On its surface, Columbia is the prototypical college town — a city that sets its cultural clock to the ebb and flow of young adults enrolled at MU, Stephens College and Columbia College.
That’s not how Dick Hessler sees it.
Hessler, a professor emeritus at MU, is an expert on longevity and healthy aging. A few years ago, he noticed a trend that has the potential to pose significant challenges to Columbia health care providers: a growing population of seniors.
Between 1990 and 2000, according to census data, the number of people age 65 and older living in Boone County increased almost 20 percent to more than 12,000. The number of people 85 and older living here grew by more than 44 percent — double the state’s growth rate for the same age group.
By 2020, Hessler estimates, people 75 years of age and older will number more than 25,000, and that doesn’t include seniors who will move to Columbia and Boone County.
“This is a real demographic transition,” Hessler said. “It tells me that we better be doing the planning now to get these things in line.”
The problem, Hessler said, is that this growth in the older population will outstrip the ability of existing recreational and social programs to provide services. Even now, there are not enough adult day-care facilities to meet the need, according to an assessment Hessler conducted with the help of Boone Hospital Center. That same survey suggested that the need for child care is even more acute; about 30 percent of respondents said they had trouble finding an accredited day-care center.
Hessler proposed a solution: intergenerational day care. Based on a concept conceived 15 years ago in Van Nuys, Calif., intergenerational day care would serve the elderly and young children alike, under one roof.
Administrators at Boone Hospital Center loved the idea, Hessler said. They loved it so much that the hospital’s board of trustees agreed to donate land near the corner of William and Walnut streets for a 21,435 square-foot facility with adjoining day-care centers for children and seniors.
Jan Grossmann, executive director of the Boone Hospital Foundation, is leading a fundraising effort that she hopes will secure $6 million for the project. Trustees have already committed $750,000 over five years to begin developing programs for the center, which is scheduled to open in August 2008.
“If you look at population shifts, the baby boomer population is in a category where some of its members are starting to need more care,” Grossmann said. “As it ages, there just won’t be enough resources for this care.”
The county’s Intergenerational Daycare Center would be the first facility of its kind in Missouri. With a focus on carefully planned interaction between the young and the old, it will serve up to 60 seniors and up to 104 children, from newborn to age 6.
A city for retirees
Hessler said Columbia is a good fit for this type of care. An educated population, with training in both gerontology and child care, helps, he said, as does the availability of medical services and access to MU, which provides social services and adult-learning opportunities.
Those amenities have fueled an effort, begun in 1992, by the Columbia Chamber of Commerce to market the city as a retirement destination.
Elizabeth Echols, co-chairwoman of the chamber’s Retiree Recruitment Committee, said the goal is to “promote the great and wonderful things of Columbia.”
Hessler estimates that there are 80 to 90 adult day-care facilities in Missouri, including Columbia’s Adult Day Connection, which operates at Clark Hall on the MU campus and at The Intersection, on Sexton Road. One goal of adult day care is to support the personal independence of seniors by focusing on their physical, social and mental well-being.
Moreover, the longer a senior can avoid long-term nursing care, the more financial resources can be put into a broader range of care.
In Missouri, the average stay for a senior at an adult day-care center is two years, at a daily cost of about $56. Assisted living costs $500 a week, Hessler said, with nursing homes running about $1,000 a week. When it comes to care costs, Hessler said, “two years is buying a lot of time for society.”
To qualify for adult day care, seniors must exhibit a certain amount of independence. They must be mentally aware, mobile and able to stand and sit with limited assistance. Some seniors have been at Adult Day Connection for years, said director Tish Thomas. One patient, Gladys Turner, has been with the program for nine years.
“It just makes sense,” Thomas said. “People want to be independent for as long as possible.”
Positive effect is seen
At Adult Day Connection, seniors have the opportunity to interact with children five or six times a year, usually around the holidays or other special occasions. Intergenerational day care is built around a half-dozen or more planned activities every day.
Hessler has seen the concept firsthand several times during visits to ONEgeneration, in Van Nuys, Calif. He witnessed seniors and children cooking, gardening, doing arts-and-crafts projects, dancing, singing and telling stories together. Sometimes seniors simply rocked newborn babies and infants.
But Hessler was most impressed by the impact on the adults. Before the children came, Hessler described the seniors as “what I expected frail, older seniors to be like.” In the presence of youngsters, he said, “I would be hard-pressed to tell the difference between the volunteers and the day-care participants.”
Research has shown that intergenerational care can really benefit seniors. Hessler points to a study at ONEgeneration that looked at patients recovering from strokes. Those who had intergenerational interaction were less depressed, showed a more rapid rate of improvement in speech and motor function, and were less likely to suffer another stroke within eight months.
Hessler said having children around offers “a different kind of stimuli” that is valuable for seniors.
“Adult day care alone provides the kind of stimuli you need to keep from going downhill too fast,” Hessler said. “You can tell just by looking that these folks were doing better than you would expect them to do, because of the children.”
In Boone County, intergenerational day care will consist of planned activities designed for children and seniors eight times a day. Hessler and Grossmann anticipate that this level of interaction will not only benefit seniors, but that it will offer a life-changing experience for children.
Research suggests that contact with seniors improves the attitudes and manners of children, Hessler said. They exhibit better social skills and show more empathy.
“The children will be able to realize when people are different, that’s OK,” Grossmann said.
While some seniors will not move as quickly and will have to rely on walkers and wheelchairs, children will understand they are functional and fun to be around, she said. For Hessler, simply bringing seniors (“natural teachers”) and children (“natural learners”) together is a big part of intergenerational day care’s proven success.
“Any place there is a community,” he said, “people find each other and build relationships.”
A week before Halloween, children from the Robert G. Combs Language Preschool in Clark Hall visited Adult Day Connection, a short walk away in the same building. The door chimes as a group of 3- to 5-year-olds enters with a handful of students from the MU School of Health Professions.
The activity that day is making black paper bats with googly eyes, a fuzzy nose, a sticker mouth and a bow tie. Each person’s artwork is unique because it involves a tracing of the artist’s hand.
Virginia Stephens, who attends Adult Day Connection, said she enjoys the attitudes of the children.
“I like their cheerfulness,” Stephens said. “They behave very well, and they’re always happy and not afraid of us.”
This type of day care has a positive effect on another group: caregivers. The more seniors are engaged while in adult day care, the happier they are, Hessler said. They have more energy and sleep better at night. As a result, caregivers have an easier time and tend to worry less because they know the adults are enjoying themselves.
College intergenerational programs
While the Intergenerational Day Care Center is still in the fundraising stages, the Boone Hospital Foundation is working with area colleges to begin training caregivers who can work with both adults and children. Moberly Area Community College is developing a curriculum for an associate’s degree in intergenerational studies.
At Stephens College, a bachelor’s degree in intergenerational studies is in the works, while Columbia College plans to offer a minor in the subject. William Woods University will have internship opportunities with the center, and MU will offer service learning projects in research, as well as internships.
To date, the foundation has limited its fundraising efforts to other foundations, organizations and people capable of making large contributions. Next in line are campaigns aimed at employees and physicians. The fundraising campaign will go public in the spring, Grossman said.
Hessler will eventually step back from his role as the center’s project leader. At that point, he plans to begin researching the impact the estimated 250 intergenerational centers around the country have on children and seniors.
For now, though, the concept is an easy one to understand and, he hopes, an even easier one to sell.
“It’s about making life really enjoyable for children and adults during just a brief encounter,” he said.