Examining the Benefits of Intergenerational Volunteering in Long-Term Care: A Review of the Literature

Impact of an intergenerational program to improve loneliness and social isolation in older adults initiated at the time of emergency department discharge: study protocol for a three-arm randomized clinical trial

BACKGROUND

Social isolation and loneliness (SIL) worsens mortality and other outcomes among older adults as much as smoking. We previously tested the impact of the HOW R U? intervention using peer support from similar-aged volunteers and demonstrated reduced SIL among older adults discharged from the emergency department (ED). Generativity, defined as "the interest in establishing and guiding the next generation," can provide an alternative theoretical basis for reducing SIL via intergenerational programs between members of younger and older generations. The current protocol will examine the impact of younger intergenerational volunteers providing the HOW RU?

INTERVENTION

METHODS

In this randomized clinical trial, we will compare the following three arms: (1) the standard same-generation peer support HOW R U? intervention, (2) HOW R U? intervention delivered by intergenerational volunteers, and (3) a common wait-list control group. Outcome assessors will be blinded to the intervention. Trained volunteers will deliver 12 weekly telephone support calls. We will recruit participants ≥ 70 years of age with baseline loneliness (six-item De Jong loneliness score of 2 or greater) from two EDs. Research staff will assess SIL, depression, quality of life, functional status, generativity, and perceived benefit at baseline, at 12 weeks, and 24 weeks post-intervention.

DISCUSSION

We hypothesize participants receiving the intergenerational intervention will show improved outcomes compared to the control group and peer support HOW R U?

INTERVENTION

We also hypothesize that participants with higher perceptions of generativity will have greater reductions in SIL than their lower generativity counterparts. Aging is experienced diversely, and social interventions combatting associated SIL should reflect that diversity. As part of a program of research following the Obesity-Related Behavioral Intervention Trials (ORBIT) model, the findings of this RCT will be used to define which intervention characteristics are most effective in reducing SIL.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05998343 Protocol ID:21-0074E. Registered on 24 July 2023.

Reminiscence and Digital Storytelling to Improve the Social and Emotional Well-Being of Older Adults With Alzheimer's Disease and Related Dementias: Protocol for a Mixed Methods Study Design and a Randomized Controlled Trial

BACKGROUND

Increasing attention is being given to the growing concerns about social isolation, loneliness, and compromised emotional well-being experienced by young adults and older individuals affected by Alzheimer disease and related dementias (ADRD). Studies suggest that reminiscence strategies combined with an intergenerational approach may yield significant social and mental health benefits for participants. Experts also recommended the production of a digital life story book as part of reminiscence. Reminiscence is typically implemented by trained professionals (eg, social workers and nurses); however, there has been growing interest in using trained volunteers owing to staffing shortages and the costs associated with reminiscence programs.

OBJECTIVE

The proposed study will develop and test how reminiscence offered by trained young adult volunteers using a digital storytelling platform may help older adults with ADRD to improve their social and emotional well-being.

METHODS

The proposed project will conduct a randomized controlled trial to assess the effects of the intervention. The older and young adult participants will be randomly assigned to the intervention (reminiscence based) or control groups and then be randomly matched within each group. Data will be collected at baseline before the intervention, in the middle of the intervention, at end of the intervention, and at 3 months after the intervention. An explanatory sequential mixed methods design will be used to take advantage of the strengths of both quantitative and qualitative methods. The quantitative data from surveys will be entered into SPSS and analyzed using covariate-adjusted linear mixed models for repeated measures to compare the intervention and control groups over time on the major outcomes of participants. Conventional content analysis of qualitative interviews will be conducted using data analysis software.

RESULTS

The project was modified to a telephone-based intervention owing to the COVID-19 pandemic. Data collection started in 2020 and ended in 2022. In total, 103 dyads were matched at the beginning of the intervention. Of the 103 dyads, 90 (87.4%) dyads completed the midtest survey and 64 (62.1%) dyads completed the whole intervention and the posttest survey. Although we are still cleaning and finalizing data analyses, the preliminary results from both quantitative and qualitative data showed promising results of this intergenerational reminiscence approach that benefits both the older adults who have cognitive impairments and the young adult participants.

CONCLUSIONS

Intergenerational reminiscence provided by young adult college student offers promising benefits for both the younger and older generations. Future studies may consider scaling up this pilot into a trackable, replicable model that includes more participants with diverse background (eg, public vs private college students and older adults from other agencies) to test the effectiveness of this intervention for older adults with ADRD.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05984732; https://classic.clinicaltrials.gov/ct2/show/NCT05984732.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/49752.

Exploring the Effects of Volunteering on the Social, Mental, and Physical Health and Well-being of Volunteers: An Umbrella Review

Volunteering provides unique benefits to organisations, recipients, and potentially the volunteers themselves. This umbrella review examined the benefits of volunteering and their potential moderators. Eleven databases were searched for systematic reviews on the social, mental, physical, or general health benefits of volunteering, published up to July 2022. AMSTAR 2 was used to assess quality and overlap of included primary studies was calculated. Twenty-eight reviews were included; participants were mainly older adults based in the USA. Although overlap between reviews was low, quality was generally poor. Benefits were found in all three domains, with reduced mortality and increased functioning exerting the largest effects. Older age, reflection, religious volunteering, and altruistic motivations increased benefits most consistently. Referral of social prescribing clients to volunteering is recommended. Limitations include the need to align results to research conducted after the COVID-19 pandemic. (PROSPERO registration number: CRD42022349703).

Supplementary Information

The online version contains supplementary material available at 10.1007/s11266-023-00573-z.

Exploring French Canadian high school students' interest in and perspectives of a career with older adults

For the next 30 years, population aging will impact many facets of our society. Of specific concern is future human resources in the aging sector and related health fields. Every year, high school students make decisions related to their future careers, but few express interests in a career in aging. The goal of this study was to explore high school students' interest in and perspectives of a career in the field of aging. The specific objectives of the study were to identify high school students' perspectives of older adults, explore their level of interest in an aging-related career and understand the reasons for their level of interest for a career in aging. In this qualitative descriptive study, 41 French-speaking students in Grades 10 and 11 from an eastern Canadian province participated in a total of five focus group discussions where an educational video complemented the semi-structured interviews. Content analysis produced four common themes: perspectives of aging and older adults, exposure to aging in school, reasons for disinterest and increasing awareness and interest. Results indicate a lack of aging content or intergenerational activities in schools, whereas students made suggestions for better integration of aging content in the school curriculum. Future research with school guidance counsellors or educators would be beneficial in understanding aging content integration and student exposure to aging. Study limitations are also presented.

Effectiveness and sustainability of volunteering with older people living in care homes: A mixed methods systematic review

Older people living in care homes should be considered part of the wider local community; however, little is known about what enables them to connect with people not paid to look after them or family members. Volunteering can complement paid and familial support. While volunteering is common in community settings, care home residents are less likely to benefit from their input. We conducted a mixed methods systematic review and stakeholder consultation that aimed to identify volunteer activities in care homes and evidence for their effectiveness and sustainability. Databases were searched from 2000 to July 2021. Studies of all designs reporting volunteer-led activities with care home residents 65-years or over were included. Data on interventions, study population, study context, outcomes and implementation issues were extracted and synthesised. We identified 36 studies on the use, effectiveness and implementation of volunteering in care homes, although the overall strength of evidence was weak. Resident engagement and mood appeared to improve during volunteer-led activities, but there was little research examining the longer-term impact. Qualitative and stakeholder data suggest considerable investment is needed to initiate and maintain volunteering initiatives, but there are positive benefits for volunteers, residents and staff if an intervention is sustained. Financial cost for care home facilities is unclear. Interventions that address inequalities in accessing volunteer support within the resident population and between facilities should be considered.

Is an Intergenerational Program Effective in Increasing Social Capital among Participants? A Preliminary Study in Korea

The rapid growth of the aging population and low economic growth have intensified generational conflicts, especially in the workplace. Social capital is one option that can solve generational conflicts by encouraging cooperation among colleagues. This study aims to explore the impact of the intergenerational program, Sedae Ieum Madang, on perceived social capital among participants in Korea. To measure the impact of the program, a one-group pretest/posttest design was applied, and a purposive sampling method was adopted to recruit participants. The final sample size was 53, including 30 older adults and 23 young adults. In items that measured participants’ level of trust in colleagues, the subindex of social capital was compared between before and after the program. Each item relates to peoples’ experience of social support in workplaces, as suggested in the swAge model. According to the measurement, peoples’ level of trust in their colleagues changed; only the older generation’s trust in their colleagues increased, while that of the younger generation did not. The results of this study show that the intergenerational program is effective in encouraging the older generation to trust their colleagues and fostering mutual support between younger and older generations, which is important in developing sustainable work environments.

A pen pal program during COVID-19 pandemic increases student interest for careers in geriatrics

Social isolation and loneliness are serious issues facing older adults that have been intensified during COVID-19. Through a pen pal program, we connected 69 healthcare professional students with 180 older adults in our community to help reduce social isolation and loneliness. Participants were connected through letters, e-mails, and phone calls for three months. At the end of the program, we surveyed students (response rate: 62%). Half of the students reported spending less than 20 minutes per week on the project. Of the survey respondents roughly 91% were white, 74.4% were enrolled in the College of Medicine, and 51.1% were in their first year of their respective program. Students increased their knowledge of social isolation and loneliness (p = .0001), their interest in volunteering (p = .018) and working with older adults (p = .028), and their comfort communicating with older adults (p = .002). Students reported that their wellness improved and that they practiced skills that would be used in their future careers. By providing volunteer experiences to students, we can increase their exposure to the geriatric population, hopefully increasing the number of students who enter geriatrics while simultaneously reducing social isolation and loneliness in older adults.

Norwegian Nurses' Reflections Upon Experiences of Ethical Challenges in Older People Care: A Qualitative Thematic Analysis

Introduction

Internationally, aging populations have increased needs for health care services, and often specialized care is required. However, services for older people tend to be underfunded, resulting in lack of qualified staff and poor quality care. Resource shortages lead to ethical challenges and insufficient nursing care. Therefore, quality in daily care for older people also depends upon the nurses’ ability to make complex, ethical decisions in their practice.

Objectives

To explore ethical challenges experienced by nurses caring for older people in clinical practice, and to provide examples of management for the challenges.

Methods

The data collected were written reflection notes by Norwegian continuous education students in advanced gerontology. Forty two of 83 notes were included and a thematic analysis in six steps was utilized.

Findings

There are three main themes: (1) meeting vulnerability, discomfort, and suffering, (2) collaboration with relatives, and (3) struggling to perform professional care.

Conclusion

Nurses strive to “do what is in the patients’ best interest”, and this is fostered through collaboration, professionalism, care, and presence. Nurses’ ethical competencies may develop when reflecting upon their own care performance. Building ethical competencies should be a priority in both nursing education and clinical practice. However, to improve care quality, nurses also need professional knowledge about older people care and ethical awareness should be supported by the workplace.

Deeply Discrediting: A Systematic Review Examining the Conceptualizations and Consequences of the Stigma of Working in Aged Care

BACKGROUND AND OBJECTIVES

The stigma of working in aged care can discredit and devalue those working in gerontology. This overlooked workforce issue may underpin complex staffing challenges like chronic worker shortages and inadequate care delivery. Our review synthesizes the existing literature and introduces a conceptual framework based on linguistics to reconcile disparate conceptualizations and negative consequences of this stigma.

RESEARCH DESIGN AND METHODS

We conducted a systematic review and assessed peer-reviewed articles published from 1973 to 2019 across 5 databases. Fifty-nine articles were selected based on criteria grounded in stigma theory.

RESULTS

Only 10 articles explicitly used the term "stigma" when conceptualizing the stigma of working in aged care. An additional 49 articles conceptualized this stigma in terms of stigma processes (e.g., status loss). Findings from a deeper examination using a linguistic analysis revealed societal groups predominantly conceptualized stigma in 3 distinct ways based on (a) unfavorable character judgment of aged care workers, (b) lower value placed on aged care work, and (c) negative emotional reactions towards working in aged care. Last, stigma was associated with adverse psychological and job-related consequences.

DISCUSSION AND IMPLICATIONS

Reconceptualizing this workforce issue and recognizing it as a societal challenge will enable policymakers to design evidence-based interventions at industry and societal levels. We propose workforce challenges in the aged care sector such as attraction, retention, and well-being may lessen with interventions aimed at mitigating the stigma of working in aged care.

Effectiveness of intergenerational participation on residents with dementia: A systematic review and meta-analysis

Aim

This meta‐analysis evaluated the effectiveness of intergenerational program participation for long‐term care institution residents with dementia.

Design

A systematic review and meta‐analysis.

Methods

Ten electronic databases were systematically searched until August 2020: CINAHL, the Cochrane Library, EBSCO, EMBASE, Ovid Medline, ProQuest, Psychology and Behavioral Sciences Collection, PubMed, Scopus, and Web of Science. The Joanna Briggs Institute tool (JBI tool) was used for the quality appraisal of the included publications, and Review Manager 5.3 was used for the meta‐analysis.

Results

Thirteen articles were identified (1993–2015). Intergenerational program participation could improve the pleasure level and significantly reduce disengagement behaviours of residents with dementia. The intergenerational program intervention caused no apparent improvement in their quality of life, depression levels, and engagement levels.

The Role of Volunteers in Enhancing Resident Quality of Life in Long-Term Care: Analyzing Policies that May Enable or Limit this Role

Research has shown that long-term care (LTC) volunteers play important roles in enhancing the quality of life (QoL) of older LTC residents, often through providing unique forms of relational care. Guided by Kane's QoL domains, we used a modified objective hermeneutics method to analyze how unique volunteer roles are represented and supported in provincial policies in Alberta, British Columbia, Ontario, and Nova Scotia. We found that policies define volunteer roles narrowly, which may limit residents' QoL. This happens through (1) omitting volunteers from most regulatory policy, (2) likening volunteers to supplementary staff rather than to caregivers with unique roles, and (3) overemphasizing residents' safety, security, and order. We offer insights into promising provincial policy directions for LTC volunteers, yet we argue that further regulating volunteers may be an inadequate or ill-suited approach to addressing the cultural, social, and structural changes required for volunteers to enhance LTC residents' QoL effectively.

Constituição do discurso da autonomia de idosas no cotidiano de uma Instituição de Longa Permanência para Idosos

Resumo Objetivo analisar a constituição do discurso da autonomia da pessoa idosa em uma Instituição de Longa Permanência, na perspectiva de profissionais e de idosas institucionalizadas. Método pesquisa qualitativa, desenvolvida na perspectiva do referencial pós-estruturalista, realizada em uma instituição filantrópica da cidade de Belo Horizonte, Minas Gerais, Brasil. Os dados foram coletados no período de janeiro a março de 2018, por meio de entrevista semiestruturada, com 13 profissionais e sete idosas, análise documental e observação e foram submetidos à análise de discurso. Resultados os efeitos da institucionalização na constituição da autonomia das idosas pode ser observado nos discursos das idosas e dos profissionais. A Instituição se constitui num local de disciplina, com rotinas bem estabelecidas, com pouco espaço para a tomada de decisão das idosas. Sua autonomia fica esquecida, pois as rotinas, de certa forma, encobrem seus desejos, suas escolhas e sua própria liberdade. Conclusão para um funcionamento adequado da estrutura, limites e regras fazem-se necessários. Entretanto, é importante considerar que as normas não são utilizadas, unicamente, como instrumento de controle e cerceamento do exercício de tomada de decisão das idosas. A transição epidemiológica exige das instituições mudanças em suas práticas cotidianas, advindas de políticas públicas específicas para as instituições, com a definição clara de seu papel e diretrizes para uma prática qualificada.