As difficult as it is to learn about the death of a spouse, imagine experiencing it in the shadow of dementia and short-term memory loss, each day waking up only to forget you are bereaved.

"She couldn't get it out of her mind," recalls Sid Waxman about breaking the news of his father's death to his mother, Fritzi. "But by the next day she had forgotten it. So I told her again, and she had to go through the same pain."

A nightmare scenario for most of us, dealing with dementia is a reality for those with family members who suffer the symptoms of strokes, Alzheimer's disease and other afflictions of extreme old age. In his mother's case, said Waxman, the dementia eventually led to feelings of isolation and withdrawal.

"She would have preferred to lay in bed than to be up doing something."

At the Jewish Home in San Francisco, an innovative program is helping experts and caregivers rethink the possibilities for elderly men and women who, even a short while ago, might have been written off for lost.

As Mary Steinhauer, director of day services at the Jewish Home, explains, the idea took root after problems were noticed in some of the Russian-speaking units. Many were showing signs of decline. Physically, they were fine. But mentally they were sliding — dropping items, not eating right, avoiding social contact.

"Individuals were coming in who were isolated because of the language. They were lonely. They were depressed."

After all they had come through in getting to the United States, age now appeared to be setting them back.

Through a small grant from the Louis and Rose Shenson Fund, a group of the most at-risk residents were enrolled in the facility's daytime activities program. There they were given access to Russian-language social opportunities, music, games and exercises. Most importantly, they got access to each other on a regular basis.

Within just a few months the results were spectacular: Residents were smiling more, holding hands, eating better and taking less medication. Clearly, a community was being born. They even gave their group its own name, which translates from Russian to "Club of Friends."

In 2001, with funding from the S.F.-based Jewish Community Endowment Newhouse Fund, the project was relaunched as the Quality of Life program and expanded to several of the Jewish Home's English-speaking floors. Today, nearly 100 residents take part in the program, and it's recognized as the only one of its kind in the nation.

"They had wonderful activities at the home, but there was still a lot of down time," said Allyson Washburn, a psychologist who has studied the impact of the Jewish Home's programs since 1997. "Having a beautiful place helps, but the important thing is engagement. Yes, producing cultural change requires making each person feel good, but it also requires creating a sense of community."

According to Washburn, the key to slowing down the decline of nursing home residents is recognizing two things: first, that the potential for a rich life is there for nearly every resident; and second that it must come through a group dynamic, not from the staff alone.

Creating that dynamic has been a major goal of the Quality of Life program from the start.

Program participants meet as a group for four hours during the week. Their activities include everything from music, to dancing, exercising and discussions of current events. Two trained staff members work with each group of 20 residents. The slim ratio — rare in the nursing home world — ensures extra care and attention.

Recently residents gathered in a circle as two staff members, Ila Cherney and Jessica Brodie, bounced large balloons their way. Smiling, residents had to act quickly to avoid getting a soft wake-up call.

Despite her memory loss, Fritzi Waxman has clearly benefited, said her son, whose father was also in the program until he died last fall.

"If you were to ask her about the program, she wouldn't know what you are talking about. And yet she is a very active participant. It is what they call it — a quality of life program."

"A miracle, an absolute miracle," is how John Kaye describes the Quality of Life program. His mother, Eva, was selected for the program in 2001 after suffering a massive stroke. Before that she had spoken five languages.

"When we brought her there she was almost vegetative," Kaye recalls. "There was nothing at all. She was drooling, and she couldn't complete a sentence. She was 91 years old. We thought, 'OK, this is the end.'"

A year and a half later, Eva can hold a conversation for 20 minutes and seems to be entering a new phase of life. "It shows there's still a lot in there," said Kaye. "A lot of memories, a lot of ideas, a lot of thoughts, a lot of abilities."

In 2001, Washburn and Jewish Home staff collaborated to publish the psychologist's research in the Journal of the American Medical Directors Association. That and other reports Washburn has produced eventually reached the Newhouse Fund, which has provided more than $235,000 in funding for the Quality of Life program to date.

"The committee was really excited at the impact," said Mark Reisbaum, the fund's director of grants. "Particularly to the extent that it is a model not just for the Jewish community, but for other skilled nursing facilites as well."

The Jewish Community Endowment Fund and Jewish Home staff are now looking for additional partners to shoulder the funding for the program and help experts like Steinhauer and Washburn work on developing it as model for other facilities.

As Kaye sees it, nothing could be better.

"I used to visit during the week ," he said laughing. "Then I realized that their activity was better than my being there! And why compete anyhow? I'll let her have the program during the week, and I'll come on the weekends!"