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Business Clinic
Intergenerational care – is it time to combine young and old?

Intergenerational projects are starting to happen around the country, is it time for more care settings to open their doors and welcome in children for the benefit of young and old?

Did you watch Old People’s Home for 4 Year Olds on Channel 4? The social experiment, set at St Monica Trust’s Cote Lane retirement community, saw 10 children from local preschools spend their days with residents to assess the benefits for the older people. It created interest in the need for care settings to become more intergenerational.

Research base

The programme was based on the Intergenerational Learning Center, a nursery and pre-school set within the building of Providence Mount St. Vincent (The Mount) in West Seattle. The Mount is home to more than 400 adults who need assistance with daily living or 24-hour care. Every weekday, the children and residents come together in a variety of planned activities, including music, dancing, art, lunch, storytelling or just visiting. Children can go anywhere in the building for activities and visits, and residents are welcome to drop by the centre at any time.

The Intergenerational Learning Center has been running since 1991 and has 125 children enrolled, aged between six months and five years old.

Social isolation

The Channel 4 experiment was led by Professor Malcolm Johnson, Visiting Professor in Gerontology and End of Life Care in the Department of Social and Policy Sciences at the University of Bath. Working alongside Dr Zoe Wyrko, Consultant Physician and Dr Melrose Stewart, Lecturer from the University of Birmingham and Vice President of the Chartered Society of Physiotherapy. Its intention was to address social isolation in care settings.

According to Age UK, social isolation affects around 1 million people in England and has a severe impact on people’s quality of life in older age. Not only that, it’s also harmful to health. The Campaign to End Loneliness says that, ‘Lacking social connections is a comparable risk factor for early death as smoking 15 cigarettes a day, and is worse for us than well-known risk factors such as obesity and physical inactivity. Loneliness increases the likelihood of mortality by 26%.’

There are many initiatives to tackle loneliness and social isolation. In its Loneliness and Social Isolation Review, Age UK considered the role of intergenerational contact, saying that it is ‘probably more effective in combating loneliness than contact with one’s own age group, although both have proven successful’.

Social experiment

Despite efforts to encourage interaction and visitors, people aren’t immune to loneliness and social isolation in care settings. In a statement about its involvement in the Channel 4 programme, The University of Bath said, ‘This has a huge impact on health, wellbeing and even life expectancy. And so, based on an existing American scheme, a team of scientists and gerontologists for the programme attempted to dramatically improve the situation by bringing together 10 retirement community residents and 10 pre-schoolers.

‘Over the six weeks, the residents and children shared daily activities designed by the three experts, including Professor Johnson, who measured and analysed the older groups’ physical and mental progress throughout.

The aim was to see if, at the end of the six-week experiment, it could improve the physical, social and emotional wellbeing of the older people.’

The results

Speaking at the time of the show, Professor Johnson explained some of the results, ‘We saw our older folks doing things they never imagined they’d do again: jumping, dancing and rolling around on the floor.

‘The most marked results were in mood and depression. Almost all our care home residents measured “depressed” on the geriatric depression scale at first; at the end of the experiment that had completely changed. Some of them had moved a tremendously long way and it was transformative for them.

‘It’s not proof or a miracle cure, but the results are impressive. It’s very moving to watch them reclaiming part of themselves from the losses of being very old.’

After the show aired, the St Monica Trust confirmed that it is to establish a nursery at one of its retirement communities, consulting about a potential partnership with a local preschool, installing playgrounds, and, specifically adding an indoor play area at its new development in Keynsham.

Other approaches

The St Monica Trust may have hit TV screens, but there are other examples of young and old coming together in care settings.

Nightingale Hammerson in London has a nursery on site. Apples and Honey Nightingale House launched its baby and toddler group in the lounge of Nightingale House in January 2017. Held every Monday, it is a weekly fixture for residents who wish to attend.

Apples and Honey has now opened a nursery on the Nightingale House premises. It wants to provide the best possible early years’ experience, while developing a meaningful intergenerational curriculum that benefits young and old together.
In Cambridgeshire, residents at Home Meadow care home in Toft have regular visits from seven children, aged one to four, after their childminders forged a partnership with the home to enable the children to learn more about older people in their community.

Since January 2017, Little Owls group has been based at the home every Monday. The children spend the day with the residents and invite them to take part in their activities, such as dance, arts and crafts and singing. The group has a dedicated room to use for their lunch and nap time and residents are free to come and go as they please. CMM

Over to the experts…

These are just a few examples of how young and old are coming together in care settings. Is this a model that should be adopted far and wide? How easy would it be for more care providers to develop this model? What are the starting points? What considerations are needed? What are the benefits? What does the panel think? 

When it works it can be magical

Making the walls of care homes disappear is vital. Homes and their residents need to be seen as part of the community. Many older people fear moving into care and many experience loneliness once there. There are physical means to do this, whether site-sharing with a nursery, as at St Monica’s Trust, or students living in care homes, as pioneered by Humanitas care home in the Netherlands. There are also specific programmes like Cocktails in Care Homes run by Magic me – where young volunteers regularly come to cocktail parties in care homes – or its arts project, Portraits of a Dream, an inter-generational photography, story-telling and drama project run in Jewish Care homes.

We need to raise the aspirations for older age and living well in care homes. That’s why the Baring Foundation has funded a huge range of interactive arts projects in care homes and community settings – like artists in residence and A Choir in Every Care home – to give voice, build friendships and, most importantly, absorb and entertain. Those that are successful share some key features which involve meaningful activity, engaging equally the skills and passions of both generations, never patronising or assuming one-size-fits-all. Though, obviously, the greatest challenge is finding sustainable funds to support them. You don’t need me to tell you there’s a crisis in the funding for social care.

But when it works it can be magical. I remember visiting Kotoen, a shared-site nursery school/care home in Tokyo, and seeing young and old doing their morning callisthenics together – something that had twice as much meaning being done together as it would separately. Beautiful.

Janet Morrison Chief Executive, Independent Age 

Many potential benefits for care providers

Interest in intergenerational care has really taken off in the UK in 2017. Previously, some nurseries had undertaken one-off visits to care homes, but there was little regular interaction between older residents and nursery children.

That is beginning to change. Several different models are emerging – from full co-location of care homes and nurseries, to weekly visits to care homes by nurseries and toddler groups.
In September, Apples and Honey Nightingale in Clapham will be the first fully-integrated nursery on a care home site in the UK offering daily joint activities. This co-location has been years in the planning. The interaction between older residents and children started with a weekly babies and toddlers group at the care home. It’s now being taken forward in a nursery developed in a converted building alongside some beautiful gardens in the care home grounds.

The benefits for children are enhanced learning as part of their early years curriculum as well as social development through contact with older people. For older people, more activities will help improve health and tackle loneliness. Other generations, from staff to families, will benefit from the mixing across ages.

There are also potential benefits for providers of sharing sites – from reduced back office costs, maintenance, gardening and catering to recruiting and retaining staff, and increased income.

For a care home or housing with care scheme considering co-location, the first question is whether their site has spare space (buildings, rooms, grounds) and access to host a nursery. United for All Ages is working with providers to make the co-location of care happen.

Stephen Burke Director, United for All Ages 

An idea that has found its time

Old People’s Home for Four Year Olds (OPHF4YO) was one of the surprise delights of the summer. Well done to St Monica Trust for having the confidence to participate and to Channel 4 for scheduling it at primetime. It proved to be brilliant, uplifting telly.

To see the immediate improvements in mood and mobility amongst older people surely impressed even the most cynical of viewers. And the results (independently evaluated) smashed the idea that the model of intergenerational working has tremendous value as an antidote to ‘loneliness, helplessness and boredom’, to quote the plagues of residential care according to the Eden Alternative principles. A fine example of a ‘win/win’ with benefits for old and young.

Co-locating a nursery and a care home was trialled in Tokyo as long ago as 1976 and expanded quickly in Japan due to its success. There are now well-established models in many parts of the world, with Singapore and USA as leading proponents, so plenty of learning on which to build. Creating mutual respect and co-operative relationships are significant features of intergenerational models which help to prevent barriers and misunderstandings between generations, and much more.

I think something has started with OPHF4YO and similar examples are emerging. Obviously, safeguards will be necessary, but there are plenty of tried-and-tested models from which to learn so that schemes can be developed relatively quickly.

According to Arthur C Clarke, ‘New ideas pass through three periods: 1. It can’t be done. 2. It probably can be done, but it’s not worth doing. 3. I knew it was a good idea all along!’

Des Kelly OBE Chair, Centre for Policy on Ageing 

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