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The “At Home” Program: Students Residing with Older Adults:

The “At Home” Program: Students Residing with Older Adults: “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 social sciences, aging and the life course, sociology of health and illness, sociology, social structure, sociology, community and urban sociology, political sociology, evolution and sociology At Home is an innovative social program, run jointly by the to get to know the older adult, and to make sure that there is Ministry for Social Equality and the Student Union in Israel, a suitable place to live for the student. (3) Finding a suitable in which students reside in the homes of older adults. The student, for example, a female for a woman or a male for a student occupies a free room in the house of an independent man, and signing contracts. older adult (women aged 62 and over and men aged 67 and The program admission process regarding the students over) who are living on their own in the community and have after registration includes also three stages: (1) Personal a room for student accommodation. Students are required to interview with the coordinator. (2) Scheduling a meeting of spend at least three nights a week in the house for a period of the student with the older adult to coordinate expectations. residence not less than 9 months and not more than 12 months. (3) Signing contracts. It is possible to extend the contract and continue to participate Monitoring and training for students: The program coor- in the program for another year. As part of the program, stu- dinator conducts a telephone call once a month with the stu- dents interact socially with the older adult for at least 5 hours dents and older adults, as well as conducting home visits for a week, and a total of 160 hours throughout a year of activity, follow-up and assistance. Students are accompanied by the for example, computer studies dinner, and walking together. program coordinator who responds to any need that arises. The older adults undertake not to require students to perform There are also two training days a year in which students activities that go beyond joint social activities such as nurs- receive training and lectures on various topics from profes- ing, home cleaning, and shopping. In exchange, the students sionals (Israel Student Union, 2020; Ministry of Social enjoy accommodations, paying $80 a month to cover the Equality, 2020). extra utility costs, 11 as well as a tuition scholarship of $2344. This paper presents a series of studies designed to evalu- The aim of the program is to relieve the solitude of the older ate the program. 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 Ariel University, Israel as to strengthen intergenerational bonds. Corresponding Author: The program admission process regarding the older adults Ahuva Even-Zohar, School of Social Work, Faculty of Social Sciences, after registration includes three stages: (1) Telephone inter- Ariel University, Ariel 40700, Israel. view with the coordinator. (2) Home visit of the coordinator Email: ahuvaez@gmail.com Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). 2 SAGE Open than among older populations (Kite et al., 2005; Rupp et al., Aging in Place 2005), others report more positive attitudes and less ageist Most older adults wish to continue to live in their own homes behaviors in younger groups (Cherry et al., 2016; Öberg & in the community they are familiar with, to maintain existing Tornstam, 2003). In addition, female students have been social connections to alleviate their loneliness, and to receive found to have lower levels of ageism than their male cohorts community services that will enable them to live indepen- (Kalavar, 2001; Rupp et al., 2005), presumably because dently (Martens, 2018; Vanleerberghe et al., 2017). This women typically display greater empathy and concern trend can also be seen in Israel, where some 97% of the pop- whereas men are higher on instrumental qualities. A survey ulation aged 65 and over was living in private households in of interventions aimed at dealing with ageism produced 2020 (Israel Bureau of Statistics, 2021). complex results (Christian et al., 2014). It was found that Older adults’ strong attachment to their home goes beyond long-term intergenerational interventions led to more posi- the physical connection to include experiences, memories, tive attitudes toward older adults among younger people, and the surrounding sociocultural environment (Hidalgo & while short-term interventions had no effect, and in some Hernandez, 2001; Stones & Gullifer, 2016). Remaining in cases even led to more negative attitudes than those assessed their home affords them a sense of independence and auton- at the start of the intervention. omy, as well as control over everyday activities (Hearle et However, combined programs of education and intergen- al., 2005; Stone & Gullifer, 2016). erational contact of adolescents and students with older In order to stay in the community, older adults require adults have shown a very positive effect on reducing ageism appropriate support services in addition to the assistance especially among women, adolescents, and young people they may receive from family members (Vanleerberghe et (Burnes, et al., 2019; Leedahl et al., 2020). In addition, there al., 2017). Where such services are available, the older popu- are programs of intergenerational sharing of young and old lation reports a higher quality of life and lower sense of lone- in housing. liness (Ahn et al., 2017; Hawkley & Kocherginsky, 2018; Neiboer & Cramm, 2018; Vitman Schorr & Khalaila, 2018). Intergenerational Housing Programs In some countries, there are several intergenerational hous- Loneliness among Older Adults ing projects such as living in older adults’ homes, in shel- Loneliness is a common problem among older adults and has tered housing, in nursing homes, and on university campuses become increasingly prevalent in recent decades (Lee et al., (Gorjup, 2020). In these programs, a living environment is 2019; Perissinotto et al., 2019). Statistics in Israel show that created in which young and old people live together. For the 11% of people aged 65 and over report often feeling lonely older adults, the purpose is to enable the continued aging in (Israel Bureau of Statistics, 2021). Loneliness may be either place in their community, improve their quality of life, chronic, when individuals have not developed lasting social solve the problem of their loneliness and social isolation relations over the years, or situational, resulting from life and get help from the young people in various tasks. For events such as retirement, the loss of a spouse, relocation, or students and other young people, the purpose of this living alone (Pikhartova & Victor, 2015). Moreover, loneli- arrangement is to facilitate rent reduction especially in ness adversely affects not only psychological well-being, urban localities where rents are high (Gonzales et al., 2020; leading to depression and anxiety, but also physical health, Gorjup, 2020; Labit & Dubost, 2016). After matching the increasing the chances of morbidity and mortality (Bodner & profile of the old person with the young one they sign a Bergman, 2016; Courtin & Knapp, 2017; Shankar, et al., contract. Usually, the young person/student engages in joint 2011). Among the factors that may contribute to the loneli- activities with the old man several hours a week: informal ness of older adults is the lack of intergenerational relations. activities, for example, participating in a meal and provid- ing assistance or in informal activities, such as personal conversations, shopping, cafes, restaurants, concerts, teach- Intergenerational Relations and Ageism ing various technologies (Arentshorst et al., 2019; Gorjup, Research indicates that both a positive intergenerational rela- 2020; Landi & Smith, 2019). tionship in the family, particularly between grandchildren Various studies show that these programs benefit both and grandparents, and social interactions in which older older adults and young people. Benefits of successful adults can contribute to the lives of younger people, are asso- arrangements include reducing the need for care services for ciated with decreased prejudices and stereotypes regarding the older adults resulting in a reduction in emergency care the older adults (Abrams, et al., 2006; Bodner, 2009; Crisp & costs, a beneficial effect on psychological health, feelings of Turner, 2009; Drury et al., 2016; Tam et al., 2006) security, independence, reducing loneliness, raising vital and Furthermore, the results of studies of ageism among happy feelings, intergenerational communication, and reduc- young adults are inconsistent. While some have found more ing ageism among young people (Arentshorst et al., 2019; negative attitudes toward older people among young adults Gonzales et al., 2020; Gorjup, 2020). Even-Zohar 3 A similar program has existed in Israel for several years. The mean age of the research group was 24.17 (SD = 3.31), At Home is an innovative program in Israel, in which stu- and of the comparison group, 25.56 (SD = 3.70). The large dents reside in the homes of older adults and has not yet been majority of the whole sample (N = 202) were Jewish (97%), evaluated. To fill this gap in knowledge on this topic, three with about half defining themselves as religious (44.6%), studies were conducted. 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 The Current Series of Studies academic disciplines, including therapeutic and educational This paper presents the results of a series of three initial eval- fields, as well as natural sciences, engineering, communica- uation studies conducted on the At Home program in 2017- tions, and law. The duration of the students participating in 2019. Consent for the studies was received from the Ministry the program ranges from 1 month to 40 months and the aver- of Social Equality and the Student Council, and they were age duration was 9.3 (SD = 8.30). The age of the older adults approved by the University Ethics Committee (No. AU-AEZ- with whom they lived ranged from 67 to 97 (M = 81.46, 2018114; AU-SOC-AEZ-20190213). SD = 6.62). Study 1. A quantitative study—Comparison between Instruments two groups: Students participating in the program versus students who do not participate in the program. Fraboni Scale of Ageism (FSA; Fraboni et al., 1990), trans- lated into Hebrew (Bodner & Lazar, 2008). Participants were This study was a comparative quantitative investigation asked to indicate the degree to which they agree with the state- that used a cross-sectional survey design aimed at assessing ments in 24 items (e.g., “Old people complain more than other ageism and knowledge of ageing among students. Based on people do”), marking their responses on a 6-point Likert scale the literature review of the contribution of close relationships from 1 (strongly disagree) to 6 (strongly agree). Cronbach’s between young and old people in reducing ageism, and add- alpha = .86 is reported for the original scale and was .77 in the ing knowledge about old people, two study questions were current study. Each student was assigned a score equal to the examined: sum of their responses to all items, with higher scores indicat- ing more negative attitudes to older people. 1. Are the levels of ageism and knowledge of ageing of Knowledge of aging questionnaire based on the Facts on students who participate in the program different Aging Quiz (Palmore, 1977). In the current study, we used from those of students who do not? the instrument employed by Shiovitz-Ezra et al. (2013) for 2. What sociodemographic variables are associated a survey on ageism. Participants were asked to indicate the with ageism and knowledge of aging? 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 Method all items, with higher scores indicating greater knowledge of aging. Participants and Procedure A sociodemographic questionnaire was used to obtain After receiving the necessary approval, an email was sent by data including age, gender, and relationship with the the Student Union At Home coordinator to all the students grandparents. who were currently or had previously been in the program An additional questionnaire regarding the At Home pro- (around 400) explaining the aim of the study and requesting gram was completed by the research group. Participants their participation. Those who returned a signed consent were asked to indicate their joint activities with the older form constituted the research group. A comparison group of adult and to assess the program’s contribution to both sides. students who were not in the program was recruited through social media. Both groups were sent a secure link to the same Results questionnaire and completed it online. No identifying data was collected. Differences Between Groups The final sample consisted of 104 students in the research group (25% of the participants in the program), and 98 in a T-tests for independent samples were conducted to examine matching comparison group. The socio-demographic charac- differences in ageism and knowledge of ageing between the teristics of the two groups were similar except for gender. two groups. No differences were found in ageism. However, Most of the students in the research group (88.5%) were students who did not participate in the program displayed female (N = 92) and only 12 (11.5%) were male, which cor- greater knowledge of ageing than those who did (N = 98, responds with the significant correlation found between gen- M = 8.95, SD = .1.61; N = 104, M = 8.17, SD = .1.69, respec- der and participation in the program (χ = 12.15, p < .001). tively; t = 3.37, p < .01). 4 SAGE Open Figure 1. The activities shared by the student and the older adult (N = 104). knowledge of aging added 9.3% to the explained variance. Associations Between Sociodemographic The total percentage of explained variance was 15.8%. That Variables and Ageism (Whole Sample) is, female students with a knowledge of ageing showed the t-tests for independent samples yielded a significant differ- lowest levels of ageism. ence only for gender. Female students were found to exhibit a lower level of ageism (N = 159, M = 2.41, SD = .468) than Assessment of at Home male students (N = 43, M = 2.72, SD = .539), t = 3.74, p < .000. The activities shared by the student and the older adult appear in Figure 1. Associations Between the Relationship with the As can be seen, the most common activities were watch- Grandparents and Ageism and Knowledge of ing television and eating dinner, going for walks, computer Ageing training followed by a range of other activities, including Pearson correlations were conducted, and it was found that doing crosswords, talking, gardening, cleaning, and laundry, the stronger the relationship with the grandparents, the less knitting, playing games, looking through photo albums, negative the attitude to older adults (N = 202, r = −.20, shopping, cooking, and, as well as attending outdoor events. p < .01) and the more the students knew about aging (N = 202, Most of the participants believed that the program contrib- r = .15, p < .05). uted to promoting the status of older adults, assessing its con- tribution as large (33.6%) or very large (40%). Moreover, they felt that it helped relieve the loneliness of the older adult Factors Associated with Ageism to a large (16.5%) or very large (82.5%) degree. Stepwise regression was performed to identify the factors The students’ satisfaction with the program is presented in affecting ageism. The sociodemographic variables of gender, Figure 2. age, economic status, and religiosity were entered in Step 1, As can be seen, most students were satisfied. Additionally, and relationship with the grandparents, contact with older 52.9% stating they would like to remain in the program the adults, participation in the program, and knowledge of age- following year. Of the others, 44.2% indicated they do not ing in Step 2. The results indicated that gender entered in the wish to continue, and 2.9% did not respond. Furthermore, first step (β = −2.56, p < .001) which explained 6.5% of the 73% reported wanting to maintain contact with the older variance. Gender (β = −2.79, p < .001), and knowledge of adult after leaving the program, 26% stated they did not, and aging (β = −2.44, p < .001), entered in the second step, and 1% did not respond. In addition, 89.4% of the students Even-Zohar 5 Figure 2. The students’ own satisfaction with the program (N = 104). indicated that they would recommend the program to a Data Analysis: Content analysis was performed to iden- friend, with 9.6% reporting they would not, and 1% not tify the major themes in the interviews. The analysis fol- responding. lowed the stages prescribed by the IPA method (Smith & Finally, 31.7% of the students indicated that participating Osborn, 2003; Smith et al., 2009): (1) The transcripts were in the program contributed to funding their studies to a large read several times, both by the students who conducted the degree, 51.9% to a very large degree, and 13.5% to a small interviews and by their teacher (the current author) to gain an degree. Only 2.9% reported that it was of no financial benefit overall picture, (2) We re-read the texts of the interviews and to them. divided and coded them into meaning units, and wrote a descriptive or conceptual label for each meaning unit, (3) We Studies 2 and 3. Qualitative studies—The perspective organized the meaning units into categories first for each of the students and the older people. interview separately, then used a cross-case analysis to create shared categories for all of the interviews, (4). We composed The other two studies were qualitative studies aimed at central themes by finding connections between the catego- obtaining the perspective of the students and the older peo- ries, (5) Finally, we discussed the appropriate headings and ple. Since the research method and the method of data analy- to which to assign each theme, and focused and narrowed sis were similar in the two qualitative studies conducted, we them down to broad issues common to all the interviews that will first address these issues in common with the two stud- reflected the content relating to the research question. ies and then present the research procedure, research instru- ment, sample, and findings for each study separately. Study 2. A qualitative study: The perspective of the stu- The study employed qualitative methodology based on dents in the At Home program. Interpretative Phenomenological Analysis (IPA; Smith et al., 2009; Smith & Osborn, 2003). IPA aims to explore how par- Method ticipants perceive and interpret significant experiences in their life in a particular context. This method was therefore chosen Participants and Procedure for the current study in the effort to understand the significant meaning of the students’ and older adults’ experiences in the Telephone interviews were conducted by social work stu- context of sharing intergenerational housing based on their dents with 16 participants in the program who consented to experiences in their daily lives from their point of view. take part in the study after being approached by the Student The interviews followed a semi-structured in-depth inter- Union. The aim of the study was explained, and they were view guide that included several open-ended and general ensured confidentiality and anonymity. Of the 16 interview- questions that enabled the participant to share their experi- ees, 14 were female and 2 were male. Age ranged from 19 to ence in a manner they felt most comfortable with while 35 (M = 24.2). Most defined themselves as traditional or reli- focusing on the issues relevant to the study. gious, 4 reported an economic status above average, 3 below 6 SAGE Open average, and the rest average. Three had been in the program 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 in the past and the others were still participating in it. In she would limit me and invade my privacy. . . that she wouldn’t terms of length of participation, 9 were in the program for allow me to come home late, to bring friends over. . .I was half a year, 1 for a year, 4 for a year and a half, 1 for 2 years, afraid I wouldn’t feel at home. I was concerned about her and 1 for 3 years. physical health, afraid that if something happened I wouldn’t know what to do. Instrument Shared Activities A semi-structured interview was prepared that began with an invitation to speak about the experience in general (“I’m The activities mentioned most frequently were cooking and interested in hearing about your experience of living in the eating dinner, watching the news and discussing current home of an older adult”). This was followed by questions affairs, listening to the older adult’s stories of their past, and relating to specific issues, such as reasons for joining the pro- taking an interest in each other’s daily life. Additional activi- gram, joint activities with the older adult, the contribution of ties included teaching the older adult to use a computer, help- the program. ing 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. Results Background to Participation Relationship Between the Student and the Most of the participants learned of the program from notices Older Adult on social media or in the press in the course of their search The interviewees drew a picture of relationships along a con- for financial assistance. Several heard about it on the radio, tinuum from very close to strained. At one end of the spec- and a small number were told about it by a friend who had trum, they described a bond similar to that between a taken part in the past. The majority of interviewees knew grandparent and a grandchild. One student stated: “We have very little about At Home before signing up. a good relationship. . .She treats me very well as if I were Reasons for deciding to join the program: The inter- her granddaughter.” Another student expressed: viewees noted two major reasons. The first was practical: the financial benefit and the convenience as one student said: “I We have a good relationship. We have a lot to talk about. It’s joined because it would save me the cost of the rent. It was interesting and I feel comfortable with her. The relationship is the convenience. The apartment was close to the university”. warm and maternal. One example is that once I went to a party. The second reason was ideological. Another student I got home close to midnight and I saw that she had stayed up to explained: make sure I was okay. I was very interested in the issue of older adults and loneliness. At the other extreme, interviewees described relationships I hadn’t thought about it until I saw a documentary about another that were complicated and difficult, especially at the begin- country where students lived with older adults. It touched my ning, primarily because of the generation gap as one student heart and aroused my interest. I was very happy to hear the same expressed: thing existed in Israel. I think it’s very important. At the beginning of the year, our relationship was very strained. Most students mentioned both reasons for joining: “I joined I even considered leaving. There was a lack of communication because of the scholarship and the apartment. It’s very conve- between us . . .But gradually I got to know her, we learned to nient. I also wanted to be part of a project with social value.” trust each other and adapt to the situation. . . Prior expectations and concerns: Most interviewees reported having no specific expectations before beginning Another student talked about differences in personality the program. However, several noted a desire to form a close and attitudes: “It’s hard for me to connect with her. Her per- and meaningful relationship with the older adult and hoped sonality is very different from mine. We come from different for a positive experience. One student expressed: “I expected ethnic backgrounds.” Another student said: it to be a good experience, that the older adult would enjoy my presence and I would make him feel good,” another stu- Our relationship is complicated. On the one hand, she really dent said: “I expected it to be like living with my grand- enjoys our conversations, something she didn’t have before. mother, that it would be meaningful for me and for her.” On the other hand, [she] expected me to be at home more. That On the other hand, the students expressed substantial con- sometimes creates a sense of dissatisfaction and tension on cerns, anxiety, and stress as one student expressed: both sides. Even-Zohar 7 Interviewees who reported a close relationship also stated situations that might arise with older adults, so that we’ll with certainty that they would continue to be in contact with be more prepared.” the older adult. Study 3. A qualitative study: The perspective of the older people in the At Home program. Contribution of the Program The majority of students felt that At Home had contributed Method substantially to themselves, the older adults, and intergenera- tional ties in general. They noted a number of specific bene- Participants and Procedure fits: “It changed with way I look at them [older adults]. I Interviews were conducted with seven older women who had gained a lot from it. It exposed me to their difficulties and been approached by the Ministry of Social Equality and had limitations. For example, getting in and out of a car, working consented to allow their details to be given to the Student in the kitchen. . . And because of what I learned, I visit my Union for purposes of the study. Although the program coor- grandmother more often. With respect to the loneliness of the dinator asked the older adults to participate in the study, the older adults one student stated: response was low and only seven women expressed their consent to participate in the study. Social work students In my opinion, she was a lot less lonely. The older woman told called the women, explained the aim of the study, and assured me recently that she was glad there was someone with her, them that their privacy would be maintained and no identify- someone in the house, because now she has a reason to get up in the morning and cook. ing information would be published. After receiving their consent, a time and place for the interview was agreed on. All However, some students also referred to the temporari- the women chose to be interviewed in their home, save for ness of the arrangement and the fact that they only spent part one who preferred to be interviewed over the phone. The of their time with the older adult according to one of the stu- interviews lasted from half an hour to an hour. Before begin- dents: “We’re not home most of the day. . . The program is ning, each of the women signed an informed consent form. only temporary. Nobody will be with the older person when The age of the interviewees ranged by 72 to 88 (M = 81.4). the student leaves.” Six were widowed, and one was single. Most reported rea- Moreover, the majority of interviewees referred to the sonable health, although three noted health problems such as financial benefit. Not only did they receive a scholarship that diabetes or a previous stroke. In terms of religiosity, four helped pay their tuition, but their participation also obviated defined themselves as secular and three as traditional. Six the need to pay rent. were retired and one was still working. One woman was par- ticipating in the program for a second year. Satisfaction and Recommendations Instrument Most interviewees expressed a high degree of satisfaction with the program, and about half were interested in con- The interviews followed a semi-structured protocol. As with tinuing the following year. On the whole, they indicated the students, it began with an invitation to speak about the they would recommend At Home to other students, experience in general (“I’m interested in hearing about your although several also warned that “not everyone is suited experience of living with a student”), followed by questions for the program because it’s intense and demands time and relating to specific issues, such as reasons for joining the pro- responsibility.” gram, the relationship with the student, and the contribution The students also offered recommendations in a number of the program. of domains relating both to advance preparation for partici- pation and support during the shared living experience. One Results student stated: Background to Participation Expectations should have been spelled out more clearly, together Most of the interviewees learned about the program from with me and the older adult. For instance, how many hours I their daughters, who believed it would suit their mothers. have to be with them. Two joined after hearing about it on the radio. There should be more training days before the program begins The older adult’s family also played a large part in the and you start living together. decision to participate. The fact that their mothers were liv- ing alone appears to have been of considerable concern to Other student noted: “We should be given more informa- family members. As one woman put it simply: “They didn’t tion about things we should know about. . .All sorts of want me to sleep in the house alone.” 8 SAGE Open Another interviewee explained that she joined in order to In addition to the hours of shared activities to which the make things easier for her family: students committed themselves, there are household chores that derive from living in the same house. Several women I was alone, and my grandchildren would come, every day related to this issue, for example: “She isn’t required to do the kids would come, each time someone else, and I thought, anything. She keeps her room clean, does the dishes some- poor things. They have their own room with a computer, and times. . .we straighten up together.” I’m a nuisance, me. It bothered me that they had to come and In this regard, one woman, who now had a second student stay here. 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 Concerns and Expectations and walked out.” The women were prepared for the arrival of the students by the program coordinators at the Student Union. Some women Relationship Between the Older Adult and the claimed to have had no concerns. One woman said: “I’m a Student very social person, you see. . .I didn’t have any real fears. No [I wasn’t worried]. I get along with everyone. Most of the women described a good relationship with the On the other hand, others described uneasiness about tak- student. Their comments indicate a sense of commitment and ing a stranger into their home. One woman explained: concern for the younger women, which is often reciprocated. One woman said: 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 I made sure she had her own room, that she had a closet. I made lying around the house, in the bathroom. There are girls like that. sure she felt comfortable, that she felt good. I cleared out a shelf, Not everyone’s neat and clean. even more, in the kitchen, like she needed. She feels very free [here]. Daily Routine and Shared Activities Other woman described: On the whole, the interviewees noted that the presence of the student in their home did not affect their daily routine. We get along very well, understand each other. . .Watch Several related to minor changes. In the words of one of the television together. . .If I need something she helps me and I women: 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 The only thing is if she has to go to university in the morning, I and medicine. She’s really good. 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 A good relationship with the student was also reflected in hurry to get to class. I won’t be late for anything, but she could be. contact with the older woman’s family. Two women reported having met with the student’s family as well, testifying to the In response to the question, the women mentioned a num- closeness of their relationship. ber of activities they engage in with the student: “We watch An exception to this rule can be found in the words of one television, have tea, go for a pizza downstairs. interviewee who expressed her disappointment because the student wasn’t available when she needed her: She tells me personal stories. . .Sometimes we sit and talk. . .” Everything was very nice until two months ago. I was in physical The students also offered the women their help: “If she’s going therapy, and when I left I fell. . .They called an ambulance. I shopping she’ll ask me if I need anything and get it for me.” 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. . . Since most of the older women reported being independent Right after that I asked her to leave. 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 Satisfaction and Contribution of the Program convenient for the student, and allowed them more free time For most of the interviewees, having the student in their for their studies and personal lives. One woman explained: home was a very positive experience and they expressed a high degree of satisfaction At Home. The majority even She really makes an effort, but she doesn’t have time. She comes stated they would like to continue in the program. From their to talk to me and then from eleven at night until the morning she point of view, their primary goal had been achieved. One sits and does her assignments. She wants to be with me. . . Sometimes we watch a movie. woman explained: Even-Zohar 9 So, I’m not alone. . . It’s great to be with someone. It’s just that very wide (from 1 month to 40 months) with 75% of them now I can sleep without worrying and that’s very important to participating in the program for a short period, and it was not me. I recommend it from the bottom of my heart for anyone possible to examine the effect of the time variable. In addi- who’s alone. tion, the sociodemographic characteristics of the students in the two study groups were similar, hence the explanation Several interviewees noted the contribution of the pro- why the students who were not in the research group had a gram to strengthening intergenerational ties as one of the higher level of knowledge about older adults could be purely women noted: “A connection between youngsters and older coincidental. Consequently, it is difficult to draw conclusions people is good, it’s nice. I tell her about my life and she tells regarding the influence of the program, and it is recom- me about hers. . . She learns from me and I learn from her.” mended to examine this issue in a longitudinal study among Some women expressed their pleasure in being given the students participating in the program. Moreover, similar opportunity to contribute to the younger generation. One results are reported by a study evaluating a short-term inter- woman noted: “I gave her more than she gave me. . . Maybe generational intervention, where no effect was found for the she saw a different kind of home here.” intervention (Christian et al., 2014). Another interviewee praised the involvement of the Analysis of the sample as a whole revealed that the Student Union: “The woman [coordinator] from the Student closer the student’s relationship with their grandparents, the Union often calls me to make sure that everything’s okay. . . lower their level of ageism and the greater their knowledge So they take an interest. I think it’s a very good project and it of ageing. This is also consistent with previous studies doesn’t cost them a lot.” (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 Criticism of the Program level of ageism, so that female students exhibited less age- Nevertheless, a number of women recommended that the ism than male students. student be required to spend more time in their home. One of the women expressed: Conclusions of the of the Qualitative Studies I don’t understand that idea. They’re only required to sleep here Further results of the quantitative study, as well as the inter- for three nights. But I think whoever decided that is wrong. In views in the qualitative studies (2 and 3), shed light on the general, the whole program should change. If they come to stay participants’ perception of the program. On the whole, they with an older woman, three nights she feels comfortable and expressed a high degree of satisfaction, indicating that At that’s fine. But what about when they’re not here? What Home had contributed significantly to both sides. happens then!? One of the aims of the program was to strengthen inter- generational bonds. As suggested by Bodner (2009), encour- Those who weren’t happy with the program attributed their aging social contact between the generations appears to dissatisfaction to incompatibility and a lack of communi- helped achieve this goal. As a result of sharing a home with cation As one woman explained: “It doesn’t suit people an older adult, the students became more familiar with their like me. Who are people like me? I’m a strong woman, world and more aware of their limitations and needs. In addi- dominant.” tion, they were able to learn from their host’s rich life experi- In addition, some women believed the program would not ence. Similar outcomes are described by a program in which affect the status of older people in society, for example: “An students of gerontology lived in an institutional home for old person is always an old person. Who sees us? That’s it.” older adults on different levels of functioning (Gordon, 2007). As in the current series of studies, the students Discussion reported learning about the world of older adults and noted the positive value of creating an intergenerational bond. A The studies presented here evaluated At Home from different student of pharmacology at the University of Rhode Island perspectives: The students and the older adults. who lived with a 92-year-old woman in sheltered housing as part of a special project described her experience in similar Conclusions of the Quantitative Study terms (Anastasia, & Estus 2013). The student developed close friendships with many of the residents, became famil- The comparative study found no differences between stu- iar with their way of life, and had a unique opportunity to dents who did and did not participate in the program, save for observe and assess characteristics of older adults that cannot more knowledge of ageing among those who did not. It be taught in a classroom. Without a doubt, the students in our should be noted, however, that the study was conducted not study felt that the program had contributed to forging an long after the students took up residence in the home of the intergenerational bond and enhanced their recognition of the older adult. The duration of participation in the program was 10 SAGE Open importance of this relationship. As one student noted, it even academic year, it was impossible to assess the effect of the encouraged her to visit her own grandmother more often. program on the students’ attitudes and behavior toward the In addition, such arrangement as home-sharing programs older population. Longitudinal studies conducted at two points provided the students in our study as well as other students in time, before the students take up residence in the home of rent-free housing (Labit & Dubost, 2016; Mirza et al., 2019). the older adult and when they leave, would be of value, and a In exchange, the students were required to spend some hours better measure of change. On the one hand, they might shed a week with the older adult, performing activities such as light on the degree to which participation in the program walking, teaching computer use, and simply talking and decreased the students’ ageism, increased their knowledge of spending time together. As in previous studies, the activities ageing, and changed their behavior toward the older adults. On reported by both the women and the students in our study the other hand, they could reveal whether the program were shared dinners, watching TV, walking, conversations, improved the quality of life of the older adult, relieved their sharing life stories and experiences, learning computer tech- loneliness, and strengthened intergenerational ties. In addition, nology. However, due to the study load, and lack of time, the number of older adults interviewed for the study (Study 3) Israeli students as well as other students were unable to stay was small (seven women), and in the future it may be helpful with the older adults for the full required time (Hock & to conduct another qualitative study in which both, men and Mickus, 2019; Gonzales et al., 2020; Labit & Dubost, 2016). women participating in the program will be interviewed to The older adults (Study 3) reported that the program expand the knowledge from other perspectives. enabled them to contribute to the students on various levels. Conclusions and implications: In order to evaluate the At Not only did they provide the younger person with a conve- Home program, we used a mixed-method design that nient living arrangement, but they also looked out for them included two distinct methods; a quantitative study that and enriched their life by drawing on their own life experi- examined students’ attitudes toward older adults, and their ence. The opportunity for older adults to give to the younger opinions about the program, as well as two qualitative stud- generation further demonstrates the value of encouraging ies that examined the perceptions of the students and the social contact between them in order to strengthen intergen- senior citizens participating in the program. Despite the limi- erational ties (Bodner, 2009). tations of the studies, mentioned above, it can be concluded Another aim of the program was to alleviate the loneli- that the value of these methods complements the knowledge ness of older adults, a common problem that can adversely on the issue examined, and indicated conclusions derived affect the individual’s well-being (Bodner & Bergman, 2016; from the findings of these studies. Courtin & Knapp, 2017; Hawkley et al., 2018; Shankar et al., The primary contribution of this series of studies lies in 2011). The interviews revealed that loneliness was indeed presenting the point of view of the participants in the At the older women’s main motivation for joining At Home, and Home program. These perspectives add to the knowledge of both the students and the women felt that the program did, in evaluating this innovative program in Israel. The results of fact, achieve its goal in this regard. This finding is consistent the quantitative study and the two qualitative studies alike with a review of 38 studies on loneliness and social isolation indicate that both the students and the older people felt the intervention programs conducted between 2003 and 2016 program was successful. In addition, they offered a number and found that most interventions reported some success in of practical suggestions for improvement. The students reducing social isolation and loneliness (Gardiner, et al., related primarily to the need for more guidance and emo- 2018). Not only did the presence of the student give the older tional support at various stages in the process, while the older adults greater peace of mind, but, similar to studies of shared adults recommended increasing the number of nights the stu- intergenerational housing programs, staying with young stu- dents are required to sleep in their homes. dents caused to positive, vital emotions, and increased feel- The participants expressed a high level of satisfaction and ings of joy among the older adults (Arentshorst et al., 2019; felt the program had contributed to both sides. The contribution Hock & Mickus, 2019; Gorjup, 2020). of the program for the older adults reflected in the relief of their Moreover, like most people their age, the interviewees in loneliness. Among the students, the contribution is expressed in our study wished to remain in their own home (Vanleerberghe, familiarity with the world of older adults, and the financial aid et al., 2017), and, at least in some cases, participation in At for their studies in scholarship and housing. Both sides felt suc- Home helped make this possible. cess in strengthening of intergenerational relationships. We, therefore, recommend that At Home be continued, with refine- ments introduced as a result of this and future evaluations. Limitations of the Studies and Recommendations for Future Research Acknowledgments One major limitation of the comparative study (Study 1) The author gratefully acknowledge the Ministry for Social Equality should be noted. As it was conducted at a single point in time and the Student Union in Israel for their cooperation and assistance in conducting the studies. 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The “At Home” Program: Students Residing with Older Adults:

SAGE Open , Volume 12 (1): 1 – Mar 28, 2022

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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 social sciences, aging and the life course, sociology of health and illness, sociology, social structure, sociology, community and urban sociology, political sociology, evolution and sociology At Home is an innovative social program, run jointly by the to get to know the older adult, and to make sure that there is Ministry for Social Equality and the Student Union in Israel, a suitable place to live for the student. (3) Finding a suitable in which students reside in the homes of older adults. The student, for example, a female for a woman or a male for a student occupies a free room in the house of an independent man, and signing contracts. older adult (women aged 62 and over and men aged 67 and The program admission process regarding the students over) who are living on their own in the community and have after registration includes also three stages: (1) Personal a room for student accommodation. Students are required to interview with the coordinator. (2) Scheduling a meeting of spend at least three nights a week in the house for a period of the student with the older adult to coordinate expectations. residence not less than 9 months and not more than 12 months. (3) Signing contracts. It is possible to extend the contract and continue to participate Monitoring and training for students: The program coor- in the program for another year. As part of the program, stu- dinator conducts a telephone call once a month with the stu- dents interact socially with the older adult for at least 5 hours dents and older adults, as well as conducting home visits for a week, and a total of 160 hours throughout a year of activity, follow-up and assistance. Students are accompanied by the for example, computer studies dinner, and walking together. program coordinator who responds to any need that arises. The older adults undertake not to require students to perform There are also two training days a year in which students activities that go beyond joint social activities such as nurs- receive training and lectures on various topics from profes- ing, home cleaning, and shopping. In exchange, the students sionals (Israel Student Union, 2020; Ministry of Social enjoy accommodations, paying $80 a month to cover the Equality, 2020). extra utility costs, 11 as well as a tuition scholarship of $2344. This paper presents a series of studies designed to evalu- The aim of the program is to relieve the solitude of the older ate the program. 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 Ariel University, Israel as to strengthen intergenerational bonds. Corresponding Author: The program admission process regarding the older adults Ahuva Even-Zohar, School of Social Work, Faculty of Social Sciences, after registration includes three stages: (1) Telephone inter- Ariel University, Ariel 40700, Israel. view with the coordinator. (2) Home visit of the coordinator Email: ahuvaez@gmail.com Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). 2 SAGE Open than among older populations (Kite et al., 2005; Rupp et al., Aging in Place 2005), others report more positive attitudes and less ageist Most older adults wish to continue to live in their own homes behaviors in younger groups (Cherry et al., 2016; Öberg & in the community they are familiar with, to maintain existing Tornstam, 2003). In addition, female students have been social connections to alleviate their loneliness, and to receive found to have lower levels of ageism than their male cohorts community services that will enable them to live indepen- (Kalavar, 2001; Rupp et al., 2005), presumably because dently (Martens, 2018; Vanleerberghe et al., 2017). This women typically display greater empathy and concern trend can also be seen in Israel, where some 97% of the pop- whereas men are higher on instrumental qualities. A survey ulation aged 65 and over was living in private households in of interventions aimed at dealing with ageism produced 2020 (Israel Bureau of Statistics, 2021). complex results (Christian et al., 2014). It was found that Older adults’ strong attachment to their home goes beyond long-term intergenerational interventions led to more posi- the physical connection to include experiences, memories, tive attitudes toward older adults among younger people, and the surrounding sociocultural environment (Hidalgo & while short-term interventions had no effect, and in some Hernandez, 2001; Stones & Gullifer, 2016). Remaining in cases even led to more negative attitudes than those assessed their home affords them a sense of independence and auton- at the start of the intervention. omy, as well as control over everyday activities (Hearle et However, combined programs of education and intergen- al., 2005; Stone & Gullifer, 2016). erational contact of adolescents and students with older In order to stay in the community, older adults require adults have shown a very positive effect on reducing ageism appropriate support services in addition to the assistance especially among women, adolescents, and young people they may receive from family members (Vanleerberghe et (Burnes, et al., 2019; Leedahl et al., 2020). In addition, there al., 2017). Where such services are available, the older popu- are programs of intergenerational sharing of young and old lation reports a higher quality of life and lower sense of lone- in housing. liness (Ahn et al., 2017; Hawkley & Kocherginsky, 2018; Neiboer & Cramm, 2018; Vitman Schorr & Khalaila, 2018). Intergenerational Housing Programs In some countries, there are several intergenerational hous- Loneliness among Older Adults ing projects such as living in older adults’ homes, in shel- Loneliness is a common problem among older adults and has tered housing, in nursing homes, and on university campuses become increasingly prevalent in recent decades (Lee et al., (Gorjup, 2020). In these programs, a living environment is 2019; Perissinotto et al., 2019). Statistics in Israel show that created in which young and old people live together. For the 11% of people aged 65 and over report often feeling lonely older adults, the purpose is to enable the continued aging in (Israel Bureau of Statistics, 2021). Loneliness may be either place in their community, improve their quality of life, chronic, when individuals have not developed lasting social solve the problem of their loneliness and social isolation relations over the years, or situational, resulting from life and get help from the young people in various tasks. For events such as retirement, the loss of a spouse, relocation, or students and other young people, the purpose of this living alone (Pikhartova & Victor, 2015). Moreover, loneli- arrangement is to facilitate rent reduction especially in ness adversely affects not only psychological well-being, urban localities where rents are high (Gonzales et al., 2020; leading to depression and anxiety, but also physical health, Gorjup, 2020; Labit & Dubost, 2016). After matching the increasing the chances of morbidity and mortality (Bodner & profile of the old person with the young one they sign a Bergman, 2016; Courtin & Knapp, 2017; Shankar, et al., contract. Usually, the young person/student engages in joint 2011). Among the factors that may contribute to the loneli- activities with the old man several hours a week: informal ness of older adults is the lack of intergenerational relations. activities, for example, participating in a meal and provid- ing assistance or in informal activities, such as personal conversations, shopping, cafes, restaurants, concerts, teach- Intergenerational Relations and Ageism ing various technologies (Arentshorst et al., 2019; Gorjup, Research indicates that both a positive intergenerational rela- 2020; Landi & Smith, 2019). tionship in the family, particularly between grandchildren Various studies show that these programs benefit both and grandparents, and social interactions in which older older adults and young people. Benefits of successful adults can contribute to the lives of younger people, are asso- arrangements include reducing the need for care services for ciated with decreased prejudices and stereotypes regarding the older adults resulting in a reduction in emergency care the older adults (Abrams, et al., 2006; Bodner, 2009; Crisp & costs, a beneficial effect on psychological health, feelings of Turner, 2009; Drury et al., 2016; Tam et al., 2006) security, independence, reducing loneliness, raising vital and Furthermore, the results of studies of ageism among happy feelings, intergenerational communication, and reduc- young adults are inconsistent. While some have found more ing ageism among young people (Arentshorst et al., 2019; negative attitudes toward older people among young adults Gonzales et al., 2020; Gorjup, 2020). Even-Zohar 3 A similar program has existed in Israel for several years. The mean age of the research group was 24.17 (SD = 3.31), At Home is an innovative program in Israel, in which stu- and of the comparison group, 25.56 (SD = 3.70). The large dents reside in the homes of older adults and has not yet been majority of the whole sample (N = 202) were Jewish (97%), evaluated. To fill this gap in knowledge on this topic, three with about half defining themselves as religious (44.6%), studies were conducted. 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 The Current Series of Studies academic disciplines, including therapeutic and educational This paper presents the results of a series of three initial eval- fields, as well as natural sciences, engineering, communica- uation studies conducted on the At Home program in 2017- tions, and law. The duration of the students participating in 2019. Consent for the studies was received from the Ministry the program ranges from 1 month to 40 months and the aver- of Social Equality and the Student Council, and they were age duration was 9.3 (SD = 8.30). The age of the older adults approved by the University Ethics Committee (No. AU-AEZ- with whom they lived ranged from 67 to 97 (M = 81.46, 2018114; AU-SOC-AEZ-20190213). SD = 6.62). Study 1. A quantitative study—Comparison between Instruments two groups: Students participating in the program versus students who do not participate in the program. Fraboni Scale of Ageism (FSA; Fraboni et al., 1990), trans- lated into Hebrew (Bodner & Lazar, 2008). Participants were This study was a comparative quantitative investigation asked to indicate the degree to which they agree with the state- that used a cross-sectional survey design aimed at assessing ments in 24 items (e.g., “Old people complain more than other ageism and knowledge of ageing among students. Based on people do”), marking their responses on a 6-point Likert scale the literature review of the contribution of close relationships from 1 (strongly disagree) to 6 (strongly agree). Cronbach’s between young and old people in reducing ageism, and add- alpha = .86 is reported for the original scale and was .77 in the ing knowledge about old people, two study questions were current study. Each student was assigned a score equal to the examined: sum of their responses to all items, with higher scores indicat- ing more negative attitudes to older people. 1. Are the levels of ageism and knowledge of ageing of Knowledge of aging questionnaire based on the Facts on students who participate in the program different Aging Quiz (Palmore, 1977). In the current study, we used from those of students who do not? the instrument employed by Shiovitz-Ezra et al. (2013) for 2. What sociodemographic variables are associated a survey on ageism. Participants were asked to indicate the with ageism and knowledge of aging? 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 Method all items, with higher scores indicating greater knowledge of aging. Participants and Procedure A sociodemographic questionnaire was used to obtain After receiving the necessary approval, an email was sent by data including age, gender, and relationship with the the Student Union At Home coordinator to all the students grandparents. who were currently or had previously been in the program An additional questionnaire regarding the At Home pro- (around 400) explaining the aim of the study and requesting gram was completed by the research group. Participants their participation. Those who returned a signed consent were asked to indicate their joint activities with the older form constituted the research group. A comparison group of adult and to assess the program’s contribution to both sides. students who were not in the program was recruited through social media. Both groups were sent a secure link to the same Results questionnaire and completed it online. No identifying data was collected. Differences Between Groups The final sample consisted of 104 students in the research group (25% of the participants in the program), and 98 in a T-tests for independent samples were conducted to examine matching comparison group. The socio-demographic charac- differences in ageism and knowledge of ageing between the teristics of the two groups were similar except for gender. two groups. No differences were found in ageism. However, Most of the students in the research group (88.5%) were students who did not participate in the program displayed female (N = 92) and only 12 (11.5%) were male, which cor- greater knowledge of ageing than those who did (N = 98, responds with the significant correlation found between gen- M = 8.95, SD = .1.61; N = 104, M = 8.17, SD = .1.69, respec- der and participation in the program (χ = 12.15, p < .001). tively; t = 3.37, p < .01). 4 SAGE Open Figure 1. The activities shared by the student and the older adult (N = 104). knowledge of aging added 9.3% to the explained variance. Associations Between Sociodemographic The total percentage of explained variance was 15.8%. That Variables and Ageism (Whole Sample) is, female students with a knowledge of ageing showed the t-tests for independent samples yielded a significant differ- lowest levels of ageism. ence only for gender. Female students were found to exhibit a lower level of ageism (N = 159, M = 2.41, SD = .468) than Assessment of at Home male students (N = 43, M = 2.72, SD = .539), t = 3.74, p < .000. The activities shared by the student and the older adult appear in Figure 1. Associations Between the Relationship with the As can be seen, the most common activities were watch- Grandparents and Ageism and Knowledge of ing television and eating dinner, going for walks, computer Ageing training followed by a range of other activities, including Pearson correlations were conducted, and it was found that doing crosswords, talking, gardening, cleaning, and laundry, the stronger the relationship with the grandparents, the less knitting, playing games, looking through photo albums, negative the attitude to older adults (N = 202, r = −.20, shopping, cooking, and, as well as attending outdoor events. p < .01) and the more the students knew about aging (N = 202, Most of the participants believed that the program contrib- r = .15, p < .05). uted to promoting the status of older adults, assessing its con- tribution as large (33.6%) or very large (40%). Moreover, they felt that it helped relieve the loneliness of the older adult Factors Associated with Ageism to a large (16.5%) or very large (82.5%) degree. Stepwise regression was performed to identify the factors The students’ satisfaction with the program is presented in affecting ageism. The sociodemographic variables of gender, Figure 2. age, economic status, and religiosity were entered in Step 1, As can be seen, most students were satisfied. Additionally, and relationship with the grandparents, contact with older 52.9% stating they would like to remain in the program the adults, participation in the program, and knowledge of age- following year. Of the others, 44.2% indicated they do not ing in Step 2. The results indicated that gender entered in the wish to continue, and 2.9% did not respond. Furthermore, first step (β = −2.56, p < .001) which explained 6.5% of the 73% reported wanting to maintain contact with the older variance. Gender (β = −2.79, p < .001), and knowledge of adult after leaving the program, 26% stated they did not, and aging (β = −2.44, p < .001), entered in the second step, and 1% did not respond. In addition, 89.4% of the students Even-Zohar 5 Figure 2. The students’ own satisfaction with the program (N = 104). indicated that they would recommend the program to a Data Analysis: Content analysis was performed to iden- friend, with 9.6% reporting they would not, and 1% not tify the major themes in the interviews. The analysis fol- responding. lowed the stages prescribed by the IPA method (Smith & Finally, 31.7% of the students indicated that participating Osborn, 2003; Smith et al., 2009): (1) The transcripts were in the program contributed to funding their studies to a large read several times, both by the students who conducted the degree, 51.9% to a very large degree, and 13.5% to a small interviews and by their teacher (the current author) to gain an degree. Only 2.9% reported that it was of no financial benefit overall picture, (2) We re-read the texts of the interviews and to them. divided and coded them into meaning units, and wrote a descriptive or conceptual label for each meaning unit, (3) We Studies 2 and 3. Qualitative studies—The perspective organized the meaning units into categories first for each of the students and the older people. interview separately, then used a cross-case analysis to create shared categories for all of the interviews, (4). We composed The other two studies were qualitative studies aimed at central themes by finding connections between the catego- obtaining the perspective of the students and the older peo- ries, (5) Finally, we discussed the appropriate headings and ple. Since the research method and the method of data analy- to which to assign each theme, and focused and narrowed sis were similar in the two qualitative studies conducted, we them down to broad issues common to all the interviews that will first address these issues in common with the two stud- reflected the content relating to the research question. ies and then present the research procedure, research instru- ment, sample, and findings for each study separately. Study 2. A qualitative study: The perspective of the stu- The study employed qualitative methodology based on dents in the At Home program. Interpretative Phenomenological Analysis (IPA; Smith et al., 2009; Smith & Osborn, 2003). IPA aims to explore how par- Method ticipants perceive and interpret significant experiences in their life in a particular context. This method was therefore chosen Participants and Procedure for the current study in the effort to understand the significant meaning of the students’ and older adults’ experiences in the Telephone interviews were conducted by social work stu- context of sharing intergenerational housing based on their dents with 16 participants in the program who consented to experiences in their daily lives from their point of view. take part in the study after being approached by the Student The interviews followed a semi-structured in-depth inter- Union. The aim of the study was explained, and they were view guide that included several open-ended and general ensured confidentiality and anonymity. Of the 16 interview- questions that enabled the participant to share their experi- ees, 14 were female and 2 were male. Age ranged from 19 to ence in a manner they felt most comfortable with while 35 (M = 24.2). Most defined themselves as traditional or reli- focusing on the issues relevant to the study. gious, 4 reported an economic status above average, 3 below 6 SAGE Open average, and the rest average. Three had been in the program 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 in the past and the others were still participating in it. In she would limit me and invade my privacy. . . that she wouldn’t terms of length of participation, 9 were in the program for allow me to come home late, to bring friends over. . .I was half a year, 1 for a year, 4 for a year and a half, 1 for 2 years, afraid I wouldn’t feel at home. I was concerned about her and 1 for 3 years. physical health, afraid that if something happened I wouldn’t know what to do. Instrument Shared Activities A semi-structured interview was prepared that began with an invitation to speak about the experience in general (“I’m The activities mentioned most frequently were cooking and interested in hearing about your experience of living in the eating dinner, watching the news and discussing current home of an older adult”). This was followed by questions affairs, listening to the older adult’s stories of their past, and relating to specific issues, such as reasons for joining the pro- taking an interest in each other’s daily life. Additional activi- gram, joint activities with the older adult, the contribution of ties included teaching the older adult to use a computer, help- the program. ing 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. Results Background to Participation Relationship Between the Student and the Most of the participants learned of the program from notices Older Adult on social media or in the press in the course of their search The interviewees drew a picture of relationships along a con- for financial assistance. Several heard about it on the radio, tinuum from very close to strained. At one end of the spec- and a small number were told about it by a friend who had trum, they described a bond similar to that between a taken part in the past. The majority of interviewees knew grandparent and a grandchild. One student stated: “We have very little about At Home before signing up. a good relationship. . .She treats me very well as if I were Reasons for deciding to join the program: The inter- her granddaughter.” Another student expressed: viewees noted two major reasons. The first was practical: the financial benefit and the convenience as one student said: “I We have a good relationship. We have a lot to talk about. It’s joined because it would save me the cost of the rent. It was interesting and I feel comfortable with her. The relationship is the convenience. The apartment was close to the university”. warm and maternal. One example is that once I went to a party. The second reason was ideological. Another student I got home close to midnight and I saw that she had stayed up to explained: make sure I was okay. I was very interested in the issue of older adults and loneliness. At the other extreme, interviewees described relationships I hadn’t thought about it until I saw a documentary about another that were complicated and difficult, especially at the begin- country where students lived with older adults. It touched my ning, primarily because of the generation gap as one student heart and aroused my interest. I was very happy to hear the same expressed: thing existed in Israel. I think it’s very important. At the beginning of the year, our relationship was very strained. Most students mentioned both reasons for joining: “I joined I even considered leaving. There was a lack of communication because of the scholarship and the apartment. It’s very conve- between us . . .But gradually I got to know her, we learned to nient. I also wanted to be part of a project with social value.” trust each other and adapt to the situation. . . Prior expectations and concerns: Most interviewees reported having no specific expectations before beginning Another student talked about differences in personality the program. However, several noted a desire to form a close and attitudes: “It’s hard for me to connect with her. Her per- and meaningful relationship with the older adult and hoped sonality is very different from mine. We come from different for a positive experience. One student expressed: “I expected ethnic backgrounds.” Another student said: it to be a good experience, that the older adult would enjoy my presence and I would make him feel good,” another stu- Our relationship is complicated. On the one hand, she really dent said: “I expected it to be like living with my grand- enjoys our conversations, something she didn’t have before. mother, that it would be meaningful for me and for her.” On the other hand, [she] expected me to be at home more. That On the other hand, the students expressed substantial con- sometimes creates a sense of dissatisfaction and tension on cerns, anxiety, and stress as one student expressed: both sides. Even-Zohar 7 Interviewees who reported a close relationship also stated situations that might arise with older adults, so that we’ll with certainty that they would continue to be in contact with be more prepared.” the older adult. Study 3. A qualitative study: The perspective of the older people in the At Home program. Contribution of the Program The majority of students felt that At Home had contributed Method substantially to themselves, the older adults, and intergenera- tional ties in general. They noted a number of specific bene- Participants and Procedure fits: “It changed with way I look at them [older adults]. I Interviews were conducted with seven older women who had gained a lot from it. It exposed me to their difficulties and been approached by the Ministry of Social Equality and had limitations. For example, getting in and out of a car, working consented to allow their details to be given to the Student in the kitchen. . . And because of what I learned, I visit my Union for purposes of the study. Although the program coor- grandmother more often. With respect to the loneliness of the dinator asked the older adults to participate in the study, the older adults one student stated: response was low and only seven women expressed their consent to participate in the study. Social work students In my opinion, she was a lot less lonely. The older woman told called the women, explained the aim of the study, and assured me recently that she was glad there was someone with her, them that their privacy would be maintained and no identify- someone in the house, because now she has a reason to get up in the morning and cook. ing information would be published. After receiving their consent, a time and place for the interview was agreed on. All However, some students also referred to the temporari- the women chose to be interviewed in their home, save for ness of the arrangement and the fact that they only spent part one who preferred to be interviewed over the phone. The of their time with the older adult according to one of the stu- interviews lasted from half an hour to an hour. Before begin- dents: “We’re not home most of the day. . . The program is ning, each of the women signed an informed consent form. only temporary. Nobody will be with the older person when The age of the interviewees ranged by 72 to 88 (M = 81.4). the student leaves.” Six were widowed, and one was single. Most reported rea- Moreover, the majority of interviewees referred to the sonable health, although three noted health problems such as financial benefit. Not only did they receive a scholarship that diabetes or a previous stroke. In terms of religiosity, four helped pay their tuition, but their participation also obviated defined themselves as secular and three as traditional. Six the need to pay rent. were retired and one was still working. One woman was par- ticipating in the program for a second year. Satisfaction and Recommendations Instrument Most interviewees expressed a high degree of satisfaction with the program, and about half were interested in con- The interviews followed a semi-structured protocol. As with tinuing the following year. On the whole, they indicated the students, it began with an invitation to speak about the they would recommend At Home to other students, experience in general (“I’m interested in hearing about your although several also warned that “not everyone is suited experience of living with a student”), followed by questions for the program because it’s intense and demands time and relating to specific issues, such as reasons for joining the pro- responsibility.” gram, the relationship with the student, and the contribution The students also offered recommendations in a number of the program. of domains relating both to advance preparation for partici- pation and support during the shared living experience. One Results student stated: Background to Participation Expectations should have been spelled out more clearly, together Most of the interviewees learned about the program from with me and the older adult. For instance, how many hours I their daughters, who believed it would suit their mothers. have to be with them. Two joined after hearing about it on the radio. There should be more training days before the program begins The older adult’s family also played a large part in the and you start living together. decision to participate. The fact that their mothers were liv- ing alone appears to have been of considerable concern to Other student noted: “We should be given more informa- family members. As one woman put it simply: “They didn’t tion about things we should know about. . .All sorts of want me to sleep in the house alone.” 8 SAGE Open Another interviewee explained that she joined in order to In addition to the hours of shared activities to which the make things easier for her family: students committed themselves, there are household chores that derive from living in the same house. Several women I was alone, and my grandchildren would come, every day related to this issue, for example: “She isn’t required to do the kids would come, each time someone else, and I thought, anything. She keeps her room clean, does the dishes some- poor things. They have their own room with a computer, and times. . .we straighten up together.” I’m a nuisance, me. It bothered me that they had to come and In this regard, one woman, who now had a second student stay here. 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 Concerns and Expectations and walked out.” The women were prepared for the arrival of the students by the program coordinators at the Student Union. Some women Relationship Between the Older Adult and the claimed to have had no concerns. One woman said: “I’m a Student very social person, you see. . .I didn’t have any real fears. No [I wasn’t worried]. I get along with everyone. Most of the women described a good relationship with the On the other hand, others described uneasiness about tak- student. Their comments indicate a sense of commitment and ing a stranger into their home. One woman explained: concern for the younger women, which is often reciprocated. One woman said: 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 I made sure she had her own room, that she had a closet. I made lying around the house, in the bathroom. There are girls like that. sure she felt comfortable, that she felt good. I cleared out a shelf, Not everyone’s neat and clean. even more, in the kitchen, like she needed. She feels very free [here]. Daily Routine and Shared Activities Other woman described: On the whole, the interviewees noted that the presence of the student in their home did not affect their daily routine. We get along very well, understand each other. . .Watch Several related to minor changes. In the words of one of the television together. . .If I need something she helps me and I women: 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 The only thing is if she has to go to university in the morning, I and medicine. She’s really good. 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 A good relationship with the student was also reflected in hurry to get to class. I won’t be late for anything, but she could be. contact with the older woman’s family. Two women reported having met with the student’s family as well, testifying to the In response to the question, the women mentioned a num- closeness of their relationship. ber of activities they engage in with the student: “We watch An exception to this rule can be found in the words of one television, have tea, go for a pizza downstairs. interviewee who expressed her disappointment because the student wasn’t available when she needed her: She tells me personal stories. . .Sometimes we sit and talk. . .” Everything was very nice until two months ago. I was in physical The students also offered the women their help: “If she’s going therapy, and when I left I fell. . .They called an ambulance. I shopping she’ll ask me if I need anything and get it for me.” 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. . . Since most of the older women reported being independent Right after that I asked her to leave. 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 Satisfaction and Contribution of the Program convenient for the student, and allowed them more free time For most of the interviewees, having the student in their for their studies and personal lives. One woman explained: home was a very positive experience and they expressed a high degree of satisfaction At Home. The majority even She really makes an effort, but she doesn’t have time. She comes stated they would like to continue in the program. From their to talk to me and then from eleven at night until the morning she point of view, their primary goal had been achieved. One sits and does her assignments. She wants to be with me. . . Sometimes we watch a movie. woman explained: Even-Zohar 9 So, I’m not alone. . . It’s great to be with someone. It’s just that very wide (from 1 month to 40 months) with 75% of them now I can sleep without worrying and that’s very important to participating in the program for a short period, and it was not me. I recommend it from the bottom of my heart for anyone possible to examine the effect of the time variable. In addi- who’s alone. tion, the sociodemographic characteristics of the students in the two study groups were similar, hence the explanation Several interviewees noted the contribution of the pro- why the students who were not in the research group had a gram to strengthening intergenerational ties as one of the higher level of knowledge about older adults could be purely women noted: “A connection between youngsters and older coincidental. Consequently, it is difficult to draw conclusions people is good, it’s nice. I tell her about my life and she tells regarding the influence of the program, and it is recom- me about hers. . . She learns from me and I learn from her.” mended to examine this issue in a longitudinal study among Some women expressed their pleasure in being given the students participating in the program. Moreover, similar opportunity to contribute to the younger generation. One results are reported by a study evaluating a short-term inter- woman noted: “I gave her more than she gave me. . . Maybe generational intervention, where no effect was found for the she saw a different kind of home here.” intervention (Christian et al., 2014). Another interviewee praised the involvement of the Analysis of the sample as a whole revealed that the Student Union: “The woman [coordinator] from the Student closer the student’s relationship with their grandparents, the Union often calls me to make sure that everything’s okay. . . lower their level of ageism and the greater their knowledge So they take an interest. I think it’s a very good project and it of ageing. This is also consistent with previous studies doesn’t cost them a lot.” (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 Criticism of the Program level of ageism, so that female students exhibited less age- Nevertheless, a number of women recommended that the ism than male students. student be required to spend more time in their home. One of the women expressed: Conclusions of the of the Qualitative Studies I don’t understand that idea. They’re only required to sleep here Further results of the quantitative study, as well as the inter- for three nights. But I think whoever decided that is wrong. In views in the qualitative studies (2 and 3), shed light on the general, the whole program should change. If they come to stay participants’ perception of the program. On the whole, they with an older woman, three nights she feels comfortable and expressed a high degree of satisfaction, indicating that At that’s fine. But what about when they’re not here? What Home had contributed significantly to both sides. happens then!? One of the aims of the program was to strengthen inter- generational bonds. As suggested by Bodner (2009), encour- Those who weren’t happy with the program attributed their aging social contact between the generations appears to dissatisfaction to incompatibility and a lack of communi- helped achieve this goal. As a result of sharing a home with cation As one woman explained: “It doesn’t suit people an older adult, the students became more familiar with their like me. Who are people like me? I’m a strong woman, world and more aware of their limitations and needs. In addi- dominant.” tion, they were able to learn from their host’s rich life experi- In addition, some women believed the program would not ence. Similar outcomes are described by a program in which affect the status of older people in society, for example: “An students of gerontology lived in an institutional home for old person is always an old person. Who sees us? That’s it.” older adults on different levels of functioning (Gordon, 2007). As in the current series of studies, the students Discussion reported learning about the world of older adults and noted the positive value of creating an intergenerational bond. A The studies presented here evaluated At Home from different student of pharmacology at the University of Rhode Island perspectives: The students and the older adults. who lived with a 92-year-old woman in sheltered housing as part of a special project described her experience in similar Conclusions of the Quantitative Study terms (Anastasia, & Estus 2013). The student developed close friendships with many of the residents, became famil- The comparative study found no differences between stu- iar with their way of life, and had a unique opportunity to dents who did and did not participate in the program, save for observe and assess characteristics of older adults that cannot more knowledge of ageing among those who did not. It be taught in a classroom. Without a doubt, the students in our should be noted, however, that the study was conducted not study felt that the program had contributed to forging an long after the students took up residence in the home of the intergenerational bond and enhanced their recognition of the older adult. The duration of participation in the program was 10 SAGE Open importance of this relationship. As one student noted, it even academic year, it was impossible to assess the effect of the encouraged her to visit her own grandmother more often. program on the students’ attitudes and behavior toward the In addition, such arrangement as home-sharing programs older population. Longitudinal studies conducted at two points provided the students in our study as well as other students in time, before the students take up residence in the home of rent-free housing (Labit & Dubost, 2016; Mirza et al., 2019). the older adult and when they leave, would be of value, and a In exchange, the students were required to spend some hours better measure of change. On the one hand, they might shed a week with the older adult, performing activities such as light on the degree to which participation in the program walking, teaching computer use, and simply talking and decreased the students’ ageism, increased their knowledge of spending time together. As in previous studies, the activities ageing, and changed their behavior toward the older adults. On reported by both the women and the students in our study the other hand, they could reveal whether the program were shared dinners, watching TV, walking, conversations, improved the quality of life of the older adult, relieved their sharing life stories and experiences, learning computer tech- loneliness, and strengthened intergenerational ties. In addition, nology. However, due to the study load, and lack of time, the number of older adults interviewed for the study (Study 3) Israeli students as well as other students were unable to stay was small (seven women), and in the future it may be helpful with the older adults for the full required time (Hock & to conduct another qualitative study in which both, men and Mickus, 2019; Gonzales et al., 2020; Labit & Dubost, 2016). women participating in the program will be interviewed to The older adults (Study 3) reported that the program expand the knowledge from other perspectives. enabled them to contribute to the students on various levels. Conclusions and implications: In order to evaluate the At Not only did they provide the younger person with a conve- Home program, we used a mixed-method design that nient living arrangement, but they also looked out for them included two distinct methods; a quantitative study that and enriched their life by drawing on their own life experi- examined students’ attitudes toward older adults, and their ence. The opportunity for older adults to give to the younger opinions about the program, as well as two qualitative stud- generation further demonstrates the value of encouraging ies that examined the perceptions of the students and the social contact between them in order to strengthen intergen- senior citizens participating in the program. Despite the limi- erational ties (Bodner, 2009). tations of the studies, mentioned above, it can be concluded Another aim of the program was to alleviate the loneli- that the value of these methods complements the knowledge ness of older adults, a common problem that can adversely on the issue examined, and indicated conclusions derived affect the individual’s well-being (Bodner & Bergman, 2016; from the findings of these studies. Courtin & Knapp, 2017; Hawkley et al., 2018; Shankar et al., The primary contribution of this series of studies lies in 2011). The interviews revealed that loneliness was indeed presenting the point of view of the participants in the At the older women’s main motivation for joining At Home, and Home program. These perspectives add to the knowledge of both the students and the women felt that the program did, in evaluating this innovative program in Israel. The results of fact, achieve its goal in this regard. This finding is consistent the quantitative study and the two qualitative studies alike with a review of 38 studies on loneliness and social isolation indicate that both the students and the older people felt the intervention programs conducted between 2003 and 2016 program was successful. In addition, they offered a number and found that most interventions reported some success in of practical suggestions for improvement. The students reducing social isolation and loneliness (Gardiner, et al., related primarily to the need for more guidance and emo- 2018). Not only did the presence of the student give the older tional support at various stages in the process, while the older adults greater peace of mind, but, similar to studies of shared adults recommended increasing the number of nights the stu- intergenerational housing programs, staying with young stu- dents are required to sleep in their homes. dents caused to positive, vital emotions, and increased feel- The participants expressed a high level of satisfaction and ings of joy among the older adults (Arentshorst et al., 2019; felt the program had contributed to both sides. The contribution Hock & Mickus, 2019; Gorjup, 2020). of the program for the older adults reflected in the relief of their Moreover, like most people their age, the interviewees in loneliness. Among the students, the contribution is expressed in our study wished to remain in their own home (Vanleerberghe, familiarity with the world of older adults, and the financial aid et al., 2017), and, at least in some cases, participation in At for their studies in scholarship and housing. Both sides felt suc- Home helped make this possible. cess in strengthening of intergenerational relationships. We, therefore, recommend that At Home be continued, with refine- ments introduced as a result of this and future evaluations. Limitations of the Studies and Recommendations for Future Research Acknowledgments One major limitation of the comparative study (Study 1) The author gratefully acknowledge the Ministry for Social Equality should be noted. As it was conducted at a single point in time and the Student Union in Israel for their cooperation and assistance in conducting the studies. 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Journal

SAGE OpenSAGE

Published: Mar 28, 2022

Keywords: social sciences; aging and the life course; sociology of health and illness; sociology; social structure; sociology; community and urban sociology; political sociology; evolution and sociology

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