Loneliness and isolation have long proven to cause health implications among the elderly — especially if they’re showing signs of memory loss or dementia.
In senior housing, this can be even more of a challenge, particularly when the line between assisted living and memory care becomes blurred.
Sunrise Senior Living has taken on the challenge of catering to these residents in transition, who may need some additional support, but don’t yet need to move into memory care.
Terrace Club, a Sunrise reminiscence program, is designed specifically for residents who are experiencing the early stages of memory loss. It takes on two forms: In about 20 communities, it’s a full-fledged neighborhood, and in about 25 communities, it’s a day program.
“The real goal of the programming in Terrace Club and the highest priority is creating a sense of belonging so people feel safe socially and can continue to express themselves,” says Eric Portnoff, Sunrise regional director of memory care for the West Division. “Oftentimes people start worrying about others noticing that they’re losing short-term memory, so they have a tendency to retreat.”
As research suggests, both social isolation and loneliness are associated with increased mortality. In fact, a 2013 study shows that those over age 52 who were socially isolated were 26% more likely to die during the study period (2004-2012) than those who led the most active social lives, even after controlling for age and illness.
Terrace Club, in both of its forms, is meant to prevent that.
“The most important part is the social environment — to not isolate. When people isolate, that’s when they tend to decline more quickly,” Portnoff says.
The Neighborhood Approach
Several years ago, Sunrise developed the Terrace Club Neighborhood at select communities to create a comfortable transition between assisted living and its Reminiscence (memory care) Neighborhood.
“The intent is to provide a more intimate environment — a place for residents to go to activities together that’s not as big or overwhelming as assisted living can be for people experiencing memory loss,” Portnoff says. “But they’re not secured, and that’s one of the differences between Terrace Club and the Reminiscence Neighborhood.”
In the Terrace Club Neighborhood, residents benefit from more structured days, and receive guidance and gentle reminders as needed. Staff members focus on strategies that preserve and enhance residents’ sense of identity and self-esteem, while respecting their ability to socialize and manage activities of daily living on their own.
The neighborhood provides both a secure environment and structured programming that supports residents as their memory starts to decline, a strong focus for the operator.
“Sunrise has always wanted to provide the right kind of programming for residents, regardless of where they are in their form of dementia or in the aging process. Our communities have different neighborhoods that are designed for different stages of that journey,” Portnoff says.
The Day Program
The Terrace Club Day Program is designed for communities that don’t have a purpose-built neighborhood, but have residents who need extra programming and support.
“Three to four years ago, Sunrise started to realize the demographics of the industry changing, with more residents in assisted living having early stages of dementia,” Portnoff says. “We saw a need for more structure and specialized programming, and at that point [we developed] the Terrace Club Day Program.”
Though it wasn’t launched until March 2013, the Day Program is similar to that of the Neighborhood, and has common goals: promote socialization and acceptance among residents, decrease isolation, provide structure and foster cognitive stimulation.
The program typically runs from morning to early afternoon on weekdays and during the afternoon hours on weekends to accommodate residents’ and families’ needs and preferences. A group of six to 12 residents meet and participate in back-to-back programming led by a life enrichment manager — a staff member focused specifically on providing support to residents with memory loss.
“Life enrichment managers encourage people who perhaps were musicians to continue to play their instrument. If they were a teacher, we create a teachers’ club or schedule to have children visit so residents can read to them,” Portnoff says. “The focus isn’t just on activities, but on meeting people’s higher needs of purpose and self-esteem, and [helping them] continue feeling relevant in the world they live in.”
Programming centers around three dimensions: physical well-being, cognitive functioning and spirituality. Examples include exercise classes, brain fitness exercises, and painting and cooking classes.
Both the Day Program and the Neighborhood have improved resident engagement, Portnoff says, noting that those who were beginning to withdraw prior to participating in Terrace Club were becoming more engaged at their communities. And, he says, Sunrise is looking to expand its Day Program into more communities in the future.
“We really try to individualize the support that we offer residents — both in terms of care and programming,” Portnoff says. “Terrace Club is really geared toward engaging residents and giving them a sense of their continued abilities to be successful and important.”
Written by Emily Study
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