ABSTRACT
Lack of engagement has detrimental effects on the quality of life of residents, especially those with dementia. Yet the level of engagement of individuals in memory care units that had implemented the Pearls of Life® program (US program) had not been determined. Seventy-four residents of 13 skilled nursing and assisted living facilities were observed for 10 minutes during five planned activities to describe engagement levels and determine factors influencing engagement. Participants were engaged only about 50% of the time. Total engagement time was significantly associated with the number of engagement strategies used. There were several differences in the use of select strategies for the setting. The evaluation served as the basis for program refinement.