Intergenerational care

Share

Intergenerationalism isn’t new, but over the last few years it has been enjoying something of a renaissance, with claims that everyone benefits from making relationships with those far away from them in age, Jef Smith explores some examples.

Academic backing for this vision of a potential win-win collaboration came last year from the University of Kent whose Centre for the Study of Group Processes published an evidence review under the title Making Intergenerational Connections.

Intergenerational contact in health and social care settings does appear to promote a softening of ageist attitudes, and, as one might expect, the project found “staff working with older adults have more positive attitudes towards older people” than members of the general public. Some research studies, however, point to the dangers of staff adopting patronising attitudes and showing benevolent but damaging stereotyping. In addition, staff in homes and day care settings who have negative experiences with their elderly clients can end up having ageist feelings towards older people in the wider community.

The Kent study concluded that intergenerational contact is far from unambiguously positive. It advised that future research should be more subtle in defining precisely what the term “older adult” embraces, pointing out for a start the variations in its use between social care and hospital settings.

Homes and other agencies which seek to introduce children and young people to their elderly clients do not often have the resources or skill to carry out systematic evaluation, but they should certainly approach such experiments with a measure of scepticism, willing to observe the downsides as well as the hoped-for advantages.

The Kent researchers provide a useful framework for such an evaluation. Their suggestions include setting out the aimed for outcomes clearly, trying to identifying measures to gauge success or otherwise, and treating participant feedback confidentially. Their advice for using a control group with randomly assigned participants may be beyond the capacity of the average home, but the principle of looking at the activity with as much objectivity as possible is surely sound.

Setting up an intergenerational activity

A home engaging in an intergenerational activity will obviously be less concerned with long range considerations such as reducing the age prejudice that participating young people may demonstrate in adult life than in the immediate objective of enhancing the welfare of its residents. Within this simple-sounding aim, however, there are many variations in what can be achieved. Visits to the home by young people may provide residents with immediate pleasure, even therapeutic benefits, but it is worth looking beyond the moment to at least the slightly longer term effects.

Given the obvious value of lasting intergenerational friendships, for example, homes might give some thought to sustaining and supporting any relationships which develop. Young people’s lives change quickly — academic timetables impose fresh priorities, local sixth formers move on to perhaps distant universities — so both homes’ staff and teachers need to think imaginatively about ways of keeping relationships going if at all possible. It is clearly sensible to build in such strategies from the scheme’s inception.

Some of the benefits to older people of contact with members of younger generations arise, let’s be frank, from simply providing a distraction from the customary, often boring, routines of life in a home. Encounters, however, require careful management as not all older people or school pupils can deal with such relationships without help. I recall observing a visit to a home by a group of sixth formers during which one 18-year-old boy and an 80-year-old female resident surveyed each other in embarrassed silence before giving up — a painful experience for both of them. Warmth of contact and the pleasure and learning that accompanies it does not always happen spontaneously.

Nightingale House

Recently, the emphasis of intergenerational activities in care homes has shifted to include involving the very young. At Nightingale House, a long established Jewish home in southwest London, a nursery was opened last year in a converted bungalow in the grounds. Children from the Apples and Honey nursery now often visit the home to take part in activities with the elderly residents; singing and baking are reported to be favourites. Nightingale House draws on experience of such schemes in the USA, Canada, Singapore, Australia and Japan, as well as in other parts of Europe, but it claims to be the first scheme of its kind in the UK.

A report on the early months of the scheme is enthusiastic. Chief Executive Officer Helen Simmons says that the project is part of the home’s attempt to “reflect all the ages you would see in a whole family” and that the nursery has brought in the sight and sounds — and, she might have added, the smells? — of those just starting out in life. From the other side, Apples and Honey founder Judith Ish-Horowicz points out that many contemporary Jewish families have grown up without grandparents and for little children contact with elderly residents compensates for this loss. (Although both nursery and home claim to “embrace all religions”, their shared faith has clearly provided an additional bond.)

A great deal of thought was given to the precise physical arrangement of the two functions of providing a home for older people and looking after under fives. The result gives the nursery necessary space of its own but with a playground overlooked by residents. “Perhaps one day,” it was speculated, “conversations and relationships would also develop across the playground fence.” In fact many informal contacts take place, with both residents and parents testifying to the benefits. People with dementia often seem to find these encounters particularly liberating.

The centrepiece of the intergenerational work, however, is a formal weekly session during which children visit the home’s activity room and meet the (voluntarily) participating residents. It includes half an hour of singing and storytelling, a period for craftwork like painting or for making something such as sandwiches, and time for informal socialising. The singing part of the day is quite formalised with each child taking the “song bag” to an older person who then selects a toy, which determines the next song. “This familiarity,” says the report, “puts both groups at ease and gives them a sense of ownership over the activity”, developing “a real sense of security in knowing what is going to happen next.” Use of such imaginative rituals — in this instance totally secular — makes good sense for both the very young and the extremely old.

The Nightingale experience will almost certainly be imitated elsewhere. There are indeed already homes and retirement villages with similar plans, and many others are opening their doors to little children on a more limited scale. Indeed Stephen Burke, Director of the think tank United for All Ages, says that there should be 500 care home nurseries developed over the next five years across the UK, an ambitious if rather arbitrary target.

Downshall Primary School

Meanwhile an east London day centre for older people with dementia and depression is also claiming a first, being located within Downshall Primary School in the Borough of Redbridge. The day centre attenders share a range of activities with school pupils including music, art and reading and the two groups take lunch together. Started following an idea of the local consultant psychiatrist, the project is claimed to bring benefits to both sides of the equation. It was recognised that the unusual format posed safeguarding issues, and though these have been surmounted through comprehensive staff training there is a warning that such projects need to be thought through thoroughly and resourced accordingly.

Social care is not alone in considering how potentially hostile intergenerational contacts can be used positively. A wider debate in the media and elsewhere about whether contemporary young people are getting a poor deal economically compared with the comparatively well-off baby boomers runs the risk of actually stimulating intergenerational antagonism. Such talk of the conflicting interests of different generations is clearly divisive; can it be balanced by a more positive picture of the mutual benefit arising from co-operation between age groups?

Questions for care home managers

  1. Do your residents have any contact with children other than the occasional grandchild?

  2. What could you do to promote more intergenerational contact, visits from local schools or nurseries, for example?

  3. Do you have space within your building which might be used on a permanent or occasional basis by some group involving children?

  4. On the other hand, can you be sure that your (relatively young) staff’s contacts with older people are not generating age-related stereotypes?

Last reviewed 2 October 2018

Croner-i Care Management Newsletter

Since you're here... Why not sign up to our free weekly newsletter?

Remain compliant and stay ahead of industry changes in Croner-i Care Management.