A patient approach

Taking the decision to entrust the care of an elderly relative to a nursing home is often difficult and traumatic, especially if that vulnerable relative also has dementia. In that situation, families are keen to find an environment that will provide a comfortable home for the loved one, where they can feel safe and secure.

Inevitably, however, a high standard of care often incurs considerable costs, not only in the provision of expert nursing, but also in maintaining the fabric of the building and answering the running costs of a 24/7 operation.

“The cost of care is an issue for both families who pay for their relatives’ care and the local authorities who run care homes,” explains Peter Udall, head of design services at Gateshead Council.

“Ensuring our care homes are as energy-efficient as possible is one tangible way in which we can reduce costs, so we are always looking for ways in which we can achieve this, while maintaining a high standard of care.”

Energy-efficient comfort

At Shadon House, a nursing home for elderly people with advanced dementia run by Gateshead Council, refurbishment offered an ideal opportunity to build energy efficiency into the design of the electrical services.

“We had two major concerns when looking at the design of the electrical fit-out,” continues Udall. “The first was how we could make the building more energy-efficient than before, to help us reduce the building’s energy bills. The second, equally important, consideration, was how we could use the opportunity of new electrical services to enhance patient care and make Shadon House a more comfortable environment for residents.”

Originally purpose-built as a nursing home in the 1930s, Shadon House is largely a single-storey building. The layout is based on a series of corridors with residents’ rooms to either side, each of which consists of a bedroom/sitting room with its own ensuite bathroom.

There are also assisted bathrooms and visitor cloakrooms, a dining hall, communal sitting rooms, a kitchen, staffroom and administration areas.

Because all the residents suffer from dementia, many are disoriented and have difficulty with things like locating the bathroom at night or even identifying the light switch in their room.

“For some residents, the ideal solution would be to leave a light on in their room every night,” says Udall. “But in addition to wasting electricity, this would be a completely impractical way to address the problem as it would disturb other residents.

“Instead, what we decided to do was install a lighting control system that would ensure lights came on when and where they were needed – but only when and where they were needed. We also wanted something that would interface with other patient care and security services so that we could integrate the lighting control system with other services to enhance the level of patient care and overall safety.”

Flexible controls

Gateshead Council’s in-house contracting services, LES, installed Electrak buscom trunking throughout the building in the loft space. Buscom is a busbar hybrid that was developed to meet the increasing need for prefabrication and flexibility by using overhead power and control distribution systems.

As well as supplying power, it also supplies signal bus distribution by means of its integral, twisted-pair communication control circuit. This solution combines with the Lightrak lighting control system, which was used to control all the lights throughout the corridors, residents’ rooms, communal areas and staff areas.

“The Lightrak system was fast and cost-effective to install,” explains Udall. “The plug-and-play system means that it will be easy for us to make changes or add new elements if the needs of Shadon House change. Because the system uses KNX, a protocol recognised across Europe, the control system can be integrated with any other KNX building control product, which meant that we could use lighting controls to complement other patient care systems.”

Movement detectors in all residents’ rooms ensure that the lights come on automatically in the ensuite bathrooms, if the patient gets out of bed during the night, and the system also controls the extractor fan in the bathroom.

Meanwhile, in an effort to ensure lights are never left on unnecessarily in the assisted bathrooms and communal toilets, presence detectors have been fitted in these areas to switch lights on automatically when someone enters, and to switch them off again when they leave.

These lighting controls are used alongside manual switching, but attention to detail here is also helping to save energy at Shadon House too.

“We specified large plate switches moulded in green plastic, as green is a colour easily recognised by dementia patients,” explains Udall. “The idea was that this would encourage residents to use the switches, which are positioned by the door and by the bed in each room, so that they could retain some independent choice in the use of electric light, alongside the lighting control systems.”

In the communal lounges, scene-setting switches have allowed further energy savings, while external lights are controlled with both a light sensor and a timer. This combination of lighting controls ensures that the exterior lights come on automatically when it gets dark but are switched off automatically at the same time every night, preventing the nursing home from wasting energy by leaving them on all night.

An integrated solution

Being able to keep corridor lights switched off at night was another important element in making Shadon House as energy-efficient as possible.

“Keeping the corridor lights switched to a night light setting not only saves energy but prevents residents from being disturbed by the light when they are trying to sleep,” says Udall.

However, in an environment like Shadon House, where residents’ care needs can be acute, it is important for staff to be able to reach patients quickly if they need help. Interfacing the Lightrak lighting control system with the nurse-call system was the ideal way to get the best of both worlds on this issue, and thanks to the Electrak system’s interoperability, this was easy to achieve.”

The interface between the lighting control system and the nurse-call system at Shadon House means that appropriate lighting is automatically switched on when the nurse-call alarm is activated. When the nurse call is pressed, only the lights between the specific resident’s room and the administrative area are lit. This helps to identify where the distress call has come from, as well as lighting the way to the relevant room.

The interface with the fire alarm system has also been designed to enhance patient safety without disturbing any residents who are not affected. If the fire alarm is triggered, the lighting controls switch on the lights in the administrative and corridor areas so that staff can respond quickly.

However, waking all the residents at once by switching on the lights in their rooms in the middle of the night would not only disorient and upset them but could also prove too difficult to manage for staff. Instead, staff will be able to respond quickly to the potential risk of fire and wake residents if necessary in a controlled and sensitive manner.

Caring for the future

“The main advantage of the lighting control system for us is that it allows us to manage the energy consumption at Shadon House while offering the elderly residents in our care a lighting system that is tailored to their needs,” concludes Udall.

“The integration with the nurse call and fire alarm systems provides additional functionality that enhances patient safety and, because the system is fully programmable, we have the peace of mind that comes with knowing that the system can adapt with us, should our needs change.”