LeadingAge Magazine · January/February 2012 • Volume 02 • Number 01

All Aboard! Providers Embrace Intergenerational Care

January 15, 2012 | by Kimberly Fernandez

Youthful energy mingles with the wisdom of long lives to build relationships and improve quality of life for all. More than simply co-locating child care in long-term care communities, these programs put seniors and children in position to enrich each other’s lives.

Visit Chandler Hall in Newtown, PA, on any weekday and you’ll likely run into groups of children running around the building, intermingling with its older residents just like family. You might think you’d arrived on the campus on the same day as a school field trip, but you’d be mistaken. That’s because 55 infants, toddlers, and preschoolers, and kindergarten students spend their days at Chandler Hall as part of its licensed child care and school program.

“We’re a shared site,” says Karen Freedman, manager of the intergenerational program at the CCRC. “The children are here all day, and that affords so many opportunities.”

Residents, as one might imagine, love having the young ones in the halls, where they ask questions, sing songs, read stories, make crafts, and engage residents in all sorts of conversations and activities. But the real benefit may be to the children.

“By bringing generations together, you can change generations,” says Freedman. “We’ve improved their view on the circle of life starting when they are very young, and the program gives them a good comfort level they can move forward with.”

  Chandler Hall launched its child development program in 1988, mainly to help staff members with child care. By 2004, the program added a licensed kindergarten and it now runs both the year-round child care program and a 10-week-long summer camp program for children aged six to 14.

“We actually added the program for 13- and 14-year-olds on the recommendations of our outgoing 12 year olds,” says Freedman. “They didn’t want to leave.” Those kids spend two hours a day volunteering.

“These are dynamite kids,” she says. “They are so accepting and unconditional with our residents. It’s really been very successful.”

The same can be said of the child care program and school offered by Isabella Geriatric Center, New York, NY. There, 39 children from three months through five years old enjoy playing and learning from and with older residents, through Project N.O.I.S.E.E.SM (Naturally Occurring Interactions in a Shared Environment Everyday). Like Chandler Hall’s program, this one was also born out of necessity.

  “We started a daycare in the early 1990s because there was a shortage of nurses,” says Janet Listokin. “We thought that if we could provide child care for nurses, we could attract more nurses. It was a very traditional intergenerational program and very limited.”

That grew, and eight years ago, Karen Ellefsen joined the staff as child care center director. “Janet visited me on one of my first days here and told me to push the envelope,” Ellefsen says. “So the children here are a natural part of the rhythm of the day. It’s not announced anywhere that they’re coming. They can do whatever they want on the floor. There is no area of the building that’s off limits.”

“It’s woven through the fabric of what we do every day,” she says of the child care component of Isabella. “The children might take their magic carpets to the seventh floor and have story time there. The residents can listen in, or a resident might even read the story to them. We’re big into talking about the journey—it’s not just the activity we’re doing, but the interactions along the way that are important.”

Thanks to that, she says, the children who start their educations at Isabella learn early on that oxygen tanks, walkers, or even missing limbs are nothing to fear. And some residents have seen unexpected benefits too.

“When we started this, we felt the children shouldn’t go to the dementia area,” says Listokin. “They got very upset with us, and so we decided to try it. All of our wanderers sat down. They didn’t wander when the kids were there.”

  Laura Lamb is challenging ageism, one school, and one student, at a time. As vice president of residential housing and healthcare at Episcopal Retirement Homes (ERH) in Cincinnati, OH, she manages a community that provides care for more than 450 residents. Lamb also serves on the LeadingAge Ohio Board, is a 2010 graduate of the LeadingAge Leadership Academy (formerly Leadership AAHSA) and the recipient of the Association of Professionals in Aging’s 2010 Project of the Year Award for ERH’s Person-Centered Care.

  During her time in the Leadership Academy Lamb developed an Action Learning Project that seeks to change the way the world thinks about aging. With the support of ERH, she developed the Council for Lifelong Engagement (CLLE), which seeks to create positive interactions between students and elders, highlighting the elders’ knowledge and talents in furthering the education of young people. The mission of this project is to develop a replicable model for schools and aging-services organizations across the country.

LeadingAge spoke with Lamb about this innovative program.

LeadingAge: What are the origins of the CLLE?

Laura Lamb: The concept came together after I read research about elderspeak, a way people communicate with elders that actually fosters their decline. That night, I saw a television show about the education system and it clicked: Why not get elders in the classroom and create a purposeful dialogue between elders and children? This is not just elders reading a story to children. This is elders teaching children based on their own work and life experiences, with the goal of eradicating ageism and fostering learning between generations.

LeadingAge: How does the program work?

Laura Lamb: The CLLE includes 12 board members, made up of ERH residents and staff … as a steering team to guide the work of CLLE. CLLE contacts a school that a board member may have a connection to and asks to make a presentation to the faculty about having ERH residents teach their students. A board member then speaks with a prospective resident about teaching and if the resident agrees, they both meet with the teacher to go over the curriculum and find out where they can contribute to the teacher’s lesson. A liaison is appointed to work with resident and teacher to make sure that they meet the needs of both and coordinates everything from transportation [and] lunch [to] documenting the experience. The program has evolved into having two volunteers who coordinate the process. They also follow up with the school with a newsletter article about the experience.

LeadingAge: How many schools participate?

Laura Lamb: We started in the 2010-2011 school year with one school. Now we are in five schools, including one high school. So far we have calculated that 1,200 lives [have been] touched.

LeadingAge: How often does the CLLE board meet?

Laura Lamb: During the school year we hold meetings every other week for an hour. It sounds like a lot, but I have found it is the one meeting where everyone shows up! We even meet twice during the summer.

LeadingAge: How has this impacted your organization?

Laura Lamb: This program has enriched our community and brought the residents and staff closer. It is all volunteer so there are no additional costs to the organization. Staff finds time to be a part of the program, and organization and supervisor support are crucial to the success of the program. We have calculated that there have been about 400 staff volunteer hours contributed so far.

LeadingAge: What advice can you give for someone interested in starting this program in their own community?

Laura Lamb: Start small with a pilot program. This will allow you to make mistakes and learn what works best for you, your organization and community. Set yourself up for success by getting the support of your organization early, utilizing your connections that you or your residents have in the community, and most importantly, get your elders out and in front of the community, they have a lot to share and offer.

LeadingAge: Are there any fun anecdotes from your experience that you want to share?

Laura Lamb: I was told by a teacher that kids usually start to think they “can’t do” a particular career path by the fifth grade. So last year one of the schools we worked with had a career fair featuring elders. 23 elders came to the school representing 23 different careers! By the end of the day, when the students were reflecting on the experience, a boy stood up and said: “What I have learned today is that old people aren’t sitting rotting away, they have something I can learn from.” I thought, BINGO! That’s exactly what I want kids and adults to realize.

What’s next?

Laura Lamb: We are in the process of creating a template and developing standards so that this can be replicated in every community. Our short term goal is to partner with other LeadingAge member organizations expand this program to run in 20 cities by 2020! This year we also received interest from a retirement community in Canada and another in Israel, so we are ready for anything.

Click here to learn more about this program.

Written by Kevin Bradley, manager, education development in LeadingAge’s Education and Leadership Development Department.

  Both programs usually have waiting lists for child care and kindergarten slots; as word has spread, more parents have become interested in the programs. But that doesn’t mean they’re without challenges.

“Having more hands and more staff to do these kinds of activities is quite expensive,” says Ellefsen. “We have one-and-a-half year olds who do a ‘scooter scuttle,’ where they ride scooters down the hall and into an elevator to go to another floor. The elevator doors open and out pop these little ones who ride up and down the hall. But while we can have one teacher with five older infants in the classroom, we can’t have one teacher going after five who are all willy-nilly. We need three to do that, and we need someone to put all the scooters away.”

  Freedman says she originally “begged, borrowed, and stole” to find space and the proper equipment for her infants and toddlers. The program has grown through the years, and it now has nine classrooms in the building and a staff of teachers and child development professionals. All of that costs money.

“We do have classrooms,” she says, “But all of our shared spaces were designed for all generations to be comfortable there.”

Isabella makes use of grants to bring in interns, students, and professionals, all of whom are trained in both the child care and gerontology aspects of the program.

“There is no shortage of ideas,” says Ellefsen. “We’ve built so much momentum and are ready to take it to the next level, and it’s all about getting the right staffing. We have to ensure that residents are treated with respect and not spoken to in a juvenile way, and that the children are safe and that the activities are developmentally appropriate.”

  The benefits of these intergenerational programs to everyone are immeasurable, say those who run them.

“Living in a long-term care community so often means you’re only around other older people,” says Listokin. “We’re introducing these very little people who have very big mouths, and we just love that.”

“We have one lady who comes into the baby room and she might rock a bouncer with her foot or push a stroller,” says Ellefsen. “She’s very limited in her capabilities, so a teacher might put a baby in her lap and let her feel like she’s holding the baby, even though the teacher is really holding the baby. She has no grandchildren, and we’ve made her a grandmother. We asked her, ‘Could the children call you Nana?’ and she was so happy. ‘I’ve never been a Nana,’ she said.”

  Freedman agrees. “Just the positive energy the children put into the hallways is incredible,” she says. “Just going from the classroom to the playground, showing off their new coats, things they normally do. The residents say, ‘Wow, that looks great,’ or are excited for them. Every child needs more adults in their life to support them, and our residents take that very seriously.”

“The real benefit for us is that we meet together on a regular basis and really get to know each other,” Freedman says. “We bake together, we celebrate birthdays, and we all enjoy live through each other’s eyes. We focus on strengths, and it’s very pro-social from both generations.”

Freedman says she’s amazed that more CCRCs haven’t jumped on the intergenerational care bandwagon.

“Once you’ve taught here,” she says, “it’s difficult to imagine how you could teach three-year-olds without the broader spectrum.”