Providing Optimal Resident Sleep Hygiene in Assisted Living Communities; Opportunities for Design and Operation Teams to Collaborate and Share Their Unique Knowledge

Authors

Beverly BJ Miller, University of Nebraska-LincolnFollow

First Advisor

Lindsey Bahe

Second Advisor

Christopher M. Kelly

Date of this Version

12-2023

Document Type

Article

Citation

A thesis presented to the faculty of the Graduate College at the University of Nebraska in partial fulfillment of requirements for the degree of Master of Science

Major: Architecture

Under the Supervision of Professor Lindsey Bahe and Christopher M. Kelly

Lincoln, Nebraska, December 2023

Comments

Copyright 2023, BJ Miller

Abstract

Research is emerging relating sleep hygiene to disease pathogenesis including Parkinson's, dementia, Alzheimer’s disease and increased cardiovascular risk. The application of circadian science as it relates to human wellness has intensified as a result. The quality of sleep significantly impacts the wellness of residents living in long term care, however sleep hygiene research is lacking in assisted living (AL) communities.

The thesis question inquires; How can operation and design teams collaborate to optimize sleep health for residents in assisted living communities? The research methodology utilized a two-phase process. Phase I identified three AL communities as test sites, providing case studies and cross-analysis of each site’s circadian related design and operation procedures. Phase II surveyed both teams of each community to gauge each discipline’s understanding of sleep hygiene and interventions to promote optimal circadian entrainment.

LED lighting systems that mimic the solar cycle are in use by design teams in AL settings, as a therapeutic modality. The research results reveal a higher level of training in circadian science recorded by the design teams, yet the collaboration between the teams occurred primarily during the Program Phase of the project with little involvement of front-line operation teams. As buildings became operational, design teams exited the project decreasing collaborative opportunity.

The operation teams’ response revealed poor sleep contributing to undesirable behavior, but they were less aware of circadian interventions. Of the four circadian lighting interventions (spectrum, timing, duration, photic history), design professionals have more control over the spectrum and timing categories, based on the specification and location of lighting, but the operation team impacts resident exposure to light and dark, and the 24-hour photic history of the residents. This dual responsibility for geriatric sleep health necessitates the two teams’ collaboration. Enhancing sleep hygiene awareness has the potential to better resident quality of life leading to longer stays, fewer hospital transfers, and reduced stress on the care providers.

Advisors: Lindsey Bahe and Christopher M. Kelly