key: cord-1047693-g8gdt968
authors: Tan, Li Feng; Tee, Louis Yun Shou; Seetharaman, Santhosh Kumar
title: Virtual Intergenerational Therapy: New Platforms for Engagement of Older Adults During The COVID-19 Crisis.
date: 2020-09-19
journal: Am J Geriatr Psychiatry
DOI: 10.1016/j.jagp.2020.09.012
sha: cb88577b3c5c417c1e5a90edd42131cee562d731
doc_id: 1047693
cord_uid: g8gdt968

nan

We declare no conflicts of interest.

No funding was received for this manuscript.

To the Editor:

Intergenerational programs have been shown to bring benefits to all groups involved and have been implemented internationally (1) . Activities implemented during intergenerational sessions are highly varied and involve diverse groups from children (2), volunteers(3) to college students. Kindergartens and childcare centers have been co-located(4) in the same building to facilitate intergenerational interactions and activities.

The coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented public health measures being implemented such as the restriction of gatherings and closure of elder care facilities. Social distancing has led to social isolation with many older adults experiencing higher levels of depression, anxiety, poor sleep and functional decline during this period of social isolation (5) .

Despite the challenges, this 'new normal' is an opportunity for programs to innovate. Virtual and tele-delivered programs (6) have been shown to be effective in alleviating social isolation and mood symptoms (7) . Due to social distancing measures, the intergenerational program run at our geriatric center which is part of a tertiary public hospital in Singapore had to cease.

Before the pandemic, there was a weekly intergenerational program for older adults admitted to our geriatric ward. Patients who consented to participate and were assessed to be suitable by the healthcare team are selected for this weekly program. The program is run by a multidisciplinary team together with the childcare teachers and administration. The 1 hour program usually starts off with an ice breaker for participants to warm up to each other. This is followed by a structured activity that is curated on a weekly basis by the healthcare team and childcare teachers. The activities are planned to ensure suitability for older adults and to meet the teaching curriculum and goals of the childcare. These activities include craftwork, simple games, music and movement and reading. to be selected to participate in this program. The similarities and differences between the two platforms are summarized in Table 1 .

There are however benefits to holding intergenerational activities on a virtual platform. These include being able to engage more participants per session. Previously the program was limited to one ward due to manpower and resource constraints. With a digital platform, multiple wards can be engaged at the same time and without the fear of cross-infection especially with the current COVID-19 pandemic. Co-location of centers is also not necessary with a virtual platform and the program has been expanded to engage children and youth from other places such as schools and volunteer groups. This allows programs catering to older adults to expand their network and pool of volunteers and activities. Apart from interactions with children, our program has expanded to include leisure music classes, musical and arts performances and even virtual tours of various landmarks around the country.

Virtual intergenerational therapy has benefits and limitations. Virtual programs will never be able to fully replicate in-person sessions that have physical touch that enables older adults with cognitive, visual or functional impairments to be engaged. Nevertheless, in the present 'new normal', it is likely that technology will be an enabler for more of such programs to continue which would otherwise be halted due to social distancing measures. Moreover, innovation during a pandemic can allow for the benefits of such programs to reach an even wider audience.  Program has potential to be scaled up readily. Able to reach more wards and groups and more rural or remote areas. Table 1 . Differences and similarities between in-person and virtual platforms for intergenerational programs

The impact of intergenerational programs on children and older adults: a review

Interactive programs with preschool children bring smiles and conversation to older adults: time-sampling study

Intergenerational service learning: to promote active aging, and occupational therapy gerontology practice

Multiple impacts of an intergenerational program in Japan: Evidence from the Research on Productivity through Intergenerational Sympathy Project

COVID-19 and the consequences of isolating the elderly

Improving Social Connectedness for Homebound Older Adults: Randomized Controlled Trial of Tele-Delivered Behavioral Activation Versus Tele-Delivered Friendly Visits

Using Skype to Beat the Blues: Longitudinal Data from a National Representative Sample

The authors have no conflicts of interest to declare.No funding was received for this manuscript