Intergenerational Care in Aged Care _ SMacD 231130.pptx

Overview of Intergenerational care in Aged Care with particular emphasis on Australia

1. Intergenerational Care in Aged Care Associate Professor Sean MacDermott

2. Definition Radford, Gould, Vecchio, & Fitzgerald, (2018) 1 describe intergenerational care as: “ a situation where both a younger and elder generation are currently receiving care in situations of shared resources and activities”. (p. 304) Interactions should be more than just fleeting: “A monthly morning tea is not intergenerational practice. It’s a visit. What we are talking about is something that’s planned, curriculum-based and has reciprocal benefit.” - Anneke Fitzgerald, Australian Institute for Intergenerational Practice 2 1 Radford, K., Gould, R., Vecchio, N., & Fitzgerald, A. (2018). Unpacking intergenerational (IG) programs for policy implications: A systematic review of the literature. Journal of Intergenerational Relationships, 16 (3), 302-329. doi:10.1080/15350770.2018.1477650 2 https://www.theage.com.au/national/victoria/now-more-than-ever-we-need-connection-joint-childcare-and-aged-care-to-open-20220309-p5a33n.html?fbclid=IwAR2RONT1iKH3 _e6ooK3-fBAgUGeUJIKvwr8YCwB8h_TyF5Gh2OAdhsPOvzY

3. Models Radford et al’s (2018) review of the literature located 13 articles that described models of formal intergenerational care. The review suggests three predominant models of intergenerational care being visitations; collocated visitations or collocated shared space Visitation models typically involve the younger generation leaving their place of care to visit the older generation for a shorter period (generally 2-3 hours) before returning to their place of care Collocated models provide intergenerational care where both the younger and older generation’s regular place of care is situated under the same roof or within the same grounds. Within collocated models are collocated visitation models, where there is no shared space, but one generation can visit the other by walking a short distance (i.e., down a hallway) Collocated shared space models have a dedicated area to intergenerational interaction Programs differ in delivery with either the young visiting the older generation at their place of care only; both generations visiting each others place of care, having a dedicated space created for both generations or meeting at a neutral place outside of both generations place of care. Radford, K., Gould, R., Vecchio, N., & Fitzgerald, A. (2018). Unpacking intergenerational (IG) programs for policy implications: A systematic review of the literature. Journal of Intergenerational Relationships, 16 (3), 302-329. doi:10.1080/15350770.2018.1477650

4. IG programs respond to modifiable ADRD risk factors Education Purposeful engagement Physical activity Attitudes towards self-ageing Cognitive Engagement Social Supports

5. Potential benefits for older people Reducing social isolation Feeling valued and increasing self-worth, self-esteem and confidence as well as sense of purpose Learing new skills and sharing existing skills/experiences Improves health and wellbeing often related to being more active as a result of participation in various activities which include fitness and mobility improvements Increased understanding of other generations Enhanced sense of connection with the community – older people feel that they are contributing to the lives of younger people.

6. Potential benefits for younger people Learning new skills through access to new experiences, resources and history that older adults may provide e.g., communication, empathy and wider social skills Increased self-esteem and confidence Developing friendships and improves relationships – younger people may be more likely to speak to an older person that they haven’t met before and be more comfortable interacting with them Positive benefits for academic work including improved school attendance and attainment and increased enjoyment of learning Enhances sense of social responsibility

7. Co-located Intergenerational Programs Co-located services can be in the same building or same or shared site Benefits of shared sites: Sharing community resources Less demanding for carers and staff Mutual benefits to both groups Eliminates barriers e.g., transport Cost effective

8. Planning and Preparation Took approximately 4 months including ethics. Program planning meetings to allow co-design of the program Visiting aged care home to identify suitable sits and logistics Introductor session for the parents of the Early Learning Centre Centre Lifestyle staff selected and invited older people Interviews Parents/guardians of children Person living with dementia (PLWD) and their carer Analyse data from interviews Resources

9. Program Design Residents and children could walk to area (approx. 100 metres) Original site in outdoor garden area due to COVID Weather related issues required alternative spaces The intervention was designed for activities of mutual interest to encourage: Forming relationships Social interaction Developing outcomes for the children Fun

10. Barriers and Challenges Pre-program – parent concerns Staffing at aged care facility COVID-19 Weather Cost Enablers Collaboration and relationship development between all services Engagement and communication with families of participants Facilitator skills

11. Popularity and Profile Jarrott and Lee (2022) 1 surveyed 95 sites in America that offered intergenerational programs at a shared site in 51.1% of cases older and younger generations occupied separate spaces in same building, 25% occupied same space remaining were on the same campus Most common services offered were adult day services (43.2%) and preschool program (54.7%). Some offered programs to older children (summer programs/before and after school care, primary and secondary learning) 38.6% offered intergenerational programming once or more per day, with the rest varying from 1-4 times a week to monthly or seasonally Common themes to arise from qualitative component was the alleviation of social isolation, cultural enrichment and improved understanding between groups (breaking down stereotypes) Increased interest in Australia with 3 intergenerational shared sites being developed in Melbourne 2 1 Jarrott , S. E., & Lee, K. (2022). Shared Site Intergenerational Programs: A National Profile. Journal of Aging & Social Policy , 1-18. doi:https://dx.doi.org/10.1080/08959420.2021.2024410 2 https://www.theage.com.au/national/victoria/now-more-than-ever-we-need-connection-joint-childcare-and-aged-care-to-open-20220309-p5a33n.html?fbclid=IwAR2RONT1iKH3_e6ooK3- fBAgUGeUJIKvwr8YCwB8h_TyF5Gh2OAdhsPOvzY

12. Pre-schoolers & Older Adults Rosa Hernandez et al (2020) 1 focused their research on an intergenerational playgroup in Australia Qualitative case study design using in-depth interviews and five observation sessions 12 residents (8 with dementia, 4 without), 3 staff and 10 parent/child dyads consented Four key themes emerged; learning from each other, appreciating experience in the moment, connecting through play and sense of home and belonging. The authors noted that activities need to be structured in a way that does not infantilise the older adults 1 Rosa Hernandez, G. B., Murray, C. M., & Stanley, M. (2022). An intergenerational playgroup in an Australian residential aged-care setting: A qualitative case study. Health & Social Care in the Community, 30 (2), 488-497. doi:https://dx.doi.org/10.1111/hsc.13149

13. Multiple generations Skroptea et al’s (2014) 1 study included multiple generations; aged care residents, pre-school children and their carers in Sydney, Australia 48 residents (mean age 85) participated in the study along with 28 parents, 9 grandparents and 4 paid nannies who bought 50 0–4-year-olds to the aged care facility. Interactions were 1.5 hours a week and were developed in line with Playgroup NSW guidelines. Data collected over a 6-month period Residents ranged in cognitive status from no impairment (15%), mild dementia (28%), moderate dementia (38%) and severe dementia (19%) Pre-and-post Quality of Life measured with SF-36 and depression measured by Geriatric Depression Scale. Qualitative interviews performed during the sessions Significant decrease in fatigue scores, trend toward reduction in depression score although not significant Qualitative data suggested the program provided enjoyment, two-way interaction and routines, a chance for intergenerational exchange and help with child's development (among others) and a sense of support for mothers without family nearby. 1 Skropeta , C. M., Colvin, A., & Sladen, S. (2014). An evaluative study of the benefits of participating in intergenerational playgroups in aged care for older people. BMC Geriatrics, 14 (1), 109. doi:10.1186/1471-2318-14-109

14. Structuring programs Jarrott and Smith (2011) 1 noted there are many manuals on how to run an intergenerational care program, but none based on theory They assessed whether a shared site intergenerational care program based on contact theory differed from one based on a traditional planning approach. Contact theory (Allport, 1954 revised by Pettigrew 1998) tenets are; support from authority; a common goal; cooperation; equal group status and opportunity for friendship. 59 participants (25 children and 10 adults at theory-based setting; 20 children 4 adults at non-theory-based setting) Differences in age of older participants at both sites (50 years and older at theory-base v 65 years and older) Found more active intergenerational engagement at the theory-based site, although also more solitary behaviours in children at this site. Those in the non-theory site engaged in more watching behaviours (watching the activity of others rather than engaging) Findings suggest using theories of engagement to approach program design would be beneficial 1 Jarrott , S. E., & Smith, C. L. (2011). The complement of research and theory in practice: contact theory at work in nonfamilial intergenerational programs. Gerontologist, 51 (1), 112-121. doi:https://dx.doi.org/10.1093/geront/gnq058

15. Appetite for Intergenerational Care Vecchio et al (2018) 1 surveyed prospective Australian consumers of intergenerational care (parents of preschool children, older adults receiving care and family care givers) to ascertain preferred models of care and willingness to pay for such care. 809 responses to survey; shared campus (both facilities on one campus) and visiting models (two separate campuses with daily visitation) were the most endorsed. Parents of pre-school children more likely to endorse using intergenerational care than the status quo (83%) and carers of older adults endorsed a higher willingness to pay for such a service. 1 Vecchio, N., Radford, K., Fitzgerald, J. A., Comans , T., Harris, P., & Harris, N. (2018). Intergenerational care: an exploration of consumer preferences and willingness to pay for care. Aging Ment Health, 22 (8), 990-998. doi:10.1080/13607863.2017.1330873