AG Architecture is synonymous with senior living architecture nationwide. I have been fortunate to spend over twenty years working to evolve and improve that product. When you work primarily in a specialty field, it is a good idea now and then, to step back and examine the path that has led us to our successes and evaluate areas for improvement. One topic that lends itself to periodic review is building lighting, specifically in resident rooms.

The word evolution usually refers to a slow gradual change. Our industry is experiencing more of a jolt when it comes to the process of delivering a successful building and all the new technologies and products available. End-user expectations have increased, owner timetables shortened, budgets are tighter and regulations are significantly increasing. What worked yesterday likely needs to change for today, if it can be repeated at all.

A prime example of this is light fixture selection for skilled nursing rooms. Today this building type emulates a typical home environment more than ever. This is a huge departure from the institutional roots when nursing homes were part of a hospital environment where the infirmed were housed, essentially waiting to die. Greater dignity, care and meaningful existence is provided to skilled residents in current models. To do this, the built environment around residents mimics the home that they spent their lives in, as much as possible. This can put some of the old, throw-back thinking in conflict with the creation of “home”.

Newer designs include dedicated exam rooms where medical staff can meet with and provide diagnostics and treatment. In the hospital line of thinking this was done in patient beds. Regulations still exist in many health codes requiring extremely high light levels over the bed. Additional task or reading lights are also required for both staff and resident use. When lying in bed, no one wants to stare up into a blindingly bright light fixture, so other light sources are required for general, daily use.

In the past, a wall mounted bed-light providing soft indirect light off the ceiling and a downward reading light satisfied many of these goals, while office-like, recessed ceiling fixtures provided the intensity.  Those fixtures and ceiling treatments have fallen out of favor with interior designers. A more decorative style with frosted glass feels more appropriate for a bedroom setting, however they do not supply nearly the minimum code required light levels. A good choice to satisfy these requirements is the Serenity light fixture series from Visa Lighting. They offer an attractive fixture with numerous finish options that provide comfortable ambient, high intensity exam and even low amber night lighting all in one fixture housing. There are recessed or surface mounted options for installation in 2’x2’, 1’x4’ or 2’x4’ sizes.

Another difficulty with skilled nursing is that it is often being constructed more like a house. A cost saving feature attaches the finished drywall ceiling of the resident room directly to the structure. This eliminates a lower dropped ceiling that conveniently allowed for HVAC, wiring and lights to be installed without penetrating the fire-rated roof-ceiling assembly. This can complicate placement of recessed light fixtures directly over the bed surface due to location and direction of structural members. This presents the dilemma of installing numerous recessed downlights throughout the room or fewer fixtures designed for “patient room” use.  Electrician labor, fire-rated tenting of lights and design aesthetic must be included with light fixture cost to determine the best approach.

Regardless of the approach taken, it is wise to have a discussion with the owner, interior designer and code officials prior to construction to ensure all requirements and expectations are met. There are a multitude of light fixture manufacturers to choose from for this application, but for more information on the Serenity lights from Visa Lighting, visit