Shedding Light on Falls: The Effect of Lighting Levels on Fall Risk in Long-Term Residential Care Facilities

To compare lighting levels in care facilities with local recommendations and determine their cross-sectional association with fall rate, we recruited residents (n = 126) from 12 long-term care facilities (mean ± SD age 85.1 ± 7.9 years; 64.3% female). Lighting levels were measured at different times in various areas within facilities, according to each resident's movements and habitual use of light. Lighting fell short of focused activity recommendations in 57.7% of bedrooms and 68.5% of bathrooms (bathing and toileting areas); 22.8% and 41.9%, respectively, were also below general activity recommendations. Lower bedroom and overall lighting correlated with higher fall rates (all p < .05). Covariate-adjusted negative binomial models showed lighting in dining rooms (incidence rate ratio [IRR] = 0.92 (95% CI 0.87-0.98; p = .005) for 100 lux increase), bathrooms (IRR = 0.87 [0.78-0.98]; p = .016), and overall (IRR = 0.91 [0.83-1.00]; p = .03-.04) predicted lower fall rates. Areas used by care facility residents commonly have lower than recommended lighting levels, which increases fall risk.