How care homes and nurseries are coming together for good

Intergenerational care is the practice of bringing the young and elderly together by introducing nurseries and care homes to one another. This new style of care is revolutionising care homes worldwide and participants swear by the practice. We are going to investigate the history behind intergenerational care and talk to some of the people behind this new trend.

The history behind it

Intergenerational care is thought to have officially started in 1976, when Shimada Masaharu merged a nursery school and care home in Tokyo with great success. This started a wave and soon more intergenerational care facilities opened in Japan and the US, with everyone in the know applauding the positive effects of the practice. Today there are intergenerational care facilities in countries across the globe, although it’s fair to say it has yet to become a mainstream practice.

In more recent times, a big boost for the publicity of intergenerational care came from Channel 4’s show Old People’s Home for 4 Year Olds. This two-part documentary documented the impact of introducing a pre-school class to a group of older people.

This is the first time that intergenerational care has been publicised this way in the UK and a lot of watchers praised the experiment and the show for its results. The current epidemic we are facing with loneliness in old age is not forgotten, and a lot of viewers liked how the show, and indeed this type of care, proposed a potential solution to this.

As well as the viewers, the experiment had a powerful effect on the volunteers. The children were seen to be more confident by the end and formed connections with new friends. And the adults were happier. A volunteer called Zena, aged 77, perfectly summed up the experience by saying this:

“The most important thing in life is to be loved, and children have such a pure and positive love. To find a child’s hand in yours is one of the most moving things that can happen to you.”

The science behind it

It isn’t just word-of-mouth reviews and documentaries that are claiming that this style of care works, many studies have now been made and conclude the same thing: intergenerational care is good. 

In 2013 a study by BMC Geriatrics in Japan found that elderly people who were part of an intergenerational care scheme were not only engaging with the toddlers, but they were engaging with each other and smiling more as a result of the children’s visits. The scheme made the residents more comfortable with conversation, and also gave them something new to talk about.

A lot of the residents are used to limitations, many struggling with mobility and relying on things like mobility bathrooms and walking aids. As well as others with more severe physical illness.

However, when talking to CNN, Ali Somers, co-founder of Apples & Honey intergenerational care facility, said residents: “very often forget their own physical limitations, and they find that they are encouraged; they stretch themselves; they will lean up out of their chair, extend a hand, and engage in conversation.”

There are even numerous studies that show social interaction cannot only decrease loneliness, a prevalent issue in our older generations, but can also delay mental decline, lower blood pressure and even reduce the risk of disease and death in elders. The social interactions between the older generation and the youngsters in these experiments, as well as the further interaction between care home residents could be a simple solution to a lot of these issues. 

A study on the Friendship Center, an intergenerational care facility in New Jersey, has even seen evidence that intergenerational care has a profound effect on the middle generation: “Unknown to us at the start of our intergenerational experiment was the profound impact the Friendship Center concept would have on the middle generation- namely the parents of the centre’s children. In fifteen years of operation, the exposure that this ‘sandwich generation’ (and younger parents too!) has had to the residents and the facilities at Heath Village has been enlightening to them.

“Many have become aware of the retirement community living style and now no longer label senior housing as a ‘nursing home.’ Still, others have remarked at how their children now seem to feel comfortable around grandparents and great-grandparents while at social and family reunions, a decided change brought about by the Friendship Center experience.”

As well as the science behind it, a lot of the care homes practising intergenerational care have first-hand accounts of the effects, we reached out to some of them for their stories.

Apples & Honey Nightingale

We spoke to Judith Ish-Horowicz, founder and Principal of Apples & Honey Nightingale, a nursery located within Nightingale House- a Jewish care home in South London. Apples & Honey is the UK leader in intergenerational care, setting up in September 2017 it was the UK’s first integrated facility. The children of Apples & Honey can often be found alongside the elderly residents of Nightingale House taking part in the communal activities like singing and arts and crafts.

Judith kindly spoke to us about the inspiration behind bridging the gap between Nightingale House and Apples & Honey: “I have been visiting Nightingale House, a Jewish care home in South London for a nearly 20 years with the children of my nursery, Apples and Honey, and watched the relationships grow and the impact it has had on all involved from children to elderly residents, from the care staff to extended family members. It just made so much sense for these interactions to be a daily experience and for there to be a nursery on the site of the home. Everyone would benefit.”

The advantages of intergenerational care can change from person to person. Judith shared with us some of the advantages she has seen working first hand in Nightingale, along with personal examples of these advantages:  

• “Many have not had children - they were growing up during the second world war when so many young men were killed, and they never found a life partner, had children and, of course, grand and great-grandchildren. Now they have the chance to become the 'grandma' they couldn't otherwise be. I have seen special friendships develop and nursery children having 'lunch dates' with residents and them exchanging notes. Just the other day, I saw a childless resident feeding a baby from a bottle, something I'm sure he has never done before or ever expected to do.
• They are often confined to the home because of poor mobility, health or cognitive impairment through dementia. This way, the home becomes a proper cross-generational community and they can feel as if they are still part of the real world.
• It gives them a sense of purpose as the children relate to them without judgement and with ease and share their secrets. The residents have time to listen in a way that most people don't.
• Many of the residents have said that they look forward to being with the children more than anything else and one actually said that, from being really depressed, it has given her a reason to live.”

A lot of these stories coincide with the scientific results found, which show that even on a smaller level the advantages are showing. It is worth mentioning the shared faith of Apples & Honey gives the older generation and the younger generation something immediately in common.

As well as the myriad of advantages to elderly residents, intergenerational care can also be incredibly beneficial to the children taking part which is something often overlooked in studies. Judith shared with us some of the advantages she has experienced:

• “Many children do not have extended family living nearby. Some are international families whose grandparents live in USA or Australia etc. Some families have had to relocate for work, so they don't get the opportunity to mix regularly with elderly people who can give them that uncritical love of a grandparent.
• Being with people who have lived so long and have so many stories to tell gives the children a sense of being a part of a long line of history, we use the expression ‘L'dor vador' which is Hebrew for 'From generation to generation'. It gives them a sense of time and place that is important for feeling secure and safe.
• The children seem to mature more quickly and to be more responsible. They are careful when moving around the residents and are actively concerned for their well-being.
• They benefit from the attention of people who have time to listen to them and to share stories.”

It is fair to say Apples & Honey are leading the charge towards normalising intergenerational care in the UK, and for all of the right reasons. They have seen positive results all around and continue to lead the way for other care homes and nurseries in the UK.

The Intergenerational Care Project, Australia

The Intergenerational Care Project is a programme run by Griffith University on the Gold Coast of Australia. The project commenced in 2017 and is aiming to study the effects of intergenerational care in Australia. Similarly to the UK, Australia are just starting to really uncover the benefits of intergenerational care and this project is aiming to study the effects in order to bring the practice to Australia in the best possible way.

Professor Anneke Fitzgerald is the Program Evaluation Lead for the project and spoke to us about the history of the scheme:

“The idea for this project started off during a dinner table conversation. I was having dinner with my daughter Kimberley who is a childcare worker and she was telling me some of the tasks and issues she dealt with during the day. Most of these were about tensions between being able to care for the children, whilst also pressured to do lots of administrative tasks. I commented that her stories reminded me of working in aged care. Then Kimberley asked, ‘why is child care and aged care not together?’ This sparked a background research into childcare and aged care in the same facility, also known as intergenerational care.

“Following the dinner conversation, I got together with two of our other Chief Investigators for this project, Dr. Katrina Radford and Dr. Nerina Vecchio. Together we conducted a feasibility study on intergenerational learning programmes in Australia to gather more information on this topic. We found that while intergenerational learning programmes are increasing in popularity in the United States, Europe and United Kingdom, they remain in their infancy in Australia. In addition, we observed that existing programmes typically operate in residential aged care facilities, lack a formalised programme based on educational pedagogy, and do not monitor or evaluate participant outcomes. Further, we also noted psychological aspects of mixing generations are commonly reported in existing research on intergenerational learning programmes but documented research on other outcomes associated with intergenerational interaction such as improved quality of life, cognitive skills, and independence are limited.”

Professor Fitzgerald spoke to us about the increasing importance of intergenerational care in today’s society: “We are living in an age where people’s interactions outside of their homes are almost always with members of their own age group. In recent decades, many of the places where people traditionally mixed are slowly disappearing. There is a significant reduction in opportunities to meet with people of all ages from local shops to places of worship and even workplaces with more people opting to work from home. Where we live is also being age segregated these days. While some suburbs are dominated by young families, others are occupied mainly by ageing populations. If this age segregation continues, it can have detrimental effects on our society in the long run.

“Age segregations can foster mistrust, suspicion and misunderstanding between generations. The talents, skills and experiences of different generations also get wasted as a result. We believe that intergenerational care and learning programmes provide an excellent platform to tackle the increasing age segregations in our society. By getting the young and old to mingle and interact with one another, meaningful connections can be built between the two generations. It can help create real understanding of the social and economic issues that other generations are facing.”

Professor Fitzgerald touches on an interesting subject here that isn’t spoken about as much as it is regarding care in other countries. A lot of people socialise only with their own generation or family. Whether it’s school friends, students or new mums all throughout life people find new clichés and groups of people their own age and this tends to continue in to old age. Intergenerational care solves this issue by bringing the older and younger generation together, even when the two parties aren’t related, which is often the exception to the rule. 

Langdale Care Homes

Langdale Care Homes are based in the Midlands and champion the advantages of intergenerational care. These family-run care homes run on the philosophy that every person is an individual and they should be treated as so. They concentrate on a person-centred approach and embrace their resident’s unique life stories.

We spoke to the team at Langdale who spoke to us about their inspiration behind starting intergenerational care: “We had watched the Channel 4 experiment on old people’s homes for 4-year olds, together with hosting Halloween parties, Christmas parties, birthday functions etc. I have seen first^t hand the difference having children in our care homes makes.”

They also told us about some of the positives they have observed: “I believe having seen the difference that all residential/care/nursing homes should have some form of intergenerational care. The advantages we have noticed so far in our residents are – increased socialisation, more smiles, more laughter, provokes conversation, better diet and children and residents encourage snack etc. over all a more settled atmosphere and persona for those who may suffer anxiety and aggression. Children grow with knowledge of dementia, without fear. Dementia is not seen in children’s eyes. Disability is not seen. Children see grandparents. Undivided attention for residents, they see smiles. And the children give so much more than they receive.”

Activate Learning

Activate Learning is an education group working across further and higher education, schools, apprenticeships and training. They aim to create a far-reaching and impactful change through their learning. It works with care homes and nurseries in Banbury and Reading, in Oxfordshire and Berkshire. In Reading it works with St Luke’s Care Home, Berkeley Gardens Day Nursery and Wigwam Day Nursery. In Banbury it works with Green Pastures Christian Nursing Home and their own on-site nursery, The Hobby Horse Children’s Centre.

The interesting thing about Activate Learning is it brings the third generation in to the mix. As well as having older generations and younger children, they also have the middle generations, the students who are learning from the experience by getting directly involved in the science behind it, and the practicing of it. 

We spoke to Leah Bryan and Fiona Taylor, the two-staff leading this project about Activate Learning. Leah, the early year’s assessor at Activate Learning, told us some more about how it came to be: “Initially the project was inspired by the care home for four-year olds program that was televised. This sowed the seed of thought for Activate Learning services to the public staff to embark on a new and inspiring project. Whilst investigating inter-generational work in the UK a connection was made with ‘United for all ages’. The motivation and the passion soon developed to work with some of our closest placement providers and employers. Students too were shown the program and a committee of students soon developed.  

"The first groups started in January 2018, in a very short space of time we have already seen some strong friendships develop between the residents and the children. One child has spoken so much at home about her new friend that the families have actually arranged to visit the care home and the resident.”  

Leah went on to talk about how the project has affected the middle generations, the student involved: “For our students involved this is a new way for them to learn both communication and industry skills. It is completely hands on and already they have seen the relationships develop between the children and the adults.”

"Recently some of the students were invited to an intergenerational conference at Goldsmiths University, they presented in front of academics, and industry professionals. They were by far the youngest people to present but this helped them to apply professional and confident skills all linked to the Activate Learning college attributes.”

Fiona, the work placement officer at Activate Learning added: “Both health and child care students are working hand-in-hand to provide inspiring and engaging activities, for both the older and the younger participants. As the conduit for developing stimulating activities, students will ultimately gain a deeper understanding of the needs of both generations as well as they themselves becoming part of the social integration with different members of their own community. The bringing together of three generations can only serve to enrich the intergenerational focus of the project as a whole, beyond that of the pre-school child age group and the older generation to incorporate both teens and young adults as well.”

"Intergenerational care has great benefits for reducing depression and isolation in the older generation, It can also help with greater mobility and physical skills. For the children it helps them develop empathy and their language and communication skills."

The advantages to intergenerational care can be seen not only in scientific results but also in first-hand experiences. The accounts from Angels & Honey, The Intergenerational Care Project and Langdale Care Homes show positive effects for participants who are both young and old. If intergenerational care interests you there are plenty of facilities across the UK and around the world then you can get in contact with to discuss your options.

Image Credits: Apples & Honey Nightingale, Activate Learning.