Intergenerationality Programs For Portuguese Population: History
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Contributor:
Maria Inês Carvalho
,
Maria João Póvoa
,
Mariana Neves
,
Joana Bernardo
,
Ricardo Loureiro
,
Rafael A. Bernardes
,
Inês F. Almeida
,
Elaine Santana
,
Rosa Silva

The aging process is characterized by diverse and complex changes in the individual’s various dimensions, requiring continuous adaptation. In this sense, this transition can be faced from an active aging standpoint through strategies such as intergenerationality programs/projects, resulting in an active social participation and valorization that is so important to life in society. Portugal has undergone demographic changes, significantly transforming its age structure and populational dimension. In 2021, the aging index was 182.1%.

  • aged
  • healthy aging
  • intergenerational relations

1. Introduction

Like other countries, Portugal has undergone demographic changes in recent decades, significantly transforming its age structure and populational dimension. In 2021, the aging index was 182.1% [1]. At the same time, according to the National Institute of Statistics (INE), there is a predicted decline in the number of young people, from 1.5 million to 0.9 million, and an increase in the number of seniors, from 2.1 to 2.8 million, doubling the aging index, from 147 to 317 older adults for every 100 young people in 2080 [2].
From a biopsychosocial perspective, the aging process is ruled by various complex transformations, losses and limitations on different levels compared to other life cycle phases [3][4].
In this sense, aging can be defined as natural, slow, progressive, continuous, multidimensional, multidirectional and dynamic, affecting all of our organism’s organs and tissue, leading to an inevitable increase in dependency, fragility and vulnerability, as well as the decline in seniors’ functionality [5][6].
On the other hand, aging is a role and behavior-changing process at a social level. In the same way, this process is ruled by multiple losses in this context, such as the loss of a valued social place as a productive individual and the loss of family and social and economic roles, driving the older adults to situational transitions, often leading to vulnerability, resulting in isolation, loneliness, depression, an increase in alcohol consumption, pathological anxiety and even suicide [7][8][9]. The absence of life projects and the lack of acknowledgement of the end of family social and parental responsibilities can effectively generate feelings of fragility, incapacity, uselessness, low self-esteem, dependency, loneliness, hopelessness and existential emptiness [10][11].
It appears that factors such as social exclusion, stigma, unemployment, poverty and economic situation affect mental health and increase the need to intervene among this population, which is increasingly needed and suitable [12][13].
This way, since aging is a period marked by losses and gains, the individual must adapt to the developmental transition process, accompanied mainly by other situational and health-illness transitions [4][7][11]. Consistent well-being will result from balance when experiencing the transition, allowing the individuals to develop their physical and psychological capabilities [14][15].
In this sense, according to literature based on some studies developed on the subject, intergenerationality programs/projects seem to be one of the active aging promotion strategies, encouraging mental health promotion, capable of initiating continuous and positive changes during the various phases in people’s life cycle [6][8][10].
Thus, as aging is a period marked by losses and gains, the individual must adapt to the developmental transition process, accompanied mainly by other situational transitions and health-disease [4][7][11]. Consistent well-being will result from the balance in experiencing transition, allowing individuals to develop their physical and psychological capabilities [14][15].
Therefore, successful aging will be one in which the person can experience life transitions and reach well-being. Within a multidisciplinary team, the challenge for nurses, given the need for support in transition processes, is to understand the transition process itself and implement interventions that provide effective help to people to provide stability and a sense of well-being [10]. Nursing care for older adults must be based on a multidisciplinary and multidimensional perspective, understanding the aging process of people, maximizing its potential, reducing dependencies and increasing the quality of life, and nursing interventions that promote interactional activities that enhance well-being and social inclusion, fighting isolation and sedentary lifestyle are crucial [10][11].
According to the literature based on some studies developed on the subject, intergenerational programs/projects are thus considered effective interventions for inclusion and cooperation. These inclusive methodologies, based on these two phenomena, become relevant as they prioritize the social value of equality and seem to be seen as one of the strategies to promote active aging, encouraging the promotion of mental health, capable of triggering continuous and positive changes during the various stages of people’s life cycles [6][8][10].
According to the World Health Organization (WHO) [16] and the Directorate-General for Health (DGH) [17], active aging is understood as a process of optimizing health, participation and safety to improve the quality of life as people age, maintaining functional capacity and well-being.
This type of relationship is expected to be increasingly common in the following years because one of the goals of the 10th Sustainable Development objective for 2030 advocates empowerment and promotion of social inclusion [18]. This way, cooperation between generations could be a potential strategy, encouraging contact between people of different generations to be increasingly frequent.
Intergenerationality is a social interaction between people of different ages and generations through exchanging life experiences, values and principles [6][13][19]. Nowadays, expanding these relationships for the whole of society becomes essential as an incentive for intergenerational solidarity [6][20].
The growth of older adults brings social changes between generations, which are evident in the loss of spaces to give and receive affection, share and communicate due to the accelerated dynamics of modern societies, focused on the production, development and consumption of goods and services [10][20].
So, intergenerational practices can be defined as a way to unite people with a purpose, resorting to activities that mutually benefit them and promote better respect and understanding between generations [6][21]. Faced with the reality of the aging world population, international organizations have increased and promoted being oriented towards formulating policies that contribute to coexistence between generations [19]. This implies expanding the concept of intergenerationality, considering it not only as coexistence between groups of individuals of different ages but valuing both the scope and the importance of each generation itself and the contribution that the interrelation between them offers to individuals, the community and the society [10][19].
This symbiosis between generations allows the achievement of joint goals and articulates interests. Then defined, the relationships between generations must be characterized by the presence of a series of elements that favor the production of «intergenerational synergy». In short, whenever in the relationship between generations, actions and behaviors are capable of repercussions on our environment and, in turn, bringing benefits to it, we can speak production of intergenerational synergy [11][20][21].
In this sense, it was considered pertinent to carry out a Scoping Review (ScR) since it allows researchers to find available evidence regarding this specific area of investigation, also clarifying the conceptual limits of the topic under study [22][23].
The present ScR’s objective is to find programs/projects existent in Portugal, promoting interaction between children and older adults, and identify the evaluated dimensions, including those in the mental health field, among the older adult population, during its implementation.

2. Intergenerationality Programs For Portuguese Population

The nursing intervention should function as a process that facilitates the experiences of transitions experienced by older adults, promoting maximum autonomy and well-being.
  • Programs/projects promote generational interaction between children and the older adults
Six of the eight studies refer to programs/projects implemented within the scope of intergenerationality [24][25][26][27][28][29]. The remaining studies [30][31] address the perceptions of older adults and professionals regarding intergenerational relationships/practices.
Thus, in response to the central question of this ScR, researchers verify that, in Portugal, there are at least six programs/projects implemented within the scope of intergenerationality, which were subjected to investigation and consequent dissemination of the results.
  • The characteristics of these programs/projects
Overall, the programs/projects analyzed have a heterogeneous structure of the design, implementation and evaluation (assessed dimensions and evaluation moments), with theoretical and practical sessions held for both generations. In these sessions, the target population’s interest and motivation were parameters considered by all studies, using expository, interactive and interrogative methods.
With this mapping and analysis, researchers can verify that several themes were addressed, demonstrating that these intergenerational practices enable a multivariate and comprehensive approach focusing on active and healthy aging.
The sessions’ duration is heterogeneous, lasting from 15 to 120 min. Thus, the recommended amount of time the older adults and children should share to obtain good results is between 45 and 90 min, according to Soares [30]. Some of the analyzed studies do not present a duration within this range [25][27][28]; researchers can consider that there is not an overall consensus between professionals regarding the ideal duration of these activities. This duration will certainly also depend on the type of activity being developed. This is because cognitive activities will require more concentration/attention from these groups. So, the duration should be well thought out, while other activities, such as more recreative ones, can be longer for older adults and children.
  • The evaluated dimensions in the older adult population during the implementation of these programs/projects
The theory and available evidence seem to demonstrate that Intergenerationally can be seen as one of the strategies that promote active aging, capable of triggering positive and continuous changes during the various phases of people’s life cycles [19][20].
Older generations primarily transmit knowledge to younger generations, essential for preserving collective culture [24][27][28].
The dimensions evaluated in the various programs/projects were organized into five categories: emotional, motor, cognitive, communication and interaction.
Within each category, several parameters were evaluated. In the emotional aspect, parameters such as satisfaction, affection, well-being, depression and self-esteem were assessed. The evaluated aspects show positive results, as shown in Valente [24], which showcases the presence of affection, happiness and satisfaction in the participants in all the sessions, who considered that the activities developed foster dialogue and Intergenerational coexistence. The themes related to the emotional and interaction elements are transversal to all selected programs/projects [24][25][26][27][29].
Vieira et al. [27] show positive results regarding well-being and happiness, as the older adults describe their time spent on activities with children as joyful and something that makes them feel well. In the study, it is also possible to see benefits in terms of intergenerational learning since children would teach seniors how to play with a tablet. In turn, seniors taught children to play board games. Besides this, in terms of communication, their mutual understanding was notorious because, in group activities, both the children and the older adults enjoy finding ways to understand each other using verbal and non-verbal communication.
Estevam [25] also highlights positive results in terms of positive emotions, adding to these the presence of social benefits, given that for older adults, working or supporting school garden activities reveals that besides therapeutic benefits, these activities also contribute to social inclusion. So, the results of Barbosa et al. [28] have also shown that the intervention caused a significant reduction in loneliness and depression, being also relevant in terms of self-esteem and a sense of rejuvenation, since for older adults, the opportunity to share life experiences enhances these feelings, providing the construction of an affective bond. Another point highlighted simultaneously in the study and Henriques [29] demonstrates that the older adults’ active participation in planning activities to be carried out allows them to feel a sense of purpose in life with the establishment of goals.
The study by Pascoal et al. [26], in line with the results of the other studies included in this entry, also points out that it is possible to see positive results in terms of increasing literacy on what active aging and intergenerational activities consist of, and that, on the other hand, interacting with children is a facilitating factor in their life processes/transitions, for example, when acquiring coping strategies in the grieving process. Another factor evidenced as a potentiator of the older adults’ adhesion to intergenerational activities was the possibility of them being able to transmit knowledge and values to the children with whom they related in developing the activities of the programs/projects.
In the same way, younger generations can also transmit knowledge and promoters of older adults’ well-being, social participation and self-valorization [25][26][27][28][29].
In addition to the studies included here, other studies also support this idea [6][21][32]. In this sense, intergenerationality is perceived by Estevam [25] and Henriques [32] as a principle that promotes the mental health and the quality of life of older adults, as well as equality between generations, enabling the transformation of mentalities. On the other hand, it also contributes to fostering citizenship, which, in turn, should facilitate inclusion, social solidarity and people’s well-being. This idea is supported by Cantinho [33]. In the same line of thinking, this same strategy admits the promotion of mental health as one of the areas of intervention for active aging, which is as important as the promotion of physical health in the older adult population, if not more. In this context, the scientific evidence analyzed alerts researchers to the importance of environments that favor well-being and mental health and enable older adults’ autonomy and independence [11][15].
So, the development of activities that promote intergenerationality and allow older adults to be an integral part of it seems to have therapeutic effects that will contribute to the maintenance of the person’s functionality and, consequently, to healthy aging [25][26]. In this way, several authors indicate that programs focused on promoting solidarity between generations present benefits for younger and older adults, obtaining gains from this experience [13][20]. Even so, comparing the results from intergenerational relationships perceived by institutionalized older adults [24][25][27][28][29] and older adults people residing in the community [26][31], it was possible to verify differences. Generally, both groups point to positive points such as satisfaction, affective bonds and feeling of reward. However, the older adults residing in the community still need to set boundaries, stating that, despite finding it exhausting to take care of children, they feel a moral obligation to take care of their grandchildren as a matter of family support.
This reality highlights the impact they can have in different areas, particularly in the mental health area, and the gains that can result from this at a motor, cultural and emotional level, reinforcing the added value of their implementation. In the daily clinical practice of nurses.
According to the results of all the studies analyzed, these gains are positively reflected in older adults at a cognitive level, changes in mood and vitality, as well as self-concept, in their autonomy, their social image of old age, as well as having a preventive action within the scope of isolation, through the social inclusion of the older adults, promotion of physical and mental well-being and respect for the younger generations, fostering both linguistic and digital learning [24][25][26][27][28][29][30][31] In children, the gains will be reflected in their social behavior, avoiding antisocial behavior and the valuation of the aging process, as well as a greater acceptance of im-age alteration and demystification of old age, thus reducing stereotypes and derogatory comments [24][25][26][27][28][29][30][31]. These practices influence their values and cultural learning, thus promoting a better adaptation to the contexts of personal and professional life in their future [29][30], an idea shared by other studies [6][21][33][34].
Thus, including older adults in this panorama of joint and cooperative activities allows them to obtain benefits related to psychological factors of elementary importance, such as self-esteem and emotional well-being. It also allows them to promote their quality of life, receive social benefits and oppose social paradigms associated with their capabilities [25]. As an example, the implementation of the horticultural program, as can be seen in the results mentioned above, proved to be a significant social factor, as it integrates older adults and contradicts a paradigm of disability associated with them, thus acting as a promoter of social inclusion [25]. This way, one begins to simultaneously minimize loneliness and isolation, which are very much associated with the older adult population, serving as a stimulus to the possibility of having active aging [4][11].

This entry is adapted from the peer-reviewed paper 10.3390/nursrep12040081

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