An interdisciplinary team of researchers from Griffith Business School and the Menzies Health Institute Queensland led by Professor Anneke Fitzgerald (program evaluation), and Dr Katrina Radford (workforce evaluation) from the Department of Business Strategy and Innovation, and by Dr Nerina Vecchio (economic evaluation) from the Department of Accounting, Finance and Economics, are in the final stage of a project, that has successfully trialled two intergenerational care models with learning programs that improve the wellbeing of people with cognitive decline.
The research: A trial to evaluate innovative models of respite care – implementing an inter-generational community day care centre for Australians living with dementia, was financed by the Australian Government’s Dementia and Aged Care Services fund, and later named the Intergenerational Care (IGC) project.
It follows the team’s earlier research that examined child care and aged care sectors in 2014, and other studies covering policy analysis, global programs, preference models and feasibility.
“Most of the research we are doing, is multidisciplinary first off, but secondly it’s all developmental,” said Professor Fitzgerald.
“Our project is unique in that it focuses on building a strong business case for operating intergenerational care projects in Australia. In particular, we are interested in building a strong education pedagogy that fits within child care and aged care sectors as well as exploring the workforce and economic cost/benefit analysis that sits behind the innovative program to keep it a sustainable practice for industry,” said Dr Radford.
The IGC project involves children and elderly people interacting in a day care facility with structured learning program activities once a week, over 16 weeks, under the supervision of formally trained caregivers. Two different models of care were trialled, one a shared campus model and the other a visiting campus model. It’s suggested an Intergenerational model of care, which includes learning programs should be considered to assist people living with dementia.
“Our project ran 16 sessions over 16 weeks, across 6 different organisations throughout QLD and NSW. While some industry partners were established before the grant, some were newly established because of the grant opportunity. Since the trial completed, some of our partners have continued a revised program,” said Dr Radford.
“The Intergenerational Care program involves putting together younger (aged 3-5 years) and older (aged 65+) people in a purposeful manner to share in educational experiences, that involves learning from each other under the supervision of formally trained caregivers.”
“What we have done is actually incredibly hopeful and uplifting, and builds resilience in the community. It’s been really good to work on, one of the nicest projects I have ever worked on,” said Professor Fitzgerald.
There are currently over 400,000 Australians living with dementia and by 2056 this is expected to increase to over 1 million. Currently, dementia is the second leading cause of death in Australians aged 65 and over, contributing to 5.4% deaths of males and 10.6% of all deaths in females each year. To combat this expansion a merging of child care and aged care systems, along with the widespread implementation of IGC programs has the potential to solve many of Australia’s social and economic challenges associated with child, aged and respite care.
”The umbrella program works sits under building an ‘age friendly’ community,” said Professor Fitzgerald.
“There’s a need to focus on how to prevent loneliness and this is one of the ways of doing this, to prevent social isolation and loneliness by bringing generations together.”
“Where we are all lagging behind of course, all Western people, is behind the Asian population. We are lagging because here it (IGC) is novel and we want to normalise it. Over there is no doubt about intergenerational relationships as a part of their family make-up.”
“And that is why it’s interesting for us to work with CASS in Sydney, which is the Chinese Australian Services Society. They were very interested in what they felt was a gap, which is – we’re not as a norm mixing with children, we are missing that from the home country,” said Professor Fitzgerald.
“Additionally, limited health care budgets and population aging have resulted in a need to determine value for money for care programs,“ said Dr Vecchio.
“Economic evaluations from early childhood and older care programs demonstrate that the impacts of intergenerational care are likely to be broader than the psychological aspects currently reported in the literature.”
“A challenge for analysts is the evaluation of intergenerational care programs that capture multiple aspects. Results from an economic analysis is particularly useful to agencies seeking to identify the business implication of changing cost items, regulations and staff ratios.”
“Our results will guide future programs in the pursuit of cost effective and sustainable service options,” said Dr Vecchio.
The major goal of the IGC project was to examine the feasibility of an intergenerational care learning program in Australia and to develop a business case to support its introduction into care facilities. This involved looking at IGC through three different lens; business feasibility, workforce sustainability and educational theory for elders – eldergogy, and securing partners from industry networks; Wesley Mission, Blue Care, Bonnie Babes Christian Childcare Centre, Churches of Christ, Little Hands and CASS.
“This project will deliver the initial business case for running a successful intergenerational care program in Australia,” said Dr Radford.
“After our initial investigation about the feasibility of the program (looking at legislative barriers and supports, workforce similarities and differences and conducting a Delphi feasibility study of the models and demands for services), we recruited Dr Jennifer Cartmel who is an expert in Early Childhood services in Australia and leads our education sub-unit.”
“We then recruited other vital team members, Associate Professor Neil Harris who co-leads our social behavioural evaluation of effectiveness with Anneke, Professor Wendy Moyle, who provides expert dementia insight and Dr Xanthe Golenko, who is our project manager.”
“We then found our consumer experts John Quinn, and Glenys Petrie (aged care) and Kimberley Fitzgerald (child care) who were a critical element of this project that without them, as were our industry partners – Wesley Mission, Blue Care, Bonney Babes Christian Childcare Centre, Churches of Christ, Little Hands Early Learning centre, and CASS (Chinese Australian Services Society), this project would not have been successful,” said Dr Radford.
Griffith researchers investigated the educational qualifications and learning programs required for effective intergenerational care. A key question asked was how will people become qualified in IGC, and what are the workforce employability and retention aspects of this field?
“There is no point having an intergenerational program, where you do not have people trained in intergenerational care. So it’s really important to pursue this, which is the basis of the work that Dr Radford is doing in this space,” said Professor Fitzgerald.
“The qualification in intergenerational care is still being developed and we are currently applying for funding to pursue the development of this as well as the development of a national professional network of intergenerational professionals, who can come together and share resources, tools and tips with each other,” said Dr Radford.
“The other element which is important is the educational learning program itself, because no one ever talks about eldergogy, which Anneke is doing a systematic literature review on at the moment.”
“Often these programs are run with the children in mind, but not the older adults. Whereas, what we wanted to do was give a program that has beneficial gains for both populations,” said Dr Radford.
The IGC trials were conducted across four locations in Queensland and NSW with industry partners, and consumer experts representing child care and aged care sectors. One involved multicultural interaction between English children and Chinese elderly participants, and two trials incorporated elderly participants with early stage cognitive decline.
“The shared campus models were trialled at Wesley Mission and CASS, and our visiting campus model was at Bonnie Babes and Blue Care, where Blue Care seniors went to visit the children at Bonnie Babes. And the other one was Little Hands and Churches of Christ, where the child care participants went to the aged care site,” said Dr Radford.
“We worked with Wesley Mission in Brisbane, where child care and residential aged care were literally across the road from each other. Similarly with CASS in Sydney, where child care is on the same site as the residential aged care facility. We called that a ‘shared model’.”
“In terms of the ‘visiting sites’, the children from Little hands in Southport visited the respite care clients at Churches of Christ in Southport. A maxi taxi took the children to and from the site from the childcare centre, which was about 5 minutes drive away,” said Professor Fitzgerald.
“Equally, older residents from Blue Care in Coomera visited the Bonnie Babes Christian Childcare Centre for the program. The Blue Care bus travelled the participants between the sites. So transport was important.”
“And additionally, I think that one of the things that it would be really lovely to highlight, is how important consumers are to our research. Our consumer representatives were vitally important in every step of the research in terms of consultations and idea generation. To that effect they were our co-researchers,” said Dr Radford.
A mini-documentary video was created to capture the program trial at Bonnie Babes child care, with the assistance of Griffith film school. In this video, Blue Care takes their elderly consumers to Bonnie Babes to interact with the children.
“Some of our preliminary data, and it’s still being analysed so it’s still preliminary at this point, did find that older participant’s mood did increase as the program went on, which is great. But with children there wasn’t a valid measure,” said Dr Radford.
“In the video, the supervisor was talking about the mood scale, and that was the only data that was mentioned. Whereas my recommendation is not to use mood scales on younger participants in the future, as the kids thought it was a colouring in piece of paper,“ said Professor Fitzgerald.
“For older people there was an interesting finding, that even though before and after they did not have much change, over time they were happier coming to the sessions, they were looking forward to it!”
Our research team’s work has recently assisted industry to secure co-investment funding to build the first intergenerational care facility in Wellington, Dubbo, New South Wales. This facility will combine child care and aged care facilities, and run intergenerational learning programs between the groups.
“There was a gentleman who contacted us about two years ago or longer now, and he asked could we help him with endorsing a proposal to local government, and this gentleman is situated in Wellington, outside Dubbo,” said Professor Fitzgerald.
“In Wellington the biggest industry is the jail and there is no child care centre in Wellington, so mothers that work in the jail have to drive all the way to Dubbo for 40 mins. (for child care), and 40 mins. back then start work.”
“So there was a big gap and there needed to be a child care centre in Wellington. Initially it was knocked back, so he was very upset. Because they had the land and some money, but they needed to have support from the local government.”
“The gentleman wrote an application to the Commonwealth that we reviewed for him and we wrote letters of support and reference to our website. Anyway, in early March he heard from the Federal Government and it was approved,” said Professor Fitzgerald.
The regulations and legislative requirements for permitting child care and aged care services in one shared facility are about to be tested when the new Wellington (NSW) facility is opened later this year. It is likely to be the first time a business offering IGC will be certified to comply to both regulations, in health (aged care) and education (child care) sectors.
“The Commonwealth sets out those standards and then it’s the State’s interpretation, if you went to Health, every State would be doing it differently,” said Professor Fitzgerald.
“We are giving them an indicative package, really almost like a formative package, that shows people what they could do, but it needs to be contextualised by them.”
“Aged care is under health and child care us under education. So that’s why we always thought this is going to be very difficult, because who is going to fund it,” asked Professor Fitzgerald.
“Our previous (2014) research has determined that this should sit under education, and should be called a learning facility, which the new Wellington project has kindly took up.”
The research team has been proactive in getting the intergenerational care message out to the broader community. They created a logo, an impressive website and other marketing materials and they began dissemination early to ensure maximum awareness and traction was achieved.
“We are very creative in getting the word out, we know that as academics we have to disseminate thought peer reviews, papers and we are doing that, but we also believe very strongly in marketing materials to get the idea out there and become part of the language,” said Professor Fitzgerald.
“We created a logo and people now recognise the logo (Intergenerational Care). I know that sounds like something very tiny and small, but you know people identify themselves with it and it becomes part of an identity.”
With the project completion approaching in June 2019, the leaders would like to thank all the project contributors and highlight the inclusive spirit and nature of how the research has been conducted over the last two years, and their future aspirations to have IGC research grow into a community of practice.
“And even though this particular program has got several projects in it, most of this comes about from the philosophy that we should all be able to follow-up on each other’s work,” said Professor Fitzgerald.
“So if there is then an opportunity to have legacy work, which is clearly for us now, it can be sustained not necessarily by the ones that started all this, but if you like rippled effect through. So that in the end we have got a whole community of practice doing this kind of research.”
“We do believe that sustainability is dependent upon at least two things, one is a social movement, so a lot of social movement happens by word of mouth. And the other one is that we make sure that we have got a prepared workforce.”
“Hence, the real importance of an ongoing website. We set up the site so that when we have to go because there is no further funding for the research, at least that will be ongoing,” said Professor Fitzgerald.
In June, Professor Fitzgerald, Dr Radford and Dr Vecchio will be engaging with Generations United USA, a national non-profit that improves children, youth and older adults’ lives through intergenerational programs and policies. They will be attending ‘Bridging the Generations’ conference to present a workshop, engage with global affiliates and participate in an award ceremony.
“There are other systems around the world, there is an entire community in the US and Europe. The Netherlands does some really interesting innovations in this space,” said Dr Radford.
“We are linking in with Generations United. Dr Radford, Dr Vecchio and I are going over in June and we have been commended for two awards there,” said Professor Fitzgerald.
“One for a paper award and one for a research idea award, if you like. And so we have been nominated by external parties for this which is really nice.”
“And we should really connect with them and see what they are doing and how they are doing it etc., and see if we can be a Chapter of Generations United.”
For more information on the latest developments with Intergenerational Care in Australia, please contact Professor Anneke Fitzgerald, or Dr Katrina Radford – or attend the public forum event on August 21, 2019 at South Bank Campus (or online live webcast) to see the research findings and lessons learned.
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