Intergenerational Programmes in Community-Based Support Initiatives for People Living with Dementia – Understanding the Impacts and Outcomes

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Supervisory Team Director of Studies: Dr Julie Barrett, Association for Dementia Studies, School of Health and Wellbeing, University of Worcester. Supervisors: Professor Alison Kington, Institute of Education, University of Worcester.

Research Group: Association for Dementia Studies

The PhD Opportunity

Background

With population ageing and urbanisation being two of the biggest social transformations of the 21st century, the World Health Organization has emphasised the need to create age-friendly communities within the context of the UN Decade of Healthy Ageing (World Health Organization, 2025). Intergenerational solidarity is recognised as one of the guiding principles for the Decade of Healthy Aging because it enables social cohesion and interactive exchange among generations thereby supporting health and well-being for all (World Health Organization, 2020). There has recently been a significant growth internationally in the practice of social care innovations involving bringing children and young people together with older people and people living with dementia who are experiencing significant social care needs (Radford et al., 2018; Sánchez et al., 2018, Houghton et al, 2022). These innovations go beyond traditional health and social care interventions and aim to decrease isolation, loneliness, and prejudice. The collective term for these innovations is ‘Intergenerational Programmes’ (IGPs).

There are different levels of engagement between the two age groups which Kaplan (2002) represented on a “Scale of Intergenerational Engagement”: 1. Learning about other age group; 2. Seeing the other age group but at a distance; 3. Meeting each other (one-time experience); 4. Annual or periodic activities; 5. Demonstration projects (ongoing intergenerational activities over a set period of time); 6. Ongoing intergenerational programs; 7. Ongoing, natural intergenerational sharing, support, and communication.

In recent years some care homes in the UK have opened on-site fully integrated nurseries where the children and residents share activities on a regular basis and which allow for spontaneous interaction. Other examples include joint walking and activity groups between schools and care providers. Placements and visits to care homes feature in a number of school courses on care and citizenship. Some reviews of the literature (Galbraith et al., 2015; Gualano et al., 2018; Houghton et al., 2022; Peters et al., 2021) have suggested benefits of IGPs for both the children and the PhD Opportunity Intergenerational programmes in community-based support initiatives for people living with dementia – understanding the impacts and outcomes

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older people and people living with dementia. However, although a more recent review of the impact of intergenerational activities on the wellbeing and mental health of older people found a small positive trend towards improving self‐esteem and depression (Whear et al., 2023), the authors could not be confident about any effects due to the small study sizes and low number of studies available. The authors also highlighted that research on IGPs should measure outcomes for both of the age groups, noting that the same outcomes may not be reflected in both populations. They also stated that further research is needed on long‐term impacts, that is whether participants need to continue participating in the programme to continue to benefit, and sustainability of IGPs.

Only a few studies focus specifically on dementia. An evaluation of the Adopt a Care Home Scheme (Di Bona et al., 2017) in Sheffield combined learning about dementia in school for Year 5 pupils and then visiting a local care home where the children made life-story books with residents. This appeared to improve the children’s knowledge and awareness and evaluated as an enjoyable experience for all those involved. A small Australian study (Baker et al., 2017) assessed the impact of teenage technology students meeting with care home residents over a 15-week period to craft an item of interest with them. This intervention appeared most beneficial (improved affect and engagement) to those with greater cognitive impairment but had little impact on students self-reported attitudes and empathy.

A recent mapping review of the evidence on non-familial intergenerational interventions and their impact on social and mental wellbeing of both younger and older people (Campbell et al., 2023) found a number of gaps in the evidence including the fact that many studies evaluated the impact on only one of the generations and did not consider mutual, societal and community outcomes. In addition, studies tended to focus on benefits, with adverse or unexpected outcomes not being consistently measured or reliably reported (Campbell et al., 2023). Other gaps included: mental health, loneliness, social isolation, peer interactions, physical health and health promotion outcomes in children and young people; health promotion in older people; outcomes centred on carer wellbeing, mental health and attitudes; economic outcomes (Campbell et al., 2023).

There is very limited UK research focussed on understanding how these innovations occur and sustain. Potentially, there could be multiple benefits to both people living with dementia, younger people and to society more widely. It could, for example, nurture a younger generation with improved empathy leading to a more caring dementia-friendly community and an improved potential care workforce. It could also go some way to prepare children and families for a caring role in their own family circle. However, if such innovations are undertaken without full understanding, there may be unintended detrimental consequences, leading to younger generations gaining a negative impression of dementia and actually distancing them from further contact.

The project: The project will seek to understand the impacts, challenges, successes, barriers, sustainability issues and best practices in community-based support initiatives for people living with dementia in Worcestershire and Herefordshire. The successful PhD candidate will be responsible for formulating the detail of this project, the

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methodology and methods with guidance by the Supervision team. This project will build on the Association for Dementia Studies research within Meeting Centres. It also anticipated that the project would adopt a mixed-methods approach to address the evidence gaps and enable people living with dementia, children / young people, providers of community-based support initiatives and educators to be part of the codesign of the research. Investigating the impacts, both positive and negative, on both age groups as well as care and education staff will be important. Other factors to consider are sustainability, cost effectiveness, outcomes for carers and impact in terms of reducing ageist and stereotypical views of a person living with dementia.

References: • Baker, J.R., Webster, L., Lynn, N., Rogers, J. and Belcher, J. (2017) Intergenerational Programs May Be Especially Engaging for Aged Care Residents With Cognitive Impairment: Findings From the Avondale Intergenerational Design Challenge. American Journal of Alzheimer’s Disease & Other Dementias, 32(4), 213-221. • Campbell, F., Whear, R., Rogers, M., Sutton, A., Robinson-Carter, E., Barlow, J., Sharpe, R., Cohen, S., Wolstenholme, L. and Thompson-Coon, J. (2023) Non- familial intergenerational interventions and their impact on social and mental wellbeing of both younger and older people - A mapping review and evidence and gap map. Campbell Systematic Reviews, 19(1), 1-22. • Di Bona, L., Kennedy, S. and Mountain, G. (2017). Adopt a Care Home: An intergenerational initiative bringing children into care homes. Dementia, 18(5),1679-1694. • Galbraith,B., Larkin, H., Moorhouse, A. and Oomen, T. (2015) Intergenerational Programs for Persons With Dementia: A Scoping Review. Journal of Gerontological Social Work, 58(4), 357-378. • Gualano, M. R., Voglino, G., Bert, F., Thomas, R., Camussi, E. and Siliquini, R. (2018). The impact of intergenerational programs on children and older adults: a review. International psychogeriatrics, 30(4), 451-468. • Houghton C., Hennessy M., Smyth S., Hennelly, N., Smalle, M., Jordan, F. Jones, C.H., Quinn, M., Casey, D. and Teahan, A. (2022) The experiences and perceptions of young people and older people living with dementia of participating in intergenerational programmes: A qualitative evidence synthesis. Dementia. 21(7), 2144-2171. • Kaplan, M. (2002) Intergenerational Programs in schools: considerations of form and function. International Review of Education, 48(4), 305-334. • Peters R., Ee N., Ward S.A., Kenning G., Radford K., Goldwater M., Dodge H.H., Lewis E., Xu Y., Kudrna G., Hamilton M., Peters J., Anstey K.J., Lautenschlager N.T., Fitzgerald A. and Rockwood K. (2021) Intergenerational Programmes bringing together community dwelling non-familial older adults and children: A Systematic Review. Archives of Gerontology and Geriatrics. May-Jun, 94. • Radford, K., Gould, R., Vecchio, N. and Fitzgerald, A. (2018) Unpacking Intergenerational (IG) programs for policy implications: A systematic review of the literature. Journal of Intergenerational Relationships, 16(3), 302-329.

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• Sánchez, M., Whitehouse, P. and Johnston, L (2018) Intergenerational Learning and Education in Schools and Beyond. Journal of Intergenerational Relationships, 16 (1-2, 1-4). • Whear, R., Campbell, F., Rogers, M., Sutton, A., Robinson-Carter, E., Sharpe, R., Cohen, S., Fergy, R., Garside, R., Kneale, D., Melendez-Torres, G.J. and Thompson-Coon, J. (2023) What is the effect of intergenerational activities on the wellbeing and mental health of older people?: A systematic review. Campbell Systematic Reviews,19(4), 1-51. • World Health Organization (2020) Decade of Healthy Ageing: Plan of Action 2021–2030. Geneva: World Health Organization. • World Health Organization (2025) Creating age-friendly cities and communities, Available at: https://www.who.int/activities/creating-age-friendly-cities-and- communities.

Application Process: To begin the application process please go to https://www.worc.ac.uk/research/research-degrees/applying-for-a-phd/.

The Interview: All successful applicants will be offered an interview with the proposed Supervisory Team. You will be contacted by a member of the Doctoral School Team to find a suitable date. Interviews can be conducted in person or over Microsoft Teams.

Funding your PhD: For information about Doctoral Loans please visit: https://www.worc.ac.uk/study/fees- and-finance/doctoral-loans.aspx

During your PhD you can access the Research Conference Support Scheme to support the costs of presenting your research at an external conference.

Research at the University of Worcester Research is central to the University’s mission to make a difference in everything that we do. We are committed to delivering excellent research which extends the boundaries of human knowledge but which also improves people’s lives by enabling better health outcomes, improving food security, developing environmentally sustainable solutions for crop production and socially sustainable solutions to our ageing population, enhancing public knowledge and understanding of the past and present.

The University hence focuses its research around five high-level challenges facing society, locally, nationally and globally:

• Human Health and Wellbeing • Sustainable Futures • Digital Innovation • Culture, Identity and Social Exclusion • Professional Education

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The success of our research is reflected in our continuous improvement in external research assessment processes. In the most recent Research Excellence Framework, REF 2021, the University saw a near 50% increase in the scale of its research and 12% increase in quality, building on its performance in REF 2014 when it was the UK’s most improved university in terms of Research Power, a combination of scale and quality.

Research Degrees at Worcester Our research students are central to our overall mission for research. They are working at the cutting edge of their disciplines and driving forward the quality of our research whilst enriching our research culture. We are looking to increase our research student numbers as a strategic imperative.

Our commitment to our students is reflected in the results of the Postgraduate Research Experience Survey 2025 in which we ranked 3rd for overall research student satisfaction nationally. Key to our success in his area is the Doctoral School, a focal point for all our research students.

It provides:

• day-to-day support for our students, both administrative and practical, through our dedicated team • a Research Student Study Space with both PCs and laptop docking station • a comprehensive Researcher Development Programme for students and their

supervisors

• a programme of student-led conferences and seminars

Widening Participation: As part of its mission statement the University is committed to widening participation for its higher degrees. Although most candidates will have an undergraduate and/or a Masters degree, the University is happy to accept applications from candidates with relevant professional qualifications and work related experience.

For further information or an informal discussion on this project, please contact Dr Julie Barrett j.barrett@worc.ac.uk

Research areas