Good for each other

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 tissue 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.

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 a 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 ONEgeneration, 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. They 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 of ONEgeneration. The children want an adult smile of acceptance. The adults want to feel needed.

“They can share their natural instincts,” adds Lois Pellegrino, director of 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. Erikson, 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 Encino 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 as 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 from 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 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 on 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 goodbye.

“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 Dylan’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.”

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(BEGIN TEXT OF INFOBOX)

Merging the generations

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 an 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 in children.

* 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 your 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.

-- Susan Brink