Special project brings children, nursing home residents together

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Janet Listokin
Janet Listokin
Perhaps Project N.O.I.S.E.E.(TM) is not the name of a project one would associate with a nursing home.  However Project N.O.I.S.E.E, which stands for Naturally Occurring Interactions in a Shared Environment Everyday, is a highly innovative intergenerational program that weaves together ongoing needs and services at the Isabella Geriatric Center to the benefit and enjoyment of all involved-residents, children, families, visitors and staff.

In September 2004, on the urban campus of Isabella, a unique partnership formed between the on-site childcare center and the Therapeutic Recreation Department. The childcare center, which began in 1991, accommodates 39 children between the ages of 3 months and 5.9 years old.  Under the supervision of the Therapeutic Recreation Department and the Child Day Care, the children are afforded the opportunity to interrelate and are offered close contact with the residents. Using the format of a children's board game, 43 offices, public areas, dining rooms, recreation rooms, etc. throughout the campus were renamed. The recreation suite was referred to as "Marshmallow Sky," the 9th floor dining room was Chocolate Chip Jungle, the finance department was Caramel Swamp, and the beauty parlor was Mashed Potato Mountain, to name just a few.  

From the onset, co-creators Janet Listokin, CTRS, director of therapeutic recreation, and Karen Ellefsen, director of child day care, understood the challenge of creating an intergenerational environment in a long-term facility-one that boosts the morale of the residents and staff alike. The innovative idea of bringing children and residents together, both for scheduled programs and spontaneously, would ultimately become part of the natural rhythm of the day.

It challenged traditional assumptions that children would disrupt an environment, which in the past, was suppose to be peaceful, or at least quiet and controlled. Children bring noise—laughter, scream and giggles—and their physical presence completely changes the atmosphere, injecting enthusiasm, energy and youthful excitement.

The basic NOISEE objectives set were:

• To facilitate daily natural interactions between residents of the nursing home and the children of the on-site day care center.

• To utilize the entire Isabella campus as the children's classroom.

• To provide therapeutic recreation for residents in the form of daily intergenerational activity. Residents can actively participate or passively observe.

• To stimulate the spontaneous feelings of nurturing and loving that older adults (despite disabilities) often feel-when the environment is conducive to such attention and caring.

• To create for children the non-threatening experience of being with individuals who are elderly and/or impaired, which will serve as a foundation for sensitized interaction with people, over the course of their lives.

Intergenerational activities are important to both the development of children and the quality of life of the nursing home residents. On the most basic level, children get an opportunity to become familiar with the issues of aging. Sometimes, these issues involve the difficulties of wheelchairs, life support equipment, intravenous, or just the disabilities associated with aging.

 At the same time, residents are teaching the children about respect, understanding and celebrating other cultures. Dialogue between generations is promoting positive attitudes toward the elderly and children are learning how to relate to seniors, even those with dementia and illness. NOISEE has a huge advantage over traditional childcare settings, as it helps develop a sense of responsibility and recognition of the rights and needs of others and reaffirms the resident's sense of being an integral part of the community.

Because the childcare center is housed within the nursing home, there has always been some contact between the generations, but, prior to NOISEE with a ground floor location and separate staff, interactions between the children in their classroom and play areas, and the residents upstairs, with their own activities and recreational venues, was limited. However since the inception of NOISEE, and with the complete support of the administration of Isabella, the children utilize the entire three-acre urban campus as their classroom and are a part of the natural rhythm of the day.

As the locations were renamed, the children ventured throughout the Isabella campus to share their enthusiasm with the residents, staff and visitors.  Rather than have story hour in the childcare center, the teachers and children would bring their books and magic carpets to Raisin Rain Forest (the physical therapy gym) or have their snacks at Yum Yum Hill (the staff cafeteria).

Project NOISEE consists of five puzzle pieces-structured activities, scheduled programs, spontaneous playtime, special themed events and senior sharing sessions.  Examples of structured activities include arts and crafts, cooking, gardening and dancing.  Scheduled programs are Scooter Scuttle, Sign language and "Ooey Gooey" Fridays.  Spontaneous playtime includes story time, circle games, rhythm band and Show & Share time. Bathing Suit Parade, Pajama Day, Zany Hat Hunt and the Oodle Kanoodle Soup Voyage are a few examples of special themed events.

Following the therapeutic recreation assessment, the therapeutic recreation specialist ascertains which residents would be willing and would benefit from Senior Sharing Sessions-an opportunity for the resident to share his or her special skill with the children. There are several residents who "work" in the childcare center several hours during the week. Under the supervision of the teachers in the Infant Room, these residents' responsibilities may include patting the baby's back as an aid to falling asleep, rocking the carriage, gently bouncing the baby bouncing seat, feeding, etc.  Another resident comes to the pre-school classroom twice weekly to read to the children. The toddlers often visit one particular resident so that she can play the piano for them.

Following Isabella's long tradition of innovation, Project NOISEE is a pioneer in addressing age segregation and serves as a role model for both metropolitan and less urban geriatric centers. In the fall of 2004, the National Therapeutic Recreation Society awarded Project NOISEE with the Jean Tague Innovative Programming Award.  During the winter of 2005, Project NOISEE was cited in the American Association of Homes and Services for the Aging's "Best Practices in Aging Services." And, in the spring of 2006, the Metropolitan New York Recreation and Park Society awarded Project NOISEE the Presidential Citation.

With residents and children increasingly sharing their environment and interacting with one another, acceptance and affection have blossomed. As written by resident Ms. K.H., prior to her discharge back to her home in the community, "The 'therapeutic' component is so subtle that all the events are just fun, unless you really think about the cumulative feelings of well being you experience."

It is clear that children who participate in an intergenerational program have more positive feelings towards older adults. At the same time, residents have something to look forward to and contribute to; activity is increased while loneliness and depression are decreased. Just as important, staff throughout Isabella say they feel uplifted by the children's presence and the parents believe that being brought into more frequent contact with older people and individuals with special needs has had a positive and important impact on their children.

Residents are finding new joy in friendships with children and discovering a sense of value in sharing their rich life experiences to help youngsters learn. Also, the children delight in having a whole community of "grandmas and grandpas."

Though the children move on to elementary school and new residents are admitted and others discharged, the NOISEE journey continues. Future goals include:

• Intergenerational trips

• Interactive NOISEE playground

• Intergenerational mini retreats for staff children

• Outreach to local schools to increase children's presence on the Isabella campus

• Intergenerational after-school program

• As resident Ms. K.H. wrote, "If a sense of lasting value is a therapeutic goal—NOISEE gives us its living, breathing noisy manifestation!"

Janet Listokin, CTRS, is director of therapeutic recreation at Isabella Geriatric Center in New York City. Founded in 1875, Isabella provides comprehensive services to its senior housing, 705-bed long-term facility and more than 10 community-based programs.

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