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Good for each other
Day-care centers that mix the generations have doubled in the last decade.
Researchers are finding that they boost children's self-esteem and improve elders' moods.
By Susan Brink
LA Times December 5, 2005
The Elderly woman, white hair brushed and tidy,
peach lipstick matching her velour jogging pants, isn't quite sure why she goes to the adult day-care
center in Van Nuys, and can't remember how long she's been going there. "My memory isn't so good anymore,"
says Irene Overlee, 88, of North Hollywood.
But she remembers every word of "The Itsy Bitsy Spider,"
and that's all that matters right now to the half -dozen wild-haired toddlers in the center of a circle
made up of Overlee and four other seniors. The children are dancing and clapping as the seniors chant
the spider ditty - until, on cue, Overlee and the others reach the line about the rain coming down.
In unison, they upturn the contents of a paper bag, causing crumpled, colorful paper to rain down on the
floor.
The toddlers squeal with delight. They want to do it again and
again. They pick up the papers and refill the bags held open by the five senior citizens, their fun
undiluted by the fact that the adults around them have canes, walkers, hearing aids and, in some cases,
mild to moderate dementia. These things are all very familiar, for the seniors and youngsters attend day care
at the same site.
Children and elderly people increasingly live in age-segregated
worlds. Developmental experts say that the growing number of facilities offering intergenerational day care, where seniors like Overlee and young children spend time together, is a partial answer to some
undeniable demographics.
Today, 45% of grandparents live more than 200 miles from their most distant grandchild, according
to a survey by AARP. Not coincidentally, that's exactly the percentage of grandparents who say they don't see
their grandchildren often enough.
To geographical distance, add the fact that huge numbers of young children
need day care. About 55% of mothers of infants are in the workforce, according to the U.S. Census Bureau, and the 44%
of Americans who have both aging parents and children younger than 21 are so squeezed that they've been
labeled the "sandwich generation".
Finally, factor in the reality that our population is aging, and that
increasing numbers of people will need doses of mental stimulation along with physical care. There are 35
million people older than 65, with that number projected to rise to 55 million by 2020 and nearly 87 million by 2050.
From the youngest to the oldest, a bond
In response to these trends, close to 500 day-care centers nationwide say they have
intergenerational components , says Donna Butts, executive director of Generations United, a Washington, D.C.-based advocacy
group for such programs. That's about twice the number that existed 10 years ago, says University of Pittsburgh
researcher Sally Newman, editor and founder of the 2-year old Journal of Intergenerational Relationships, a publication that
studies this kind of care.
"People want to start these programs, and they want more
concrete information" says Butts, who observes that calls to her organization for help have been
increasingly specific over the last few years. "Parents will call and say their children's grandparents live
far away, or adult children will call and say their parents are depressed in nursing homes."
A small but growing body of science is beginning to provide information on
how to develop programs that combine care for these bookend generations in a way that best helps them help each other.
"People," Butts says, "are starting to wake up and smell the demographics."
Role Model
A leader in this movement is ONEgeneration Daycare in Van Nuys,
which began in 1993 as a serendipitous pairing of an adult and preschool center that were next-door neighbors
on Victory Boulevard. Now national experts hold it up as a model for intergenerational care.
Each week, some 120 senior citizens come to ONE generation, usually
for about three days. Ninety-two children, infants to 5 years old, also go to the center daily.
They're not simply tossed into a room together: Mostly the children are in age-specific groups with all the appropriate
accouterments - cribs, tricycles, Play-Doh and swing sets. And mostly the older adults are in comfortable
day rooms hearing current events talks, dancing a fox trot, playing a board game or chatting with neighbors.
But several times a week, for half an hour or so, those seniors who want to visit the kids' areas mosey
across the sidewalks and pathways that separate the two facilities. The might cook with a child, bring
a guitar and play some old cowboy songs or simply sit and rock a baby.
"The needs of the two generations fit like a glove," says Kelly Bruno, vice president on ONEgeneration.
The children want an adult smile of acceptance. The adults want to feel needed.
"They can share their natural instincts," adds Lois Pellergrino, director on My Second Home, an
intergenerational care program in Mt. Kisco, N.Y. "In that setting, the walker is no longer an assistance
device. It becomes a jungle gym."
The notion of mixing generations has long made intuitive sense. After all, that grandparents love and
care for grandchildren is as old as human history. As people age, according to psychologist Erik Erikson's
theories of lifelong development, they need to pass the torch, to share lifetimes of wisdom, to feel they're
leaving a legacy behind. Erickson, who developed his theories in the 1950s, summed up those needs in a stage
of human development he called generativity. Its opposite: stagnation.
Today there's an increasing appreciation that older people need social contact to thrive - and to live.
According to a 2001 editorial in Psychosomatic Medicine by James S. House, a sociologist at the University
of Michigan, isolation is as deadly to aged adults as cigarette smoking. It increases the risk of disease and
reduces the odds that they'll be alive in five years.
Researchers have also started to measure the benefits of mixing generations. Shannon Jarrott, a
professor at the Virginia Polytechnic Institute and State University, is the lead investigator for an
adult day-care research study taking place at ONEgeneration. So far, the team has found that even people
with mild or moderate dementia benefit from being with youngsters. Using a technique called dementia
care mapping (which involves observations of smiles, laughter and conversation), they found that contact
with youngsters improved mood and interaction, at least during the time spent with the children.
Intergenerational care seems to help children too. A still-unpublished study by researchers at the Marilyn
and Gordon Macklin Intergenerational Institute in Findlay, Ohio, compared 100 3- and 4-year old
preschoolers who had been in intergenerational day care for at least a year, with 100 preschoolers in
typical day care. The kids who interacted with seniors were an average of 11 months ahead of kids in
standard day care on measures of social development, says Vicki Rosebrook, executive director of the institute.
"They were most advanced in manners," she says. "I guess grandmas and grandpas teach them to say 'please'
and 'thank you.'"
Steve Zarit, who heads the department of human development and family studies at Pennsylvania State
University, is just wrapping up another study on the effect of intergenerational care on children. He's
comparing children in kindergarten through third grade who have been in the Van Nuys program with those
who had been in standard day care. He hopes to find improved language skills and self-confidence in
children exposed to intergenerational care, bolstering a 1993 University of Missouri study that found
greater self-esteem, and even improved family relationships, among children in an intergenerational program.
So when Ryan Collura, 5 1/2 months old, settles himself comfortably on Lois Condon's lap at the Van Nuys center
and takes eagerly to his bottle, they each get something out of it.
He pulls at her thick oversized bifocals as she rocks him. The glasses slide down her nose, but she deftly
pushes them back into place with one hand while she holds the bottle steady with the other. She never
misses a beat in her rocking-chair rhythm. "This is the best thing in the world," says the 71-year old Enchino
resident. "I love it."
The meshing of needs is apparent again as Keith Mullins, 61, holds a bowl filled with muffin mix, and
3-year-old Joanna Ray, a curly haired blond from Lake Balboa, stirs with a big spoon. Mullins, of Van Nuys,
can't both hold and stir, even if he wants to. He's in a wheelchair, his left arm paralyzed as a result of an
automobile accident five years ago. Joanna hasn't yet developed the strength or the coordination to both hold
the large bowl and stir.
So they help each other out: Mullins holds with one hand while she uses both her hands to maneuver the big
spoon. "Sometimes we switch," says Mullins. "She holds and I stir."
Time to settle in
To an outsider, the scene appears effortless, idyllic - in lock step with the romantic notion that the
older generation always has wisdom, kindness, humor and guidance to offer the youngest. In fact, says Butts,
good intergenerational day-care centers are very deliberate about what they do. They require programs
that enhance the lives of both generations, staff members who understand the needs of children and elders, and
activities aimed at interaction, not just entertainment.
It's certainly not as easy as just throwing two generations of strangers together. Guidance can be a rusty
role for many older people who, with age and disability, have often become increasingly dependent. The
company of children is not for everyone. Some grown-ups are glad their child care responsibilities are well
behind them. Others, perhaps never cared for children.
Don Cohon, director of the institute for the Study of Community-based Services in San Francisco,
says he was surprised by the reaction of the audience during a recent talk with seniors about having
children join their day-care program. "There was a lot of vocal opposition from women saying, 'We've done this. We're tired.
It's our turn now,'" Cohon says. "They were very clear that this was not something they wanted."
Others, such a Bob Winslow, a 56-year-old with early-onset Alzheimer's disease who attends ONEgeneration, enjoy
children - up to a point. "Sometimes I like them, and sometimes I don't," he says. People like Winslow
need what researchers call "escape space," in line with the cliche about grandparenting. It's a wonderful role
because, grandparents say, at the end of the day you get to go home.
Even those seniors who thrive in the company of children need time to get to know new people, just like
anyone. And youngsters need time to get comfortable with the paraphernalia of aging: wheelchairs, hearing aids,
thick glasses and canes. "They need some icebreakers, just like the rest of us," Jarrott says.
Luckily, settling in doesn't take much time, according to a 2003 study in the Journal of Intergenerational
Relationships. For a year, researchers at a day care program in Port Jefferson, N.Y., videotaped the
interaction among 20 preschoolers and 27 older adults suffering form dementia, Alzheimer's, diabetes, blindness
or depression. The children, ages 3 to 5, and the adults, ages 63 to 95 met for 45 minutes once a week.
When the two groups first met, they hardly acknowledged each other. But after only three sessions
together, the adults began to seek out specific children to talk to or to bake or draw with, and children
began to sit next to chosen adults.
After five weekly sessions, children and seniors were actively helping each other stir pots or find
out the right color crayon without coaxing from the staff. By week eight, most children and adults were
routinely embracing at the beginning or end of the session.
A few children and adults never warmed to each other and seldom communicated across the generational line,
underscoring the point that such care is not for everyone.
Successful intergenerational centers also need projects appropriately presented. If adults and children are
all thrown together and given building blocks, it's condescending to the grown-ups, says Bruno. The
danger is of infantilizing older adults by having staff members treat both groups as though they're children.
A 2002 study published in the Gerontologist examined two adult day-care programs that brought children
in for part of a day, and found through observations and follow-up interviews that the seniors enjoyed
programs that were voluntary and that put them in the role of teacher.
When adults volunteer for the role of mentor, the building blocks become a teaching tool for the adult and a
learning tool for the child, says the University of Pittsburgh's Newman Together, old and young can
build a castle or a skyscraper. The child is practicing coordination and balance. An adult recovering
from a stroke, for example, is getting occupational therapy as well as fulfilling a need to pass on
knowledge.
But even with all these checks and balances in place, some specialists worry that intergenerational day care
may give children a distorted view of the elderly because they only see elderly people with health problems
severe enough to require some daily assistance. That could give them as warped a view of aging as if they see
no older adults at all, Newman says.
"The image of an old, frail person is not the image of all older adults," she says. "If these children have
their own grandparents who are high functioning, then they get the whole picture. I often advise co-location centers to have some high functioning adults as well, but so far it has fallen of deaf ears."
In a children's room at the ONEgeneration program, Robert Maneri, 71, of Reseda, finished reading "I Spy"
to 2-year-old Dylan Shragg. then he started a book about the purple TV dinosaur Barney, and soon they
were both singing: "I love you. You love me. We're a happy family."
Nap time approached for Dylan, and lunchtime for Maneri, so Dylan scooted off Maneri's lap, they shook hands
and said good-bye.
"Robert," Dylan called as they parted. "I like you, Robert."
So when he comes home, it's not surprising that he talks not only about Robert, but also about the other
older people at his day care he calls "neighbors."
"We're big proponents of day care for the socialization," says Daylan's father Stephen Shragg of Encino.
"This adds to it - a respect for older generations."
As for baby Ryan, it's a little soon to tell what mixing up the generations will do for him. He's a happy
boy, whether rocked by his parents, his own grandparents, his day-care teachers or Lois Condon.
"He's only 5 1/2 months old, and he's bringing happiness into someone else's day," says his father,
Frank Collura of Lake Balboa.
"He's already starting his work."
Tips
Mixing older and younger generations makes sense for some, but may not be for everyone. Here are some tips
from experts on what to look for if you are considering intergenerational care for an aging parent or a
young child:
For your parent
Have cross-trained staff or staff trained in senior care always available, so that your parent is
appropriately cared for and treated as and adult, not a baby.
Voluntary, not mandatory, interaction with children.
Daily health checks for children and adults alike (fevers, runny noses or stomachaches rule out interaction.
Activities designed to treat the senior as an adult, not an aging child.
Limited time with children, the bulk of time with peers.
A neighborhood-like physical arrangement, enabling seniors to walk over to visit children.
A senior who returns home happy, smiling, not bored.
For your child
Cross-trained staff or child development staff always available, so that your child is supervised by experts
who understand appropriate behavior.
Limited visits with seniors (perhaps daily half-hour sessions), the bulk of time with peers.
"Escape" space with teachers or aides for the child who might be shy around elders.
Activities designed to encourage one-on-one supervised interactions, such as a senior telling a child a story, rather than passive
entertainment.
If you child has no regular contact with healthy, aging people such as grandparents: a facility that
occasionally brings in healthy senior volunteers to show children that many older people continue to function
without disability.
Predictable visiting times, for example, after snack time. Children like to know when they'll be getting a visit.
A neighborhood-like physical arrangement, where children can be taken to visit seniors.
A child who comes home and happily talks about teachers, other children and their elder friends.
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