Impact of intergenerational activities on older people

ESSS Outline
Published on 26 Mar 2020

Introduction

This evidence summary seeks to address the following question relating to intergenerational activities:

What is the impact of intergenerational activities on the older participants in these practices?

Accessing resources

We have provided links to the materials referenced in the summary. Some materials are paywalled, which means they are published in academic journals and are only available with a subscription. Some of these are available through the The Knowledge Network with an NHS Scotland OpenAthens username. The Knowledge Network  offers accounts to everyone who helps provide health and social care in Scotland in conjunction with the NHS and Scottish Local Authorities, including many in the third and independent sectors. You can register here. Where resources are identified as ‘available through document delivery’, these have been provided to the original enquirer and may be requested through NHS Scotland’s fetch item service (subject to eligibility).

Where possible we identify where evidence is published open access, which means the author has chosen to publish their work in a way that makes it freely available to the public. Some are identified as author repository copies, manuscripts, or other copies, which means the author has made a version of the otherwise paywalled publication available to the public. Other referenced sources are pdfs and websites that are available publicly. 

About the evidence presented below

To understand the impact of intergenerational activities on older people we searched for evidence among both academic and grey literature. The focus of this inquiry was on intergenerational activities that involved early learning children and older adults. This inquiry took a snowballing approach by identifying several sources and following the trail of evidence around them. Some of the case studies discussed above were found in the Generations Working Together archive. There is also a dedicated Journal of Intergenerational Relationships where several key sources were identified. 

Background

The population over 65 in Scotland is around 19% (NRS, 2018). This number is due to increase steadily and substantially over the next decade. As a result, services are increasingly concerned with providing a good quality of life for an aging population. Many organisations are focusing on promoting active ageing (WHO 2002, p 12) which is “the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age”. 

Within older groups of the population there is significant variation in terms of health and wellbeing needs and considerations. Dury et al. (2017) also caution us to consider that “old” and “young” might mean different things in different contexts. Nonetheless, an NHS Scotland (2004) report  into the mental health and well-being of older people in Scotland identified several common issues that are important for the quality of life of older individuals. These issues were: 

  • Family and friends as a factor that ensures positive mental health and well-being 
  • Having a sense of value, being open and tolerant of new ways of doing things, and being willing to learn and having a positive attitude 
  • Keeping as active as possible physically, socially and mentally
  • Loss of capability or loss of health were identified as the main barriers to mental health and well-being in later life 
  • Negotiating transitions into retirement, moving from the family home and bereavement. For some, retirement was felt to bring freedom, but for others it brought a sense of being poorly valued and a sense of alienation.

The issues highlighted above indicate that social participation, community engagement and activity have a positive impact on the physical and mental health and quality of life of older adults (Murayama et al 2014). Moreover, as individuals over 50 are managing long term illnesses according to the Scottish Health Survey ( Bardsley et al 2017), more and more people will be living in adult care facilities. This in itself poses further challenges. Research indicates that older adults living in adult care facilities often experience social isolation and have fewer opportunities to use their skills and energy, which in turn, can lead to disenchantment, frustration, and depression (Murayama, et al 2015). On the other hand, due to increasing urban living, there are increasingly less opportunities for ongoing contact between different generations, especially between younger and older generations. This can lead to stereotyping and ageist attitudes where older generations are poorly valued (McAlister et al 2019). 

Ongoing social connections between the young and the elderly are often seen as one way to increase the sense of well-being of both parties. However, it may be difficult to maintain and cultivate intergenerational relationships when physical, temporal, or social distances exist as a result of current demographic distribution and concentrated urban living (Davis et al 2008). Intergenerational activities aim to overcome these barriers. Intergenerational programmes were first developed in the USA and starting from the 90’s, similar programmes have spread worldwide (Gualano et al 2018). 

Intergenerational programmes are “social vehicles that create purposeful and ongoing exchange of resources and learning among older and younger generations” (Kaplan 2001 p. 4). Other, less explicit definitions within the literature suggest that interactions are mutually beneficial (Murayama et al 2015), and consider the needs and expectations of everyone involved (Travis et al 1996).

Intergenerational programmes involve bringing children or young people and older adults together with the aim of improving intergenerational relationships (Chua et al 2013; Gaggioli et al 2014). Often, the focus of programmes is to change young people’s attitudes towards older adults, although some projects consider the attitudes of, and implications for, older adults themselves (Drury et al 2017). Drury et al’s review found that intergenerational contact is linked with several positive behaviours and less likelihood among young people of stereotyping and ageing anxiety. Gualano’s et al (2018) review also explores the benefits of intergenerational activities on both groups. The effects on older participants were varied considering well-being, depression, self-reported health, and self-esteem. 

The evidence below highlights the impacts on older people for a range of case studies across Scotland and the UK as well as among several international projects. These case studies were chosen because they include a robust approach to evaluating the impact of intergenerational activities. 

Intergenerational projects in  Scotland and the rest of the UK

Brighter Bervie, Inverbervie, Aberdeenshire  

Brighter Bervie is a voluntary gardening group which hosts intergenerational activities in Inverbervie, Aberdeenshire (started in 2018).  Reported impact for older people include a sense of enjoyment, new friendships and increased physical activity levels. Older people felt sharing their life’s experiences and stories to the young generation was rewarding and they enjoyed hearing about the children’s newly-learned knowledge.

The project was evaluated through observation, photography and asking questions from the participants informally. The organisers observed that both younger and older people undertook more physical activity by being part of the project. 

Anam Cara 

Anam Cara is an intergenerational project in Kilbirnie which aims to tackle stereotypes around dementia by connecting older people and young children for the benefit of both age groups (started in 2015). Ten children aged 3 -5 years from St. Bridget’s Early Years Centre visit the residents of the Anam Cara residential care home aged 55–98 every second Thursday for two hours.

Reported impact on older participants include:

  • Increased mobility and flexibility which can reduce the incidence of falls
  • Increased incidences of laughter and singing which could increase wellbeing
  • Remembering old skills e.g. playing a musical instrument, knitting, and other crafts which could be linked with a sense of value
  • Learning new skills e.g. computer games 

The project was evaluated through participant feedback sheets and from comments made immediately following the children’s visits. The project also has photographic evidence of the physical activities during the children’s visit. Additionally, the project reports that carers of people with dementia are arranging their respite dates to coincide with the intergenerational activities as they feel it benefits the project.

Leicester,  Sandfield Close Primary School

The project in Sandfield Close Primary School focused on improving positive food choices for both generations and on improving social inclusion for older individuals (2017 to 2019). 

This programme involved a group of Asian women and children aged 4 and 5 who were commencing school. The older volunteers helped demonstrate and encourage children to use knives and forks correctly. They also assisted in producing a food growing and cooking plan for the school. The aims were to help children improve their knife and fork skills, to tackle social exclusion, increase activity levels for the older group and to improve eating outcomes for both younger and older participants. The report identifies several benefits for the older group:

  • Learning new information and skills
  • A sense of social inclusion through building new social bonds
  • A sense of empowerment for the older group derived from the co-design approach of the project
  • Enjoyment of being with the children
  • Increase in activity
  • A sense of pride and positive self-image from volunteering
  • A sense of purpose and accomplishment from seeing the children progress 

Qualitative, semi-structured interviews with both the grandparent volunteers and the children were used for evaluation. 

Ageing Well Torbay

Ageing Well Torbay aims to reconnect communities and reduce social isolation experienced by people aged 50+ living across Torbay. The organisation found that people over the age of 50 in the Torbay area felt isolated due to retirement, bereavement, low income, poor health and mobility, lack of transport, and fear of leaving the house. Ageing Well Torbay is part of Ageing Better, a programme set up by The National Lottery Community Fund. Ageing Better aims to develop creative ways for people over 50 to be actively involved in their local communities, helping to combat social isolation and loneliness. This includes different kinds of intergenerational projects.

One project created a space in Warberries Nursing Home where two Childminders a day and their minded children (0-4yrs) participate in shared activities with the residents ( 65+), eat lunch together, walk & play in the garden and learn together. As the project is recent there is no evaluation yet (established in 2019).

Another project is Making Bridges with Music (ran in 2017). Music workshops were facilitated by artists to build neighbourhood connections. The project brought together early years children (from six weeks to 4 yrs old) and older care home residents (approximately 70 yrs old and over). 

Reported benefits for older people include:

  • Increased satisfaction and happiness
  • positive improvements in the residents’ social and emotional well-being
  • opportunities to learn, be inspired, be physically active and be motivated
  • Care Home staff reported that interactive music and arts sessions were effective in increasing self-worth and wellbeing in the elderly offering the participants an opportunity to be active and engaged in the music-making process.

The report had a formal evaluation done through the Arts Observational Scale; observations (6 sessions in total: 3 sessions in 2 care homes), feedback from residents and children after 4 the music sessions, 6 telephone interviews with childminders, 4 face-to-face interviews with care home staff members and 1 focus group with the intervention team (Blandon, 2017). 

Apples and Honey Nightingale

Apples and Honey Nightingale connects two local organisations in London: Apples and Honey Wimbledon Nursery and Nightingale Hammerson residential care. The activities involve an intergenerational baby and toddler group which runs weekly and takes place on Mondays in Nightingale House. It is open to the public and free of charge. Parents and carers can bring children who are newborn upwards. Reported benefits for the older group involve a general sense of wellbeing for participants with dementia. This is based on observations from the project organisers. 

The case studies considered above indicate that intergenerational activities have a range of positive impacts on older people. Often these include a sense of enjoyment, a general sense of wellbeing, increased activity levels, opportunities to learn and a sense of purpose and accomplishment. It is unclear if there are any negative impacts of intergenerational activities. Moreover,  from the projects above it is not clear how intergenerational activities impact older people in the long term. Apart from one project the Sandfield Close Primary School it is also unclear whether older groups had any input in the development of these activities. Previously, Dellman-Jenkins (1998) had highlighted that many intergenerational activities were designed only with the young people in mind. They also stress that older adults are not homogenous, they have different interests and levels of functioning that need to be considered. They argue that contact with members of the young generation is most likely to be positive for older people when they perceive themselves to be in meaningful and valued roles. Interactions should also be perceived by older adults to be centred around meaningful and worthwhile activities. Older adults should be involved in the planning and content of the activities. 

Long term impact of intergenerational activities on older people

The evidence below considers other intergenerational programmes and the long term impacts that they might have on older individuals.

Murayama, Y., Ohba, H., Yasunaga, M., Nonaka, K., Takeuchi, R., Nishi, M., … Fujiwara, Y. (2015). The effect of intergenerational programs on the mental health of elderly adults. Aging & Mental Health, 19(4), 306–314. https://doi.org/10.1080/13607863.2014.933309

This study examines the long-term impact of intergenerational activities on the mental health of older people. The intergenerational project involves older adults reading to school children in Japan. Senior applicants attended intensive weekly training seminars for three months involving picture book reading projects. 26 participants in the intervention group and 54 in the control group were included in this evaluation. Murayama et al’s (2015) collected data about participants baseline data which included health checks, surveys and interviews. They then collected further data every year for two years to explore any changes. Their evaluation study suggests that intergenerational programmes can help with depressive moods in an elderly population. There are limitations to consider. First, given their participant sample, generalizability is restricted to active and relatively wealthy elderly people in three specific areas of Japan. Second, the sample size was small and the subjects were not randomized. 

Parkinson, D., & Turner, J. (2019). Alleviating Social Isolation through Intergenerational Programming: DOROT’s Summer Teen Internship Program. Journal of Intergenerational Relationships, 17(3), 388–395. https://doi.org/10.1080/15350770.2019.1617606

This study evaluates an intergenerational programme within New York City. The DOROT programme is an intergenerational programme that promotes mutual learning across generations. Activities include home visiting, workshops, theatre, discussions. Teen interns are recruited for a year long programme. Some  take part in a summer internship over four weeks. This study found that older people report feeling good about the sharing of experiences. Some also feel hopeful about the future following their engagement in activities alongside young adults. Others felt the atmosphere was more energising. Both groups felt they were able to bridge generational gaps. 

Reisig, C. N., & Fees, B. S. (2007). Older adults’ perceptions of well-being after intergenerational experiences with youth. Journal of Intergenerational Relationships, 4(4), 7–22. https://doi.org/10.1300/J194v04n04_02

The study evaluates older adults’ perceptions of wellbeing after their involvement in intergenerational experiences. Specifically they look at the relationship between age, years of volunteer service, and sense of well-being among older adults (n = 46; 55 to 100 years of age) participating in intergenerational programmes at 10 sites in Midwestern. Their study uses a mixed methods approach and found that older adults reported successful ageing including staying active, not worrying about one’s problems, feeling young and keeping up with children and community. Their study found that adults between 74 and 85 reported greater satisfaction and enjoyment than older adults. They found that 85 and older reported lower levels of satisfaction which could be due to an increase in sensory losses and reduced mobility and increase in depression.  Their study found no relationship between years of involvement and and well being. It is unclear from the study what the intergenerational programmes involved.

Sakurai, R., Yasunaga, M., Murayama, Y., Ohba, H., Nonaka, K., Suzuki, H., … Fujiwara, Y. (2016). Long-term effects of an intergenerational program on functional capacity in older adults: Results from a seven-year follow-up of the REPRINTS study. Archives of Gerontology and Geriatrics, 64, 13–20. https://doi.org/10.1016/j.archger.2015.12.005

This study examined the long-term effects of the intergenerational picture-book reading programme “REPRINTS” (Research of Productivity by Intergenerational Sympathy) on older adults. In total, 349 older adults (mean age, 82.8% women) were included in the study. Data was collected at a baseline point and a 7-year follow-up from both the REPRINTS and control groups. It involved health check-ups, interviews, and pre-mail surveys received within three–five days prior to each health check-up, submitted at the health check-up site. 

This study indicates that the REPRINTS intergenerational programme has long-term, positive effects that help maintain and promote intellectual activity, physical functioning, and intergenerational exchange, although the effect of the increasing amount of physical activity is unclear. REPRINTS has demonstrated relatively short-term interventional effects (within three years) on grip strength, social network (e.g., frequency of interchange with grandchildren), subjective health and sense of coherence among older adults, and on stress reduction for school children. This indicates the importance of developing intergenerational social engagement programmes in older adults to help maintain their functional health, as well as to promote healthy child growth and development.

Challenges

The majority of intergenerational experiences discussed above focus on the positive impacts of intergenerational activities. The case studies describe many approaches to intergenerational activities but impact is less often evaluated, and even when it is,  it does not always capture the perspective of older people. This was highlighted by Dellman et al (1998) and seems to be still the case. Often impact is focused on short-term outcomes like positive feelings and emotions. Also, older people are not always involved in developing these programmes or in choosing the activities. 

Gualano et al (2018) urge to also consider that there are risks which occur when the IG programme’s organization is not adequate. Steining (2005) highlights that older adults can be infantilised by intergenerational activities when the focus is on “childish” games and activities in which older individuals are seen to be in the same developmental cohort with young children. Moreover, the implemented activities often lack evidence-based activities and are not adequately evaluated. The presence of specifically trained staff appeared to be extremely important for the good outcome of the intergenerational activities. 

References

Ageing Well Torbay (2020), Accessed at https://ageingwelltorbay.com/about/

Bardsley D , Dean L , Dougall I , Feng Q, Gray L , Karikoski M , Rose J , Stevens C , Leyland A H, (2017) The Scottish Health Survey, A National Statistics Publication for Scotland, Scottish Government https://www.gov.scot/publications/scottish-health-survey-2017-volume-1-main-report/pages/9/

Blandon C (2017) Making Bridges with Music Evaluation Report, Accessed at https://generationsworkingtogether.org/downloads/5bb4e7f390bbc-The%20Making%20Bridges%20with%20Music%20Evaluation%20Report-Final%20Version.pdf 

Chua P H, Jung Y, Lwin M O, & Theng Y L (2013) Let’s play together: Effects of video-game play on intergenerational perceptions among youth and elderly participants. Computers in Human Behavior, 29(6), 2303–2311. https://doi.org/10.1016/j.chb.2013.04.037

Davis H, Vetere F, Francis,P, Gibbs M, & Howard S (2008) “I Wish We Could Get Together”: Exploring Intergenerational Play Across a Distance via a ‘Magic Box.’ Journal of Intergenerational Relationships, 6(2), 191–210. https://doi.org/10.1080/15350770801955321

Didier L (2019) Reducing health inequalities and social exclusion through an intergenerational food project in a primary school, Accessed at https://generationsworkingtogether.org/downloads/5d9b229b3aa59-we%20love%20our%20grandmas%201.pdf

Drury L, Abrams D, & Swift H J, (2017). Making intergenerational connections: What are they, why do they matter and how to make more of them. London: Age UK

Gaggioli A, Morganti L, Bonfiglio S, Scaratti C, Cipresso P, Serino S, & Riva G. (2014). Intergenerational Group Reminiscence: A Potentially Effective Intervention to Enhance Elderly Psychosocial Wellbeing and to Improve Children’s Perception of Aging. Educational Gerontology, 40(7), 486–498. https://doi.org/10.1080/03601277.2013.844042

 Generations Working Together (2019), Spanning the Ages by Brighter Bervie Accessed at: https://generationsworkingtogether.org/case-studies/spanning-the-ages-by-brighter-bervie

Generations Working Together (2018), Anam Cara, Accessed at https://generationsworkingtogether.org/case-studies/anam-cara

Generations Working Together (2019) Childminders, a solution for intergenerational co-location, Accessed at https://generationsworkingtogether.org/case-studies/childminders-a-solution-for-intergenerational-co-location

Generations Working Together (2018) Baby and Toddler Group, Accessed at https://generationsworkingtogether.org/case-studies/baby-and-toddler-group

Gualano M R, Voglino G, Bert F, Thomas R, Camussi E, & Siliquini R (2018) The impact of intergenerational programs on children and older adults: a review. International Psychogeriatrics, 30(4). https://doi.org/10.1017/S104161021700182X

McAlister J, Briner E L, & Maggi S (2019) Intergenerational Programs in Early Childhood Education: An Innovative Approach that Highlights Inclusion and Engagement with Older Adults. Journal of Intergenerational Relationships, 17(4), 505–522. https://doi.org/10.1080/15350770.2019.1618777

Murayama Y, Ohba H, Yasunaga M, Nonaka K, Takeuchi R, Nishi M, … Fujiwara Y (2015) The effect of intergenerational programs on the mental health of elderly adults. Aging & Mental Health, 19(4), 306–314. https://doi.org/10.1080/13607863.2014.933309

National Records of Scotland (NRS), (2018). Accessed at: https://www.nrscotland.gov.uk/files/statistics/council-area-data-sheets/stirling-council-profile.html 

NHS Scotland (2004) Mental Health and Well-Being in Later Life: Older People’s Perceptions, Accessed at http://www.healthscotland.com/uploads/documents/7924-WellbeingBook.pdf

Parkinson D, & Turner J (2019) Alleviating Social Isolation through Intergenerational Programming: DOROT’s Summer Teen Internship Program. Journal of Intergenerational Relationships, 17(3), 388–395. https://doi.org/10.1080/15350770.2019.1617606

Sakurai R, Yasunaga M, Murayama Y, Ohba, H, Nonaka K, Suzuki H, … Fujiwara, Y (2016) Long-term effects of an intergenerational program on functional capacity in older adults: Results from a seven-year follow-up of the REPRINTS study. Archives of Gerontology and Geriatrics, 64, 13–20. https://doi.org/10.1016/j.archger.2015.12.005

Steinig S (2005) Under One Roof: A Guide to Starting and Strengthening Intergenerational Shared Site Programs. Retrieved February 18, 2020, from Generations United website: https://s3.amazonaws.com/pushbullet-uploads/ujzNDwQrsR2-FU6mFaxJ6i35ga24xorjysU9FJj7oKD1/05-SharedSites-Report-UnderOneRoof.pdf

Travis S S, Stremmel A J, & Kelly-Harrison P (1996) Intergenerational Programming for Young Children and Dependent Elders: Current and Future Directions. Activities, Adaptation and Aging, 20(2), 33–50. https://doi.org/10.1300/J016v20n02_04

World Health Organization (2002) Accessed at https://apps.who.int/iris/bitstream/handle/10665/67215/WHO_NMH_NPH_02.8.pdf;jsessionid=E99A2FA7340F79814066AED1306BBC0F?sequence=1

 


Suggested reference: Bocioaga, A (2020) ESSS Outline: Impact of Intergenerational Activities on Older People. Iriss. https://doi.org/10.31583/esss.20200325

 

 

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