When a Real Grade 6 Class Moves Into A Nursing Home

I've blogged before about the Eden Alternative approach to eldercare. I've blogged before about the benefits of benefits of bringing children into long-term care homes. But I've never blogged about an elementary class of students moving into an Eden Alternative seniors' home!

This morning I hopped in the car with Daisy, our golden retriever. We were headed for a lovely walking trail nearby our home. Out of habit, I turned on the radio and tuned into CBC. A summer rerun of The Sunday Edition was playing and luckily for me, it was an inspiring episode about a unique model of learning and eldercare.

When I find myself wondering about how to create a society in which everyone gives and receives care naturally, I think of stories like this. These children aren't 'heroes' or 'saints' for learning alongside elders - they just get on with living and learning together. These children will grow up to be natural caregivers.

From the CBC Sunday Edition website page, read on!

Originally published on September 23, 2018.

Old people living out their days in nursing homes and young people soaking up lessons in elementary schools live in separate universes — Canada's generational silos.

But at the Sherbrooke Community Centre, it's a different story.

The Saskatoon nursing home houses 263 high-needs residents. It's also the site of an intergenerational school.

Elder Jeff Siemens and IGen students Jace Hein and Athan Swales on one of Sherbrooke's indoor streets.(David Gutnick/CBC)

Intergenerational school

Every year, after winning a city-wide lottery, a batch of sixth graders ditch the traditional classroom and spend a year attending school at Sherbrooke. It is the only classroom of its kind in Canada.

After 18 years of teaching in a "regular" elementary school, Keri Albert, the program's founder, felt something was missing.

"I lived in a small town and we had all ages and stages and all different types of people around us all the time," she told The Sunday Edition's documentary producer David Gutnick at the end of the last school year.

The Grade 6 IGen students in the playground with founder Keri Albert (in purple on the right) and teacher Callie Spafford in the green shirt. (David Gutnick/CBC)

She remembers being particularly affected by her relationships with older people.

So in 2013, she went to the Saskatoon Board of Education with a proposal to co-mingle the generations.

Saskatoon program turns long-term care home into Grade 6 classroom

The following year, iGen was born.  

Her plan: students would complete their provincial curriculum requirements within the confines of the nursing home. They would be constantly on the move — sometimes all together for math, science and reading, sometimes working one-on-one with Keri, sometimes meeting with the elders.

At Sherbrooke, there are no classrooms, no desks, and no blackboards. Students get together with their teachers in the chapel in the morning and again at noon, but the rest of the time they are free to go where they want, and sit with anyone they feel like talking to.

Elder Dr. Jodi Grant speaks at the IGen Graduation with students Shova Akter and Faith Luu. (David Gutnick/CBC)

We're talking about their character development.- Keri Albert

The program is now in its fourth year.

Albert says she's often asked, "How do you do this?"

The secret, she says, is combining lessons.

For example, one recent project had students build entire solar systems and present them to the elders.

"[The students] not only did their research and built the model, but they also got to practise their presentation skills," Callie Spafford, a co-teacher in the iGen program explained.

The purpose of the program isn't just academics, Albert stressed.

"We're talking about their character development, we're talking about goals and plans that they have for themselves in terms of their generosity, in terms of their mastery, in terms of their independence, and in terms of being a part of a community which is belonging," she said.

Helena McKenzie Blenkinsop and Elizabeth Grunau greet the guests attending their iGen graduation. (David Gutnick/CBC)

'It's all just part of the human experience'

"There are things in this environment that you do not see in a school. Because this is an adult world."

Death, for example, is a common occurrence.

"It was so emotional," said iGen student Brooke, describing how she felt after her friend Vicky, a veteran, died.

"When he passed away, we were pretty sad."

"If an elder passes away they are not going to hide us from that. They are going to let us know, and we have to learn about grief and stuff, so we have to learn how to cope," she said.

Albert said dealing with grief in this matter-of-fact way is a valuable life lesson.

"We grow confident. We grow used to and normalized around differences, and we realize it's all just part of the human experience. And at the end of it we're okay," she explained.

Student Adam Brookman and Elder Herb Nolan in front of the Tumbleweed Gift and Thrift Shop at Sherbrooke. (David Gutnick/CBC)

Without the kids, I just feel that a part of me dies.- Dr. Jodi Grant

The school is a life-changing experience for the elders as much as it is for the kids.

Dr. Jodi Grant used to teach literacy and children's literature. For her, the students help stave off loneliness.

"If we didn't see the kids, we would just be a bunch of old people in this building, and that is stark and it's ugly. Without the kids, I just feel that a part of me dies," she said.

"I have the wonderful fortune to be down here with the kids and I am able to read to them and it brings me the greatest joy."

Click HERE to listen to David Gutnik's documentary, The School of Real Life

The Truth About Toxic Friends vs Good Friends

Telling the difference between good friends and toxic friends is especially important for caregivers.  Caregivers simply don't have the dual luxuries of boundless time and energy to invest in friendships that are not reciprocal.  So, here's a quick guide to recognising good friends and toxic friends.

TOXIC FRIENDS

For caregivers, there are two common types of toxic friends; the troll and the narcissist.  


The troll is someone who calls and visits often.  He or she will ask many questions about your loved one and may even visit in hospital to chat over coffee or lunch.  They will appear warm and concerned, while inquiring into the minutiae of your loved one's symptoms and treatments.  This type of toxic friend does not offer help of any kind.  They simply want to know.  The human drama of a caregiver's life provides vicarious interest and fodder for their dinner table chat, but that is all.  This type of friend cannot make the intellectual leap between listening to your experience and offering to sit with your loved one or doing your grocery shopping.

The second type of toxic friend is the narcissist. 

Narcissists rarely, if ever, ask how you or your loved is doing.  They are bored by others' experiences, so constantly direct the conversation back to themselves.  No matter how difficult a caregiver's situation may be, it will always be worse for a narcissist - and they will want you to listen and sympathise.

GOOD FRIENDS

Caregivers soon find out that longstanding friendships don't necessarily translate into good friendships when the going gets tough.  Some lifelong friends do show their loyalty and generosity, while others suddenly become too busy to call or drop by.  The messy and often sad events in caregivers' lives may be too difficult for some people to witness and absorb.  The fact is, not everyone is cut out for helping others through the toughest times. The trick is to determine quickly who will be a good friend for the long haul and who may be limited in their ability to walk with you through your caregiving journey.  Wise and experienced caregivers will forgive friends who disappear upon hearing your loved one's diagnosis.  Holding on to bitter feelings will only make it more difficult to spot new friends who genuinely want to help.


The extraordinary friend is one who intuits your needs, listens without judgement, visits often and always brings food.  The new friend is an acquaintance who, upon hearing that you are giving care, offers help that is truly helpful.  The kindness of new friends is always a surprise - often the most helpful friends are those you would least expect.  Whether a good friend is old or new, it is clear that your friends are those who truly want to help.  Friends who have a capacity for generosity combined with the character to suffer with you will want to give what they can.  Some may not cook, but their keen wit can suddenly flip fear into dark humor - that is a gift to a caregiver.

KEEPING FRIENDS

Caregivers have the obligation of reciprocating friendship, too.  Most often, this means accepting kindness and saying thank you.  The sincere expression of gratitude is not a sign of weakness or evidence that the caregiver is incapable of handling a loved one's needs independently.  The gracious acceptance of help and friendship in the full knowledge that love flows both ways, is the key here.  Good friends say,  "You look tired. Here, let me help you." The second friend answers, "Wonderful! Thank you so much." That's just what good friends do.

What Goes Around, Comes Around in Caring

Hello all Caregiving.com Holiday Progressive Blog Party Readers and Welcome to The Caregivers' Living Room!  I am a caregiver, an author and a caregiving consultant.  Feel free to look around my site and visit often!  Read lots of other caregiving bloggers in the party by clicking on the blog party widget on the right.  Happy Reading!

What Goes Around, Comes Around in Caring

A mother arrives home from the hospital, newborn baby boy in her arms.  Family and friends arrive with casseroles and plates of sandwiches.  A neighbour invites the older children outside for a ball game.  The new father smiles and whispers to his wife, “I will look after everything… you go and lie down with the baby.  I’ll bring you some tea.”

Everyone understands that the delicate process of building the bond between mother and baby is sacred, especially in the first days and weeks of a new life.  Everyone understands that the mother’s most essential and immediate task is to bond with and care for her baby without distraction.

Years later, the same mother stumbles and falls.  She has broken her hip.  Her husband has passed away and all the children, except one, have moved to find work in cities far away.  Her youngest son, the baby she nursed so long ago, lives nearby.  He is his mother’s caregiver.

Older brothers and sisters telephone and write, asking for daily updates. They use technology to support their brother in his caregiving.  Neighbours, friends and work colleagues drop by with groceries and home cooked meals.  They do this so that a son can give care to his mother without distraction.

‘I care for you because you cared for me’ represents the ethic of reciprocity that children of the frail elderly cite as an important motivation for caregiving.  When caregivers decide to devote time, energy and kindness to an elderly parent, they have made a moral decision about what is right under the circumstances.  And that moral decision is one that is rooted in love as well as duty.  Parents of children with disabilities or spouses of people with chronic illness make this decision, too.  They make it every day, often over a period of many years.  

Eva Kittay, a philosopher and mother of a young woman with severe disabilities, also cared for her mother until she died.  Eva coined the term 'doulia' to describe the concept of caring for the caregiver so that she could care for a loved one without distraction.  She says,  "There is a notion I call ‘doulia’ which I define as the public responsibility to provide support for the caregiver so that the caregiver can give care without depleting herself and her resources."

 There is a saying “You can’t pour from an empty cup.  Fill yourself up first so you can then overflow.”   When we see someone giving care, we pour in her cup.  And the pouring and overflowing repeats itself in every family, in every culture.  Sometimes, it happens naturally and sometimes this process requires intention.  

There is no better time than the Holiday Season to reflect on love, family, intention and the good in supporting caregivers.

Good Friends vs Toxic Friends

Telling the difference between good friends and toxic friends is especially important for caregivers.  Caregivers simply don't have the dual luxuries of boundless time and energy to invest in friendships that are not reciprocal.  So, here's a quick guide to recognising good friends and toxic friends.

TOXIC FRIENDS

For caregivers, there are two common types of toxic friends; the troll and the narcissist.  The troll is someone who calls and visits often.  He or she will ask many questions about your loved one and may even visit in hospital to chat over coffee or lunch.  They will appear warm and concerned, while inquiring into the minutiae of your loved one's symptoms and treatments.  This type of toxic friend does not offer help of any kind.  They simply want to know.  The human drama of a caregiver's life provides vicarious interest and fodder for their dinner table chat, but that is all.  This type of friend cannot make the intellectual leap between listening to your experience and offering to sit with your loved one or doing your grocery shopping.

The second type of toxic friend is the narcissist.

Narcissists rarely, if ever, ask how you or your loved is doing.  They are bored by others' experiences, so constantly direct the conversation back to themselves.  No matter how difficult a caregiver's situation may be, it will always be worse for a narcissist - and despite their healthy family status, they will want you to listen and sympathise.

GOOD FRIENDS

Caregivers soon find out that longstanding friendships don't necessarily translate into good friendships when the going gets tough.  Some lifelong friends do show their loyalty and generosity, while others suddenly become too busy to call or drop by.  The messy and often sad events in caregivers' lives may be too difficult for some people to witness and absorb.  The fact is, not everyone is cut out for helping others through the toughest times. The trick is to determine quickly who will be a good friend for the long haul and who may be limited in their ability to walk with you through your caregiving journey.  Wise and experienced caregivers will advise forgiveness in the case of friends who disappear upon hearing your loved one's diagnosis.  Holding on to bitter feelings will only make it more difficult to spot new friends who genuinely want to help.


The extraordinary friend is one who intuits your needs, listens without judgement, visits often and always brings food.  The new friend is an acquaintance who, upon hearing that you are giving care, offers help that is truly helpful.  The kindness of new friends is always a surprise - often the most helpful friends are those you would least expect.  Whether a good friend is old or new, it is clear that your friends are those who truly want to help.  Friends will want to give what they can.  Some may not cook, but their keen wit can suddenly flip fear into hilarity - that is a gift to a caregiver.

KEEPING FRIENDS

Caregivers have the obligation of reciprocating friendship, too.  Most often, this means saying thank you.  The sincere expression of gratitude is not a sign of weakness or evidence that the caregiver is miserably incapable of handling a loved one's needs independently.  The gracious acceptance of help and friendship in the full knowledge that love flows both ways, is the key here.  Good friends say,  "You look tired. Here, let me help you."  That's just what good friends do.

My book, 'The Four Walls of My Freedom: Lessons I've Learned From a Life of Caregiving' (House of Anansi Press) is now available from all major booksellers in the USA and Canada

A Concept for Giving Back to Caregivers

There have been times around the holiday season of giving when I have thought, “I give to others every day.  Will anyone give to me?  If they do, what do I need or want?”  I wasn’t thinking of a sweater or a new pair or socks – I was thinking of care.  I was daydreaming about someone caring for me, the caregiver. 

Eva Feder Kittay is a philosopher and mother of an adult daughter, Sesha, who has severe cognitive disabilities.  Eva also cared for her ailing and elderly mother until last year. 

Eva coined the word doulia to describe a new paradigm for reciprocity for caregivers in the community. She describes doulia as an ethical principle that recognizes giving care as an important contribution to the overall good of society. “We can ask whether parents or kin who assume the role of caregiver should have claims on the larger society to support them in their efforts to provide care. If, for all the effort and care in raising a child with disabilities into adulthood, there is no payback (conventionally understood) to the society at large, can we still insist that there be a state interest in helping families with the additional burdens of caring for a developmentally disabled child? Is there a state interest in assuring families that their vulnerable child will be well cared for when the family is no longer able or willing to do so?”[i] Kittay answers her own question with a resounding yes and that response is rooted firmly in her own mothering experience. She describes a concept of interdependency or “nested dependencies” that recognizes the inevitability of dependency as a fact of being human. It is via the idea of doulia that reciprocity can be realized through policy because the driving force is an equality that “our full functioning presumes our need for and ability to participate in relationships of dependency without sacrificing the needs of dependents or dependency workers.”[ii]

Here Kittay is advocating an ethical framework and moral obligation for society to look after caregivers so that caregivers can carry out that care without sacrificing their own wellbeing. She is talking about ‘payback’ for the caregiver. 

We know doulia as friends and family members who help a new mother by watching the older children and performing household chores so that the mother can give total care to her newborn. Implicit in this natural family tradition is the understanding that the mother is “owed” care because she is giving care to a much loved, highly vulnerable newborn. Her first priority is to give the best care possible to her beloved charge.

Over the past few years, I have been thinking about how to ignite a wholesale shift in thinking about care across society.  Kittay’s ideas about doulia and inevitable, nested dependencies provide a great jumping off point for a new conception of care for the caregiver. 

But where do these ideas lead, practically speaking?  Well, I believe that employers should have a two-pronged corporate social responsibility program – family care and community care.  Assuming that some employees have caregiving responsibilities that are sometimes onerous, causing them to claim sick days or leave to look after a critically ill spouse, elderly parent or child with a disability, the company could and should support its own.  The second prong of the corporate social responsibility strategy would be a focus on the needs of the greater community.  Another idea would be to have local volunteer bureaus match families with volunteers.  My local volunteer bureau matches only willing helpers with agencies, never with needy private citizens. 

Kittay is right.  We don’t blink an eye when people rush to help with household chores of the new mother.  We instinctively know that she needs to have her full attention on caregiving and the duty of others is support that role.  So why are older caregivers any different?  They aren’t.  And if long-term caregivers don’t receive long-term support, they and their charges will suffer.  Doulia is a concept worth thinking about and acting upon this giving season and all year round.

---

[i] Eva Feder Kittay, “When Caring Is Just and Justice Is Caring: Justice and Mental Retardation,” Public Culture, 13.3 (2001): 565.

[ii] Kittay, Love’s Labor, p. 132.

Fairness in Policymaking for Family Caregivers - Part 2

Continued.... this is Part 2 of a reflection on fairness in policymaking for family caregivers.   

So, what are the roles of families and governments in supporting society’s most vulnerable citizens?  What kinds of policies can facilitate true partnership between governments and families who seek to care for someone needing help?  One such policy is the groundbreaking Canadian Registered Disability Savings Plan (RDSP).  In the late 1990s, Al Etmanski of PLAN called me and told me of his idea to create a fund for people with disabilities.  I remember saying “I have a savings plan for my daughter’s university….why can’t I have a savings plan for Nicholas’ future?”  Hundreds, if not thousands of parents chimed in to a national conversation about financial tools that could transform the lives of people with disabilities from victims and consumers of tax dollars to contributing participants in our market economy and masters of their own destinies.  

     The RDSP was announced in the Canadian federal budget of 2007 and our family has one now for Nicholas.  Previous to this plan, families had no tax sheltered savings vehicle that could be used specifically for the future of a loved one with disabilities.  Furthermore, if someone received government disability pension benefits every month, they were not allowed to have more than $5,000 in assets.  A friend whose daughter had recently turned 18 was forced to sell back her daughter’s prepaid funeral plan in order for her to qualify for disability pension benefits – the funeral plan was worth more than $5,000.  This “all government” or “all private” finance thinking ensured that people with disabilities were effectively poor and had limited choices in terms of their discretionary spending.  The thinking was that anyone who had private finances, yet was in receipt of government benefits, was guilty of welfare fraud.  

     To be disabled and accept financial assistance from the state meant you had to be poor, or at least be SEEN to be poor.  The RDSP, on the other hand, is a new savings plan that will assist families in planning for the long-term financial security of their relative with a disability.  Over time, it is estimated that the RDSP will provide billions of dollars to supplement income, enable home ownership, and enhance quality of life for as many as 500,000 Canadians with disabilities.  The plan is similar to an education savings plan, in that contributions remain tax-free until withdrawal.  There are no annual limits on contributions, but there is a lifetime limit of $200,000, and these funds can be contributed by any family member or friend.  There are no restrictions whatsoever on how the funds are used by the beneficiary, and when funds are withdrawn, they are taxed in the hands of the beneficiary at a much lower rate.  For lower and middle-income families, the federal government will contribute to the plan as well through the Canada Disability Savings Grant.  For families with an income less than $77,664, the grant will contribute $3 for every $1 contributed on the first $500 and subsequently $2 for every dollar on the next $1,000.  If the family income is over $77,664, the government will match dollar for dollar up to $1,000.  

     But those families with little or no capability to contribute to the plan are not excluded.  When annual income is less than $21,816, the Canada Disability Savings Bond will provide $1,000 per year without any contribution from the family at all.  Currently, British Columbia, Newfoundland and Labrador, Saskatchewan, Manitoba, Yukon, Alberta, Nova Scotia, Northwest Territories and Ontario have all exempted the RDSP as an asset and income when determining eligibility for disability pension benefits.  Quebec, New Brunswick and Prince Edward Island have exempted the RDSP as an asset and partially tax exempted payments from the plan.  Nunavut has not yet made a decision on the plan.  

     Of course, just having savings does not make someone happy or keep them safe.  In fact, someone who has the combination of learning difficulties and ready cash is even more vulnerable to exploitation.  Furthermore, someone who is in need of social care is likely to have very limited means of converting his funds into good living.  This is where personal networks come in to the picture of support.  The PLAN values state clearly that people who have disabilities or are otherwise suffering from the effects of social exclusion need money AND caring friends to create a good life.  Personal support networks consisting of family and friends who are coordinated in their caring tasks can fulfill a trustee role, ensuring accountability and transparency.  The idea of distributive justice is difficult to apply when families who care for an aging parent or child with disabilities are so isolated.  When my mother in law knew that we were struggling desperately with Nick’s ill health, she used to say “Now if there’s anything I can do…but I’m sure there’s nothing I can do”.  She was a kind person who was completely flummoxed by the scale of what might be required to be helpful.  But when I asked for a banana loaf or company in Nicholas’ hospital room, she was only too happy to oblige.  The carving up of a gigantic need into small, do-able parts is the trick here.  Ensuring that no one person is burdened by the lion’s share of dependency work is key, alongside a shared and celebratory love for the person at the heart of the network.  

  Fiscal policies such as the RDSP that allow people to save without penalty, spend as they wish and participate in community life with the assistance of state funded services constitute the elements that allow people with disabilities to convert financial assets to good living.  

So, in Canada families like mine finally have a financial tool to plan a decent future for their loved with a disability.  Friends and extended family can help too.  That’s the good news.  The bad news is that governments are scratching their heads wondering how to fund exploding social and health care budgets.  The demographics of aging populations in developed nations around the world are the culprits.  A US Census Bureau report of July 20, 2009 is full of terrifying numbers.  Italians are advised to look away now: their country’s population will in the space of thirty years shrivel dramatically, while numbers of elderly women will outstrip every other country on the planet.  Emigration is sapping that nation of its employable youth and huge numbers of pensioners have all but bled the state coffers dry.  (The Guardian, July 21, 2009 pg.17)  In Great Britain, politicians and academics alike are busy inventing new ways of injecting private funds into pension funds to pay for the looming long term care crisis.  Young Britons are not saving, given the current recession which comes on the heels of a borrowing and spending frenzy over the previous decade.  At a roundtable of economists and accountants hosted by the Lord Mayor of London Ian Luder in September of 2009, Professor Ian Mayhew of the Cass Business School reviewed the gloomy UK demographics and proposed a radical solution to funding seniors’ care.  He noted that although life expectancy is increasing (especially among females), it is estimated that about ten years at end of life are spent with some form of disability.  (Mayhew and Smith, 2009) In other words, people are living longer, but not without suffering all the effects of very old age.  “Intuitively as the health care system becomes more successful at lengthening life the possibility of greater social care needs is increased, insofar as any extra years are spent in poor health have limiting effects on activities of daily living, or lead to the greater occurrence of other diseases such as dementia.  Such trends have the capacity to significantly affect the UK economy.” (Mayhew 2009)  No western democracy is immune from the problem.  Governments in all developed nations are considering raising the age of pension eligibility, if they haven’t already done so.  Australia has introduced a compulsory pension scheme and other countries are watching closely how that initiative plays out.  

In Canada, health, social care and education are matters under provincial jurisdiction.  

My family experience has been in the province of Ontario, but federal guidelines are such that in principle at least, there shouldn’t be too much difference in standards of decent support across the country.  In light of a proposed reinvented public/private partnership between government and families, what exactly should be the bottom line expectation of provincial governments?  I believe “adequacy” is the correct response here.  Charles Taylor’s notion of lower functioning and higher functioning is helpful yet again.  Governments should ascertain what is required to support individuals’ lower functioning.  This should include mobility equipment, nursing services as currently identified for medically complex care such as patients on ventilators, and of course residential care facilities for acute and long term care patients.  The state has a duty to partner with families to provide and pay for these matters of basic living. Higher functioning activities such as personal relationships, social outings, pursuing interests and offering civic contributions should be enabled by friends and family on a private basis.  But these activities do not come free, and often in cases like my own family, require armies of people to carry out.  Similarly with the aged, we must find ways of including the less able into our community life that will not bankrupt families and drive their primary caregivers to an early grave.  Governments have a responsibility to enable active citizenship and the benefits of altruism – secondary schools in Ontario are doing this by requiring community service of their students.  Some corporations reward their employees who volunteer.  The Institute for Canadian Citizenship embraces the value that “we believe that citizenship requires that one take responsibility for others” (www.icc-icc.ca/en/about/index.html).  Co-founders of that Institute Adrienne Clarkson and John Ralston Saul told me that members of local citizenship committees befriend new Canadians and provide examples of civic contributions that are part and parcel of being a good Canadian.  But contributions reap rewards and new citizens are given a Cultural Access Pass for one year’s family admission to publicly funded cultural institutions.  Currently, the scheme operates only in Toronto, but is set to expand to other regions across the country.  This ethic of community giving and receiving is an example of a programme that forges a connectedness between people that if extended, will benefit vulnerable and isolated citizens as well.