A personalised lighting and health intervention technology to deliver improved wellbeing for people living with dementia in care homes

Living with dementia can have an impact on mental health and wellbeing. There are associated behavioural and psychological symptoms which present throughout the day and can negatively affect quality of life. Commonly discernible within these symptoms are poor sleep quality, agitation, low mood and fluctuating rest-activity patterns; all of which can be managed by supporting the body’s circadian rhythm.

The circadian rhythm is controlled through lighting cues, whereby light is the stimulus which instructs the main body clock and its peripheral clocks to initiate functions such as hormone balance, body temperature and metabolism. In turn, coordinating these functions can influence the severity of dementia symptoms and can be used as an aid to wellbeing. Daylight is accepted as the best resource for harmonising our circadian rhythms with our evolutionary needs. Since humans spend around 90% of their time indoors, this daylight needs to be made available indoors. One way to achieve this is through the use of circadian lighting; light which is diurnally dynamic and resembles the sun.

Monitoring the impact of aligning a person’s circadian rhythm can be achieved by implementing digital technologies. However within dementia cohorts, additional symptoms such as cognitive decline may make this difficult to implement using wearable technologies. In this work, environmental radar sensors are integrated within luminaire fittings in order to monitor the symptoms which can be directly influenced by a changing circadian rhythm. Of particular focus is the rest-activity patterns and sleep-wake cycles. This work is currently being implemented as part of a trial in a care home in Belfast.

The luminaires and sensors are connected in an Internet of Things centred around an intelligent backend behavioural logic. This logic reads sensor data and applies algorithms which deliver activity and sleep-wake metrics with the use of dementia activity domain knowledge. An assessment of the changes in activity can then be used to better inform the circadian lighting on an individual basis. If required, this occurs via modifications to the timings, durations, colour temperature and intensities, in order to phase-shift sleep and encourage fewer bouts of high activity in the evening before bed (sundowning). This data is presented on a group and individual basis in order to further explore the relationship between dementia, lighting and circadian rhythms. These conclusions can then inform the best default lighting for supporting the wellbeing of future residents with dementia.

In summary, a more aligned circadian rhythm for people living with dementia can improve the severity of some of the most common symptoms. Therefore, both the information and actuation provided by this digital health intervention can support the wellbeing of people who are living with dementia. In turn, this can improve their quality of life and also offer some relief on the pressures faced by traditional healthcare services today.