The ABC’s hit television series ‘Old people’s home for four year olds’, is a reminder that older people are survivors, they are resilient and have amazing stories to tell, but they also want to be cherished – just like everyone else – and they have a great capacity for fun.
HelloCare spoke to the series’ geriatrician consultant, Dr Stephanie Ward, about why she thinks the series proved so popular with audiences.
“I think the show has been a bit of a wake-up call to a lot of people who don’t have much interaction with older people, who tend to overlook older people and their stories and issues, and it’s reminded them that people who are older are pretty extraordinary. They’re like us, just a bit older, and because they are a bit older they’ve been through more and they’ve got more to share with us.
“They’ve probably been through more than I have, than you have, and they’re pretty tough.”
The experiment lasted for seven weeks, with the involvement of 21 children and older adults. The children spent six hours a day at the aged care facility, three to four days each week. Activities were carefully planned to generate results, but they also had to be suitable for the widely different age groups and be consistent with the Australian preschool curriculum.
Dr Ward said she believes many are missing out on the benefits of being around older people.
“I do think we live in an ageist society,” she told HelloCare. “I think that often when we talk about older people, particularly very old people, we’re talking about them in terms of rising healthcare costs, aged care issues, and the greying population, and we’re not seeing that older members of the population are so incredibly valuable and deserve to be cherished, just like the rest of us.”
As a geriatrician, Dr Ward said she knows the benefits of spending time with older people. In medical circles, it’s often said that geriatricians are the happiest of all doctors.
“I think there’s a lot of truth to that,” she said. “I think we’re really blessed by our job because we really do benefit from spending time with older people, so for us it’s normal that we hear about older people’s extraordinary stories.”
Dr Ward said her colleagues have told her how wonderful it has been to see older people talking for themselves on ‘Old people’s home’.
“We hear it every day, but I don’t think the rest of the population does,” Dr Ward said. “I think a show like this is really wonderful in helping to change attitudes and helping to overcome ageism.”
“Intergenerational contact is a really important way forward to tackle ageism because if you instil positive attitudes toward older people early in life… (it has an) effect on children and then I think that carries through.”
The television series was based around an experiment, and some key indicators of the older people’s health were measured both before and after.
The key priority was to lift the mood of the older people. To measure that, the geriatric depression scale was used, a well-known tool to screen for depression in older adults.
“We also checked for measures of physical strength of mobility and balance. All of these outcomes were chosen because they are really important for older people. We know how important being physically able and having balance is when we get older, and being strong, and we know how prevalent depression is, particularly for people living in residential aged care facilities where some studies show that over half the people living in aged care facilities do have symptoms of depression and anxiety.
“What we found is, at the end of the experiment, there were significant improvements on all of those measures.
“For example 75 per cent of the participants who screened positive for depression at the beginning of the experiment no longer screened positive at the end, which is pretty remarkable,” Dr Ward said.
The only resident who still recorded positive for depression was John, who unfortunately missed more than half of the program because he had to undergo a knee operation during filming.
Eight per cent of the older adults also improved in mobility. Most of the participants improved in balance and in strength, and also in a measure of frailty.
“So the effects were pretty impressive,” Dr Ward said.
The children had a powerful ability to motivate the older people to be more active.
“Most aged care residents are not very active,” Dr Ward said. “In part, it’s because the level of physical disability that is the reason that someone is in aged care, limits their ability. But I think there is often a component that can be improved, and we saw that with this show – that encouragement and pushing people’s mobility and levels of activity could improve.
Aged care residents sometimes spend up to 20 hours a day in their room. Often there’s a sense that there’s not much motivation to get out.
“There’s not much to look forward to or a sense that there’s anything worth doing,” Dr Ward said.
But keeping active is important at any age. “We know that being physically active can help protect us as we get older against physical frailty, against falls, against cognitive impairment, against dementia, as well as being protective for heart health,” Dr Ward said. “It becomes more and more important as we get older – but you can’t start too young, and it’s never too late to start being more physically active.
“This was a really important aspect of the experiment and it was so lovely to see how the older adults responded to the children, or what we used to call ‘the four-year-old personal trainers’,” Dr Ward said.
The four year olds were “incredibly motivating” because they wouldn’t take no for an answer.
“They’re hard to say no to because they’re so lovely and sweet and adorable – and you don’t want to disappoint a younger person. When a four year old cares for you, it’s really genuine. They’re not someone who’s paid to be nice to you or to fix you up. They’re someone who really wants to do something because they really want to have fun with you.”
Some of the older adults had to overcome their own personal anxieties over the course of the television series.
“Some people in the group didn’t have a lot of experience with children, or no experience, or it had been a long time in the past. We knew that Grace spoke about children not liking her, so there was a lot of anxiety. And the great thing about four year olds is they don’t actually care because they actually don’t know how it’s meant to work anyway,” Dr Ward said.
The children’s acceptance of Grace was a “really big issue” for her, Dr Ward told helloCare. “She talked widely about it. I really hope the way the children reacted to her, and the reassurance that she was really good with children, she was very popular with children, I hope that that sank in for her,” Dr Ward said.
Tragically, Grace passed away soon after the series was filmed.
Dr Ward said she would like to see intensive intergenerational programs established with the help of government funding.
“Quite a few aged care facilities already encourage visits from local school groups, or play groups, or preschools. Some are already in the habit of doing some visits to aged care facilities, and since the show started, there’s been interest in doing more.
“That’s been absolutely brilliant. It really doesn’t cost much money and it’s very beneficial.
“What we saw in the show was something a little bit more intensive. It was a preschool run with the older participants as part of that program.
“I’d love to see some more intensive intergenerational programs operating and evaluated for their capacity to be scaled widely and implemented in a cost-effective way. It would require some funding but I think the benefits would make that worthwhile,” Dr Ward said.
Dr Ward said the show affected her as a mother as much it affected her as a doctor.
“Because I am the mother of a young child and it wasn’t so long ago that I was dropping him off when he was very little into the care of others. As a mother, what I wanted more than anything was that he had a secure attachment to somebody, and that somebody genuinely cared about him when I wasn’t around.
“I think when we entrust the care of our child to someone else, we have those anxieties, and the guilt and the sadness, at times, that they’re not with someone who really cherishes them.
“I had such an emotional response during this show because I could see the strong benefits for the children and the way they were being cared for.”
Dr Ward admitted she sometimes cried on her way home from working on the program.
“It really affected me. I wish my son had had an experience like this,” she told HelloCare, explaining that other parents working on the program had similar feelings.
In a Q&A episode dedicated to aged care aired on the ABC, one of the series older adults, Shirley, observed that the children showed so much “care and compassion” towards the older adults.
Dr Ward said this attentiveness is often a key to turning around health issues for older people.
“I think having care and compassion is so important to us as human beings,” she said.
“That feeling that we’re worthy of being cared for, that our company is being sought out, that we have a purpose – that was what was able to develop as part of this experiment.
“People were spending time together, the children and the older adults, and they did all sorts of things together. Sometimes things weren’t easy for some of the participants, whether that be the older residents or the younger children, but it all led to bonding. It led to genuine friendships developing and genuine care.
“I think as humans we all need to feel cared for, to feel important. That’s so important for our wellbeing. And we know that that relates to our mental wellbeing, our sense of self and, of course, if we’re not feeling happy and we’re not feeling healthy, we’re not likely to do things for our health either.
Dr Ward said care and compassion can’t be prescribed by a doctor. “As a doctor, it’s something that I can’t sort out with a medication. I can’t prescribe that, even though sometimes those issues are at the heart of someone’s help,” she said.