Abstract
“At Home” is a program, in which students reside in the homes of older adults. Three studies were designed to evaluate the program. One study was a comparative quantitative investigation that used a cross-sectional survey design aimed at assessing ageism and knowledge of ageing among students. The other two studies were qualitative studies based on Interpretative Phenomenological Analysis, aimed at obtaining the perspective of the students and the older people. The main findings indicated satisfaction with the program among students and older adults as well, and the relationships often described by both sides as good and warm. The most common activities shared by the student and the older adult were watching television, eating dinner, having conversations, and going for walks. The contribution of the program for the older adults reflected in the relief of their loneliness. Among the students, the contribution reflected in familiarity with the world of older adults, the strengthening of intergenerational relationships, and the financial aid for their studies.
Keywords
At Home is an innovative social program, run jointly by the Ministry for Social Equality and the Student Union in Israel, in which students reside in the homes of older adults. The student occupies a free room in the house of an independent older adult (women aged 62 and over and men aged 67 and over) who are living on their own in the community and have a room for student accommodation. Students are required to spend at least three nights a week in the house for a period of residence not less than 9 months and not more than 12 months. It is possible to extend the contract and continue to participate in the program for another year. As part of the program, students interact socially with the older adult for at least 5 hours a week, and a total of 160 hours throughout a year of activity, for example, computer studies dinner, and walking together. The older adults undertake not to require students to perform activities that go beyond joint social activities such as nursing, home cleaning, and shopping. In exchange, the students enjoy accommodations, paying $80 a month to cover the extra utility costs, 11 as well as a tuition scholarship of $2344. The aim of the program is to relieve the solitude of the older adult and encourage them to remain in the community on the one hand, and to provide a solution to student housing and an incentive for students’ social engagement on the other, as well as to strengthen intergenerational bonds.
The program admission process regarding the older adults after registration includes three stages: (1) Telephone interview with the coordinator. (2) Home visit of the coordinator to get to know the older adult, and to make sure that there is a suitable place to live for the student. (3) Finding a suitable student, for example, a female for a woman or a male for a man, and signing contracts.
The program admission process regarding the students after registration includes also three stages: (1) Personal interview with the coordinator. (2) Scheduling a meeting of the student with the older adult to coordinate expectations. (3) Signing contracts.
Monitoring and training for students: The program coordinator conducts a telephone call once a month with the students and older adults, as well as conducting home visits for follow-up and assistance. Students are accompanied by the program coordinator who responds to any need that arises. There are also two training days a year in which students receive training and lectures on various topics from professionals (Israel Student Union, 2020; Ministry of Social Equality, 2020).
This paper presents a series of studies designed to evaluate the program.
Aging in Place
Most older adults wish to continue to live in their own homes in the community they are familiar with, to maintain existing social connections to alleviate their loneliness, and to receive community services that will enable them to live independently (Martens, 2018; Vanleerberghe et al., 2017). This trend can also be seen in Israel, where some 97% of the population aged 65 and over was living in private households in 2020 (Israel Bureau of Statistics, 2021).
Older adults’ strong attachment to their home goes beyond the physical connection to include experiences, memories, and the surrounding sociocultural environment (Hidalgo & Hernandez, 2001; Stones & Gullifer, 2016). Remaining in their home affords them a sense of independence and autonomy, as well as control over everyday activities (Hearle et al., 2005; Stone & Gullifer, 2016).
In order to stay in the community, older adults require appropriate support services in addition to the assistance they may receive from family members (Vanleerberghe et al., 2017). Where such services are available, the older population reports a higher quality of life and lower sense of loneliness (Ahn et al., 2017; Hawkley & Kocherginsky, 2018; Neiboer & Cramm, 2018; Vitman Schorr & Khalaila, 2018).
Loneliness among Older Adults
Loneliness is a common problem among older adults and has become increasingly prevalent in recent decades (Lee et al., 2019; Perissinotto et al., 2019). Statistics in Israel show that 11% of people aged 65 and over report often feeling lonely (Israel Bureau of Statistics, 2021). Loneliness may be either chronic, when individuals have not developed lasting social relations over the years, or situational, resulting from life events such as retirement, the loss of a spouse, relocation, or living alone (Pikhartova & Victor, 2015). Moreover, loneliness adversely affects not only psychological well-being, leading to depression and anxiety, but also physical health, increasing the chances of morbidity and mortality (Bodner & Bergman, 2016; Courtin & Knapp, 2017; Shankar, et al., 2011). Among the factors that may contribute to the loneliness of older adults is the lack of intergenerational relations.
Intergenerational Relations and Ageism
Research indicates that both a positive intergenerational relationship in the family, particularly between grandchildren and grandparents, and social interactions in which older adults can contribute to the lives of younger people, are associated with decreased prejudices and stereotypes regarding the older adults (Abrams, et al., 2006; Bodner, 2009; Crisp & Turner, 2009; Drury et al., 2016; Tam et al., 2006)
Furthermore, the results of studies of ageism among young adults are inconsistent. While some have found more negative attitudes toward older people among young adults than among older populations (Kite et al., 2005; Rupp et al., 2005), others report more positive attitudes and less ageist behaviors in younger groups (Cherry et al., 2016; Öberg & Tornstam, 2003). In addition, female students have been found to have lower levels of ageism than their male cohorts (Kalavar, 2001; Rupp et al., 2005), presumably because women typically display greater empathy and concern whereas men are higher on instrumental qualities. A survey of interventions aimed at dealing with ageism produced complex results (Christian et al., 2014). It was found that long-term intergenerational interventions led to more positive attitudes toward older adults among younger people, while short-term interventions had no effect, and in some cases even led to more negative attitudes than those assessed at the start of the intervention.
However, combined programs of education and intergenerational contact of adolescents and students with older adults have shown a very positive effect on reducing ageism especially among women, adolescents, and young people (Burnes, et al., 2019; Leedahl et al., 2020). In addition, there are programs of intergenerational sharing of young and old in housing.
Intergenerational Housing Programs
In some countries, there are several intergenerational housing projects such as living in older adults’ homes, in sheltered housing, in nursing homes, and on university campuses (Gorjup, 2020). In these programs, a living environment is created in which young and old people live together. For the older adults, the purpose is to enable the continued aging in place in their community, improve their quality of life, solve the problem of their loneliness and social isolation and get help from the young people in various tasks. For students and other young people, the purpose of this arrangement is to facilitate rent reduction especially in urban localities where rents are high (Gonzales et al., 2020; Gorjup, 2020; Labit & Dubost, 2016). After matching the profile of the old person with the young one they sign a contract. Usually, the young person/student engages in joint activities with the old man several hours a week: informal activities, for example, participating in a meal and providing assistance or in informal activities, such as personal conversations, shopping, cafes, restaurants, concerts, teaching various technologies (Arentshorst et al., 2019; Gorjup, 2020; Landi & Smith, 2019).
Various studies show that these programs benefit both older adults and young people. Benefits of successful arrangements include reducing the need for care services for the older adults resulting in a reduction in emergency care costs, a beneficial effect on psychological health, feelings of security, independence, reducing loneliness, raising vital and happy feelings, intergenerational communication, and reducing ageism among young people (Arentshorst et al., 2019; Gonzales et al., 2020; Gorjup, 2020).
A similar program has existed in Israel for several years. At Home is an innovative program in Israel, in which students reside in the homes of older adults and has not yet been evaluated. To fill this gap in knowledge on this topic, three studies were conducted.
The Current Series of Studies
This paper presents the results of a series of three initial evaluation studies conducted on the At Home program in 2017-2019. Consent for the studies was received from the Ministry of Social Equality and the Student Council, and they were approved by the University Ethics Committee (No. AU-AEZ-2018114; AU-SOC-AEZ-20190213).
This study was a comparative quantitative investigation that used a cross-sectional survey design aimed at assessing ageism and knowledge of ageing among students. Based on the literature review of the contribution of close relationships between young and old people in reducing ageism, and adding knowledge about old people, two study questions were examined:
Are the levels of ageism and knowledge of ageing of students who participate in the program different from those of students who do not?
What sociodemographic variables are associated with ageism and knowledge of aging?
Method
Participants and Procedure
After receiving the necessary approval, an email was sent by the Student Union At Home coordinator to all the students who were currently or had previously been in the program (around 400) explaining the aim of the study and requesting their participation. Those who returned a signed consent form constituted the research group. A comparison group of students who were not in the program was recruited through social media. Both groups were sent a secure link to the same questionnaire and completed it online. No identifying data was collected.
The final sample consisted of 104 students in the research group (25% of the participants in the program), and 98 in a matching comparison group. The socio-demographic characteristics of the two groups were similar except for gender. Most of the students in the research group (88.5%) were female (N = 92) and only 12 (11.5%) were male, which corresponds with the significant correlation found between gender and participation in the program (χ2 = 12.15, p < .001). The mean age of the research group was 24.17 (SD = 3.31), and of the comparison group, 25.56 (SD = 3.70). The large majority of the whole sample (N = 202) were Jewish (97%), with about half defining themselves as religious (44.6%), and the rest as traditional (20.8%) or secular (34.6%). Most reported the economic status of themselves and their family as average or above. They were studying a wide range of academic disciplines, including therapeutic and educational fields, as well as natural sciences, engineering, communications, and law. The duration of the students participating in the program ranges from 1 month to 40 months and the average duration was 9.3 (SD = 8.30). The age of the older adults with whom they lived ranged from 67 to 97 (M = 81.46, SD = 6.62).
Instruments
Fraboni Scale of Ageism (FSA; Fraboni et al., 1990), translated into Hebrew (Bodner & Lazar, 2008). Participants were asked to indicate the degree to which they agree with the statements in 24 items (e.g., “Old people complain more than other people do”), marking their responses on a 6-point Likert scale from 1 (strongly disagree) to 6 (strongly agree). Cronbach’s alpha = .86 is reported for the original scale and was .77 in the current study. Each student was assigned a score equal to the sum of their responses to all items, with higher scores indicating more negative attitudes to older people.
Knowledge of aging questionnaire based on the Facts on Aging Quiz (Palmore, 1977). In the current study, we used the instrument employed by Shiovitz-Ezra et al. (2013) for a survey on ageism. Participants were asked to indicate the degree to which they believe the statements in 12 items are true (e.g., “The five senses decline in old age”). A score was calculated for each student by totaling their responses to all items, with higher scores indicating greater knowledge of aging.
A sociodemographic questionnaire was used to obtain data including age, gender, and relationship with the grandparents.
An additional questionnaire regarding the At Home program was completed by the research group. Participants were asked to indicate their joint activities with the older adult and to assess the program’s contribution to both sides.
Results
Differences Between Groups
T-tests for independent samples were conducted to examine differences in ageism and knowledge of ageing between the two groups. No differences were found in ageism. However, students who did not participate in the program displayed greater knowledge of ageing than those who did (N = 98, M = 8.95, SD = .1.61; N = 104, M = 8.17, SD = .1.69, respectively; t = 3.37, p < .01).
Associations Between Sociodemographic Variables and Ageism (Whole Sample)
t-tests for independent samples yielded a significant difference only for gender. Female students were found to exhibit a lower level of ageism (N = 159, M = 2.41, SD = .468) than male students (N = 43, M = 2.72, SD = .539), t = 3.74, p < .000.
Associations Between the Relationship with the Grandparents and Ageism and Knowledge of Ageing
Pearson correlations were conducted, and it was found that the stronger the relationship with the grandparents, the less negative the attitude to older adults (N = 202, r = −.20, p < .01) and the more the students knew about aging (N = 202, r = .15, p < .05).
Factors Associated with Ageism
Stepwise regression was performed to identify the factors affecting ageism. The sociodemographic variables of gender, age, economic status, and religiosity were entered in Step 1, and relationship with the grandparents, contact with older adults, participation in the program, and knowledge of ageing in Step 2. The results indicated that gender entered in the first step (β = −2.56, p < .001) which explained 6.5% of the variance. Gender (β = −2.79, p < .001), and knowledge of aging (β = −2.44, p < .001), entered in the second step, and knowledge of aging added 9.3% to the explained variance. The total percentage of explained variance was 15.8%. That is, female students with a knowledge of ageing showed the lowest levels of ageism.
Assessment of at Home
The activities shared by the student and the older adult appear in Figure 1.
The activities shared by the student and the older adult (N = 104).
As can be seen, the most common activities were watching television and eating dinner, going for walks, computer training followed by a range of other activities, including doing crosswords, talking, gardening, cleaning, and laundry, knitting, playing games, looking through photo albums, shopping, cooking, and, as well as attending outdoor events. Most of the participants believed that the program contributed to promoting the status of older adults, assessing its contribution as large (33.6%) or very large (40%). Moreover, they felt that it helped relieve the loneliness of the older adult to a large (16.5%) or very large (82.5%) degree.
The students’ satisfaction with the program is presented in Figure 2.
The students’ own satisfaction with the program (N = 104).
As can be seen, most students were satisfied. Additionally, 52.9% stating they would like to remain in the program the following year. Of the others, 44.2% indicated they do not wish to continue, and 2.9% did not respond. Furthermore, 73% reported wanting to maintain contact with the older adult after leaving the program, 26% stated they did not, and 1% did not respond. In addition, 89.4% of the students indicated that they would recommend the program to a friend, with 9.6% reporting they would not, and 1% not responding.
Finally, 31.7% of the students indicated that participating in the program contributed to funding their studies to a large degree, 51.9% to a very large degree, and 13.5% to a small degree. Only 2.9% reported that it was of no financial benefit to them.
The other two studies were qualitative studies aimed at obtaining the perspective of the students and the older people. Since the research method and the method of data analysis were similar in the two qualitative studies conducted, we will first address these issues in common with the two studies and then present the research procedure, research instrument, sample, and findings for each study separately.
The study employed qualitative methodology based on Interpretative Phenomenological Analysis (IPA; Smith et al., 2009; Smith & Osborn, 2003). IPA aims to explore how participants perceive and interpret significant experiences in their life in a particular context. This method was therefore chosen for the current study in the effort to understand the significant meaning of the students’ and older adults’ experiences in the context of sharing intergenerational housing based on their experiences in their daily lives from their point of view.
The interviews followed a semi-structured in-depth interview guide that included several open-ended and general questions that enabled the participant to share their experience in a manner they felt most comfortable with while focusing on the issues relevant to the study.
Data Analysis: Content analysis was performed to identify the major themes in the interviews. The analysis followed the stages prescribed by the IPA method (Smith & Osborn, 2003; Smith et al., 2009): (1) The transcripts were read several times, both by the students who conducted the interviews and by their teacher (the current author) to gain an overall picture, (2) We re-read the texts of the interviews and divided and coded them into meaning units, and wrote a descriptive or conceptual label for each meaning unit, (3) We organized the meaning units into categories first for each interview separately, then used a cross-case analysis to create shared categories for all of the interviews, (4). We composed central themes by finding connections between the categories, (5) Finally, we discussed the appropriate headings and to which to assign each theme, and focused and narrowed them down to broad issues common to all the interviews that reflected the content relating to the research question.
Method
Participants and Procedure
Telephone interviews were conducted by social work students with 16 participants in the program who consented to take part in the study after being approached by the Student Union. The aim of the study was explained, and they were ensured confidentiality and anonymity. Of the 16 interviewees, 14 were female and 2 were male. Age ranged from 19 to 35 (M = 24.2). Most defined themselves as traditional or religious, 4 reported an economic status above average, 3 below average, and the rest average. Three had been in the program in the past and the others were still participating in it. In terms of length of participation, 9 were in the program for half a year, 1 for a year, 4 for a year and a half, 1 for 2 years, and 1 for 3 years.
Instrument
A semi-structured interview was prepared that began with an invitation to speak about the experience in general (“I’m interested in hearing about your experience of living in the home of an older adult”). This was followed by questions relating to specific issues, such as reasons for joining the program, joint activities with the older adult, the contribution of the program.
Results
Background to Participation
Most of the participants learned of the program from notices on social media or in the press in the course of their search for financial assistance. Several heard about it on the radio, and a small number were told about it by a friend who had taken part in the past. The majority of interviewees knew very little about At Home before signing up.
I was very interested in the issue of older adults and loneliness. I hadn’t thought about it until I saw a documentary about another country where students lived with older adults. It touched my heart and aroused my interest. I was very happy to hear the same thing existed in Israel. I think it’s very important.
Most students mentioned both reasons for joining: “I joined because of the scholarship and the apartment. It’s very convenient. I also wanted to be part of a project with social value.”
On the other hand, the students expressed substantial concerns, anxiety, and stress as one student expressed:
I was afraid we wouldn’t form a connection, that it would be boring. I was worried that the woman wouldn’t accept me, that she would limit me and invade my privacy. . . that she wouldn’t allow me to come home late, to bring friends over. . .I was afraid I wouldn’t feel at home. I was concerned about her physical health, afraid that if something happened I wouldn’t know what to do.
Shared Activities
The activities mentioned most frequently were cooking and eating dinner, watching the news and discussing current affairs, listening to the older adult’s stories of their past, and taking an interest in each other’s daily life. Additional activities included teaching the older adult to use a computer, helping them to clean the house, and playing cards. Activities outside the home were also noted, such as taking walks, going shopping, and going to a movie or restaurant.
Relationship Between the Student and the Older Adult
The interviewees drew a picture of relationships along a continuum from very close to strained. At one end of the spectrum, they described a bond similar to that between a grandparent and a grandchild. One student stated: “We have a good relationship. . .She treats me very well as if I were her granddaughter.” Another student expressed:
We have a good relationship. We have a lot to talk about. It’s interesting and I feel comfortable with her. The relationship is warm and maternal. One example is that once I went to a party. I got home close to midnight and I saw that she had stayed up to make sure I was okay.
At the other extreme, interviewees described relationships that were complicated and difficult, especially at the beginning, primarily because of the generation gap as one student expressed:
At the beginning of the year, our relationship was very strained. I even considered leaving. There was a lack of communication between us . . .But gradually I got to know her, we learned to trust each other and adapt to the situation. . .
Another student talked about differences in personality and attitudes: “It’s hard for me to connect with her. Her personality is very different from mine. We come from different ethnic backgrounds.” Another student said:
Our relationship is complicated. On the one hand, she really enjoys our conversations, something she didn’t have before. On the other hand, [she] expected me to be at home more. That sometimes creates a sense of dissatisfaction and tension on both sides.
Interviewees who reported a close relationship also stated with certainty that they would continue to be in contact with the older adult.
Contribution of the Program
The majority of students felt that At Home had contributed substantially to themselves, the older adults, and intergenerational ties in general. They noted a number of specific benefits: “It changed with way I look at them [older adults]. I gained a lot from it. It exposed me to their difficulties and limitations. For example, getting in and out of a car, working in the kitchen. . . And because of what I learned, I visit my grandmother more often. With respect to the loneliness of the older adults one student stated:
In my opinion, she was a lot less lonely. The older woman told me recently that she was glad there was someone with her, someone in the house, because now she has a reason to get up in the morning and cook.
However, some students also referred to the temporariness of the arrangement and the fact that they only spent part of their time with the older adult according to one of the students: “We’re not home most of the day. . . The program is only temporary. Nobody will be with the older person when the student leaves.”
Moreover, the majority of interviewees referred to the financial benefit. Not only did they receive a scholarship that helped pay their tuition, but their participation also obviated the need to pay rent.
Satisfaction and Recommendations
Most interviewees expressed a high degree of satisfaction with the program, and about half were interested in continuing the following year. On the whole, they indicated they would recommend At Home to other students, although several also warned that “not everyone is suited for the program because it’s intense and demands time and responsibility.”
The students also offered recommendations in a number of domains relating both to advance preparation for participation and support during the shared living experience. One student stated:
Expectations should have been spelled out more clearly, together with me and the older adult. For instance, how many hours I have to be with them. There should be more training days before the program begins and you start living together.
Other student noted: “We should be given more information about things we should know about. . .All sorts of situations that might arise with older adults, so that we’ll be more prepared.”
Method
Participants and Procedure
Interviews were conducted with seven older women who had been approached by the Ministry of Social Equality and had consented to allow their details to be given to the Student Union for purposes of the study. Although the program coordinator asked the older adults to participate in the study, the response was low and only seven women expressed their consent to participate in the study. Social work students called the women, explained the aim of the study, and assured them that their privacy would be maintained and no identifying information would be published. After receiving their consent, a time and place for the interview was agreed on. All the women chose to be interviewed in their home, save for one who preferred to be interviewed over the phone. The interviews lasted from half an hour to an hour. Before beginning, each of the women signed an informed consent form.
The age of the interviewees ranged by 72 to 88 (M = 81.4). Six were widowed, and one was single. Most reported reasonable health, although three noted health problems such as diabetes or a previous stroke. In terms of religiosity, four defined themselves as secular and three as traditional. Six were retired and one was still working. One woman was participating in the program for a second year.
Instrument
The interviews followed a semi-structured protocol. As with the students, it began with an invitation to speak about the experience in general (“I’m interested in hearing about your experience of living with a student”), followed by questions relating to specific issues, such as reasons for joining the program, the relationship with the student, and the contribution of the program.
Results
Background to Participation
Most of the interviewees learned about the program from their daughters, who believed it would suit their mothers. Two joined after hearing about it on the radio.
The older adult’s family also played a large part in the decision to participate. The fact that their mothers were living alone appears to have been of considerable concern to family members. As one woman put it simply: “They didn’t want me to sleep in the house alone.”
Another interviewee explained that she joined in order to make things easier for her family:
I was alone, and my grandchildren would come, every day the kids would come, each time someone else, and I thought, poor things. They have their own room with a computer, and I’m a nuisance, me. It bothered me that they had to come and stay here.
Concerns and Expectations
The women were prepared for the arrival of the students by the program coordinators at the Student Union. Some women claimed to have had no concerns. One woman said: “I’m a very social person, you see. . .I didn’t have any real fears. No [I wasn’t worried]. I get along with everyone.
On the other hand, others described uneasiness about taking a stranger into their home. One woman explained:
I said, I’ll take in a stranger? To tell the truth, I was very anxious. I said, what if I get someone who’s dirty, who’ll leave things lying around the house, in the bathroom. There are girls like that. Not everyone’s neat and clean.
Daily Routine and Shared Activities
On the whole, the interviewees noted that the presence of the student in their home did not affect their daily routine. Several related to minor changes. In the words of one of the women:
The only thing is if she has to go to university in the morning, I asked her—until I learned her schedule a little better—do you want to take a shower before you leave? Because I usually get out of bed and go straight into the shower. . .So I ask if she’s in a hurry to get to class. I won’t be late for anything, but she could be.
In response to the question, the women mentioned a number of activities they engage in with the student: “We watch television, have tea, go for a pizza downstairs.
She tells me personal stories. . .Sometimes we sit and talk. . .”
The students also offered the women their help: “If she’s going shopping she’ll ask me if I need anything and get it for me.”
Since most of the older women reported being independent and not needing the student’s assistance most of the day, they tended not to demand that they fulfill the whole quota of hours of joint activities. Instead, they were happy with whatever was convenient for the student, and allowed them more free time for their studies and personal lives. One woman explained:
She really makes an effort, but she doesn’t have time. She comes to talk to me and then from eleven at night until the morning she sits and does her assignments. She wants to be with me. . .Sometimes we watch a movie.
In addition to the hours of shared activities to which the students committed themselves, there are household chores that derive from living in the same house. Several women related to this issue, for example: “She isn’t required to do anything. She keeps her room clean, does the dishes sometimes. . .we straighten up together.”
In this regard, one woman, who now had a second student residing with her, had not been pleased with the student who had previously lived in her home: “She didn’t change the sheets, nothing, just went home. She left the room like that and walked out.”
Relationship Between the Older Adult and the Student
Most of the women described a good relationship with the student. Their comments indicate a sense of commitment and concern for the younger women, which is often reciprocated. One woman said:
I made sure she had her own room, that she had a closet. I made sure she felt comfortable, that she felt good. I cleared out a shelf, even more, in the kitchen, like she needed. She feels very free [here].
Other woman described:
We get along very well, understand each other. . .Watch television together. . .If I need something she helps me and I worry about her as if she was my granddaughter. . . I just feel good with her. I know that if I ask for something she’ll come right away. When I didn’t feel well she helped me, gave me tea and medicine. She’s really good.
A good relationship with the student was also reflected in contact with the older woman’s family. Two women reported having met with the student’s family as well, testifying to the closeness of their relationship.
An exception to this rule can be found in the words of one interviewee who expressed her disappointment because the student wasn’t available when she needed her:
Everything was very nice until two months ago. I was in physical therapy, and when I left I fell. . .They called an ambulance. I was very upset, and in a lot of pain. I called her and she said, “I’ll be there right away.” But in the end she didn’t come. . . Right after that I asked her to leave.
Satisfaction and Contribution of the Program
For most of the interviewees, having the student in their home was a very positive experience and they expressed a high degree of satisfaction At Home. The majority even stated they would like to continue in the program. From their point of view, their primary goal had been achieved. One woman explained:
So, I’m not alone. . . It’s great to be with someone. It’s just that now I can sleep without worrying and that’s very important to me. I recommend it from the bottom of my heart for anyone who’s alone.
Several interviewees noted the contribution of the program to strengthening intergenerational ties as one of the women noted: “A connection between youngsters and older people is good, it’s nice. I tell her about my life and she tells me about hers. . . She learns from me and I learn from her.”
Some women expressed their pleasure in being given the opportunity to contribute to the younger generation. One woman noted: “I gave her more than she gave me. . . Maybe she saw a different kind of home here.”
Another interviewee praised the involvement of the Student Union: “The woman [coordinator] from the Student Union often calls me to make sure that everything’s okay. . . So they take an interest. I think it’s a very good project and it doesn’t cost them a lot.”
Criticism of the Program
Nevertheless, a number of women recommended that the student be required to spend more time in their home. One of the women expressed:
I don’t understand that idea. They’re only required to sleep here for three nights. But I think whoever decided that is wrong. In general, the whole program should change. If they come to stay with an older woman, three nights she feels comfortable and that’s fine. But what about when they’re not here? What happens then!?
Those who weren’t happy with the program attributed their dissatisfaction to incompatibility and a lack of communication As one woman explained: “It doesn’t suit people like me. Who are people like me? I’m a strong woman, dominant.”
In addition, some women believed the program would not affect the status of older people in society, for example: “An old person is always an old person. Who sees us? That’s it.”
Discussion
The studies presented here evaluated At Home from different perspectives: The students and the older adults.
Conclusions of the Quantitative Study
The comparative study found no differences between students who did and did not participate in the program, save for more knowledge of ageing among those who did not. It should be noted, however, that the study was conducted not long after the students took up residence in the home of the older adult. The duration of participation in the program was very wide (from 1 month to 40 months) with 75% of them participating in the program for a short period, and it was not possible to examine the effect of the time variable. In addition, the sociodemographic characteristics of the students in the two study groups were similar, hence the explanation why the students who were not in the research group had a higher level of knowledge about older adults could be purely coincidental. Consequently, it is difficult to draw conclusions regarding the influence of the program, and it is recommended to examine this issue in a longitudinal study among students participating in the program. Moreover, similar results are reported by a study evaluating a short-term intergenerational intervention, where no effect was found for the intervention (Christian et al., 2014).
Analysis of the sample as a whole revealed that the closer the student’s relationship with their grandparents, the lower their level of ageism and the greater their knowledge of ageing. This is also consistent with previous studies (Abrams et al., 2006; Crisp & Turner, 2009; Drury et al., 2016). Furthermore, in line with earlier studies (Kalavar, 2001; Rupp et al., 2005), gender was found to predict the level of ageism, so that female students exhibited less ageism than male students.
Conclusions of the of the Qualitative Studies
Further results of the quantitative study, as well as the interviews in the qualitative studies (2 and 3), shed light on the participants’ perception of the program. On the whole, they expressed a high degree of satisfaction, indicating that At Home had contributed significantly to both sides.
One of the aims of the program was to strengthen intergenerational bonds. As suggested by Bodner (2009), encouraging social contact between the generations appears to helped achieve this goal. As a result of sharing a home with an older adult, the students became more familiar with their world and more aware of their limitations and needs. In addition, they were able to learn from their host’s rich life experience. Similar outcomes are described by a program in which students of gerontology lived in an institutional home for older adults on different levels of functioning (Gordon, 2007). As in the current series of studies, the students reported learning about the world of older adults and noted the positive value of creating an intergenerational bond. A student of pharmacology at the University of Rhode Island who lived with a 92-year-old woman in sheltered housing as part of a special project described her experience in similar terms (Anastasia, & Estus 2013). The student developed close friendships with many of the residents, became familiar with their way of life, and had a unique opportunity to observe and assess characteristics of older adults that cannot be taught in a classroom. Without a doubt, the students in our study felt that the program had contributed to forging an intergenerational bond and enhanced their recognition of the importance of this relationship. As one student noted, it even encouraged her to visit her own grandmother more often.
In addition, such arrangement as home-sharing programs provided the students in our study as well as other students rent-free housing (Labit & Dubost, 2016; Mirza et al., 2019). In exchange, the students were required to spend some hours a week with the older adult, performing activities such as walking, teaching computer use, and simply talking and spending time together. As in previous studies, the activities reported by both the women and the students in our study were shared dinners, watching TV, walking, conversations, sharing life stories and experiences, learning computer technology. However, due to the study load, and lack of time, Israeli students as well as other students were unable to stay with the older adults for the full required time (Hock & Mickus, 2019; Gonzales et al., 2020; Labit & Dubost, 2016).
The older adults (Study 3) reported that the program enabled them to contribute to the students on various levels. Not only did they provide the younger person with a convenient living arrangement, but they also looked out for them and enriched their life by drawing on their own life experience. The opportunity for older adults to give to the younger generation further demonstrates the value of encouraging social contact between them in order to strengthen intergenerational ties (Bodner, 2009).
Another aim of the program was to alleviate the loneliness of older adults, a common problem that can adversely affect the individual’s well-being (Bodner & Bergman, 2016; Courtin & Knapp, 2017; Hawkley et al., 2018; Shankar et al., 2011). The interviews revealed that loneliness was indeed the older women’s main motivation for joining At Home, and both the students and the women felt that the program did, in fact, achieve its goal in this regard. This finding is consistent with a review of 38 studies on loneliness and social isolation intervention programs conducted between 2003 and 2016 and found that most interventions reported some success in reducing social isolation and loneliness (Gardiner, et al., 2018). Not only did the presence of the student give the older adults greater peace of mind, but, similar to studies of shared intergenerational housing programs, staying with young students caused to positive, vital emotions, and increased feelings of joy among the older adults (Arentshorst et al., 2019; Hock & Mickus, 2019; Gorjup, 2020).
Moreover, like most people their age, the interviewees in our study wished to remain in their own home (Vanleerberghe, et al., 2017), and, at least in some cases, participation in At Home helped make this possible.
Limitations of the Studies and Recommendations for Future Research
One major limitation of the comparative study (Study 1) should be noted. As it was conducted at a single point in time (a cross-sectional survey design), soon after the start of the academic year, it was impossible to assess the effect of the program on the students’ attitudes and behavior toward the older population. Longitudinal studies conducted at two points in time, before the students take up residence in the home of the older adult and when they leave, would be of value, and a better measure of change. On the one hand, they might shed light on the degree to which participation in the program decreased the students’ ageism, increased their knowledge of ageing, and changed their behavior toward the older adults. On the other hand, they could reveal whether the program improved the quality of life of the older adult, relieved their loneliness, and strengthened intergenerational ties. In addition, the number of older adults interviewed for the study (Study 3) was small (seven women), and in the future it may be helpful to conduct another qualitative study in which both, men and women participating in the program will be interviewed to expand the knowledge from other perspectives.
The primary contribution of this series of studies lies in presenting the point of view of the participants in the At Home program. These perspectives add to the knowledge of evaluating this innovative program in Israel. The results of the quantitative study and the two qualitative studies alike indicate that both the students and the older people felt the program was successful. In addition, they offered a number of practical suggestions for improvement. The students related primarily to the need for more guidance and emotional support at various stages in the process, while the older adults recommended increasing the number of nights the students are required to sleep in their homes.
The participants expressed a high level of satisfaction and felt the program had contributed to both sides. The contribution of the program for the older adults reflected in the relief of their loneliness. Among the students, the contribution is expressed in familiarity with the world of older adults, and the financial aid for their studies in scholarship and housing. Both sides felt success in strengthening of intergenerational relationships. We, therefore, recommend that At Home be continued, with refinements introduced as a result of this and future evaluations.
Footnotes
Acknowledgements
The author gratefully acknowledge the Ministry for Social Equality and the Student Union in Israel for their cooperation and assistance in conducting the studies.
Committee Approval
University Ethics Committee (No. AU-AEZ-2018114; AU-SOC-AEZ-20190213).
Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author received no financial support for the research, authorship, and/or publication of this article.
