The concept is founded upon the idea of mixing families with young children and the elderly in social activities to cultivate a better understanding of each other
Story & Pics By AZREEN HANI
THE three-storey building on a street in Edogawa, located at the east side of Tokyo, may look like a normal establishment.
The signboard on the building reads Kotoen. Apparently, it is a community-based integrated care centre for children and the elderly.
Step into the main hall of the building at any opportune morning and you’d be greeted by the sound of children and older people going through their morning exercise routines.
As the children wiggle to get their moves right, the elderly group who sit centre stage, would cheer the children to not give up.
“How are you feeling today, grandparents?” the kids greet them in unison. “We are healthy and happy to see you,” the elderly respond, beaming with smiles. The morning exercise is one of the normal scenes in Kotoen.
It’s rather interesting, if not heartwarming, to see the two generations — with six decades separating them — socialise together.
Later in the day, they would have meals and play indoor games, while some of the elderly volunteers would look after the kids with an assigned staff.
“Every Monday morning, the elderlies wait at the front gate to greet the kids who may be grumpy and cranky after the weekend,” Kotoen CEO Keiko Sugi told The Malaysian Reserve in a recent meeting.
“That’s how these kids ease into their daily routine here. This will be followed by exercises and meals together,” she added. Merging both child and elderly care is a foreign concept in most parts of the world — including Malaysia — but the social welfare corporation has been running it for 32 years now, promoting intergenerational living for the young and old.
In fact, Kotoen could be a pioneer of intergenerational concept in Japan since the programme’s introduction in 1987.
Intergenerational living is a concept that is founded upon the idea of mixing families with young children and the elderly in social activities to cultivate and enhance a better understanding of each other. It is akin to having a family that houses both grandparents and grandkids under one roof. In some countries, this concept is also described as multigenerational living.
Over the years, countries such as the US, the UK, Denmark and recently Australia have also adopted the concept.
An Australian TV programme called “Old People’s Home for 4-Year-Olds” aired this year, proved to be a hit among viewers, resulting in community leaders, politicians, and experts initiating works to create more intergenerational-based programmes in the country.
According to Sugi, when Kotoen was established in 1962, it was meant only for the elderly, but has since expanded its services to cater to young kids when a nursery was built alongside Kotoen in 1976. “We had since shared joint events or celebrations to get these two age groups together.
However, we could not integrate both services in the past due to government’s policies.
“We took the chance to merge in 1987 after a change of policy which enabled us to combine all of our services under one roof,” Sugi added.
She “inherited” Kotoen from founder Shimada Masaharu, who is also her father.
Masaharu, she said, has always been a proponent of the inclusive society.
For Sugi, despite being a CEO, she remains firm to the role she feels most passionate about: A caregiver.
According to her staff, it is hard to find Sugi in her office. She would mostly be meeting and talking to the staff, residents and healthcare providers, partly because of her job, but mostly, she is driven by her nature to connect with others.
Apart from running Kotoen, Sugi opened another care facility — Tsubaki centre — also in Edogawa, focusing on daycare services for the mentally challenged. She roped in her husband and twin sons to assist in managing both facilities.
Both facilities operate as nursing homes providing assisted care facilities and daycare for the elderly, children and mentally challenged individuals.
Sugi has 250 staff to manage and look after 138 children and 100 adults at both facilities.
They have nurses living in Kotoen and medical doctors who conduct check-ups daily.
Why the Intergenerational Concept?
“Why not?” was Sugi’s initial response.
“We aim to have a happier, discrimination- free society and by bridging the generation gap together, we believe we can achieve that,” she added.
Ultimately, Sugi stressed that Kotoen is all about creating an inclusive society where all people, regardless of age and abilities, find life’s happiness together.
“We need to have more interactions between people of different age groups. Only then we can understand and remove any bias, stereotypes or misperceptions that we might have on one another,” she explained.
More families in Japan have shifted from being multifamily-oriented into a nuclear family ever since the economic boom in the 1970s.
With the rising cost of living and other pressures, it is almost impossible for working adults to keep more than a family under one roof.
“At the same time, this has indirectly isolated the old. We are now facing various social issues, including social withdrawal problems by older people and abuse cases between the young and old. We want to play our part and try to address all these with our own expertise. That is why we strongly feel intergenerational is key,” she explained.
She may not be wrong.
Various studies have shown that intergenerational interactions have proven to reduce the risk of depression and dementia among the elderly, as well as reduce the stigma associated with ageing and discrimination against older individuals.
A study by Stanford University in 2014 revealed that ageing adults are one of the best groups to spend time with young children.
On top of imparting life’s wisdom upon them, the elderly are able and have the patience to provide the kind of guidance that young children need to progress.
“Findings from this systematic review indicate that intergenerational programmes are appropriate and effective for older adults, including people with dementia,” the study revealed.
“They have the potential to nurture a sense of being useful to society (such as the feeling that older people are able to guide and positively influence future generations), to improve the wellbeing of older adults, but also to reduce the stigma associated with ageing and discrimination against older adults,” it added.
Sugi too, has written extensively on intergenerational living, to create awareness and promote the benefits of such concept in Japan, as the country is facing the ageing population problem.
“I could not say whether we are the first to start this. But we know the numbers of intergenerational facilities are increasing by the day. We often have visitors from non-profit organisations, municipalities and government officials seeking to learn about our programmes here,” she said.
According to reports, there are 16 similar centres established in Japan in recent years.
A Sense of Purpose
For 76-year-old Akiko, enrolling herself into Kotoen has been one of her best life’s decisions.
Widowed at 65 with two kids, she said that communicating with the children and being able to gather with friends of similar age help ease her loneliness.
“I love it here,” she said. “As you can see, the kids are such joy to be with,” Akiko paused, before adding sheepishly, “…Even when I am not always fun to be around”.
Akiko, who hails from Niigata, could no longer walk after a knee surgery in 2011.
Fearing she would be burdensome to her family, she took a train ride to Kotoen alone, leaving a farewell note to her children.
“I only told them I would be here for a few days. I am healthy. I do not have to worry about having to look after myself,” she said with a laugh.
“I have meals provided for. I can take hot baths two to three times a week and I have made some friends too.”
Akiko also said despite not being able to volunteer to care for the children, Kotoen has monthly activities such as festive celebrations and public-speaking day, to keep both adults and children busy.
“Seeing these children grow right before my eyes, it gives me a sense of purpose, I guess. I look forward to seeing them every day,” she added.
Apart from seasonal activity programmes, Kotoen’s system also includes daily activities where only elderly women are in charge of changing diapers or tending to young children.
“The volunteers are very helpful. Some feel needed and that encourages them to contribute more,” Sugi said.
Sugi said the fact that both care centres are housed together it does not mean the children would be with the elderly all the time as the adults need their rest too.
When one of the residents dies, Kotoen would hold a special commemorative ceremony for the departed, attended by family members and the children, including those who have graduated from the nursery.
Rewards and Challenges
Like many other care centres in Japan, Sugi said the main challenge for Kotoen would be the shortage of social workers.
She acknowledged that in most cases, the job package in the sector is not as attractive as others.
“Also, it requires patience, utmost commitment and long hours. It’s not for everyone, but we must start somewhere. Soon, we will have more older adults (in Japan), that is why we need to educate the young about it,” she said.
Sugi said while the government has been working towards introducing artificial intelligence (AI) and robots to care for the elderly, she believes human touch would still be vital.
“I think having robots and AI is good, but they should be complementary to human interaction,” she said.
Kotoen has also embarked on community programmes that provide residential elderly and vulnerable people in the society with care plans to ensure they have a good quality of life at home.
In April 2018, Kotoen launched a project called Nagomi no Ie, Mizue (a house where heart warms) that serves mainly as a community centre.
The centre has social workers and public nurses ever ready to assist visitors with consultations and counselling. Kotoen also provides meals as it aims to reach out to poverty-stricken children and the elderly.
Still, for Sugi, nothing beats knowing that some of the children, who have long left the nursery, would return to Kotoen to work as caregivers and nursery school teachers.
“We were quite surprised at first. But some of them (children) worked really hard to get their accreditation (as social workers) because they want to give back to society,” she said.
“I have been told that people can tell the difference whether a child has been with us or not, because of how they treat their grandparents.
“I think that is the most humbling and rewarding part of all this,” she added.