The award-winning Life Quality program was Hearthstone's original innovation. Opened in 1993 the Life Quality program provides research-based treatment for dementia in a completely residential assisted-living setting. The Life Quality Program uses environmental design, specially trained staff, and a well-structured program of meaningful activities to promote well being and reduce symptoms common to mid-stage dementia.

Defining "Mid-Stage" Many people go through similar changes as their brain is damaged by Alzheimer's or one of the related diseases. A person who might be considered to be in the middle stage, and thus appropriate for the Life Quality Treatment Program, would typically have the following characteristics:

• Able to walk unassisted, unless other medical conditions cause a mobility problem
• Able to eat independently, though may have difficulty dealing with utensils or new foods
• Usually incontinent, first at night, but increasingly during the day unless supported
   with reminders
• Can understand and speak, but has increasing difficulty with word finding and may
   produce the same few familiar sentences.
• No longer able to carry on lengthy conversations
• Very poor short-term memory, nearly normal long-term memory, but may have lapses
   in remembering names of family members and other long-known information
• If not in a supportive treatment environment such as Hearthstone, may experience   agitation, "sundowning" and wandering behaviors

Treatment for People with Mid-Stage Dementia The Life Quality Program uses several treatment modalities that improve function and reduce symptoms for this group.

• A social setting that reinforces appropriate behavior
• Continuous monitoring and a secure environment to promote safety
• Structured, modified activities of daily living and meaningful recreational activities to   maintain maximum function
• Opportunities to interact with the wider community and religion to promote self-acceptance
• Naturally mapped environment to reduce confusion and increase sense of competence
• Familiar, residential characteristics to strengthen the sense of self
• Well-trained staff who maintain positive emotions and increase cognitive function
   throughout the day
• Conscientious nursing oversight to reduce medical problems
• Family support to enrich relations between residents, family and friends
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