New Study Reveals Important Insights About Social Engagement in Dementia Care

In the evolving landscape of senior care, understanding and promoting social engagement among residents with dementia remains a critical challenge. A new study published in the Journal of the American Medical Directors Association (JAMDA) has revealed promising new methods to objectively measure social engagement using real-time location systems (RTLS) technology.

The research, using information provided by Tenera Care’s solution for senior living communities, was conducted at Toronto Rehabilitation Institute's specialized dementia unit by Dr. Andrea Iaboni, Geriatric Psychiatrist and Medical Lead, Seniors Mental Health, at the University Health Network along with many of her research colleagues. The study demonstrates how Tenera Care's location tracking technology can provide valuable insights into social behavior patterns of residents, potentially transforming how we assess and support social engagement in care settings.

Understanding the Importance of Social Engagement

Social engagement—the level of involvement and quality of interaction in social activities—plays a crucial role in the quality of life and psychological wellbeing of residents with dementia. The study notes that it “describes an individual's level of involvement and quality of interaction in social activities with others and plays an important role in shaping the quality of life and psychological health of nursing home residents.” 

Previous research has established that higher levels of social engagement among people with dementia are associated with:

  • Increased happiness and quality of life

  • Reduced boredom and fewer behavioral symptoms

  • Better overall health outcomes

Conversely, low social engagement correlates with deterioration in physical abilities and worsening depressive symptoms. Despite its importance, measuring social engagement objectively has been challenging, with most assessment tools relying on subjective observations.

A New Approach to Measuring Social Connection

The study followed 37 patients in a short-stay specialized dementia unit where residents were being treated for behavioral and psychological symptoms. Participants wore Tenera Care's wrist-worn devices that used ultra-wideband (UWB) technology to track their locations throughout the unit with chair-level precision.

Researchers then extracted and analyzed multiple digital markers from the location data, including:

  1. Location-based features: Time spent in different areas (private rooms, hallways, dining/activity areas, lounges)

  2. Contact-based features: Number and duration of social contacts with other residents

  3. Activity levels: Distance traveled and time in motion

  4. Social Network Analysis (SNA): Complex metrics like degree centrality, closeness centrality, and PageRank scores

These digital markers were compared with weekly assessments using the Revised Index of Social Engagement (RISE), a common clinical tool for measuring social engagement.

Digital Markers That Matter

The study identified seven digital markers that showed statistically significant correlations with social engagement scores over time:

  1. Time spent in the dining hall: More time in the dining/activity area correlated with higher social engagement

  2. Time without co-patient contact: Less time spent alone was associated with higher engagement

  3. Time in contact with 2-3 other participants: More time spent with small groups showed strong positive correlation

  4. Number of longer social contacts: More interactions lasting over 5 minutes indicated higher engagement

  5. Social network metrics: Higher closeness centrality and PageRank scores strongly correlated with better social engagement

PageRank—a metric originally developed for Google's search algorithm—emerged as the strongest predictor of social engagement. In the context of a care environment, PageRank helps identify residents who were connected to other highly "connected" individuals, essentially measuring their position within the social fabric of the community.

Practical Implications for Senior Care Providers

For care facility managers and owners, this research opens exciting possibilities:

1. Objective Assessment of Social Wellbeing

Tenera Care’s technology offers a way to continuously and objectively monitor social engagement patterns without relying solely on staff observations. This could be particularly valuable for residents with advanced dementia who may have difficulty self-reporting their experiences.

2. Early Identification of Social Isolation

The ability to detect decreases in social engagement could allow for earlier intervention for residents showing signs of social withdrawal, which may be an indicator of depression or other health concerns.

3. Evaluating Activity Programming Effectiveness

Digital markers can help measure the impact of different activities and interventions on social engagement, enabling evidence-based decisions about which programs best support residents' social wellbeing.

4. Environmental Design Insights

The study found that different common areas had varying impacts on social engagement. The dining/activity room promoted social interaction, while the lounge area (with a TV) did not significantly contribute to measured social engagement. These insights could inform future design decisions to create more socially supportive environments.

5. Personalized Care Approaches

Understanding individual patterns of social interaction could help tailor care plans to each resident's social preferences and needs, potentially improving quality of life and reducing behavioral symptoms.

Better Care Through Data

This innovative study demonstrates how Tenera Care's RTLS technology can go beyond traditional safety applications to provide meaningful insights into the social lives of residents. As the study concludes, Tenera’s solution can “yield valuable insights into residents’ social interactions and activities by tracking where they spend their time and with whom they interact.” By objectively measuring various aspects of social engagement, care providers gain valuable tools to assess, monitor, and enhance the social environment of their communities. 

As the senior living industry continues to face staffing challenges and increasing demands for person-centered care, technology-enabled approaches like this represent a promising opportunity to better understand and support residents' social needs. The digital markers identified in this research could eventually become standard quality indicators for social care, helping facilities demonstrate their commitment to supporting not just the physical health, but also the social wellbeing of their residents.

For senior living operators looking to enhance their approach to social engagement, these findings suggest that investing in location-tracking technology may offer benefits that extend well beyond the original security and operational applications, ultimately contributing to a higher quality of life for residents with dementia.

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