Changes in traditional family structures, public policy arrangements, and new family care patterns are reducing opportunities for interaction between younger and older people in Europe and in Italy, especially when the latter live in residential care facilities. This may bolster age-related stereotypes in both generations and end up with affecting older people’s self-confidence, devaluing their emotional and relational capabilities. “
The nature of intergenerational relationships and their evolution over time may be influenced by different factors. Recent changes in these relationships have been explained by different theories on the evolution of family patterns [
The quantity and quality of intergenerational relationships also affect the capacity of transferring support and resources across generations, with a crucial impact on welfare state policies [
With regard to the Italian context, the country on which this article is focused, a trend has been observed in the attitude of an increasing number of Italians, especially “Millennials” (i.e., the people born in the 1980s or 1990s), who are refusing to have relationships with people of another age in different contexts (e.g., workplace, vacation, and health services) [
Moreover, in this country intergenerational solidarity has been pursued by means of privately employed migrant care workers (MCW), who are increasingly substituting relatives in providing daily tailored hands-on care to older recipients [
A minority of Italian households, corresponding to no more than 2% of the over 65-year-old population (
Another signal of a possible “intergenerational crumbling” [
The literature shows that frequent and meaningful direct contacts between cohorts of different generations can help overcome ageism, improve attitudes towards the other generation, and create intergenerational solidarity [
The first type embeds community-based programs involving community-dwelling older adults, which are mostly carried out in public social centres [
The second type of IGPs includes programs addressing institutionalized older people with cognitive impairment. These are carried out mainly in nursing homes and day-care centres [
Regardless of the place and age range of the recipients, the literature shows that IGPs can have great effects on individuals of both age groups [
Concerning the effects on frail older people, IGPs can improve their emotional well-being and prevent depression [
As far as community-dwelling and active older adults are concerned, IGPs may also enhance “generativity” [
With regard to younger age groups, IGPs may increase their life satisfaction [
Previous IGPs carried out in Italy have never included active older people volunteering in nursing homes as mentors for teenagers and frail older people living in residential care facilities and adolescents as a specific joint target group [
This study tested an IGP having two main specific objectives: one for the adolescents and one for the institutionalized older adults. The first objective was to promote a better prevention of intolerance and neglect towards older people, by breaking down age-related stereotypes among adolescents, through the awareness of two different ageing patterns: active older volunteers and disabled older people. The second objective of this study was to promote institutionalized older people’s social inclusion, emotional well-being, and relational capabilities, by “breaching” the wall of Italian residential facilities, which are predominantly still based on an age-segregated organizational pattern.
Thus, this study was aimed at creating community spaces and activities in which adolescents, institutionalized older adults, and active older volunteers could meet and interact with each other.
The study was developed by using a research-action methodology [
The study involved 25 14-year-old students (18 males and 7 females) and three teachers from a junior secondary school; 16 older residents (mean age: 83) and three social workers of a residential care facility for older people (hosting both a nursing home and a day-care centre); and 16 older volunteers (mean age: 70) from two different volunteers associations (Table
Typology of participants.
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Males | 18 | 6 | 5 |
Females | 7 | 10 | 11 |
Total | 25 | 16 | 16 |
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Mean Age | 14 | 70 | 83 |
Adolescents were chosen as IGP recipients from among peers, because, in this phase of their life, they have to build a new self-image and reconcile the changes induced by rapid biological and psychological growth with the strong social pressures coming from the outside world, e.g., the messages and values coming from the media and the informal groups they belong to [
The secondary school involved in the IGP was chosen due to its promising track record of interest in the field of intergenerational activities, as reflected in its previous participation in a short IGP aimed at transferring digital competences from students to community-dwelling older people.
Institutionalized older people were chosen as recipients of the IGP because they represent a type of older people among the least investigated in Italy. This IGP residential care facility, hosting totally 42 residents in the nursing home and 20 users in the day-care centre, was selected because many of its residents, though disabled, were still in a sufficiently good cognitive condition and thus able to interact with each other and with youngsters. Although in cognitive good health, many users of the day-care centre suffered from challenging physical and psychological conditions, such as arthritis, ictus-related effects, cardiac and respiratory distress, and anxiety.
The presence of active older people volunteering in nursing homes had the objective of providing youngsters with an example of active ageing and with a support to deal with home residents. The two voluntary associations were selected because they involved older volunteers actively engaged in supporting older people in the city. In this way, they represented a positive example of active ageing, potentially contrasting with and/or integrating the condition of frailty characterizing older residents in the nursing home. The first organization, namely,
The research team was composed of a sociologist, a social worker, and an expert in the psychology of communication. Researchers tried to limit the potential investigators’ bias through frequent discussions and constant reflective commentaries with a senior researcher in gerontology. This expert acted as a supervisor and kept an external role, since he did not actively participate in carrying out the activities, but observed their execution by taking notes. To keep the reliability of the study as high as possible, researchers paid constant attention to tracking and reporting processes [
The study adopted a qualitative methodology for data collection and analysis. The interview topic-guide for the youngsters covered five conceptual areas: representation of older people; relationship with grandparents; knowledge of and experience in volunteering; knowledge of intergenerational solidarity; and active ageing. Interviews with older people concerned three main issues: self-representation, representation of young people, and intergenerational relationships. The topic-guide of the interviews with older volunteers focused on four main topics: the condition of both day-care centre and residential older people; intergenerational relationships and solidarity; relationships with older and younger people while volunteering; the concept of active ageing in connection with the voluntary activity.
The data collection took place before (T0), during (T1), and after the implementation phases (T2) of the study (Table
Data Collection Tools per Typology of Participants.
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Students | Focus Group | Interview | Interview |
Older persons | Interview | Interview | Interview |
Volunteers | Focus Group | Focus Group | Focus Group |
Finally, ethnographic notes, audio and video materials, the collected participants’ impressions and feedbacks on the delivered activities, and the relational interaction experienced by the researchers contributed to data building [
The interviews with older people and the focus groups with adolescents were audio-recorded and transcribed verbatim. Textual data were managed with the support of MaxQda11 software and analyzed by using qualitative content analysis [
An action plan was defined in collaboration with the organizations involved, according to a participatory approach. In this way, each actor could contribute and take responsibility for the contents and the delivery of the actions to be performed. The management of the program followed a circular pattern in which plan, action, survey, and analysis alternated continuously and fed each other, in order to reflect the effects of the actions [
All activities were intended as instruments to help the interaction between generations, make people aware of their potentials, and facilitate their emotional involvement. Furthermore, they aimed at creating connections and “co-hold” participants’ needs [
The IGP started with two meetings designed to prepare each group for the first contact with the other. Two videotapes introducing the students and the older people living in the facility were prepared with the help of teachers and social workers. These were shown to the counterparts, prior to a first face-to-face meeting.
Considering that the most effective way of building relationships involving different generations is to share activities, spend time together, and enjoy it [
Description of IGP Activities.
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October | Overcoming stereotypes between generations | Increasing reciprocal knowledge | Watching videos of students and older people introducing themselves and discussion about them | 4 |
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November | Fostering relationship | Introducing younger generations to the dynamics of long-term care | Visit of students to older people in rest home and day care centre | 1 |
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December | Fostering relationship | Reinforcing the collaboration between counterparts | Acting class led by an older woman and final show before Christmas | 8 |
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Promoting residual capabilities of older people | Enhance manual skills of elderly | Laboratories for hand made products and exchange of Christmas gifts and visit of older people to adolescents’ school | 2 | |
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January 2016 | Assessing stereotypes and prejudices | Identifying stereotypes | Focus groups and interviews | 2 |
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February | Fostering dialogue between generations and educating on intergenerational solidarity | Increasing knowledge of active ageing and volunteering with older people | Students and elderly people’ visit to headquarters of voluntary associations | 2 |
Testimonies of volunteer at school | 2 | |||
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March/April | Promoting intergenerational learning | Fostering dialogue | Drawing and comparing the family trees (students and older people) | 1 |
Fostering collaboration | Preparation of final public event: musical and choral laboratories | 6 | ||
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May | Raising the awareness of citizens and community about intergenerational relationships | Dissemination of project results | Final public event | 1 |
Assessing stereotypes and prejudices | Program assessment | Focus groups and interviews | 2 | |
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| 33 |
The process of categorization, coding and analysis of quotations of adolescents attending the IGP at Time 0 and Times 1 and 2.
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Representation of older people | Physical/cognitive condition | Bad/good | | |
Behaviour and psychological characteristics | | | ||
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Social/economic role | Burden | | ||
Experience exploitation | | | ||
Usefulness | | | ||
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Intergenerational relationship | Kind of relationship | Conflictual | | |
Friendly | | | ||
What young people can do for older people | Teach ICTs | | ||
Understanding | | | ||
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Listening | | | ||
Psychological support | | | ||
What older people can do for young people | Tell | | ||
Read | | | ||
Teach and Mentor | | | ||
Take care | | | ||
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Lesson learnt from | The contact with older people in nursing home | Awareness | | |
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Older volunteers’ mentoring | Changes of attitudes towards volunteering | | | |
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Appreciation | | | ||
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Suggestions for improving the relationship with the youngest | Intergenerational meetings in nursing home | The role of adults | | |
The role of the school authority | | | ||
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The process of categorization, coding and analysis of quotations of older people attending the IGP at Time 0 and Times 1 and 2.
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Representation of young people | Negative representation | Egoist | | |
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Positive representation | Altruist | | ||
Able to listen | | |||
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Intergenerational relationship | Kind of relationship | Indifference/distance | | |
Friendship | | | ||
What young people can do for older people | Nothing | | ||
Physical help | | | ||
ICT literacy | | | ||
Company | | | ||
What older people can do for young people | Nothing | | ||
Love | | | ||
Listening each other | | | ||
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Impact on | Self-representation | Able to feel emotions | | |
Able to give love | | | ||
Mood | | | ||
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Suggestions for improving the relationship with the youngest | Intergenerational meetings in nursing home | More meeting chances | | |
Talking | | | ||
Systematic visits | | | ||
More time to spend together | | | ||
Trips outside and fun | | |
The main objective of this IGP regarding adolescents was to deconstruct the age-related stereotypes, by letting them experience two types of ageing: the disabled and institutionalized older people at risk of social exclusion and the older active volunteers in nursing homes.
Table
Prior to the research-action (in the following paragraph referred to as IGP), students described the relationship between young and elderly people essentially as a “conflict of interests,” as plastically highlighted by one pupil’s remark: “
Already after the first six months of joint activities, however, students started slowly to change their opinions on older people and to overcome the stereotypes on ageing they originally had: “
At the end of the program, the conflict gave way to friendship, empathy, listening, and mutual understanding: “
The IGP stimulated the change in preconceptions about the elderly and helped adolescents reflect on the condition of those in nursing homes, while developing critical thinking. Before the beginning of the program (T0), adolescents thought they could only teach the elders the use of new technologies. During the project implementation, however, the young realised they could get in touch with older people through ways that had the characteristics of solidarity, i.e., by volunteering, listening, and providing physical help.
Thanks to the IGP, some students continued meeting older persons in the care facility: “
Adolescents, although prepared for the first meeting with the elders, experienced a strong emotion when they visited the nursing home residents for the first time; some of them were moved and cried to see frail and inactive older people sitting in a wheelchair. Despite this initial impact, the interaction between students and elders led to a progressive increase in the attitude of the youngsters to speak to the elders and involve them in activities, up to playing and joking with them and exchanging looks of complicity.
Thus, we can say that the interaction with the institutionalized older people led to a change in the attitude of the adolescents, who improved their ability to listen, empathy, and understanding of the elders.
The intergenerational exchanges were boosted by older volunteers, who had a mutual-esteem and trusting relationship with the adolescents. The teenagers admired the altruism, the spirit of service, and the listening attitude of the active older volunteers and looked to them as examples to follow. The adolescents often asked the volunteers for advice on how to interact with the older residents, and they agreed together on the most effective means to involve them in the activities.
The main aim of the IGP concerning institutionalized older people was promoting their social inclusion, emotional well-being and relational capabilities, by improving their self-esteem and the representation of themselves and that of adolescents.
Table
At the beginning of the project, older people in both the nursing home and day-care centre had a negative image of themselves, because they felt physically limited: “
To plan the specific IGP activities, the researchers had to start from this context of mistrust and resignation. Nevertheless, after the first 15 events of common activities (which took place around Christmas time), the older people’s opinion slowly changed and they started defining students as “lively,” “polite,” “kind,” and “clever.” During the implementation of the program, older participants began thinking that it was possible to have a dialogue between generations and that adolescents might somehow be of help to older people.
At the end of the program, seniors felt that the young were ready to listen and to help them and that there could be a friendship between the young and the old, based on closeness, intimacy, and confidence. As an older participant clearly expressed it, “
At the end of the program, the feeling of being able to have meaningful relationships with younger pupils started building a significant hindrance to the sense of uselessness that some of the older people felt in the nursing home: “
Some older participants also realized that they were still able to do something useful for adolescents: “
The observation of the interaction between young students and older residents during the first two meetings showed a certain overall distrust among the latter who, sitting stiffly on their chairs, spoke neither to the adolescents nor to the other residents, but only to the volunteers. Nevertheless, during the program implementation, adolescents and older residents learnt to know each other, interact, and speak. The language of the latter became less formal, the looks more understanding, and the gestures more relaxed and they included searching for a physical contact, such as a handshake or a hug.
Older volunteers facilitated the building of the relationship between young and older persons, by supporting students in speaking with the older care recipients and helping the latter carry out the activities proposed. Most of them reported that they were impressed by the friendly relations born from the interaction between students and older people in the nursing home after the first four months’ activities. Older volunteers had a positive opinion of young people in general; they had a good relationship with them and thought that students were interested in the program activities, as reported in the following quotation: “
Older volunteers drew a picture of the older residents as people feeling abandoned and isolated, because they usually received very few visits from family members and had very few contacts with the external local community. Moreover, the interaction with other residents was often characterized by conflicts, because these relationships were forced and not chosen.
Volunteers contributed also to a better understanding, including among the researchers, of the time perspective in a nursing home. There is first a time “for waiting”: waiting for a son, a daughter, or a grandchild to come and visit. Then, it becomes the time of disillusionment and frustration: “
The above study confirms the potentially positive impact IGPs can have on older and younger cohorts, integrating already existing evidence reported by the literature. Thanks to the joint activities shared together for the “
On the one hand, the IGP advanced adolescents’ prosocial behavior [
On the other hand, the study gave older participants the opportunity to meet younger people and to be part of the community, by reducing social exclusion [
While the program was expected to impact on older residents’ emotional well-being, it was not expected to have an effect on their mental health. This is the case of the older woman affected by depressive anxiety wandering around the room of the day-care centre, who stopped doing so because she was attracted by the activities carried out by the youngsters. The day-care centre social workers reported that they had tried to involve her in various activities many times, without success. It can be argued that the adolescents in the nursing home distracted the lady from her depressive anxiety and persuaded her to sit down, play with teenagers, and interact with them, albeit for a limited time. If we consider that depression is a loneliness correlated disorder quite commonly found among institutionalized older people [
Older volunteers, in turn, had the chance of mentoring young students and this strengthened their generativity, mentoring capabilities [
The main novelty of this study lies in implementing an IGP targeting adolescents and institutionalized disabled older people as a joint target group and in additionally involving older volunteers as mentors of the adolescents, helping the latter to more easily understand the living conditions of nursing home residents. Another novelty was bringing the elders out of the residential facility: once to school, twice to the conference room of the city Municipality building, twice to the headquarters of the voluntary associations, and one last time to participate in the final event open to policy makers and citizens. These visits helped older people overcome the wall of isolation from the rest of the community that is partly the consequence of the persistence of age-segregated services and of the lack of economic and human resources for social animation, leisure, and social interaction, especially in Italy [
A fourth limit of this IGP was not to involve the middle-age generation, i.e., the older people’s children and/or the adolescents’ parents, because adults might play a crucial role in enhancing the relationship between young and older people, as “gatekeepers of intergenerational exchange” [
The “
This study can certainly contribute to enrich the debate on the quality of life and the quality of care of older people in nursing homes, both in Italy [
Data related to the results reported in this article are available (in Italian language) at the following link (Study Report and other resources)
The authors declare that they have no conflicts of interest.