Intergenerational engagement among older people in the long-term care facility in China

Summary

Background

China is experiencing a rapid rise in its ageing population. Cognitive and physical declines associated with ageing can limit social interaction, which particularly impacts those residing in long-term care facilities and their engagement with children and young people. Intergenerational engagement (IE)—the interaction between the old and the young—presents a promising avenue to improve the well-being of older people residing in such long-term care settings. However, there is a noticeable gap in empirical evidence supporting its potential benefits in long-term care facilities in China.

Aim/objectives

1. To explore the effectiveness and experiences of IE among older people in long-term care facilities in Asia through a mixed method systematic review. 
2. Form a patient and public involvement (PPI) team and enhance the IE intervention design by incorporating feedback from its members. 
3. To assess the feasibility and acceptability of IE in a long-term care facility through a mixed method study. 

Methods

This study is composed of three phases:

Phase 1: Mixed methods systematic review
To explore the effectiveness and experiences of IE with older people in long-term care facilities across Asia.

Phase 2: Intervention development and refinement through Public and Patient Involvement (PPI)
To refine and enhance the IE intervention by actively seeking and integrating feedback from PPI team members. Our PPI members included two older people (aged ≥60 years), two adolescents (15-16 years old), one long-term care facility staff, and one parent. 

Phase 3: Mixed methods feasibility study
To assess the feasibility and acceptability of IE in a long-term care facility in China through a mixed methods study. The feasibility study will use an embedded mixed methods design, with quantitative data as the primary focus, supplemented by qualitative insights. This approach not only corroborates findings across different types of data but also combines the empirical strength of quantitative measures with the understanding of qualitative feedback, enhancing the overall analysis of the feasibility and acceptability of the intervention. The study will commence with assessing participant eligibility, followed by obtaining informed consent. Baseline measures will be collected within 7 days before the 6-week IE programme. After the intervention, a follow-up assessment will be conducted within 7 days. This will be followed by qualitative interviews with older people and focus groups with long-term care facility staff and adolescents.

Results

Expected outcomes:

1. Understanding the effectiveness and experiences of IE among older people in long-term care facilities in Asia involves examining its impact on health and well-being outcomes, exploring key components such as the age groups of the younger generation, activity designs, duration, and frequency of contact, and identifying gaps in IE research. 
2. Incorporating feedback from the PPI team can help enhance the IE programme, tailoring it to the specific needs and preferences of both older and younger participants. This marks the first-time utilisation of a PPI team in research within China. It is more likely to ensure research and its outcomes has any impact, by working with those who experience the problem, need, or use the services under investigation, or those who provide the care, design the services, or people who make decisions on the resource allocation, or other stakeholders. Integrating PPI into research and intervention design, especially in IE programmes, has great potential to improve effectiveness and relevance to stakeholders, ultimately making interventions more meaningful.
3. The IE programme is acceptable and feasible among older people, adolescents, and staff in the long-term care facility. Older people in long-term care facilities can benefit from IE programmes by reducing loneliness through regular interaction with younger generations, improving mental well-being, and enhancing overall quality of life. Adolescents develop empathy and understanding by interacting with older people, build meaningful relationships that offer emotional support and guidance, and expand social skills through diverse intergenerational interactions. The findings could provide valuable insights for policymakers and care facility administrators on the effectiveness of IE, potentially influencing future care practices and interventions in long-term care facilities in China. 

Conclusion

By reducing loneliness, improving mental well-being, and fostering meaningful relationships between older people and younger generations, IE offers a valuable approach to addressing the social and emotional needs of older people in such care settings.

Future plans

Postdoctoral project - implementation and evaluation of IE in long-term care facilities in China.

Outputs 

1. H. Liu, A. Topping, P. Guo. Intergenerational engagement with Asian residents in long-term care facilities: A mixed-methods systematic review. Abstract accepted for presentation as a printed poster at the 13th World Research Congress of the European Association for Palliative Care (EAPC) in Barcelona, Spain, from 16th to 18th May 2024.
2. Hao Liu, Anne Elizabeth Topping, Ping Guo. Intergenerational engagement with Asian residents in long-term care facilities: A mixed method systematic review. The manuscript has been submitted to Frontiers in Public Health, under the section Aging and Public Health. (Submitted on: 23 Apr 2024).