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A model of Intergenerativity

January 6 2014
by

Danny George

on 10 November 2014

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Transcript of A model of Intergenerativity

'Pharmaceuticals'
'Socialceuticals'
What does
amyloid do?
A model of
Intergenerativity:
Bringing generations together to foster collective wisdom and community health

Our social nature
Alzhemed (anti-amyloid)
Tramiporosate (amyloid anti-aggregation)
Dimebon (anti-amyloid)
Bapineuzamab (monoclonal anti-amyloid antibody)
Tarenflurbil (gamma secretase inhibitor)
Semagacestat (gamma secretase inhibitor)
Rosiglitazone (metabolic, anti-inflammatory)
Leuprolide (endocrine)
Xaliprodene (neuroprotection)
IVIG
Other
Ginkgo Biloba
Vitamin E & B
Recent AD trials
Relationship-centered care
Non-pharmacological, relationship- and community-based, psychosocial-spiritual interventions that improve QOL and end the segregation of the cognitively frail
TimeSlips
Daniel R. George, Ph.D, M.Sc
Penn State College of Medicine
Forget memory, try imagination!
"Our medical training is more or less reductionist – kind of just look at people as diagnoses: this is an Alzheimer’s patient, a heart patient, or a diabetes patient.
Through all these sessions it’s reminded us just of learning more about these residents how these events of their lives transform who they are and we should take that to heart as physicians when we care for them.
You take time to figure out who that person is and avoid the trap of just having your blinders on. We have to take time to know who the person is since that will effect care management."
~ 4th-year medical student at Penn State College of Medicine
“SPEED QUEEN – BUNCH OF BOLOGNA!”
He is in the washer, in the center of the earth.
The washer is 3 days old! He wants to wash his shoes.
His name is Bigfoot-Max the Great Man.
He’s happy to be there because there are fish inside.
He is maybe in Philadelphia, or maybe Hershey, but this is not a Hershey type place.
He is likely not married.
He has a small family and they’re glad he’s trying to get clean.
He is a psychologist. He went to college in Pittsburgh.
He will be disillusioned after getting out of the washer, then he will go to the dryer, to the doctor, and to bed.
His friend told him to get in the washer.
His sock is clean! Both of them are!
He hears “gurgle gurgle thump thump thump” in the washing machine.
But those sneakers certainly don’t suit him.
Contact: drg21@psu.edu
www.themythofalzheimers.com/blog

What is narrative?
An Evolutionary Role for Elders: The "Grandmother hypothesis"
Person-Centered Care Relationship-centered care
Community-centered care
1. Describe the evolutionary context for intergenerational relationships

2. Define the concept of "intergenerativity" and describe its implications for intergenerational partnerships

3. Share local examples of intergenerative programs and identify best practices


Learning objectives
bapineuzumab
solanezumab
TimeSlips process
1. Greet the residents
2. Distribute pictures
3. Ask open-ended questions that engage imagination
4. Validate every comment
5. Write every comment down
While we retain a desire for relationships and social learning, modern Western culture segregates the old and cognitively frail.

Disengagement theory
: smaller social networks, lower engagement, and less purpose and usefulness increases risk for cognitive decline and mortality
A process of perception, cognition, and meaning-making
Evolution of language
≈40-60,000 years ago: Emergence of compositional language & social learning

Debunking the 'Myths' of Alzheimer's
"AD" is not 'one thing' (syndrome)
"AD" is intimately related to brain aging
'Curing AD' is tantamount to curing brain aging
If "AD" has
multiple
causes, our approach to preventing it must be
multi-faceted
My perspective
"Intergenerativity"
The Intergenerational School
Local Intergenerativity
Intergenerativity
:
-Removal of age-segregated barriers
-Development of relationship-centered and community-oriented relations
-Blend of innovation and integration
-Systems thinking
-Narrative focused
-Celebration of interdependence

http://intergenerational.cas.psu.edu
msk15@psu.edu
Hawaii 2015!

The empowerment of older persons to fully and
effectively participate
in the social, economic and political lives of their societies

The provision of opportunities for individual
development, self-fulfillment and well-being
throughout life as well as in late life, through, for example, access to
life-long learning
.

Strengthen
solidarity among generations
and intergenerational partnerships […] and encourage mutually responsive relationships between generations
What is an intergenerative program?

1) purposefully brings together different generations in mutually beneficial, planned activities;

2) aims at increasing cooperation, interaction or exchange between the generations via sharing of knowledge, skills, and/or experiences;

3) has the potential to provide benefits at both individual and community levels
UN Second World Assembly on Aging International Plan of Action
-Postmenopausal lifespans are unique amongst homo sapiens

-Postmenopausal women gathered plants, cared for grandchildren, enabling physically stronger mothers to forage for food.

-Ultimately this enhanced their own progeny's survival
Inter:
Interdisciplinary, interprofessional, international, etc
Generativity
:
A form of relations that can challenge the status quo and open new repertoires for thinking and acting
The regular presence of many adults and older adults within the hallways of TIS helps produce:

A palpable atmosphere of calm and respectful behavior.
Tolerance for disabilities.
Empathy and patience.
Opportunities for intergenerative learning and teaching
Civic activism
Previous research on environment-based intergenerational programs (Liu, 2004; Okun, 1994) has demonstrated that the most profound impact for elders is the recognition that children are genuinely receptive to their knowledge and views.
Moving forward
"Our medical training is more or less reductionist – kind of just look at people as diagnoses: this is an Alzheimer’s patient, a heart patient, or a diabetes patient.
Through all these sessions it’s reminded us just of learning more about these residents how these events of their lives transform who they are and we should take that to heart as physicians when we care for them.
You take time to figure out who that person is and avoid the trap of just having your blinders on. We have to take time to know who the person is since that will effect care management."
~ 4th-year medical student at Penn State College of Medicine
Medicalization

-When human conditions come to be defined and treated as medical conditions, and thus the subject of medical study, diagnosis, prevention or treatment

-The labels we use to define our world position people in society

-Can increase access to services/programs, but can also create self-fulfilling prophecies
How do we bring the generations together in shared learning spaces in our communities to solve the big issues of our era?

-Climate change
-Chronic diseases
-Population aging
-Financial instability
-Competitiveness in a global economy
Protective social networks
-High academic performance
-High parent engagement
-Zero-tolerance policy for aggression
-Culture of mutual respect
http://www.gu.org/
Resources
Keys to successful programs
Identify enthusiastic champions at partnering institutions
Negotiate shared resources in a fair manner and clearly define roles
Develop a
meaningful
activity (consider the power of activities emerging from the arts, as well as sensorial or civic-oriented activities)
Promote the program effectively and efficiently
Evaluate the program and measure outcomes
"Older adults constitute the only increasing natural resource in the entire world. - Dr. Linda Fried
Danny George
Reflect for a moment on someone older than you who had a significant role in your development.
"Creative Explosion"
Barriers

Power of intergenerational relationships
“You think that because you understand one you understand two, because one and one make two. But you must understand AND”.
Sufi proverb
www.themythofalzheimers.com/blog
Twitter: @MythofAlzheimer
Facebook: Myth of Alzheimer's Page
Expansion of cerebral hemispheres
Having language/culture means we are the only animal that acquires rules of daily living from the accumulated knowledge of our ancestors, rather than from the genes they pass to us
We are born receptive to culture, primed to learn language, comprehend shapes and movement, expect causation, mimic others
Children absorb information about culture from elders rather than rely on instincts
Through social learning we accumulate ideas, skills and technologies, dispositions, beliefs that produce successful societies
-Random genetic mutations influenced the development and projection of neurons (HAR1) and genes that regulate facial muscles (FOXP2).

-Language grew out of ability to vocalize and gesture, piece ideas together, project into the future and past. Nouns --> verbs --> pronouns


Language was a force for change: fostered exchange of ideas, improvements in technology, new ways of living, abstract thinking, planning depth, symbolic behavior
Social learning is intergenerational
Evolution of language
Scientific knowledge doesn't accumulate incrementally, but rather advances by the sudden abandonment of one theoretical structure - or paradigm - and its replacement with another.
27,000 yrs ago in Iberian Penninsula
Genevieve Miller
“Sometimes I get really bored with Dr Miller. She’s kind of stubborn. It takes a lot of work to get words to come out of her mouth. Most of the time, Mrs. Miller does not want to talk at all. You have to ask her 1,000 questions to write just one paragraph about her life. Sometimes I just want to get up and leave.”
“I like to work with Dr Miller. I had a great grandma who died and I missed her. It is nice to have a older person to talk to. My senior is fun to work with. She has a lot of great stories to tell.
“Umuntu ngumuntu ngabantu” = “A person is a person through others”
Local, intergenerational learning communities that connect and collectively educate individuals of any age while nurturing social, civic, and environmental responsibility and
encouraging informed action.
A modern intergenerational vision
Language and culture as a survival vehicle
Full transcript