Dr. Lydia Nguyen is LifeLoop’s Principal Researcher, leading research initiatives to measure and demonstrate the impact of technology on residents’ wellness.
In senior living, one thing is clear: social connection matters. It shapes how residents feel, how they engage, and ultimately how they live. What has been less clear, until recently, is how to measure that connection in a way that is both meaningful and actionable.
LifeLoop's Wellness Navigator was developed to help meet that need, and a key component of the Wellness Navigator is the Social Engagement Index (SEI). The SEI was developed not as a diagnosis or a replacement for staff insight, but as a rigorously constructed, evidence-informed signal that enables communities to identify where to focus, when to intervene, and how to support residents before isolation takes hold.
The SEI is a composite behavioral index that reflects multiple, distinct dimensions of social engagement:
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Participation in activities
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Time spent engaged
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Frequency of social contact
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Recency of contact
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Visits
Jump to the evidence for each component of the SEI.
Each of these dimensions matters because social engagement is not a single behavior—it is a pattern. And if we reduce something as complex as human connection to one variable, we risk missing the nuance that actually drives well-being. The SEI was intentionally designed to capture that nuance.
We recognize that the SEI represents a new way of attempting to quantify something inherently human and complex. As a result, we believe this process of creating a new index requires transparency not just in how the index is constructed, but in how it is tested, refined, and interpreted over time. The SEI is not positioned as a definitive answer, but as an evolving, evidence-informed tool that we will continue to rigorously evaluate and improve.
Designed for action, not just insight
While attendance tracking is a good starting point, it only provides a snapshot of engagement.
Subtle but meaningful shifts often go unnoticed. A resident who was once highly engaged may begin participating less frequently. Another may continue attending activities but start leaving early. Someone who once received regular visits may go weeks without seeing family.
These are the moments where risk begins to surface. But without visibility into patterns over time, they are easy to miss. By the time disengagement becomes obvious, the opportunity for early, proactive intervention has often already passed.
Part of the challenge is that some of the most important aspects of wellness are inherently subjective. Feelings like loneliness, fulfillment, and belonging play a central role in a resident’s overall well-being, yet they are rarely documented in a structured or consistent way. Staff may sense when something feels off, but without a way to capture and surface those observations, they remain anecdotal and difficult to act on.
Even when data does exist, it is often fragmented or buried. Information lives across systems or within reports that are difficult to synthesize in real time. There is rarely a single, clear view of which residents may be at risk, what has changed, or why it matters. As a result, teams spend more time piecing together information than acting on it.
And perhaps most importantly, awareness alone doesn’t lead to better outcomes. Even when disengagement is identified, the path forward is often unclear. Knowing that a resident isn’t participating doesn’t answer what should happen next. It doesn’t reveal what experiences might resonate, what has worked in the past, or who is best positioned to intervene.
Turning fragmented signals into a holistic view of well-being
The goal of the SEI is not just better measurement, but better care. By surfacing patterns of engagement in real time, we can support earlier intervention, strengthen social connection, and improve daily experience for residents. And ultimately, contribute to a broader shift:
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From reactive care to proactive well-being
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From isolated data points to meaningful insight
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From assumption to evidence
We believe the future of senior living depends on this shift, and we’re committed to building it carefully, rigorously, and transparently.
While many metrics in senior living are retrospective—meaning they tell us what has already happened—the SEI is different. The SEI is designed to be:
Proactive: Identifying risk before it becomes crisis
Dynamic: Reflecting changes over a rolling 7-day window
Actionable: Helping teams prioritize where to intervene
An ongoing commitment to validation
There is growing interest within senior living in quantifying engagement, a positive shift that can demonstrate the immense value of life enrichment. At the same time, measuring something as complex as engagement requires a consistently thoughtful and intentional approach grounded in transparency, context, and methodological rigor. Without this, even well-intentioned measures can oversimplify the reality of engagement or overstate what they can meaningfully tell us about outcomes.
Purpose-built to deliver real value to communities
At LifeLoop, our approach has been consistent: before introducing anything new to the industry, we work closely with our customers to validate that we are asking the right questions and delivering something truly meaningful and valuable. We also recognize that nothing is ever final, and that there is always room to learn, refine, and improve. We put this commitment into practice through a set of guiding principles:
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Be transparent about methodology
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Ground decisions in research evidence
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Test, validate, and iterate over time
Backed by rigorous research standards
This same commitment extends beyond our product development into our broader research efforts. For example, we committed significant time to rigorous research in our operational efficiency and staff satisfaction study with Grace Management, Inc. and our resident length of stay study with New Perspective, and shared both our findings and our methods openly.
Validated through an early adoption program
The SEI is a continuation of that philosophy. From the outset, the SEI has been approached as a research-driven initiative, not a static product. We carried out a thorough early adoption program with five senior living community partners in order to gather real-world use and feedback from corporate and frontline staff to iteratively refine the Wellness Navigator and SEI.
This early adoption program confirmed the SEI’s content and face validity by addressing two key questions: Do the SEI components fully represent the construct of social engagement? And does the SEI score align with how staff perceive resident engagement?
Additionally, survey results from the early adoption program revealed that 100% of communities acted on the SEI for multiple residents (through interventions like check-ins and personal invitations to activities of interest) and 100% of corporate leaders see the SEI as both an engagement tool and a clinical risk indicator. Trust in the accuracy of the SEI also increased across the program as their feedback was incorporated to improve the SEI.
Survey feedback from these partner communities reinforces both the validity and practical value of the SEI in real-world settings. Teams are not only seeing alignment with their intuitive assessments, but also gaining new visibility into patterns of engagement that might otherwise be missed:
“Definitely nice to have the data! I think our team here and the amount of residents that we have, we have already been able to identify who may need more engagement but I think the SEI gives us actual stats which helps with care plans prioritizing the residents that need change in their engagement.” – Lucy Simpson, Life Enrichment Coordinator, Vetter Senior Living
Looking ahead, we will continue to strengthen and refine the SEI through ongoing validation efforts. This may include examining how the SEI relates to established measures of similar constructs, as well as its ability to help us better understand and predict outcomes like healthcare utilization, length of stay, functional and cognitive status, and quality of life. Over time, this work will enable a deeper understanding of what drives meaningful engagement and continue to build a more complete, evidence-informed picture of resident well-being.
Built on evidence, not assumptions
Each component of the SEI is grounded in peer-reviewed and scientifically validated research on aging, cognition, and social connection.
Participation in activities
Frequency of engagement in activities reflects more than attendance: it signals cognitive, physical, and social stimulation. Large-scale multidomain intervention studies such as the U.S. POINTER trial (Baker et al., 2025) and the Korean SUPERBRAIN (Moon et al., 2021), both part of the World Wide FINGERS network, demonstrate that consistent engagement multiple times per week across cognitive, physical, and social domains, is associated with improved cognitive and functional outcomes.
Time spent engaged
Duration matters as much as frequency. Research has shown that as little as 1 hour of daily social interaction can improve quality of life for older adults in care settings (Ballard et al., 2022) and that 1-2 hours per day may be optimal for reducing loneliness and maximizing the benefits of social connection (Canadian Social Connection Survey, 2022).
Frequency of social contact
Regular, consistent social contact plays a critical role in shaping well-being and emotional health. Rico-Uribe et al. (2016) showed that frequency of contact predicts health outcomes more strongly than social network size, largely because more frequent contact tends to strengthen the quality of relationships. Luo et al. (2022) found that more frequent daily interactions are associated with lower loneliness and higher positive affect for older adults. Zhaoyang et al. (2021) demonstrated that more frequent, especially pleasant, social interactions are associated with better cognitive performance in older adults, with effects that can extend beyond the same day.
Recency of contact
Equally important is how long it has been since meaningful interaction. Roberts & Dunbar (2011) demonstrated that emotional closeness declines as time between interactions increases. Those with stronger social ties, or greater emotional closeness, typically had contact at least every three days (i.e., an average of ≤3 days since last interaction).
Visits
Visits capture an important dimension of social engagement by reflecting both the presence and diversity of social ties. Beyond frequency (described above), the type of social connection also matters. Fingerman et al. (2019) found that both close and peripheral social ties are associated with greater diversity of activities. They also found that they serve distinct but complementary roles, where close ties are linked to more positive mood, while peripheral ties are associated with greater physical activity. A 2024 report by AARP found that 74% of adults aged 50+ reported that in-person socializing is a significant contributor to their happiness, and 45% identified it as the most important factor in improving happiness over time (AARP, 2024).
Why a composite index?
Each of these indicators tells part of the story. Together, they create a more complete picture. A resident might:
- Attend activities frequently but have little informal connection
- Have regular contact but minimal cognitive or physical engagement
- Appear socially active but experience long gaps between meaningful interactions
The SEI integrates these signals into a single, interpretable score while preserving the ability to understand each individual component and why the score looks the way it does. This was validated by one of our partners in the early adoption program:
“So far, we’re learning that our number of residents below the SEI is decreasing as we input personal activities such as family visits, PT, and other one-on-one engagement. This has helped us recognize that while some residents may not attend group programs, they are still socially engaged in meaningful ways each day. It’s also helping us identify which residents truly need additional outreach versus those who are engaged in non-traditional ways.” – Catherine Ficklin, Community Life Director, Watermark Retirement Communities
From research to real-world action
As this work continues to evolve, our focus remains the same: to partner with communities in turning insight into impact. Because when engagement is more visible, it becomes more actionable. And when it becomes more actionable, it creates more opportunities for teams to help residents feel connected, supported, and truly at home.
