A nursery in a care home suggests that life for the old could be a lot more fun.
By Geraldine Bedell
The first person to pull a toy animal out of the bag is 15 months old. The second is aged 91. We are in a bright room in Wandsworth, singing Old Macdonald Had A Farm – changing the verses according to which animal comes out – and we are all ages: toddlers, their parents and grandparents, and the residents of Nightingale Hammerson, a care home whose residents have an average age of 90.
Play is not particularly something associated with the very old. Here, though, it is woven into the fabric of every day. Nightingale Hammerson is the first care home in Britain to have a nursery on site. The children come in for songs, games, and activities, and the residents can visit the nursery, which is located at the bottom of the gardens.
It is too early yet to make any serious assessment of the impact of this intergenerational to-and-fro. The Apples and Honey Nightingale nursery (a second branch of an established nursery in Wimbledon) only opened in the grounds of Nightingale House in September; a baby and toddler group has been coming in a little longer, since January. But an interim evaluation report notes that “the breadth of relationships formed has far exceeded what was hoped for at the outset” and offers plentiful evidence to back this up. The care home’s residents have asked for more intergenerational activities. One man who never speaks, except to his carers, communicates freely and is said to “light up” when he is with the children. Another resident, a 92-year-old woman, said: “I was very depressed before and I just wanted to die. Now that I see the children here, it encourages me to keep going, to keep trying.” The intergenerational relationships are also valued by the children and their parents: one family sent postcards when they went away on holiday because they missed seeing their friends.
After we have sung Old Macdonald, Miss Polly Had A Dolly, and Incey Wincey Spider at the baby and toddler session, I go upstairs with the nursery children for a Havdallah ceremony signalling the end of Shabbat, and more singing. (Nightingale Hammerson is a Jewish care home. The nursery is open to all faiths and none: currently around 10 per cent of the children are Jewish, but everyone celebrates Jewish culture.) Of all the arts, music is perhaps the one with the greatest longevity: it is one of the last things that people with dementia tend to lose. And, as Steven Johnson points out in Wonderland: How Play Made The Modern World, it was also one of the first to arise in human history: “Aeons before early humans started to imagine writing or agriculture, they were crafting tools for making music.” 28 There is something profoundly human about taking part in music-making. And to watch the elderly residents of Nightingale House singing with two-year-olds is to see human beings at the opposite ends of the life course communicating easily, sharing the same experience, and finding something intrinsic in each other that cuts through differences in age and circumstance, allowing them to form a bond.
Intergenerational activities at the nursery and the care home are organised to allow for both structured and unstructured play, and to be both resident- and child-led. I watched as a small child offered Margie Bloom, 91, some crayons so she could decorate a paper plate. “She’s decided to keep me supplied,” Margie noted approvingly. Upstairs, one of the residents exclaimed to a child: “Martha, you’ve got new shoes! Could I get some? Can you get my size?”
There is a sense of lightness about these encounters, a feeling that they are an end in themselves, reflecting that sense we have of inhabiting a different world when we surrender to play, of the kind that Steven Johnson describes as a “space of wonder and delight where the normal rules have been suspended, where people are free to explore the spontaneous, unpredictable, and immensely creative work of play”. 29
Given how much free time old people have – given that they are not expected constantly to be maximising their productivity (or even, like schoolchildren, preparing to be productive) – it is perhaps surprising that they don’t play more. That may be a consequence of our prevailing narrative of ageing, which sees the elderly as left behind, in decline, and possessed of diminishing selfhood. We dread ageing not simply because it is a physical and metaphorical pain, but because of a cultural sense that getting old progressively robs us of value.
That’s not necessarily how old people see themselves (despite the tempation to internalise the cultural antipathy to old age). As Jane Miller eloquently puts it in her memoir Crazy Age: Thoughts On Being Old: “I should come clean. I am not really sure that I believe I will be dead one day, any more than I believe that I’m as old as I am. Somewhere, in some part of me, I am still young and possibly eternal. I wonder whether most of us feel that in essence we are still young, and that the problem with old age is precisely that it comes to define us, blotting out earlier versions of ourselves, standing in for them, taking over.” 30
The work at Nightingale Hammerson with Apples and Honey Nursery offers small children a way of seeing beyond this blotting out. The people with whom the infants play, daily or weekly, aren’t primarily defined by dependency, aren’t marginalised, and don’t seem alien. They are individuals, friends – teasing, incorrigible, benign, quiet, whatever.
For the old people, the children offer a way into a world of playfulness and experimentation. It would, I suspect, be hard to get the residents to play if not for the presence of the toddlers and nursery children: it is quite hard to overcome cultural barriers to losing yourself in play, even for adults in midlife, still more if you are constantly being drip-fed the idea that you are “old and past it”. But if you are presented with a small child wanting you to help them stick glitter on a paper plate, or pass you a red brick, it’s easy.
The generative effects of play are well understood (and well rehearsed in this collection of essays): it is generally accepted that play makes human beings more flexible, open to new experiences, and defter in dealing with them. Play is profoundly humanising – which matters to the old, who can easily find themselves dehumanised.
Steven Johnson notes that recent scientific research has advanced the theory that dopamine, released when we play, creates a “novelty bonus”, heightening mental faculties and making us more alert and engaged. Play enourages us to pay attention because of the sense it induces that something interesting is going on here. 31 Research by the US National Institute on Aging, among others, has linked social interaction to delayed mental decline, lower blood pressure, and a reduced risk of disease and death; 32 one Japanese study found that socialising across generations led to an increased amount of smiling and conversation among older adults. 33 And a Channel 4 documentary, Old People’s Home For 4 Year Olds, which took a nursery class into a care home for six weeks, reached similar conclusions – with researchers noticing an almost immediate improvement in the mood and emotional states of the elderly residents, and a completely unexpected improvement in mobility. 34
There would be some practical obstacles to rolling out the Nightingale Hammerson /Apples and Honey Nursery model, especially in London. Nightingale House is fortunate in benefiting from economies of scale (it is unusually large for a care home, with 200 residents and extensive buildings) and in being able to draw on the engagement of the Jewish community. It has large grounds, especially for a site in such an expensive part of London (it was founded 170 years ago) and a bungalow at the bottom of the garden, which was previously used for storage, that could be transformed into a bright, two-classroom nursery.
Nonetheless, the principles of intergenerational care may offer useful ways forward. The Mayor’s Vision for a Diverse and Inclusive City, published earlier this year, makes clear that inclusivity must apply across generations as well as (for example) ethnic groups. London will have to think hard about not merely caring for its growing population of old people, but also enabling them to thrive. The Nightingale/Apples and Honey experiment will need proper evaluation; but the benefits look, to the casual observer, significant. They go in both directions: the children enjoy the adults’ attention, and the residents revel in the children’s company and irrepressible playfulness. The benefits go wider, too, because anything that helps to break down intergenerational suspicion and reserve is to the good: isolating the generations doesn’t make for a healthy city.
The children throw themselves into play with the residents without hesitation or fear, feeling at home, neither embarrassed nor awkward at having to spend time with old people. And the playfulness that the children permit in the old people engenders an atmosphere of possibility, in which anything could be about to happen, a promise of growth and opportunity. Perhaps Margie, picking up her crayon, should have the last word: “It is wonderful to be able to play again. I don’t really like to admit it, but this is just so enjoyable. When I’m here I forget everything else.”