The more time young and old people spend together, the more both parties benefit
Mon 12 Nov 2018 04.24 EST Last modified on Thu 15 Nov 2018 03.12 EST
We live in a society where age segregation is on the rise. Research by the Intergenerational Foundation has found that only 5% of older people in England and Wales now live near someone under 18, whereas 15% did so 25 years ago. So the idea of intergenerational care – where children and older people come together to sing, play or just chat – seems to have much to recommend it.
Studies claim this type of interaction can decrease older people’s loneliness, delay mental decline, lower blood pressure and even reduce the risk of disease or death. But, at heart, the benefit of almost any interaction between young and old is self-evident, according to Lesley Carter, clinical lead at charity Age UK.
“I have seen it so often, when a child touches the hand of somebody who is perhaps very withdrawn, and not really speaking, and all of a sudden that person is alive,” says Carter. “It’s really humbling.”
However, evidence for successful outcomes remains largely anecdotal and, partly because their growth has been driven mainly from the bottom up, funding for these programmes is often short-term and uncertain.
Prof Sarah Harper, an Oxford University gerontologist, points out that these initiatives are very small-scale and barely scratch the surface of the problem of social isolation: “We can learn a lot from them, but I don’t think this is going to be the solution.”
Intergenerational care started in Japan in the 1970s and was soon enthusiastically adopted in many other countries, including the US and Australia. The UK was slower off the mark, but there has been a rapid expansion in the past two years, inspired in part by the hit Channel 4 show, Old People’s Home for 4 Year Olds, which has just completed a second series.
United for All Ages, a thinktank that focuses on intergenerational work, says between 30 and 40 projects are now up and running around the country, most of which involve care homes linking up with nurseries or primary schools. Many more are in the pipeline, and director Stephen Burke predicts there will be more than 500 within five years.
The model of engagement can range from occasional, informal visits to settings where two organisations share premises, enabling children and residents to interact every day.
‘It’s like being reborn’: inside the care home opening its doors to toddlers
The best-known example in the UK is the Apples and Honey nursery in Wandsworth, south London, which was purpose-built within the grounds of the 200-bed Nightingale House care home. Children (and care workers) take part with residents in daily activities such as singing, storytelling and playing games.
The project has been running for a year and, says co-founder Ali Somers, the results have been eye-opening. “There’s something about having children on site which makes residents feel more human and gives them permission to care about others. It boosts their confidence and feeling of self-worth.”
Many people with dementia seem to thrive in this environment. Somers recalls one very withdrawn resident who “became much more communicative with the baby and toddler group and, after coming to a singalong, took the song over and began to lead. There are many of these mini-awakenings.”
Other schemes include regular get-togethers between school pupils and older people with dementia and depression in east London; weekly visits by pre-school groups to care homes in Torbay; and a link-up between Augusta Court care home in Chichester – part of the Anchor group – and a neighbouring nursery, run by national organisation Busy Bees. Discussions are already under way about replicating this model elsewhere in the country.
Lorraine George, childcare development worker with Torbay council, who spent a month last year looking at intergenerational schemes in the US, came across many success stories: “Each one of these anecdotes describes real change to one person’s life, but, for some reason, we don’t value that as much as data and statistics,” she says.
The benefits are not only felt by the older people – George noted how children’s confidence also improved in these settings, as did their vocabulary and socialisation. “All the parents I spoke to felt their children had learned so much from the elderly residents,” she says. “We’re so time-poor as a society, so to be surrounded by people who have an unlimited amount of time to read with you and answer all your questions and offer unconditional love provides an incredible opportunity to learn.”
Other benefits included greater job satisfaction among staff, improved recruitment and retention, happier relatives, and stronger links with the surrounding community.
In most US cases the care home and kindergarten or school were located together, often developing from economic or logistical necessity, since local schools were expanding and care homes had space on their hands. The UK is beginning to face similar issues. “In Torbay we have care homes that are not full and nurseries that are overflowing,” says George. “It makes sense to team up and share some of the back-office costs.”
Another abiding problem is funding. One scheme, the Together Project, which has had success in north-east London, needed crowdfunding to get going, and, even then, one of its flagship projects ground to a halt after a year because the home closed down. Age UK’s analysis of international schemes suggests they often founder if there is an imbalance in numbers between young and old or if one group feels at a disadvantage to the other.
Some observers also express concern about safeguarding, including the potential risk posed to young children by care home residents with dementia – the majority in most homes these days. Organisers say they take this issue extremely seriously, and follow rigorous safeguarding measures laid down by regulatory bodies.
Somers says Apples and Honey conducted detailed risk assessments before launching its scheme, and that residents are screened by staff before sessions and will never be left unsupervised with a child. School field-trip rules apply every time children leave the nursery.
While accepting the importance of risk assessment, however, George feels it can be used as an excuse for inaction. “Sometimes I feel we can risk-assess things so much we actually stop doing anything.”
Somers’s advice to anyone thinking about an intergenerational project is to go ahead, no matter how small the idea, because all interactions have an impact. As George puts it: “This is not rocket science and it’s not hard to do. And when you see it in action you think: ‘Why on Earth wouldn’t you do this?’”
An intergenerational initiative in London is transforming how care residents behave
When Louise Goulden brought her one-year-old son to see his great-great-aunt in her care home, the experience was “like a light had been switched on” for both the aunt and other residents. “Residents who were dozing or not particularly engaged suddenly lit up,” she recalls.
That was also a lightbulb moment for Goulden, and the result was Songs and Smiles, an intergenerational initiative that organises regular visits by local baby and toddler groups to five local care homes in north-east London.
The visits – part of the Together Project, also run by Goulden, which seeks to tackle ageism and social isolation – take place each week and last around an hour. They always start with music, taking in singing, playing instruments and movement. After a break for refreshments, parents and toddlers are then invited to stay and interact more informally.
The music acts as a focus and an ice-breaker, says Goulden. “It’s designed to work for the youngest and oldest and for a range of abilities and capacities. Some residents have quite advanced dementia, but we try to make it as inclusive and enjoyable as possible.”
Up to a dozen residents will usually attend the sessions, along with a similar number of children, plus parents, volunteers and care home staff. So it can often be quite a busy environment, but the pleasure both residents and children derive from the experience is clear.
Goulden says she and the care home staff have noticed quite significant changes in residents since Songs and Smiles launched last year. One care home manager described the transformation as miraculous. “She noticed that people who she wouldn’t have thought had the capability to use a musical instrument started to use them more and people with quite advanced dementia started to try to communicate more.”
Marilyn O’Connor, activities coordinator at Albany nursing home in Leyton, mentions one resident who rarely understands what people are saying to her, “but when I tell her the babies are coming her face lights up and she’s animated for the whole session”.
This impact is felt well beyond the sessions. “Residents look forward to them every week. It does wonders for them overall – it’s a bit like an anchor point in their week.”
It has also had an effect on the children. “Part of our aim has been to make older people and the ageing process an accepted part of their lives,” says Goulden. “Older people are people they sing with, play games with and have fun with – that makes a big difference.”
Getting to this point has not been easy. Finding suitable care homes, working out the logistics of the visits and recruiting and training volunteers to support residents and parents have all taken time and energy.
But, predictably, the biggest challenge has been funding. Goulden receives a payment from the care homes for each session, while parents pay £1 to attend. But the Together Project relied on crowdfunding to get off the ground in the first place, and future funding remains an issue. She nevertheless hopes to expand Songs and Smiles to other parts of London as well as, in time, further afield.