive and Negative Qualitative Code Distribution ...... 62 Figure 17: Frequency of Codes by Category ...... 64 Figure 18: Typical LED, CFL, and Incandescent Candela Distributions (LED Professional Review, 2016) ...... 66 Figure 19: CFL and LED Light Shapes ...... 67 Figure 20: Connections Between Brightness and Glare Comments ...... 69 Figure 21: Daylight Spectral Power Distribution (Rensselaer Polytechnic Institute, 2003) ...... 71 Figure 22: MatLab Code for HDR tonemap ...... 86 Figure 23: 2700K CFL Corner 1 ...... 88 Figure 24: 2700K CFL Corner 2 ...... 88 Figure 25: 2700K CFL Corner 3 ...... 89 Figure 26: 2700K CFL Corner 4 ...... 89 Figure 27: 3000K CFL Corner 1 ...... 90 Figure 28: 3000K CFL Corner 2 ...... 90 Figure 29: 3000K CFL Corner 3 ...... 91 Figure 30: 3000K CFL Corner 4 ...... 91 Figure 31: 4000K CFL Corner 1 ...... 92 Figure 32: 4000K CFL Corner 2 ...... 92 Figure 33: 4000K CFL Corner 3 ...... 93 Figure 34: 4000K CFL Corner 4 ...... 93 Figure 35: 5000K CFL Corner 1 ...... 94 Figure 36: 5000K CFL Corner 2 ...... 94 Figure 37: 5000K CFL Corner 3 ...... 95 Figure 38: 5000K CFL Corner 4 ...... 95 Figure 39: Feit Electric Lamp Specification ...... 97

Figure 40: Sylvania Lamp Specification ...... 98 Figure 41: Session 1 Horizontal Foot Candle Measurements ...... 101 Figure 42: Session 1 Vertical Foot Candle Measurements ...... 102 Figure 43: Session 2 Horizontal Foot Candle Measurements ...... 104 Figure 44: Session 2 Vertical Foot Candle Measurements ...... 105 Figure 45: Session 3 Horizontal Foot Candle Measurements ...... 107 Figure 46: Session 3 Vertical Foot Candle Measurements ...... 108 Figure 47: Session 4 Horizontal Foot Candle Measurements ...... 110 Figure 48: Session 4 Vertical Foot Candle Measurements ...... 111 Figure 49: Demographics Questions ...... 113 Figure 50: Survey of Community Space Visits ...... 114 Figure 51: Survey Questions ...... 116 Figure 52: Interview Questions ...... 118 Figure 53: Session 1 Positive and Negative Qualitative Code Distribution ...... 119 Figure 54: Session 2 Positive and Negative Qualitative Code Distribution ...... 120 Figure 55:Session 3 Positive and Negative Qualitative Code Distribution ...... 121 Figure 56: Session 4 Positive and Negative Qualitative Code Distribution ...... 122

List of Tables

Table 1: Lamp Specifications ...... 33 Table 2: Participant Age Distribution ...... 35 Table 3: Session 1 (2700K CFL lamps) Quantitative Responses ...... 40 Table 4: Session 2 (3000K LED lamps) Quantitative Responses ...... 41 Table 5: Session 3 (4000K LED lamps) Quantitative Responses ...... 42 Table 6: Session 4 (5000K LED lamps) Quantitative Responses ...... 43 Table 7: Participant Visits to Community Spaces ...... 114

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Chapter 1: Introduction

Even without conscious awareness, as we age, we seek both physical and mental support from the environment around us. Whether in natural or built environments, people have an innate desire to understand their space, their role within it, and how they can function within it.

Stressful situations or places amplify the need for clarity. Unfamiliar, confusing, or inherently stressful environments influence the perceived atmosphere (Martyniuk, Flynn, Spencer, &

Hendrick, 1973). The stress of newness and change can affect the feeling of interiors that should otherwise evoke comfort or feelings of home, such as in senior living facilities. In consideration of the increasing aging population in the United States, it is necessary for designers to evaluate current design practices and test possible new solutions that could improve qualities of senior living. When designed with an integration of anthropology, gerontology, physiology, psychology, and design, interior environments specifically for older adults can support, comfort, and encourage a sense of well-being.

The rapidly growing elderly population, with an expected 72.7 million adults over age 65 by 2030 (Ortman & Velkoff, 2014), has magnified the importance of residential healthcare facility design and the need for evidence-based design. In this paper, elderly, senior, and older adults all describe individuals over 65 years. There are many facets of design that influence quality of life older adults experience as they age, such as design choices that make the interior more accessible, safe, and comfortable. Theories by Lawton (1980) and Ulrich (1991) suggest emotional and psychological supports from an individual’s physical environment directly impact their ability to function successfully and experience well-being. As the aging population becomes

older and are living longer, it is imperative that interior environments support numerous functional and sensory changes, limitations, and needs.

With knowledge of emotional needs of aging people, as reported by environmental gerontologists (Kendig, 2003; Moore, 2014; Wahl & Weisman, 2003; Harris & Grootjans, 2012), interior designers are able to develop and build healthcare interiors specifically to meet the aging population’s physical, behavioral, and emotional needs. M. Powell Lawton (Lawton & Simon,

1968) articulated person-environment relationship theory and how interfacing with the environment influences an individual’s experience, behavior, and mental state. The theory further describes individual behaviors within a setting as a function of their innate characteristics, related external environmental characteristics, and person-environment interactions. Research from color scientists and psychologists indicate that material color elicits a significant emotional response, resulting from learned associations (Elliot & Maier, 2007). Just as material color influences emotional perceptions of an interior, different light color temperatures result in varying spatial, and likely emotional, perceptions. Recent research by Amor, O’Boyle, Pati, &

Pham (2015) supports the idea that light color directly affects behavioral and neural responses of individuals.

As senior care services have shifted to become patient-centric, so has the design of senior living facilities. However, many needs remain unmet within interior environments for long-term care (LTC) and continuing care retirement communities (CCRC), particularly those designed prior to the 21st century. Resident satisfaction and well-being are the most important design considerations for these facilities. Within many institutional settings, residents may feel displaced, unhappy, or uncomfortable, likely in part reflecting lack of evidence-based designs to improve ambiance, lighting quality, and place attachment (Gray, Kesten, Hurst, Day, & Anderko,

2012). Approximately 35-45% of seniors in LTC have clinically significant depressive symptoms and 30-50% have minor depression (Hyer, Carpenter, Bishmann, & Wu, 2005), suggesting broad opportunities to improve current interior designs.

Artificial lighting is a significant factor for improving both perceptual qualities of interiors and experiences of space. Appropriate quality lighting creates comfort for many older adults, who frequently experience reduced visual acuity. Without proper lighting, all activity and functions may be impaired or hindered thus promoting unsafe and uncomfortable feelings for elders. By using a layered lighting strategy including a variety of fixtures, proper illuminance levels, and colors temperatures that create appropriate physiological responses, older adults may have a more positive adjustment and overall experience in senior living. Through the evaluation of artificial light’s effects on older adults, and in conjunction with an understanding of design elements, aging, and theories on well-being and behavior, interior designers are poised to integrate artificial light as a significant element in successful designs for comfortable and fulfilling interiors.

Designers are called to improve everyday experiences. In adapting evidence-based practices, interior designers can integrate these concepts into design practice through utilizing proven research. By applying research, environments can be designed that consider older adults’ special requirements to navigate the world, live as independently as possible, and age successfully. For older adults, change can be daunting, especially for those who relocate to different housing options. Interior designers have a unique opportunity to not only ease the transitions of older adulthood, but also improve their experience of interiors, assisting sense of belonging, well-being, and overall satisfaction in these new environments through evidence- based design.

As part of interior design, lighting is an element that can transform the emotional qualities of the environment when both the physiological and psychological aspects are considered. Light is all around us. Whether daylight, flame, or from artificial sources like fluorescent or LED lamps, light is an integral part of life. As an ever-present element, all lighting affects both physiology and psychology. While artificial light cannot have the same qualities as natural daylight, its metrics allow designers to understand and manipulate its unique properties.

For older adults, who often experience reduced ability to complete daily tasks on their own, the quality of light is vital to their ability to age successfully and maintain a sense of well-being.

With the understanding that all light forms influence emotional and behavioral responses of individuals, specialized solutions for older adults can meet their specific environmental support needs. Supported by theories of environmental support and impact, designers today are positioned to significantly improve lighting within residential healthcare interiors for older adults.

Existing research on senior environments and lighting intersects both functional and emotional effects (Eshelman & Evans, 2002; Hegde & Rhodes, 2010). Research findings include functional needs of older adults in the broader interior environment through universal design, environmental gerontology, and the way long-term care facilities are designed (Crews, 2005;

Ragsdale & McDougall, 2008). A body of work on the emotional supports an environment provides an older adult through the concepts of place attachment and third spaces balances these functional requirements (Campbell, 2014; Ulrich, 1991). In research surrounding older adults and lighting, there too exists a functional and emotional spectrum (Brawley, 2009; Hegde &

Rhodes, 2010). Ambient light can significantly alter how an older adult can function; low light levels can reduce how well an older adult can perform activities of daily living (Sinoo, van Hoof,

& Kort, 2011). Research has uncovered how reduced access to bright light can also negatively affect behavior and mood (Sinoo et al., 2011). However, specific research on emotional effects of light does not address senior living environments, application of color temperature, or perceptions of lighting in familiar environments. My thesis research begins to fill this void. With a basis in the functional and emotional supports of interior environments, the functional effects of lighting, and the general effects on mood light and color temperature can have, this research expands the understanding of older adults’ subjective impressions of color temperature (Figure

1).

Figure 1: Research Cross-section

Problem Statement

Much research surrounds the idea of creating supportive environments for older adults in senior living and long-term care facilities (Sinoo et al., 2011; Zavotka & Teaford, 1997).

Research on lighting in these facilities focuses on lack of appropriate light and bright-light

interventions (Riemersma-van der Lek et al., 2008). Research specifically on effects of light’s color temperature on older adults focuses on either non-visual effects, such as changes in circadian rhythm, preference, or mood changes in clinical or laboratory environments (White,

Ancoli-Israel, & Wilson, 2013). However, these studies do not investigate older adults’ perceptions and emotional responses towards color temperature in context of an existing, familiar senior living space. This thesis research evaluates the effects of light’s correlated color temperature (CCT) on older adults’ responses to their familiar interior environment in the context of senior living communities.

Research Questions

This research seeks to determine if LED light’s correlated color temperature (CCT) is an element to be more closely considered in designing environments for older adults through an evaluation of perceptions and emotional responses to different color temperatures in a familiar community room. The effect of light’s CCT is determined through asking:

1. How do older adults respond to different CCTs, from warm to cool?

2. How does CCT affect older adult’s perceptions of lighting and their interior environment?

Aim & Scope

The scope of this research is to gather existing research surrounding functional and emotional qualities of both the interior environment and lighting, with a focus on specific needs of older adults. This research specifically addresses the application of LED light’s correlated color temperature in senior living common spaces, as established by older adults completing a survey in an existing space.

The purpose of this research is to highlight the necessity of reevaluating standard design practices and encourage designers to thoroughly evaluate the impact of lighting design decisions

on end users. Results from this research will inform improvement to existing senior living lighting and encourage ongoing research to understand needs, preferences, and effects on the future aged population of Baby Boomers and beyond.

Research Plan

This research is conducted in two phases: secondary research and in-person primary research. The secondary research established a base of existing knowledge and research methods.

From this work, a gap in research emerged which this thesis begins to explore. Primary research is conducted using both quantitative and qualitative measures. Research of this type must be done in-person, through a physical experience of conditions, to understand the impact of lighting,

CCT, and the interior environment on older adults. If not done in-person, there is potential influence from other technologies or display characteristics. With the older adult population, in- person research also reduces the possibility of problems using or learning technology.

Audience

This research is intended for a wide audience with experience or interest in interior design and lighting for older adults. Design professionals can especially benefit from this research to understand research methods and benefits that come from bringing end-users into the design process.

Definition of Terms

Activities of Daily Living (ADLs): Tasks part of normal functioning and daily care such as bathing, dressing, and using the toilet (Albert, Bear-Lehman, & Burkhardt, 2006; Kaya, Webb, &

Miller, 2005)

Color Rendering Index (CRI): a metric established in the 1960s to determine how true a lamp produces color (Rea & Freyssinier-Nova, 2008).

Continuing Care Retirement Communities (CCRC): these senior living communities “provide a full spectrum of on-site care in accordance with need, from independent living to skilled-nursing care” (Wang & Kuo, 2006 p. 124).

Correlated Color Temperature (CCT): the way of defining the color of white light that the luminaire emits. The Kelvin temperatures and color scale is derived from what color an ideal theoretical black body radiator would emit when heated to a particular temperature, establishing the correlated color temperature scale (Kay, 2007).

Evidence-Based design: “is the process of basing decisions about the built environment on credible research to achieve the best possible outcomes. Included in this process are the following eight steps:

Define evidence-based goals and objectives.

Find sources for relevant evidence.

Critically interpret relevant evidence.

Create and innovate evidence-based design concepts.

Develop a hypothesis.

Collect baseline performance measures.

Monitor implementation of design and construction.

Measure post-occupancy performance results.” (The Center for Health Design, n.d.)

Human-Centered design: “is based on the use of techniques which communicate, interact, empathize and stimulate the people involved, obtaining an understanding of their needs, desires and experiences which often transcends that which the people themselves actually realized.

Human centered design is thus distinct from many traditional design practices because the natural focus of the questions, insights and activities lies with the people for whom the product,

system or service is intended, rather than in the designer’s personal creative process or within the material and technological substrates of the artefact” (Giacomin, 2014 p. 610).

Instrumental Activities of Daily Living (IADLs): Tasks not part of normal functioning, but allowing an individual to function independently, such as housework, shopping, meal preparation, using the telephone, managing finances, and taking medication (Albert, Bear-

Lehman, & Burkhardt, 2006)

Life satisfaction: reflects overall happiness with one’s entire life, not just in individual moments

(Ni Mhaoláin et al., 2012).

Long-term Care (LTC): “Nursing homes, skilled nursing facilities, and assisted living facilities,

(collectively known as long-term care facilities, LTCFs) provide a variety of services, both medical and personal care, to people who are unable to manage independently in the community” (CDC, 2017).

Place attachment: A residents’ connections to a senior living space. “Privacy, continuity with the past, and personalization have been used to explain place attachment in older adults through social-centered, person-centered, and body-centered processes (Rubenstein, 1989).” (as reported in Zavotka &Teaford, 2005 p. 5)

Senior living facilities: An all-encompassing term for non-community dwelling senior housing options including: independent living facilities and CCRCs (Wang & Kuo, 2006).

Subjective well-being: “most often refers to a positive orientation toward life and is generally based upon such feelings as happiness, morale and positive affect” (Ni Mhaoláin et al., 2012).

Third spaces: The third space is neither home nor work, but the one that hosts community and social interactions in a comfortable setting – one that is significant only to the immediate population (Campbell, 2014).

Chapter 2: Literature Review

Design’s Effects on Function

Changes in Aging. Physiological characteristics of the aging population are constantly changing. These life-long physiological alterations play a significant role in an older adult’s ability to function in an environment (Crews, 2005), requiring more support from the designed interior. Thoughtful applications of design elements such as color, light, pattern, and texture can be used to produce more supportive interiors for this population. During the 1930’s less than a quarter of the workforce was expected to live beyond 65 years; now, over 75% of Americans live past their sixty-fifth birthday (Crews, 2005). Ever-increasing aging populations, as well as their increasing functional losses and activity limitations, result from their changing physiology, anthropometry, and sensory abilities.

Major factors influencing well-being among Americans over 65, such as self-reported disability and depression, have decreased over recent years. However, loss of visual acuity, cognitive decline, osteoporosis, and sensory loss, which occur before other significant ADL losses, are the most prevalent physiological issues they face today (Crews, 2005). Supportive interior design will aid in managing such sensory losses among our aging population by creating well-defined and specific spaces that provide proper support as they become less able to complete instrumental activities of daily living (IADLs) and activities of daily living (ADLs)

(Crews, 2005). Such spaces are found in LTC and CCRC where a multi-disciplinary, human- centered approach has been a motivator for culture change in care methods and facility design.

Long-Term Care Models. Ragsdale and McDougall (2008) discuss progress improvements in LTC methods. Early models focused on medical care needs and efficiency, not whether the patient was comfortable, properly stimulated, or supported. Today, long-term care is relationship-oriented, as exemplified by The Eden Alternative, developed in the 1990’s (Ragsdale

& McDougall, 2008). Along with designs that integrate comforts and familiarity of home, such communities also changed functions of care. Patient’s individuality is now recognized and highly considered in facility planning and design. Relationships between staff and patients are also design considerations and foster new approaches to encourage patient comfort and appropriate care. Nursing staff has permission to alter a patient’s care routine if regulatory requirements are still met. Since Eden Alternative’s implementation, additional models have developed to further care for both patient and staff. The Green House model creates small homes, housing less than

10 seniors, each with their private bedroom and bathroom and a shared living space. Eliciting the feeling of home, such as independence, comfort, and control, is at the core of this approach.

Anything related to administering nursing care, for example nursing stations and paperwork, are hidden from public sight. Residents of Green Houses show increased social engagement, decreased boredom, and general environmental satisfaction (Ragsdale & McDougall, 2008). This transition in design concepts for LTC occurred because of positive effects on patients, staff, and caregivers observed in experimental research. These new design perspectives and styles of care indicate the need for all elements of a healthcare environment to elicit a comfortable healing space.

Even in LTC communities not subscribing to the Eden Alternative or Green Houses style,

Wang and Kuo (2006) identified three major shifts in underlying concepts of long-term care design: custodial to rehabilitative care model, aging-in-place philosophies, and de-

institutionalization. In previous custodial, restrictive settings, wandering patients more frequently attempted to leave the residence, non-wandering residents would feel disoriented, patient self- esteem was low, and there was a general lack of mobility amongst residents (Wang & Kuo,

2006). Following concepts of aging-in-place, the new rehabilitative model embraces design choices to elicit feelings of home and community belonging, rather than feelings of being hospitalized. To integrate these concepts within long-term care communities, designers should strive to elicit a home-like environment, follow Universal Design standards, create defined private sleeping areas, plan for sufficient social spaces, and utilize patient room cluster layouts

(Wang & Kuo, 2006). By keeping a human-centered approach with empathy for patient needs, their potentially declining health, as well as nursing staff functional needs, these healthcare environments can have the home-like atmosphere older adults desire while supporting an aging- in-place mentality and functioning as a medically-supportive environment.

Person-Environment Relationship. Through supporting feelings of control, belonging, and functional changes experienced by older adults, interior environments can influence perceived quality of life. Both subjective well-being and life satisfaction are considered significant contributors to quality of life (Crews & Zavotka, 2006; Crews, 2005). Anxious feelings affect an older adult’s sense of subjective well-being, which represents positive feelings towards one’s life in the present. Life satisfaction, reflecting overall happiness with one’s entire life, not just in individual moments (Ni Mhaoláin et al., 2012), may also be affected. High life satisfaction scores are linked to successful aging, whereas low scores are often indicators of an individual’s physical and/or mental health issues (Ni Mhaoláin et al., 2012). Personality and mental health are the strongest correlates of life satisfaction scores, suggesting depression and loneliness, both common in residents of long-term care, likely reduce individual life satisfaction.

Research suggests the built environment impacts mood, well-being, and behavior within LTC facilities (Calkins, 2009; Ni Mhaoláin et al, 2012; Garre-Olmo et al., 2012).

To address the potential emotional and behavioral effects interior design has on older adults in LTC, the person-environment fit theory can be implemented to help older adults feel comfortable, have a sense of control, and feel positively towards their life, reducing negative feelings that influence life satisfaction and perceived quality of life (Lawton, 1980; Lawton &

Simon, 1968; Wahl & Weisman, 2003). When the design of an environment fits the functional and emotional needs of an individual, they are more likely to feel autonomy and experience normal functioning (Scheidt & Windley, 1990). With the ever-changing needs of older adults, it is important that LTC and CCRC facilities are adaptable and utilize evidence-based and human- centered design to create the most fulfilling environments.

Calkins (2009) compared various reports on group size, building configuration, wayfinding, safety, outdoor areas, dining rooms, bedrooms, and lighting, including interventions such as bright light exposure or a wider use of ambient light, finding these design factors clearly influence patient well-being. This was reinforced in research by Ni Mhaoláin et al. (2012), in which an increase in perceived control, social access, and positive distractions in healthcare environments helped counteract stress and anxiety that an individual may otherwise feel in such environments. Garre-Olmo et al. (2012) also found environmental elements of light, temperature, and noise affect quality of life scores of nursing home dementia patients in Spain. Higher room temperatures and more time spent in the bedroom correlated with lower quality of life; high noise levels in the common living room were linked to fewer signs of socialization; low bedroom light levels correlated negatively with affective mood among residents who were more frequently in their bedrooms (Garre-Olmo et al., 2012). From these research results, it is clear elements of

interior design, including lighting, may be used to positively influence older adult’s experience of an interior and result in changes in perceived well-being and quality of life.

Design’s Effects on Emotions

Supportive Design. As we age, it becomes more difficult to feel attached to new places, therefore environments must be designed clearly to foster the positive relationship between individual and interior (Zavotka &Teaford, 2005). Ulrich (1991) followed ideas of person- environment relationship with a theory of supportive design. Ulrich (1991) postulated that the physical environment promotes well-being to the degree it increases an individual’s sense of control, provides access to social supports, and provides positive distractions. When interiors fail to meet individual needs for maintaining, stimulating, and supporting themselves, negative behaviors may emerge. Using Ulrich’s theory of supportive design and sense of control, Andrade and Devlin (2015) showed that when an environment has local elements of control such as adjustable lighting or temperature, residents respond more positively to their environment and experiences. Stress, for example, was rated significantly higher in the experimental control unit, which did not allow for local elements of control, than in one with added supportive and local control features (Andrade & Devlin, 2015).

Environments that help create place attachment make older adults feel more comfortable, however most LTC and CCRCs are not appropriately designed for place attachment. Such settings may create feelings of anxiety or discomfort, and rather than provide comforts of home, may even make residents feel like they are in another’s home (Zavotka & Teaford, 1997).

Supportive and flexible designs are especially important in LTC and CCRC as residents experience significant changes when moving from their personal residence to a group living environment. All new residents experience differences in decor, lighting, privacy, and color

schemes when in a new living setting. Zavotka and Teaford (1997) determined discord exists between what is comfortable, frequently linked to familiarity with colors, textures, and furnishings, to older adults and what is being specified within CCRC facilities, which leads to dissatisfaction, discomfort, and confusion in the new settings, especially in dementia patients.

Supportive design extends to an elder’s sense of control over their environment. In public settings, such as healthcare environments, an elder's sense of control may be greatly reduced.

Elders with perceived high objective control tend to report more self-esteem and higher life satisfaction than those with low objective control scores (Mossbarger, 2005). However, control over ADLs does not significantly impact elder’s satisfaction and well-being. Kaya, Webb, and

Miller (2005) interviewed residents of assisted living communities to understand desired and achieved privacy level, contact-seeking or avoidance levels, and social, personal, and facility adjustment levels. Results indicate some differences in social behavior among assisted and independent living residents: assisted living residents more frequently kept their door open but independent residents invited others into their room more frequently. While both participant groups had similar levels of desired privacy, independent living residents perceived a higher privacy level. Sense of privacy showed that while 40% of assisted living residents felt crowded and 10.6% felt isolated, 70.8% of those in independent living felt they were at the optimal balance (Kaya et al., 2005). Privacy, satisfaction, and comfort are closely related in both assisted and independent living. Environmental designs that support a balance in privacy and social space assist in an older adult’s adjustment and development of place attachment.

Emotional Connections to Place. Place attachment is encouraged through a number of design considerations in both private and public senior living spaces. When elders can experience place attachment in their older age, it benefits their feelings of competence and self-

worth (Eshelman & Evans, 2002). This concept starts in private spaces which should accommodate the range of personal furnishings an individual may wish to keep with them as they downsize to a CCRC apartment, as furniture is a significant factor in developing place attachment (Jonsson, Östlund, Warell, & Dalholm Hornyánszky, 2014). Conflicts occur when communities have long, winding hallways, which are quite disparate from residents’ ideas of home. These can elicit negative emotions towards the overall community environment (Jonsson et al., 2014). Creating a sense of belonging, therefore, must extend beyond private home spaces.

Senior living communities can become neighborhoods with plentiful public activity spaces and integrated services. Designers must consider a balanced approach to features of function and aesthetic in both public areas and private resident spaces, as indicated by research on resident adjustment to living in a CCRC (Eshelman & Evans, 2002). While these neighborhoods must cater to their aging population, they can be improved with Oldenburg’s idea of a “third place” (Campbell, 2014). Home and work are two places, but the third place is one that hosts community and social interactions in a comfortable setting – one that is significant only to the immediate population. Therefore, LTC and CCRC facilities are designed with specific third places (practical, gathering, and home) in mind, residents may more easily find an emotional connection through place attachment.

Senior living communities must be therapeutic in nature, which is achieved through supporting clinical excellence, supporting staff, resident, and patient psychosocial needs, and producing a positive effect on patient healing and staff effectiveness (Campbell, 2014). Older adults have strong relationships to and characterizations of furnishings. These communities must therefore honor these positive associations to create a feeling of comfort and successfully instill place attachment (Eshelman & Evans, 2002). These shared third spaces should be flexible to

resident needs (Jonsson et al., 2014) and should be designed to encourage a home-like environment, fitting Oldenburg’s definition with lively, playful, welcoming atmospheres and casual, homelike décor (Campbell, 2014).

Light’s Effects on Health

Insufficient Light in LTC. As lighting is a significant component of emotional and behavioral responses within an interior, it is important to understand how older adults perceive and evaluate different lighting conditions. While much research exists on proper artificial lighting for older adults, taking into consideration glare, brightness, and color, the prevalence of adequate lighting applied in nursing homes and CCRCs is weak. Ancoli-Israel et al. (1997) indicated nursing home residents were exposed to only 9 minutes of bright light (daylight levels) per day. Hegde and Rhodes (2010) compared resident evaluations of lighting in two independent living facilities (ILF) in Texas with lighting levels as compared to foot-candle (light intensity) guidelines provided by the Illuminating Engineering Society of North America (IES). In both

ILF examined, the foot-candles measured were below recommended minimums in all spaces except resident bedrooms. Lighting levels were especially problematic in lobby and entrance areas, ranging from 8.0 to 22.6 foot-candles (fc), well below the 50 fc minimum (Hegde &

Rhodes, 2010). Since older adult’s eyes require more adjustment time when going from bright daylight to interior light, the darkness of the lobby space suggests elders will have difficulty seeing clearly upon entering the facility. Residents responded to these public environments with poor to good ratings, which may indicate that they do not realize the effects of low light levels.

The game rooms also were half the recommended 50 fc minimum, at about 21-25 fc, and residents rated this space with the lowest satisfaction (Hegde & Rhodes, 2010).

Similarly, in the Netherlands, Sinoo, van Hoof, and Kort (2011) found significant differences between standards and existing lighting quality (illuminance and color temperature) in 59 common spaces of seven nursing homes, all equipped with fluorescent general lighting and incandescent accents. European lighting standards recommends illuminances of 200 lux (lx; light intensity) for corridors and 500-1000 lx for meals and activities. While 55% of the illuminance values in commons spaces were below 750 lx (median of the standard), 75% of corridor readings were below 200 lx, significantly below the 750 lx standard. Logically, illuminance levels were higher at windows within the spaces, but when readings were taken of central or rear zones in the nursing homes, nearly every reading was below the 750 lx standard. In a separate study, De

Lepeleire, Bouwen, De Coninck, & Buntinx (2007) also found only 5 of 8 evaluated nursing homes had light levels that met the European Standard on bright, sunny days and only 1 of 8 met an adapted standard to meet the brightness needs of older adults. On overcast days, or at dusk or dark, light levels were drastically below standards, ranging from 13% - 33% of recommended levels (De Lepeleire et al., 2007). In many nursing home environments, light levels are too low for not only older adults, but also for the nursing staff. With low brightness, older adults are more at risk for falls and injury, and they are more prone to issues such as depression. In contrast, when older adults have bright light exposure during the day (9 AM – 6 PM), there was a clear reduction in cognitive decline by 5%, depression symptoms by 19%, and physical functional decline by 53% (Riemersma-van der Lek et al., 2008). Participants who took melatonin supplements had similar improvements, however they were more likely to experience withdrawal and depression than those only exposed to bright light (Riemersma-van der Lek et al., 2008).

With a mix of low illuminance and low color temperature, the surveyed nursing homes are potentially putting their residents at a greater risk for falls and visual discomfort (Sinoo et al.,

2011). Healthy environments for older adults must consider sufficiently bright light, while controlling glare, and biological effects of color temperature. When residents are bound to being indoors, artificial lighting can play a significant role in benefiting processes such as circadian rhythm.

Light’s Effects on Emotion

Light, Environment, Behavior, and Preferences. Daylight is the most beneficial source of light in healthcare design. Access to daylight regulates circadian rhythm, and is especially important for older adults as imbalances may increase depression, cognitive and functional problems, and cardiovascular issues in nursing home patients (Brawly, 2009). Successful lighting designs consider both the technical lighting strategy and the effect on users. Elements of good lighting include balance in quantity and quality, reduced glare, and high-quality color rendering

(Brawley, 2009). Glare, surface reflectance, and resulting eye strain are significant considerations as confusion and agitation in older adults are common side-effects of poor lighting design (Brawley, 2009), therefore properties of artificial light are important to evaluate for each interior’s purpose.

Beyond measurable elements, light can elicit strong effects on behavior and emotion.

Extensive research by Flynn and colleagues (Flynn, Hendrick, Spencer, & Martyniuk, 1979;

Flynn, Spencer, Martyniuk, & Hendrick, 1973; Hendrick, Martyniuk, Spencer, & Flynn, 1977;

Martyniuk et al., 1973) illustrated how lighting influences behavior. They evaluated relationships between individual impressions of and behaviors within interior spaces and the “behavior setting,” (Figure 2) i.e. the psychological environment (individual’s interpretation and feeling of the space) and the ecological (physical) environment (Martyniuk et al., 1973). Both psychological and ecological environment are impacted by interior lighting design (Martyniuk et

al, 1973). Spaciousness, pleasantness, and relaxation or tension are a few emotions significantly influenced by lighting (Flynn et al., 1979; Flynn et al., 1973; Martyniuk et al., 1973).

Figure 2: Behavior Setting, from Martyniuk et al., 1973

When understanding light’s influence on behavior, research must begin with understanding user preferences. While proper interior lighting enables an understanding of the physical environment, a light source’s quality may define how people feel or act in an interior.

Subjective responses, which can initiate from preferences, to environments influence an individual’s behavior in an environment (Martyniuk et al., 1973). Oi (2005) evaluated lighting perceptions and preference of different age groups, young (20-25), middle age (41-57), and elderly (65-75). For all age groups, perceptions of brightness, freshness, and emotion were interrelated. In the elderly group, brightness was more closely evaluated as being related to homeliness and warmness. They also rated environments using multiple light fixture types (wall

sconces, ceiling lights, and table lamps) as the highest for comfort, which may also explain why perceptions of brightness and easiness were related responses (Oi, 2005).

These preferences extend into retail environments, where visibility and detail clarity is significant to an older adult’s experience (Park & Farr, 2007). While retail environments differ in functional purpose from most public spaces in senior living, research in this sector has provided perspective in orientation, navigation, and readability, all of which are relevant and important to design of senior living facilities. Both younger (20-30) and older (65+) adults evaluated retail lighting of different correlated color temperatures (CCT) and color rendering (CRI). Older adults described cool light (over 4000K) as less cool than the younger adults, but both age groups described warm light as equally warm. Higher CCT (4100K) and higher CRI (85) improved an older adult’s experience of the environment, improved visual clarity, and visual comfort. Similar to Oi’s (2005) findings, the generational needs and preferences of older adults influenced their experience of the interior environment. These preference findings are significant because color temperature in senior care facilities can range drastically. In seven facilities evaluated by Sinoo et al. (2011), lighting CCT ranged significantly between 2000 K - 9500 K, with the median level falling below daylight levels of 5000 K. If older adults prefer a cooler CCT as Park and Farr

(2007) suggest, then senior care and senior living environments with generally warmer CCT lighting may not be meeting the needs or desires of their residents. Lowered satisfaction with an environment resulted in negative behaviors and may also extend into mood.

Light and Mood. As described by Martyniuk et al. (1973), the “behavior setting,” includes the physical environment and an individual’s psychological environment, which relates to their perception and feelings toward an environment. An individual’s behavior is not bound to only physical movement through an interior, but can manifest as positive or negative mood.

Knez and Kers (2000) found that indoor lighting not only alters positive and negative moods in people, but it also can improve cognitive performance. While exposed to either warm or cool light for two hours, young (average ages 23-24) and older (average age 65) described their mood and environmental perceptions. Negative mood in older adults increased less under cool lighting than it did in younger adults. However, the opposite occurred under warm light. Younger adults described the room as brighter and the light color as cooler, regardless of condition, than the older participants did. Of particular interest from these results (Knez & Kers, 2000) is that only negative mood was altered by the lighting, and only across age groups, not gender. As older and younger participants had different mood changes under the cool and warm lighting, a perceived emotional connotation may be associated with the colors of light. When specifying lighting for older adults, this data is significant as it indicates older adults may experience increased negative mood more so under warm light than cool light.

To better understand the behavioral and emotional effects of indoor lighting, Küller,

Ballal, Laike, Mikellides, & Tonello (2006) evaluated effects of light and color in workplaces on productivity. Unlike many other studies, this research was carried out within functioning offices with a large pool of 988 participants representing Argentina, Saudi Arabia, Sweden, and the

United Kingdom. While responses to surveys on self-reported mood and an assessment of the light and color of the workplace differed minimally across genders and age groups, there were significant differences in reported seasonal mood in Sweden and the UK (Küller et al., 2006).

Moods were reported at their highest during the summer and lowest in the winter, but the shifts were far less drastic in Argentina and Saudi Arabia, most likely due to the length of the day, lower frequency of Seasonal Affective Disorder, and the amount of daylight coming through windows in the workplace. While the lux levels varied widely amongst workplaces, most

participants responded that light levels were “just right” (Küller et al., 2006). Therefore, lighting and color of the space may have more influence on mood than intensity of light, supporting

Flynn’s earlier lighting research (Flynn et al., 1979; Flynn et al., 1973; Hendrick et al., 1977;

Martyniuk et al., 1973). Reported moods of participants in more colorful environments were also higher. These results show that lighting in interior environments modulate self-expressions of mood.

Related to mood, lighting can also create a certain ambience perceptible to people.

Kuijsters et al. (2015) explored the use of ambience created through different lighting scenes to influence anxiety and sadness, both commonly experienced by older adults. Thirty-eight older adult participants first watched a movie clip to elicit either anxiety or sadness and then experienced a lighting condition to reduce the induced mood through either activating or cozy atmospheres. The activating ambience had an illuminance of 325 lx, 4000K color temperature, and blue accents, while the cozy ambience was dimmer with 120 lx illuminance, 2700K color temperature, and orange accents. Both movie clips drastically affected self-reported participant moods and the lighting ambiances successfully communicated mood, as participants evaluated the activating atmosphere as lively and cozy atmosphere as intended. This research (Kuijsters et al., 2015) was successful in improving older adults’ moods through specially designed lighting ambiences. Anxious feelings were reduced with the cozy lighting atmosphere (2700K), but feelings of sadness were not significantly reduced by the activating atmosphere (4000K). This is significant because it indicates the potential for designers to incorporate brightness, color temperature, and color accents into an interior environment to elicit certain moods or counteract negative moods. Given depression, anxiety, and other negative behaviors often present in healthcare settings, these results could prove significant to the interior design field.

Literature Review Summary

A well-crafted interior experience can be transformative. Through thoughtful application of design’s elements in tandem with relevant research, interior designers are poised to improve the functional qualities, emotional, and perceived atmosphere of senior living facilities. For older adults transitioning to new living conditions, no matter how updated, the experience can be extremely stressful. These spaces should provide means for place attachment. Familiar styles, easy to understand layouts, and proper proportions of color and texture are basic elements for successful design. As styles have changed and research has encouraged patient-centered care approaches, so must the thought and attention placed on facility lighting. Through an understanding of older adults, their functional and emotional needs, and possible limitations, senior living interiors can be thoughtfully designed to be more physically and psychologically supportive.

Thoughtfully applied lighting in both public and private areas of senior living facilities may improve the interior experience for an older adult. As research has indicated, the many attributes of lighting influence not only the experience of the interior, but they also incite physiological changes. Color temperature of light is one significant consideration. Lighting technology has vastly improved with the development of LED lamps in efficacy, lifespan, color rendition, and color control, therefore designers can manipulate brightness, color, and quality more precisely when designing lighting. Members of this population experience many changes in their lifestyle as they age. Thoughtful design can be utilized to reduce effects of being introduced into stressful, or even new, environments. With further research into the psychological aspects of light and color temperature, as well as how it may affect an older adult’s perception of their

environment, interior designers can further improve the quality and overall experience of senior living facilities.

Chapter 3: Methods

The purpose of this research is to evaluate the effects of light’s correlated color temperature (CCT) on responses of older adults to their interior environment. Given that many senior living facilities are designed with social spaces in areas without or limited access to natural daylight, the role of artificial light on older adults’ perceptions of and emotional responses to these social spaces is important to understand. As we design senior living facilities to accommodate the current aged population, and look ahead to the even larger population of aging Baby Boomers, designing with a human-centered focus – through understanding user’s preferences and emotional responses to space – will improve the experience of residents in such facilities.

Methodological Approach

This research process is focused on a human-centered approach to design. Human- centered design approaches bring the user into the process of design. Giacomin defines human- centered design as “…the natural focus of the questions, insights and activities lies with the people for whom the product, system or service is intended, rather than in the designer’s personal creative process or within the material and technological substrates of the artefact” (Giacomin,

2014 p. 610). To understand older adults’ lighting preferences, and what role they may or may not have in affecting emotions or perceptions of interior environments, we must integrate older adults into the research process.

Mixed methods research was used in collecting and analyzing both quantitative and qualitative data to gather a more holistic perspective of CCT’s role in changing perceptions and

emotions of older adults. Quantitative data included closed-end scale specific information allowing for statistical analysis and numerical representation. Qualitative data included subjective and open-ended written and interview responses. Older adult participants were brought into an evaluation space where they were asked to provide subjective impressions of the space and its lighting via a survey, completed in private, and through conversations with the investigator on each end of the survey. Quantitative results alone can only show majority interests or numerical trends, but when supplemented with the qualitative responses, we can begin to uncover participant reasoning and personal experiences.

Research Design

Development of the survey (Appendix F) used in this research was rooted in existing research on subjective impressions of lighting, which utilized Likert-type scales to gather quantitative responses (Bernecker et al., 2017; Flynn et al., 1979; Iwata, 2012; Martyniuk et al.,

1973; Oi, 2005). Likert-type scales (Figure 51) allow participants to rank the intensity of a response by creating a range of choice. This method covers a range of responses related to emotion, like-dislike, and perception, such as comfort, anxiety, and feeling of brightness. The survey was reviewed by content experts in gerontology and lighting design; further modifications were made prior to field pilot testing.

Qualitative data were collected on the survey form and during the formal interview at the beginning and end of each session. Interview questions (Figure 52) were established to gather subjective information on participant’s lighting preferences, opinions on lighting around their community, and on the evaluation space. These data are intended to supplement quantitative results. Interview at the start of the session centered on the participant’s personal lighting preferences and what types of light they prefer to use. This time allowed for the participant to

acclimate to the lighting in the evaluation space before answering the survey. Following the completion of the written survey, a second interview elaborated on feelings towards the evaluated lighting and other lighting around the senior living facility.

Pilot Testing

All research tools were pilot tested with a group of four older adult volunteers from independent-living at Ohio Living Westminster-Thurber CCRC before the final set of questions were established. Pilot testing took place in a different common space than the final evaluated environment as focus was on the content and clarity of questions, not to gather feelings about the room itself. The format and content of the printed documents, including a demographics questionnaire, questions about time spent in community spaces, and the room evaluation questionnaire with Likert-type scales, were discussed. The qualitative interview questions were proposed and evaluated for ease of understanding. The pilot group suggested additional community spaces to add and they suggested adding building names to some spaces as a few have similar names (i.e. Community Rooms exist in both Goodale Landing and Thurber Tower buildings). Suggestions for improving the room survey form included identifying each scale as a separate question to answer through numbering. The group also recommended a change to the final question from a ranking of happiness in the room (1 – 5) to an open answer question about how the participant felt in the room since happiness was too specific of an emotion that may not fully capture a participant’s feeling towards the space. Timing for each section was established though the pilot testing activity.

Testing Space Selection

All community spaces around the campus frequented by independent living residents were evaluated as possible testing spaces. It was important for the testing space to be multi-

purpose so lighting would be evaluated in a generalized perspective. Therefore, the computer room, library, art room, and puzzle rooms, all which require more specialized light, were eliminated from possible options. The remaining community spaces host a variety of performances, educational events, and meetings. All but one were eliminated due to having immediate daylight access. Since the focus of this research is on the artificial light’s CCT, it was important to find a space that would not have other variables affecting light quality, such as daylight.

Research Setting

A community and event room at Westminster-Thurber was selected because it lacked direct daylight access and was a space that residents would be familiar with from past events.

The full room was divided in half by a white curtain supplied by investigator to be more proportional to an individual using the space and to minimize other natural or artificial light of adjacent spaces from penetrating the testing area (Figure 3). Additional pictures collected of the space during each session can be seen in Appendix B.

Figure 3: Photos of testing space

The room’s décor was minimal and left as-is with four framed digital art pieces hanging along the long wall, one on the left wall, and a corner decorative shelving display. One 42” round dining table with a white table cloth and two chairs were placed toward the center of the space.

The table and chairs were standard seating for the unused dining space adjacent to the evaluation space and are used for other events in this room. Two extra chairs were in the room corners to provide additional seating options (Figure 4). Participants were invited to sit wherever they felt most comfortable. All chose to sit at the central table in the dining chairs.

1 1572"

B 65"

A 81" C 136" Table and chairs

Curtain Room Divider Wall Break-away

1 FLOOR PLAN

Figure 4: Floor Plan

Two walls were painted green and one wall was a beige break-away wall. A soffit surrounded 3 sides of the evaluation space at 8’ height. The soffit along the two green walls had

2 recessed light fixtures each. The soffit for the break-away wall had no fixtures. The 10’ high ceiling had 4 of the same recessed fixtures (Figure 5).

1 1572"

6" Recessed Fixture Soffit: 96" AFF

Ceiling: 120" AFF 136"

Curtain Room Divider

2 REFLECTED CEILING PLAN

Figure 5: Reflected Ceiling Plan

Process

Research Sessions. This research took place over two recruiting periods: July – August

2017 and November – December 2017. For both recruiting periods, each testing episode lasted four weeks, with one session per week. Each week one of four lamp types were evaluated: the facility’s existing CFL lamps of 2700K and three LED replacement lamps with consistent CRI and similar brightness but differing CCT (3000K, 4000K, 5000K; see Table 1). Research

sessions were conducted individually for each participant to allow for participant confidentiality, so participants would not feel judged by their peers, and so answers could be more personal. The process was structured the same in each session.

Session CCT Manufacturer Type Base CRI Lumens Wattage

1 2700K Feit Electric CFL BR30 80 695 15

2 3000K Sylvania LED Par30 82 825 13

3 4000K Sylvania LED Par30 82 825 13

4 5000K Sylvania LED Par30 82 900 13

Table 1: Lamp Specifications

First, participants were invited into the evaluation space and asked to sit at whichever chair (at opposite sides of a round table) they felt most comfortable. The investigator would then begin with an interview about personal lighting preferences, how they use light in their current home at the facility, and their feelings about the CCRC facility’s lighting. This open-ended interview lasted no more than 15 minutes; this time period allowed their eyes to adjust to the evaluation space’s lighting, so responses were not focused on comparison or shock of where they had been before the interview (Kuijsters et al., 2015). Following the adjustment period, participants were provided the survey of Likert-type scales. They were asked to spend some time observing the room and the lighting, and to answer what they felt best represented their feelings toward the space at that time. The investigator stepped out of the evaluation space while the participant completed the survey, which took between 5 - 10 minutes, depending on how long each participant spent observing the space before completing the survey. After completing the survey, the investigator returned to the evaluation space and interviewed the participant about

how the room and the lighting felt to the participant for another 5 - 10 minutes. This portion of the discussion was recorded. This concluded the session.

Light Measurements. For each lighting condition (2700K, 3000K, 4000K, 5000K), illumination measurements were taken using a light meter. Full horizontal measurements were recorded over a 3’ incremental grid and vertical measurements were taken at 1’-6”, 3’-6”, and 6’ heights in 3’ horizontal increments. These measures provide a detailed map of brightness throughout the evaluation space from the approximate height of a seated person’s eyes (about

42”) and along the walls. Bright and dark spots due to the distribution of ceiling fixtures and inherent qualities of CFL and LED lamps are also visualized in the horizontal measurements.

Vertical measurements represent the amount of light reflecting off of the wall surfaces at indicated heights, which also adds to the feeling of brightness in a space and could indicate glare.

Photographic Documentation. Photographs were taken of the evaluation space from all four corners for each of the four conditions to document the quality of each light condition and appearance of the space’s materials and colors as altered by each CCT. Each final image was developed through a multi-step process using HDR software and programming. Photos were taken in bracketed exposures, combined into an HDR file, and processed to closely represent the human eye’s perception of the space. This process was also done for the most popular common spaces that light measurements were taken in.

To generate the final images that are most akin to how the human eye perceived light, a series of images of bracketed exposures were taken. The multiple exposures were combined using Photosphere into an HDR data file (Anyhere Software, G. W., n.d.). This process maintains the range of illuminance levels and colors from each exposure level, making the final image more similar to how the human eye would perceive the space than a single-exposure photograph

would (Reinhard et al., 2010). The HDR file was processed using MatLab, a programming language and data analysis environment (MathWorks, 2017). The HDR file was tone mapped, a tool that processed the HDR data into RGB color space so that it could be visible while adjusting the lightness and saturation ranges to be appropriate for the new RGB color space (“Tonemap”) and appear close to a human eye’s perception. This process was completed for each corner of the evaluation space (Appendix A).

Subjects

Seventeen independent living residents, 13 females and 4 males, from Ohio Living

Westminster-Thurber in Columbus, Ohio, a local CCRC, participated in this research. All participants were over 65 and the oldest was over 96 years old (see Table 2). Participants were recruited via a convenience sampling, a flyer distribution to all independent-living residents and sign-up sheet on their activities board. They were asked to sign up on their own to reduce feelings of pressure or bias from investigator or staff interactions. Each participant self-identified as clear of any untreated eye conditions: cataract, macular degeneration, or other. A small incentive was offered for participation. Three participants did not attend the final session and one missed the first. This study was approved by the Intuitional Review Board of The Ohio State

University. All participants provided written informed consent to participate.

Age Range Quantity 66-70 2 71-75 2 76-80 4 81-85 4 86-90 3 91-95 1 96+ 1 Table 2: Participant Age Distribution

Lighting Conditions

For each of the four sessions, eight lamps were installed within the evaluation space’s eight recessed fixtures. Session 1 used Westminster-Thurber’s existing 2700K CFL lamps, session 2 used 3000K LED replacements, session 3 used 4000K LED replacements, and session

4 used 5000K LED replacements (see Appendix C for specifications). For consistency, the LED replacements all have similar lux levels and CRIs (Table 1). Illuminance measurements for each lighting condition indicate the distribution of light, hot spots, and dark areas (Appendix D).

Figure 6: Horizontal Foot Candle Measurements

Data Collection

Research Sessions. Data was collected through a survey and interviews with each participant during each session. To ensure participant privacy, surveys were identified only by a

unique participant code. Interview portions were recorded and transcribed, also identified only by the unique participant code.

In the second session, participants completed a demographics survey indicating age range, gender, and how long they have lived at Westminster-Thurber. They also filled out a chart listing various community spaces on the campus with how often they frequent the space in a typical week and for how long, on average, in that week (Appendix E). This information was used to establish the most frequented community spaces to establish lighting comparisons with the data collected in this research.

The survey was built to gather participants’ subjective impressions of and emotional responses towards the evaluation space (Appendix F). The survey included 12 Likert-type scales and one open text for comment. The twelve scales were divided into three distinct categories:

“this room feels,” “this lighting feels,” and “in this room, I feel” to collect a range of subjective impressions and emotional responses to the evaluation space. Each category’s Likert-type scales were adapted from existing research on subjective impressions of lighting (Bernecker et al.,

2017; Flynn et al., 1979; Iwata, 2012; Martyniuk et al., 1973; Oi, 2005). The open comment section allowed participants to indicate more about how they felt in the space using their own subjective description.

Two segments of interviews occurred in each session. One prior to the survey, which allowed time for the participant to adjust to the lighting of the evaluation space. This interview was a discussion of lighting preferences and how they personally light their apartments.

Participants were asked to identify tasks and actives in which they like to use either bright, average, or dim light. They were then asked to identify what tasks and activities in which they use general, task, or decorative lighting. Participants were also asked to provide any observations

about lighting around Westminster-Thurber’s community spaces and whether they have ever had issues of too much or too little light in theses spaces. Following completion of the survey, participants were interviewed again where they were asked if there was anything else they wanted to share about the lighting in the evaluation space. At the end, participants were also given an opportunity to share any other thoughts on lighting they may have.

Data Processing

Quantitative data from the questionnaire was entered into a spreadsheet organized by participant code and session number. Qualitative responses from the survey’s open comments and interviews on participants’ feelings in the space were transcribed from the audio recordings.

Analysis. Quantitative data was analyzed using IBM SPSS Statistics (IBM SPSS

Statistics for Windows (Version 25.0) [Computer software]). Survey responses were translated into corresponding numerical values and entered into SPSS for statistical analysis. Descriptive statistics were used to generate frequency tables, including means, medians, and standard deviations, for each question and session. These data were then used to create diagrams of response frequencies (percentage) for each question and of mean responses to compare answers across the four sessions.

The transcribed written and verbal answers were coded by the investigator with support from a committee member. Codes were established using words spoken or written directly by the participant or to describe longer written or verbal passages that represented a single concept

(Burnard, 2004). All codes were generated to concisely articulate individual thoughts, ideas, or emotions that emerged from participant responses. Codes were then grouped by theme which were identified based on content of discussion.

Chapter 4: Results

Quantitative Data

Findings of these four sessions were not found to be statistically significant but trends were identified. Data were analyzed using descriptive statistics including frequency and means using IBM SPSS Statistics software. Data were not statistically significant due to small sample size and differing responses that led to a high standard deviation.

Session 1 (2700K CFL lamps).

This room feels: Stimulating 56% Neutral 25% Calming 19% Inviting 63% Neutral 13% Unappealing 25% Bright 94% Neutral 6% Dark 0% Vibrant 63% Neutral 31% Washed Out 6%

This lighting feels: Warm 44% Neutral 44% Cool 13% Too Dark 6% Just Right 81% Too Bright 13% Excessive 13% Appropriate 88% Inadequate 0% Glaring 38% Non-Glaring 63%

In this room, I feel: Calm 73% Neutral 13% Anxious 13% Relaxed 69% Neutral 19% Energized 13% Safe 75% Neutral 25% At Risk 0% Alert 81% Neutral 19% Peaceful 0% Table 3: Session 1 (2700K CFL lamps) Quantitative Responses

The evaluation space illuminated with 2700K CCT light was described as stimulating, inviting, and vibrant by 56 - 63% of participants (Table 3). All but one participant indicated the space felt bright and no participants indicated that the room felt dark. This lighting condition was

also described by 63 - 88% of participants as just right, non-glaring, and appropriate. The same percent of participants described the light as warm and neutral (44% each). For the category of how participants reported they felt in the room, 69 – 81% reported calm, relaxed, safe, and alert.

Session 2 (3000K LED lamps).

This room feels: Stimulating 59% Neutral 12% Calming 29% Inviting 59% Neutral 12% Unappealing 29% Bright 82% Neutral 6% Dark 12% Vibrant 38% Neutral 50% Washed Out 13%

This lighting feels: Warm 53% Neutral 35% Cool 12% Too Dark 6% Just Right 69% Too Bright 25% Excessive 18% Appropriate 76% Inadequate 6% Glaring 47% Non-Glaring 53%

In this room, I feel: Calm 47% Neutral 35% Anxious 18% Relaxed 53% Neutral 24% Energized 24% Safe 59% Neutral 29% At Risk 12% Alert 76% Neutral 12% Peaceful 12% Table 4: Session 2 (3000K LED lamps) Quantitative Responses

In Session 2, 59 – 82% indicated the room felt stimulating, inviting, and bright. Twelve percent of participants indicated the 3000K LED felt dark to them (Table 4). Half (50%) of the participants felt the space was neither vibrant nor washed out. In this session, 47% of participants judged the light as glaring and 53% indicated non-glaring. The light seemed just right to 69% and appropriate to 76% of participants. Light in the room was reported as feeling warm by 53% of participants. In reporting how they felt in the space, 47% reported feeling calm, 53% indicated feeling relaxed and safe, and 76% felt alert.

Session 3 (4000K LED lamps).

This room feels: Stimulating 53% Neutral 24% Calming 24% Inviting 41% Neutral 24% Unappealing 35% Bright 71% Neutral 24% Dark 6% Vibrant 65% Neutral 29% Washed Out 6%

This lighting feels: Warm 25% Neutral 31% Cool 44% Too Dark 0% Just Right 65% Too Bright 35% Excessive 35% Appropriate 65% Inadequate 0% Glaring 47% Non-Glaring 53%

In this room, I feel: Calm 53% Neutral 24% Anxious 24% Relaxed 47% Neutral 12% Energized 41% Safe 53% Neutral 41% At Risk 6% Alert 71% Neutral 14% Peaceful 14% Table 5: Session 3 (4000K LED lamps) Quantitative Responses

Fifty-three percent of participants indicated the room felt stimulating under 4000K LED lighting (Table 5). Participants indicated the room felt vibrant and bright 65% and 71% respectively. The room felt inviting by 41% of participants and 35% responded the room felt unappealing. Answers were also divided between glaring (47% of responses) and non-glaring

(53% of responses) light, but 65% indicate 4000K LED light was just right and 65% indicated it was appropriate. Forty-four percent of participants described this light as cool. Participants responded they felt alert (71%), however responses for the relaxed-energized scale were nearly split (47% and 41% respectively). While 53% felt safe, 41% reported feeling neither safe nor at- risk. Participants described feeling calm (53%), with the remainder split evenly between neutral and anxious feeling (24% each).

Session 4 (5000K LED lamps).

This room feels: Stimulating 57% Neutral 14% Calming 29% Inviting 50% Neutral 21% Unappealing 29% Bright 64% Neutral 36% Dark 0% Vibrant 38% Neutral 38% Washed Out 23%

This lighting feels: Warm 50% Neutral 29% Cool 21% Too Dark 0% Just Right 57% Too Bright 43% Excessive 21% Appropriate 79% Inadequate 0% Glaring 43% Non-Glaring 57%

In this room, I feel: Calm 57% Neutral 29% Anxious 14% Relaxed 57% Neutral 14% Energized 29% Safe 57% Neutral 29% At Risk 14% Alert 71% Neutral 14% Peaceful 14% Table 6: Session 4 (5000K LED lamps) Quantitative Responses

In this session, 57 – 64% of participants indicated the room felt stimulating and bright

(Table 6). Half of the participants (50%) felt the room was inviting, but the remaining split nearly evenly between neutral and unappealing (21% and 29% respectively). Participants equally indicated the room felt vibrant or neutral (38% each). While 50% of participants described the

5000K LED lighting as warm, 29% described it as neutral and 21% as cool. Regarding glare, participants were divided with 43% reporting glare and 57% reporting non-glaring. Participants were also divided between describing the light as just right or too bright (57% and 43% respectively). The majority (79%) indicated the light was appropriate and no participant reported it as inadequate. Fifty-seven percent of participants indicated they felt calm, relaxed, and safe in this room with 5000K LED light while 71% indicated they felt alert.

Qualitative Data

Discussions with participants yielded insights that complement quantitative data collected from completed surveys. The final survey question asked participants to describe how they felt in the room. Following completion of the survey, participants were interviewed in the room and were asked to share anything they felt about the lighting experience and space they were in.

Three main themes emerged from participant responses: functional qualities, distribution of light, and participant feeling in the space. All of the descriptions of the light and space focused on overall quality of light, except for specific descriptions regarding the light’s color. These themes signal the importance of functional and appropriate light to older adults, as they recurred in each of the four lighting conditions.

Coded words were evaluated with either a positive or negative association, and neutral comments were not considered. Participant responses regarding positive and negative associations found: session 1 (2700K), 55% of responses were positive; session 2 (3000K) 61% positive; session 3 (4000K), 35% positive; and session 4 (5000K) with 58% positive associations.

Functional theme. The functional theme describes when participants indicated the evaluated lighting was appropriate, or inappropriate, for certain functions or tasks. Functional quality was described using terms of appropriateness, good for reading or writing, and supportive or unhelpful. Terms describing appropriateness for specific settings were combined into the functional theme as the connotation for a setting’s description had to do with the ability to perform certain functions well. No male participants commented on the function of any session’s lighting.

Participant functionality comments included a female participant’s description of session

2’s (3000K) light as appropriate for reading and writing:

“…I think I identified myself earlier as a bright light person, so it’s easier for me – like

my eyes feel like they’re doing less work to read the sheets and write the answers…”

Another female participant described session 2 (3000K) as adequate for close-up work:

“If I was reading a book, I could do it. If I was doing close work, I could do it here. I’m

not squinting. If I was relaxing, it’s too bright.”

One female participant, age 71-75 years old, described the function of light in session 3

(4000K) as unhelpful:

“Hands & furniture cast shadows that would interfere (sic) with readings & other

activities.”

Distribution of light. Distribution of light developed as a theme due to the strong presence of participant responses describing features related to how the light was distributed throughout the space and specific qualities of the light. Terms used in the distribution theme described level of glare, uneven light spread, shadows, brightness, softness, dimness, a neutral distribution, color of light, and the brightness experienced when looking up at the ceiling.

Glare. Glare was also commonly discussed with each lighting condition. Participants who indicated the light felt too bright were also likely to comment on feeling glare. A male participant, aged 91-95, described session 2 as follows:

“…too bright. It’s glaring and reminds me of a situation where you’re being grilled by

someone.”

A female participant indicated in session 3:

“I feel a bit uncomfortable because the light is bright (usually to my preference) but

glaringly so, especially on this white paper. Makes me blink my eyes (for protection)

more often than usual).”

Uneven light. Another discussion in all sessions was uneven light distribution and shadows. While in session 1, only one participant referred to shadows, these ideas arose more in sessions 2-4. One female participant described her confusion over the light level in session 3:

“It seems too bright to me somehow. But it also seems dim and bright. I don’t understand

it.”

Another participant had a similar comment in the session:

“It’s both too bright and too many shadows.”

During session 2, participants described the light as uneven:

“It’s not an even light.”

“The light from the ceiling spots is variable/uneven. This is not calming.”

Brightness. Statements regarding sharp brightness when looking up at the ceiling occurred in each of the four sessions, with session 3 having the most comments regarding brightness. Brightness was discussed in sessions 1 and 4 by one participant, two participants mentioned brightness in session 2, and seven commented on brightness in session 3. A female participant, 86-90-years-old, thought the light was fine for reading and writing “as long as you’re not looking up.” Other participant comments included:

“Well, if you have to look up at one of the actual lights, it’s hurtful.”

“When I look up it’s kind of glary.”

“It just seems like I’m drawn to the bulb itself because of the brightness.”

Color. Comments on the color of light occurred only in sessions 2, 3, and 4 and all were on the blueness of the light. For example, in session 2, a female between 76-80, commented that the light felt bluer. Again, in session 3, she remarked on the light seeming bluer and remarked it may be part of her discomfort.

“I decided it was cool, but it seems way…I don’t know, bluer. I’m not sure if its blue or

something that makes me uncomfortable.”

Her dislike of blue-toned light came up again in session 4.

“I don’t like this light, particularly the color (too blue?).”

Other participants remarked on the increase in blue light in these sessions but did not directly associate the color with discomfort.

Feelings. Participants also frequently described feelings evoked by the lighting and the space. This theme contains both positive and negative emotions the participants described. Terms appearing multiple times under this theme include: comfort and discomfort, calm, like or dislike, energized, alert, and neutral. Comfort or discomfort were the two most commonly expressed feelings across all sessions. While one female participant described session 1 as uncomfortable, she indicated that session 2 felt “more inviting and less harsh than some other lighting” and session 3 was “not comfortable light for me.” A male participant, aged 91-95, described every session’s lighting as uncomfortable. A different male participant described each of sessions 1, 2, and 3 as relaxing. One female participant described discomfort with lighting in session 3:

“It’s not energizing and therefore not quite as welcoming.”

One described feeling uncomfortable and not liking the lighting in session 4 because:

“these just feel like they’re pressing down on you or something. They’re just not

appealing.”

Another female participant described the first session as appropriate functionally, but that she felt uncomfortable:

“The lighting was good for reading & writing but not conducive to talking or relaxing.

Feels closed in – artificial – not like the ‘real world.’”

Chapter 5: Discussion

Quantitative Data

None of these data were found to be statistically significant. No meaningful data in findings reflect factors of age or gender. While slight differences occurred in all Likert scales, a few themes were selected for discussion that most impact design and lighting for older adults: feelings of calm, safety, and qualities of light that support an older adult’s functioning.

Supportive interior environments for older adults help them manage loss in abilities that occur with aging, such as vision and dexterity loss (Crews, 2005). Satisfaction and comfort are two factors impacting an older adult’s ability to develop place attachment (Kaya et al., 2005).

Therefore, discussed data was selected that represents qualities influenced by the four lighting conditions that shifted participants’ satisfaction and comfort: In this room, I feel: calm – anxious;

In this room, I feel: safe – at-risk; This lighting feels: warm – cool; This lighting feels: too dark – too bright; This lighting feels: excessive – inadequate; This lighting feels: glaring – non-glaring.

Calm – Anxious.

Calm to Anxious 80%

70%

60%

50%

Session 1 (2700K CFL)

40% Session 2 (3000K LED) Session 3 (4000K LED) Session 4 (5000K LED)

30%

20%

10%

0% Calm Neutral Anxious

Figure 7: Calm to Anxious Responses for All Sessions

The majority of participants (53 – 73%) responded that they felt calm in the room for three of the lighting conditions (27000K, 4000K, 5000K) (Figure 7). The 2700K CFL was the most calming, which may be due to this lamp type being most familiar to the participants, as it is the standard down-light used across the CCRC’s facility. This confirms research by Kuijsters et al. (2015) in which 2700K light was part of a lighting ambience that reduced feelings of anxiousness in older adults. Following exposure to 2700K light, older adults self-reported higher pleasure and lower arousal than they did when anxiousness was induced (Kuijsters et al., 2015).

In my research, feelings of anxiousness increased slightly under the 4000K LED light. This may

also be supported by Kuijsters et al. (2015) because their 4000K light did not significantly change pleasure or arousal after feelings of sadness were induced.

Safe – At-Risk.

Safe to At Risk 80%

70%

60%

50%

Session 1 (2700K CFL)

40% Session 2 (3000K LED) Session 3 (4000K LED) Session 4 (5000K LED)

30%

20%

10%

0% Safe Neutral At Risk

Figure 8: Safe to At Risk Responses for All Sessions

For the 2700K CFL lighting, 75% of participants felt safe and none reported feeling at risk (Figure 8). Similar to feelings of being calm, feelings of safety could be related to familiarity with the 2700K CFL lighting as it is used throughout the CCRC campus. The three LED lighting conditions (3000K, 4000K, 5000K) are relatively clustered (53-59%). As these three conditions were bright, participants may have still perceived safety despite the unfamiliarity of the color

temperature. This is supported by research on older adults’ abilities to walk, sort pills, and read at different brightness levels (Evans, Sawyerr, Jessa, Brodrick, & Slater, 2010). When in lower light levels, older adults perform slower, a sign of uneasiness (Evans et al., 2010). Dark areas on flooring can also make older adults feel less safe in their ability to walk through an environment

(Calkins, 2009).

Warm – Cool.

Warm to Cool 60%

50%

40%

Session 1 (2700K CFL)

30% Session 2 (3000K LED) Session 3 (4000K LED) Session 4 (5000K LED)

20%

10%

0% Warm Neutral Cool

Figure 9: Warm to Cool Responses for All Sessions

In session 1, participants were split between distinguishing the light as feeling warm or neutral (44% and 43%, respectively) (Figure 9). The higher neutral responses in session 1 could

be attributed to familiarity with the quality of that light. While participants described the warm- toned lighting conditions of 2700K CFL and 3000K LED as feeling warm (43% and 53% respectively), half (50%) of participants also described the cool-toned 5000K LED light as warm. This is supported by research by Knez and Kers (2000) Park and Farr (2007) that shows older adults tend to describe cool light as warmer than younger adults would. Determining warmth or coolness of a light’s color may also be affected by the aging eye in which the lens hardens and yellows (Najjar et al., 2014). The only lighting condition in which more participants described the light as cool rather than warm or neutral was the 4000K LED light (44% cool).

This is interesting since the cooler 5000K LED light was described as cool by only 21% of participants. Research was not found that explains why more participants described the 5000K light as warmer than the 4000K light.

Too Dark – Too Bright.

Too Dark to Too Bright 90%

80%

70%

60%

50% Session 1 (2700K CFL) Session 2 (3000K LED) Session 3 (4000K LED) 40% Session 4 (5000K LED)

30%

20%

10%

0% Too Dark Just Right Too Bright

Figure 10: Too Dark to Too Bright Responses for All Sessions

Across all four lighting conditions, the majority of participants (57-81%) indicated the light seemed “just right” (Figure 10). As seen in other scales, most “just right” responses were given to the familiar 2700K CFL light. Frequency of “too bright” responses increased with each cooler color temperature. This may indicate that participants associate feelings of brightness with color temperature. This is supported by existing research (Kim, Jang, Choi, & Sung, 2015; Ju,

Chen, & Lin, 2012) that also found spaces illuminated by cooler color temperatures of light seemed brighter than those illuminated by warmer color temperatures. While these researchers worked with younger adults, it is possible that similar effects of CCT on brightness perception are occurring in the older generation. In my research, the 3000K and 4000K light brightness

were rated “just right” very closely (69% and 65% respectively). This is supported by Park and

Farr (2007), who also did not find a significant difference in brightness perception between

3000K and 4100K light.

Excessive – Inadequate and Glaring – Non-Glaring.

Excessive to Inadequate 100%

90%

80%

70%

60%

Session 1 (2700K CFL)

50% Session 2 (3000K LED) Session 3 (4000K LED) Session 4 (5000K LED) 40%

30%

20%

10%

0% Excessive Appropriate Inadequate

Figure 11: Excessive to Inadequate Responses for All Sessions

It is relevant to discuss perceptions of light level appropriateness and glare together as glare can be an indication of an imbalance in light level or distribution. Glare is excessive light from a single point, so these two scales can be evaluated in context of each other. For all four lighting conditions (2700K CFL, 3000K LED, 4000K LED, 5000K LED), the majority of

participants (65 – 88%) felt the light level was appropriate (Figure 11). Participants again felt the familiar 2700K CFL light was the most appropriate (88%). The 4000K LED received the least amount of “appropriate” responses (65%) and highest “excessive” responses (35%). This could be explained by responses to the “glaring – non-glaring” scale in which the most “glaring” responses (47%) came with the 4000K and 3000K LED light (Figure 12). Color temperature and brightness perceptions are also related (Ju et al., 2012), which corresponds with these results in which the 4000K seemed to be more excessive and glaring than warmer color temperatures.

Reducing glare is important for older adults as associated eye strain can result in confusion and agitation (Brawley, 2009).

Glaring to Non-Glaring 70%

60%

50%

40% Session 1 (2700K CFL) Session 2 (3000K LED) Session 3 (4000K LED) 30% Session 4 (5000K LED)

20%

10%

0% Glaring Non-Glaring

Figure 12: Glaring and Non-Glaring Responses for All Sessions

Note. Session 2 and Session 3 data overlap

While these data (Figure 11, Figure 12) indicate slightly higher preference for the familiar 2700K CFL light, the responses are still positive towards a few of the LED replacement options (3000K and 5000K). As indicated in research by Aarts and Westerlaken (2005), older adults tend to respond positively to different lighting options, even inadequate light. Responses to the 3000K LED are identical to that of the 4000K LED. Given the less positive responses when under the 3000K and 4000K LED light, it is likely that participants were more affected by glare and perception of brightness with this option than others, which also affected their responses to other emotional and subjective scales.

Session 3: 4000K LED lamps.

Mean Per Session - Combined 3

Session 1 (2700K CFL) Session 3 (4000K LED)

Figure 13: Session 1 and Session 3 Mean Responses

Responses to session 3 (4000K LED) act as an outlier (Figure 13). Unlike the session 2

(3000K) and session 4 (5000K LED) light sessions (Figure 14), responses for 4000K LED did not follow a similar distribution for all results. A comparison of session 1 (2700K CFL) and session 3 (4000K LED) mean responses reveals discomfort-related responses occurred more under the 4000K LED light. Consistencies across the two sessions occurred most for the

“stimulating – calming” and “vibrant – washed out” scales. The largest disparities are seen for the “warm – cool” and “relaxed – energized” scales. 4000K LED light was described as “cool” the most out of any session. The difference here corresponds to the difference in tone of white light between the two sessions. The first, which participants described as warm, is a warm-toned

2700K CFL light, while session 3 is a cool-toned light, and is appropriately described as such by the participants. In session 3, participants were nearly split between describing how they felt in the room with the 4000K light as either relaxed (47%) or energized (41%) whereas in session 1, more participants were relaxed (63%).

Mean Per Session - Combined 3

Session 1 (2700K CFL) Session 2 (3000K LED) Session 3 (4000K LED) Session 4 (5000K LED) 1

Figure 14: Mean Responses for All Sessions

Quantitative Summary. Data from the survey, while not statistically significant, revealed interesting themes for understanding older adults’ perceptions of and emotional responses towards lighting (Figure 14). While three of the four sessions generated similar responses from the participants, session 3 (4000K LED) had distinct changes in responses for

many of the scales. This could be related to a slight change in how the light is produced and directed in this lamp type than in the others used. While the three LED replacement PAR lamps are all the same type of lamp and from the same manufacturer, it is possible that phosphor coatings within the LED mechanics could change the quality of light in a way that participants perceived more glare and brightness.

Qualitative Data

Discussions with participants following the survey generated themes supporting those from the quantitative data. As from the survey, participants responded positively to the light in sessions 1, 2, and 4, but more negatively to session 3. Themes regarding the functional support of the lighting emerged, which is reinforced by ideas of establishing supportive environments for older adults (Ulrich, 1991; Crews, 2005). Participants were concerned with their ability to function, such as reading and writing with ease, under each lighting condition. This also led to much discussion about the distribution of light from the lamps themselves. Glare, uneven light, shadows and brightness were discussed frequently for each light type. Glare and brightness are significant factors to an older adult’s ability to function with ease in an environment. Following the need for environmental supports (Crews, 2005), if the lighting is too glaring or too bright, older adults may be inhibited just as much as if the light levels were too low. Discussion also focused on emotional responses to the space. Comfort, or discomfort, was most commonly mentioned and frequently was paired with other feelings such as calmness and alertness.

Positive & Negative Discussions. When coded, words were evaluated with either their positive or negative association; neutral comments were not considered. Participant responses, regarding positive verses negative associations, were mostly positive (53-61%) in session 1

(2700K), session 2 (3000K), and session 4 (5000K); However, in session 3 (4000K), only 35% of codes were positive (Figure 15).

Figure 15: Positive and Negative Qualitative Code Distribution

Participants felt most uncomfortable under the 4000K LED light and were vocal about the various features that were uncomfortable. Common negative codes appearing for this session included: glare, uneven light, and uncomfortable feeling (Figure 16). A few participants positively described this light as comfortable and commented that it was suitable for reading and writing. The negative terms appearing in Session 3 were also present in the other sessions, but at a lower frequency (Appendix G). From an evaluation of positive and negative associations within the codes, it is clear that the 4000K LED, although providing a reasonable amount of light for completing close-up tasks, was otherwise uncomfortable and not suitable for these participants.

Figure 16: Session 3 Positive and Negative Qualitative Code Distribution

Functional Theme. The functional theme was determined by participants commenting on their ability to complete certain tasks and the appropriateness of the light level for certain settings, such as an office. Across all sessions, participants remarked that the lighting was adequate for them to complete the survey. Their ability to read and write clearly was frequently discussed as a positive feature of the light. In session 2, participants stated:

“…I think I identified myself earlier as a bright light person, so it’s easier for me – like

my eyes feel like they’re doing less work to read the sheets and write the answers…”

“If I was reading a book, I could do it. If I was doing close work, I could do it here. I’m

not squinting. If I was relaxing, it’s too bright.”

This is supported by research (Sinoo et al., 2011; Evans et al., 2010) stating that if lighting is inadequate, functional abilities in older adults’ declines. Ability to safely navigate environments, read at a consistent pace, and accurately sort medication are affected by light qualities (Evans et al., 2010), therefore it is important for older adults to describe their interior lighting as appropriate and supportive for tasks at hand. This is also apparent when the lighting produces a hindrance, as a participant described in session 3:

“Hands & furniture cast shadows that would interfere (sic) with readings & other

activities.”

Here, the participant cannot function as easily because the overhead lighting is casting more noticeably obtrusive shadows that make close-up work more difficult. If an older adult had to spend a long period time reading or writing under this light, they could experience eye strain, eye fatigue or headaches (Sinoo et al., 2011). Session 3 was the only session in which participants described the lighting as hindering or inappropriate for functional needs (Figure 17).

Figure 17: Frequency of Codes by Category

Distribution of light. The theme of light distribution arose from many participant comments on the quality of light from the source and fixtures throughout the space. Glare, uneven light, brightness, and the color of the light were discussed frequently across all sessions

(Figure 17). The distribution of light is a significant design consideration as poor distribution can result in glare, bright spots, and shadows, creating discomfort for older adults (Sinoo et al.,

2011). For an interior to truly be supportive of an older adult’s needs, the light must not only be functionally supportive, but it also must not create other discomforts.

Glare. Glare was a common comment in all sessions. A male participant described lighting in session 2 as:

“too bright. It’s glaring and reminds me of a situation where you’re being grilled by

someone.”

A female participant indicated in session 3:

“I feel a bit uncomfortable because the light is bright (usually to my preference) but

glaringly so, especially on this white paper. Makes me blink my eyes (for protection)

more often than usual.”

This community room used 6” recessed downlights, which direct all light immediately downwards. When sitting, the intense brightness focused downwards can easily create glare in an individual’s eyes. Since older adults are more sensitive to glare (Evans et al., 2010), this especially became a pain-point for them in each session. As illustrated in Figure 17, terms about glare, whether glare, minor glare, or reflective glare, occurred 6 – 11% of the time across all four sessions.

Uneven light. Many participants also discussed the light around the room was uneven.

Participants described confusion over the lighting in session 3:

“It seems too bright to me somehow. But it also seems dim and bright. I don’t understand

it.”

“It’s both too bright and too many shadows.”

During session 2, participants also described the light as uneven:

“It’s not an even light.”

“The light from the ceiling spots is variable/uneven. This is not calming.”

CFL lamps disburse their produced light differently than LED lamps (LED Professional

Review, 2016). CFL lamps create a rounded distribution of light immediately from the source whereas LED lamps create a more cone-shaped distribution of light which can create darker areas towards the ceiling line (Figure 18).

Figure 18: Typical LED, CFL, and Incandescent Candela Distributions (LED Professional Review, 2016)

This is well illustrated in the testing space when comparing the distribution of light on a wall between sessions 1, which used a CFL lamp, and session 3, which used an LED lamp

(Figure 19). As seen in Figure 17, comments regarding uneven light increased from 2% in session 1 with the CFL lamps to 7 – 9% for the three following sessions using LED lamps.

Figure 19: CFL and LED Light Shapes

Brightness. Older adults require more light than younger adults to see as clearly (Najjar et al., 2014), therefore brightness is a significant factor in determining the quality of the four

lighting conditions. Participants described the lighting’s brightness in every session (Figure 17).

Comments were either about the light being bright or too bright. For these participants, bright was not seen as a negative connotation and many who reported the light as bright also reported no glare. This idea is supported by research from Oi (2005) which found older adults associated brightness with warmness and feelings of home. When participants referred to the light as being too bright, they also would report experiencing glare (Figure 20). This connection indicates that older adults associate brightness with glare and that while too bright of light becomes uncomfortable, having bright light is a positive thing. Along with reporting general brightness, many participants also specifically mentioned the brightness when looking up (Figure 17).

Participants described it as:

“Well, if you have to look up at one of the actual lights, it’s hurtful.”

“When I look up it’s kind of glary.”

“It just seems like I’m drawn to the bulb itself because of the brightness.”

These comments are likely due to the use of downlights that are not paired with integrated reflector lenses. Reflector lenses in the recessed fixtures would further diffuse the lamp’s light. The exposed bulb creates a visual hot spot and with many in a small proximity, can easily become distracting and painful to an older adult, and results in many remarks on glare.

Figure 20: Connections Between Brightness and Glare Comments

Color. Participants commented on the light’s color in all sessions except the first, and in each reporting, they described blue as present in the light. One participant commented on the blue-toned light in sessions 2, 3, and 4. In session 2, when asked to describe the lighting, she said:

“I was going to say bluer, but I don’t know if that makes any sense.”

In session 3:

“I decided it was cool, but it seems way…I don’t know, bluer. I’m not sure if its blue or

something that makes me uncomfortable.”

In session 4:

“I don’t like this light, particularly the color (too blue?).”

Other participants had similar descriptions of the coolness or blue tone to the light. Most comments on the cool-toned lighting occurred in session 3 (4000K LED). Previous research

(Knez & Kers, 2000; Park & Farr, 2007) supports that older adults describe cool-toned lighting as less cool than younger adults. This may explain why reports of blue tones in the lighting did not occur consistently across all of the cooler lighting conditions. While it would be expected that reports on blue light would remain for the 5000K LED light as it did for the 4000K LED, they dropped significantly. This could be due to differing spectral distributions produced by the two lamps (Worthey, 2003). As the 5000K LED lamp is considered a “daylight” lamp, it may have a different phosphor coating to produce either more red wavelengths or have more “power” in the red wavelengths, creating a truer color representation than the 4000K LED. Daylight has a relatively even spectral distribution (Worthey, 2003) (Figure 21), therefore it is reasonable to predict a “daylight” lamp would be engineered to have a more even spectral distribution to correlate with daylight’s qualities. The 4000K lamp, however, may have more power in the blue wavelengths and not have as much generation in the red-orange wavelengths.

Figure 21: Daylight Spectral Power Distribution (Rensselaer Polytechnic Institute, 2003)

Feelings. Participants also described how they felt in the space with the different lighting conditions. Across all four sessions, both positive and negative feelings were discussed. Comfort and discomfort were the most common with other emotions such as calmness, energy, and alertness also reported. One female participant described discomfort with lighting in session 3:

“It’s not energizing and therefore not quite as welcoming.”

One described feeling uncomfortable and not liking the lighting in session 4 because:

“these just feel like they’re pressing down on you or something. They’re just not

appealing.”

Another female participant described the first session as appropriate functionally, but that she felt uncomfortable:

“The lighting was good for reading & writing but not conducive to talking or relaxing.

Feels closed in – artificial – not like the ‘real world.’”

Comfort is significant to helping establish a supportive environment and help residents develop place attachment (Eshelman & Evans, 2002). If senior living residents feel uncomfortable in their environment, they can experience many other negative side-effects, such as stress, discomfort, or confusion (Andrade & Devlin, 2015; Ulrich, 1991; Zavotka & Teaford,

1997). Interior lighting is an element of design that can change the atmosphere of an environment. As seen in research from Kuijsters et al. (2015), color temperature is a quality of light that not only creates an ambience in an interior, but also effects emotions in older adults; they found that 2700K light with orange accents balanced feelings of anxiety. When evaluating older adults’ emotional responses to lighting in an interior, it is especially important to consider what emotions are evoked. In my research, participants felt uncomfortable with the 4000K LED light, therefore it likely would not be an appropriate solution for senior living. However, with

25% and 19% of all comments expressed as positive feelings in the 3000K and 5000K LED conditions, respectively, these may be appropriate lamps to have in common spaces throughout senior living facilities, especially since 3000K and 5000K LED received more positive feeling comments than the 2700K CFL condition (16%) (Figure 17). This is also supported by research by Knez and Kers (2010) who found that negative mood increased less under cool lighting in older adults than it did in younger adults.

Increased perceptions of glare and brightness can also explain the other negative emotional responses indicated by the participants. When an older adult experiences excessive brightness and glare, they are also likely to be uncomfortable, based on these data. These negative feelings can manifest as eye strain, agitation, and fatigue (Evans et al., 2010). Based on generally positive responses to the other LED replacement options (3000K and 5000K), it may be possible to expand the color temperatures of light used in senior living environments. Many

senior living facilities are illuminated with warm CCTs, such as 2700K, as it is similar to incandescent light that older adults are familiar with (Sinoo et al., 2011). While responses were more positive in this survey to the familiar 2700K light, participants still thought 3000K and

5000K were good options.

Chapter 6: Conclusion

Overall, these data support the important relationship of adequate lighting to the successful functioning of older adults. Many participants commented in each session’s interviews that the lighting did, or did not, support their ability to read or write. Since participants were completing close-up work through answering the paper survey, their functional ability to read and write without strain was important. Only session 3 (4000K LED) received remarks about the lighting hindering functional ability because of the shadows that were cast on the table and an increased perception of glare. Older adults need more support from their environment to function normally. These data indicate the value of adequate lighting to this cohort.

Older adults want their spaces to be bright. Brightness, in this research, was a positive feature and one that some participants specifically mentioned as relating to personal importance.

As participant reports of “bright” were frequently paired with “no glare” and “too bright” with

“glare,” designers must work towards establishing more appropriate light levels and fixture selections across senior living and LTC. As reported (Ancoli-Israel et al., 1997; De Lepeleire et al., 2007; Hegde & Rhodes, 2010; Sinoo et al., 2011), many senior living and LTC environments are hurt by below standard light levels, especially when increased brightness needs are considered. This research indicates that while brightness perceptions are subjective to the individual, brightness is something that helps establish a functional and supportive interior for older adults.

Participant discussion on perceptions of glare indicate that down-lights are not appropriate for older adults. At Ohio Living Westminster-Thurber, all of the lighting in

community spaces are down-lights: both recessed can fixtures and fluorescent tubes. Down- lighting, as used throughout this senior living community, direct most of their produced light downwards, which can result in perception of glare, especially when the fixtures are not equipped with reflector lenses or filters that soften the light distribution. “Bright looking up” was a common discussion in the interviews, where participants were recognizing the intensity of the

LED light and its downward direction.

The use of recessed fixtures can also result in uneven light distribution if they are not appropriately spaced. Spacing is also significant when switching from a CFL to LED replacement. As seen in Figure 19, because LED lamps only direct light downward and do not produce light around the sides like CFL, its distribution takes on a cone shape. When the ceiling level is lower (8’ in Figure 19) and when fixtures are located close to walls, the bright spots and shadows resulting from the way light is produced becomes more apparent. In these interviews, older adults noticed the change is light distribution and remarked on shadows and uneven light distribution. The discomfort noted with these observations signals a need to create a much more even distribution of light, without using down-lights, in senior living facilities.

Survey results and interviews also indicate that designers could begin to utilize cooler color temperatures of light than the typical 2700K (Sinoo et al., 2011). While the familiar 2700K

CFL light received the highest positive responses in the survey, positive feelings were discussed in interviews more for the 3000K and 5000K LEDs. While solving for direct glare and brightness problems that arose with the LED replacement lamps, senior living facilities could see benefits by having brighter, cooler light. The 4000K LED light was not a positive solution in this research. Participants expressed more feelings of glare and too much brightness, and much more

of the discussion was around negative qualities of the light, which is not the pattern of discussion seen in the other three sessions.

These data also show that when older adults are provided adequate and appropriate lighting, as with the 2700K CFL, 3000K LED, and 5000K LED, their experiences are varied. It was easy for the older adults to identify pain points, such as glare, uneven light, and brightness when looking up. However, on the positive spectrum of responses, there was great variety amongst feelings elicited from the space and the lighting. Responses certainly begin to indicate favorability or positive emotions, as seen in Figure 17, but when the category of “positive feelings” or “negative feelings” is broken into individual codes, participant responses and selected comments varied.

Limitations

This research was limited by a small sample size at a single senior living facility in

Columbus, OH. With 17 participants, this research is not meant to signify a change in design process or standards currently used within lighting design and interior design. There was no statistical significance found in the quantitative data, so discussed data represents trends and connections found in the limited results. However, the research discussed in this thesis represents a successful exploration into the methods and procedure. The interview components of each session, while guided by established questions, were conversational, so there was less control between each participant and each session’s discussions. From the conversational atmosphere, some questions may have led the participants to certain responses.

Using the facility’s existing fixtures also posed a limitation in LED replacement options and light distribution. As discussed, down lighting is not optimal for older adults as it creates bright spots at the source and can induce glare and resulting eye strain and discomforts, which

also served as a limitation since it was a condition with which this research was constrained to.

This research was also constrained to one environment within the senior living facility. Results could differ in other community spaces with different functional purposes (such as the library or art room) or in areas with different décor and color schemes.

Future Work

This thesis served as exploratory research into the effects of correlated color temperature on older adults and acts as rationale for future research in this area. Future works can evaluate whether seasons affect responses. It would also be worthy to explore the same process with different light fixtures, such as indirect fixtures, to produce a softer and more even light distribution, potentially eliminating a large portion of comments that arose in this research.

Understanding the potential for behavioral changes based on light’s color temperature could also be examined in a study with a much longer time frame where activity levels and locations could be tracked.

Looking towards future lighting technologies, an examination in a similar procedure as this research at senior living facilities could explore the benefits of tunable lamps, which allow for CCT adjustments to be made throughout a day. Tunable lamps have the ability to mimic the natural color temperature changes that occur as the rises, peaks, and sets. With this technology, there is potential to help not only circadian rhythm issues that arise in healthcare facilities for patients and staff, but there is also opportunity to explore if this lighting can offset sun-downing often experienced by older adults.

Another phase of this research method could be applied to understanding what Baby

Boomers, the incoming aging population, desire from lighting quality, functionality, and color temperature. While my thesis focused on improving light or the current aged population, there is

expected to be a large growth in senior living development in preparation for the aging Baby

Boomers. Knowing this populations desires ahead of development will help Boomers have a more satisfying and supportive senior living experience from the start.

This exploratory research serves as a basis for these future research endeavors. Lighting for older adults is a research area with many intricacies and considerations. With longer timelines, learnings from this thesis research can improve future research conditions and methods. Lighting for older adults has many implications as both functioning and emotional states can be impacted. With continued research, designers can further improve quality of life for older adults through interior design and lighting.

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Appendix A: MatLab Code

%Tool for generating tone-map to RGB color space of HDR file clc; clear; %close all; imdir = 'img/'; fdir = dir([imdir,'*.hdr']); %refers to file HDRs are stored i = 14; %file number to process hdr1 = hdrread([imdir,fdir(i).name]); rgb1 = tonemap(hdr1, 'AdjustLightness', [0.001 1],'AdjustSaturation', 1.0,... 'NumberOfTiles',[4 6]); %4 and 5k use 1.5 sat, 27 uses 1.0 and 3k uses 1.3 figure(1); clf; set(gcf,'Color',repmat(.25,1,3)); image(rgb1); axis('image','off'); saveas(gcf,'FileName.jpg');

Figure 22: MatLab Code for HDR tonemap

Appendix B: Room Images

Figure 23: 2700K CFL Corner 1

Figure 24: 2700K CFL Corner 2

Figure 25: 2700K CFL Corner 3

Figure 26: 2700K CFL Corner 4

Figure 27: 3000K CFL Corner 1

Figure 28: 3000K CFL Corner 2

Figure 29: 3000K CFL Corner 3

Figure 30: 3000K CFL Corner 4

Figure 31: 4000K CFL Corner 1

Figure 32: 4000K CFL Corner 2

Figure 33: 4000K CFL Corner 3

Figure 34: 4000K CFL Corner 4

Figure 35: 5000K CFL Corner 1

Figure 36: 5000K CFL Corner 2

Figure 37: 5000K CFL Corner 3

Figure 38: 5000K CFL Corner 4

Appendix C: Lamp Specification Sheets

Figure 39: Feit Electric Lamp Specification

Figure 40: Sylvania Lamp Specification

Figure 40 Continued

Appendix D: Foot Candle Measurements

100

14 20 24 18 17

20 22 25 22 19

30 26 24 21 16

27 24 23 21 17

21 19 20 18 12

Foot Candle Measurements

0-20 21-40 41-60 61-80 81-100 101-120 121-140 141-160 161+

Figure 41: Session 1 Horizontal Foot Candle Measurements

101

17 17 17 12 9

11 11 12 10 5

8 9 9 7 6

7 20 17 20 8

5 11 11 12 8

5 8 8 8 5

Figure 42: Session 1 Vertical Foot Candle Measurements

102

Figure 42 Continued

9 12 13 13 13

8 10 11 10 10

7 8 7 7 9

8 11 13 14 17

7 9 10 12 11

6 8 8 9 8

103

6 38 89 109 10

16 33 22 36 11

138 57 43 61 16

118 61 72 73 17

84 65 62 67 21

Foot Candle Measurements

0-20 21-40 41-60 61-80 81-100 101-120 121-140 141-160 161+

Figure 43: Session 2 Horizontal Foot Candle Measurements

104

18 11 89 7 4

22 24 19 8 4

13 9 10 12 4

5 11 15 38 6

4 13 28 24 7

4 11 15 13 6

Figure 44: Session 2 Vertical Foot Candle Measurements

105

Figure 44 Continued

4 7 9 9 8

6 8 8 9 7

5 7 8 8 7

6 23 10 11 21

9 15 14 15 21

7 10 11 12 20

106

7 30 72 144 9

16 34 25 37 10

155 57 43 62 20

138 56 56 63 17

120 46 59 74 26

Foot Candle Measurements

0-20 21-40 41-60 61-80 81-100 101-120 121-140 141-160 161+

Figure 45: Session 3 Horizontal Foot Candle Measurements

107

18 92 74 7 4

22 31 14 8 4

18 21 13 7 4

5 11 14 61 6

4 11 19 28 6

4 9 19 15 5

Figure 46: Session 3 Vertical Foot Candle Measurements

108

Figure 46 Continued

4 7 9 9 10

5 7 8 9 7

6 22 10 16 27

5 25 11 16 31

7 13 9 12 26

109

7 33 41 109 12

19 39 29 36 13

151 50 38 63 21

148 46 52 58 28

67 48 42 66 26

Foot Candle Measurements

0-20 21-40 41-60 61-80 81-100 101-120 121-140 141-160 161+

Figure 47: Session 4 Horizontal Foot Candle Measurements

110

13 87 77 9 4

12 16 26 13 5

22 21 22 16 6

4 11 12 35 6

5 16 18 32 6

6 17 19 13 6

Figure 48: Session 4 Vertical Foot Candle Measurements

111

Figure 48 Continued

4 7 9 9 9

5 7 8 9 9

6 7 8 10 11

7 27 8 14 21

6 14 9 11 21

6 13 9 13 17

112

Appendix E: Participant Demographics and Community Space Visits

Participant ID Number: ______Session #: 1

General Questions

Please answer the following demographic questions:

1. What is your age? 55-60 61-65 66-70 71-75 76-80 81-85 86-90 91-95 96+

2. Gender: Male Female Other

3. How many years have you lived at Westminster Thurber? Less than 1 1-3 3-5 More than 5

Figure 49: Demographics Questions

113

Participant ID Number: ______Session #: 1 4. For the following community spaces, in the past week how frequently did you visit them and how long did you stay overall?

Library ______times in week ______hours overall

Gym ______times in week ______hours overall

Pool ______times in week ______hours overall

Art Room ______times in week ______hours overall

Thurber Tower ______times in week ______hours overall Computer Room

Main Lobby ______times in week ______hours overall

Thurber Tower ______times in week ______hours overall Shuffeboard/Puzzle Area Thurber Tower ______times in week ______hours overall Community Room Goodale Landing ______times in week ______hours overall Community Room

Chapel/Auditorium ______times in week ______hours overall

Fireside Lounge ______times in week ______hours overall

______times in week ______hours overall

Figure 50: Survey of Community Space Visits

Community Room Times Visited Per Week Hours Spent Overall Library 20 10.05 Gym 21 25.5 Pool 1 2 Art Room 5 6 TT Computer Room 5 4.5 Main Lobby 22 12.25 TT Shuffle Board/Puzzles 20 16.25 TT Community Room 20 22.5 GL Community Room 12 17 Chapel/Auditorium 19 35.5 Fireside Lounge 17 8 Bistro 5 3.5 TT Laundry 2 2.5 Crossings Dining 15 19 Table 7: Participant Visits to Community Spaces

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Appendix F: Survey Questions

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Participant ID Number: ______Session #: ___ Part 2: Participant Response

Observing the room we are currently in, please rank how you feel on the following scales. Indicate your answer by circling or marking in the appropriate box

This room feels:

Somewhat Somewhat 1. Stimulating Neither/Neutral Calming Stimulating Calming

Somewhat Somewhat 2. Inviting Neither/Neutral Unappealing Inviting Unappealing

Somewhat Somewhat 3. Bright Neither/Neutral Dark Bright Dark

Somewhat Somewhat 4. Vibrant Neither/Neutral Washed Out Vibrant Washed Out

This lighting feels:

5. Warm Neutral Cool

6. Too Dark Just Right Too Bright

7. Glaring Non-Glaring

8. Excessive Appropriate Inadequate

Figure 51: Survey Questions

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Figure 51 Continued

Participant ID Number: ______Session #: ___

In this room, I feel: Somewhat Somewhat 9. Calm Neither/Neutral Anxious Calm Anxious

Somewhat Somewhat 10. Relaxed Neither/Neutral Energized Relaxed Energized

Somewhat Somewhat 11. Safe Neither/Neutral At Risk Safe At Risk

Somewhat Somewhat 12. Alert Neither/Neutral Peaceful Alert Peaceful

How do you feel in this room? (write in below) 13.

117 Participant ID Number: ______Session #: ___

Part 1: Researcher Notes

Thinking of three light levels - Bright, Average, and Dim - what activities do you like to do with that level of light? (i.e. reading, sewing, eating, watching tv):

Bright:

Average:

Dim:

What type of activities (i.e. reading, sewing, eating, watching tv) do you like to do under the following light conditions: Overhead (Ambient):

Task:

Decorative (indirect):

Participant ID Number: ______Session #: ___

Part 3: Researcher Notes

While being in this room, with this type of lighting, is there anything else you would like to share about the lighting experience?

Figure 52: Interview Questions

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Appendix G: Positive and Negative Qualitative Code Distributions

Figure 53: Session 1 Positive and Negative Qualitative Code Distribution

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Figure 54: Session 2 Positive and Negative Qualitative Code Distribution

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Figure 55:Session 3 Positive and Negative Qualitative Code Distribution

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Figure 56: Session 4 Positive and Negative Qualitative Code Distribution

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