S TRATEGIES FOR I NTERGENERATIONAL H EALTHY L IVING : I DEAS TO P ROMOTE THE H EALTH AND W ELLNESS...

STRATEGIES FOR INTERGENERATIONAL HEALTHY LIVING:IDEAS TO PROMOTE THE HEALTH AND WELLNESS OF

RELATIVE CAREGIVER FAMILIES

Matt Kaplan, Ph.D., ProfessorIntergenerational Programs & Aging

Penn State University

2014 Brookdale National RAPP Training Conference (Denver, Colorado)Saturday, October 18, 2014 [3:15PM – 4:30PM]

My goal today:

For each of you to leave with at least 2 new intergenerational healthy living activity ideas

In search of “health”

• Change individual behavior• Change family behavior

– Improve family communication dynamics• Change the way families communication about healthy

lifestyle activities (including food and physical activities)

– Strengthen family relationships– Learn about healthy living (together)– Plan to improve health (together)

• Come up with a shared agenda (find “common ground”)

Changing individual behavior

• Eat healthier foods• Exercise and other active lifestyle behaviors

Maintaining Fitness

• How many of you exercise?• How many of you participate in a formal

exercise program?• How many of you are as diligent as you

would like to be in following your exercise plans and programs?

Integrating exercise into one’s life

• Not thinking about exercise as exercise.• Make exercise part of what and who we are...

– as part of our family life.– as part of our community life.

• Don’t underestimate the power of social influence.

“Stealth Exercise”

Sharing “our moves” with others

The “Walk about-Talk About” Activity

Sharing our cultural heritage

Ikuseikai (Japan) – Families banding together for cultural arts projects.

Story of local hundred-year old trees (and the personal memories they evoke)

Taiwan

“Grandparents University”Example of an intergenerational approach

for lifelong learning

From: University of Wisconsin.

Changing family behavior

• Communicate • Learn (together)• Make plans (together)• Change behavior (together)

The Surgeon General’s Family Health History initiative

• National Family History Day (on Thanksgiving, as of 2004)

• When families gather, members talk about and write down the health problems that seem to run in their family.

• Using My Family Health Portrait families can:– Enter their family health history.– Print their family health history to share with family or your health care worker.– Save their family health history and update it over time.

[http://www.hhs.gov/familyhistory/]

Family Struggles Related to Healthy Eating

Food choices“He doesn’t like trying things. I don’t know how many times he’ll just sit there. Oh my gosh, it’s like asking for his right arm just to try something. Just try it. It’s good, try it. (Parent)

Food portions“It’s not so much having the cereal, it’s how much you eat. I think it would be fine if he had cereal. Because I think he needs a snack when he gets home from school. But, it’s the amount that he’s having…And it fills you up and you don’t want dinner.” (Parent)

Family Struggles with Communication

• Ineffective communication“Sometimes I’m to the point of crying because I think I’m doing all the right stuff and it’s still not the right stuff.” (Parent)

• Disengagement from communication“When there’s a disagreement…they’ll go to Grandma’s to eat.” (Parent)

FRIDGE [Food-Related Intergenerational Discussion Group Experiences]

An Intergenerational Nutrition Education curriculum

Making communication about food easier, more fun, and more effective for family members of all ages.

A mono-generational framework

– Reaches only part of family– Outside of family context

Nutrition Information

– Delivers information to entire family– No guarantee that family will discuss/ use/ or otherwise act upon this information

Nutrition Information

A multi-generational framework

An intergenerational framework for nutrition education

• Facilitates family interaction (involves children, parents and grandparents)

• Joint opportunities to learn, discuss, and act upon same health and nutrition information

Some FRIDGE activities:

• The Think You Know Me?” game (similar to the “Newlywed Game”)

• R.E.C.I.P.E. for Good Communication • Coolish or Foolish – talking about peer pressure and food choices• Food Fight!! – Role Reversal• Dietary Knowledge Timeline: • Back to the Future: Food Time Capsule• Baking Now and Then (comparing recipes and cookbooks)

• “Dinnertime” poem – What does it mean to eat together?

• Out with the Unhealthy and In with the Healthy• “Take Out” activities:

– A Family Food Contract– The Family Meeting

The “Think You Know Me?” activity

• Similar to the Newlywed Game• Small group: Team child and grandparent

– Parent goes to different room, or a corner, to answer questions about their parent and their child printed on a sheet, as well as questions about herself.

– Grandparent and child team up to answer questions about their child/ mother, as well as questions about themselves.

Questions

Child/Grandparent : What is your parent/ child’s

favorite food? When your parent/child goes

food shopping does he/she use a list?

Does your parent/child use the oven or the microwave?

What is your parent/child’s favorite eating location (in front of TV, at table, at computer)?

Parent: What is you favorite food? When you go food shopping

do you use a list? Do you prefer to use the

oven or the microwave? What is your favorite eating

location (in front of TV, at table, at computer)?

The R.E.C.I.P.E. for Good Communication

• R Reflective Listening• E Encouragement• C Compromise & Cooperation• I “I” messages• P Practice• E Engagement

Hands-on activity

Role reversal activity (“Food Fight”)

Role Playing Scenarios for the FOOD FIGHT!

A Role Reversal activity• Scenario #1: A caregiver is disappointed when a

planned family meal falls apart. It turns out that the child ate pizza following afterschool activities and has no appetite for the family dinner. The child loves pizza and complains that there are too many foods he hates to eat at home. “Why can’t we have more pizza at home?”

• Scenario #2: Mom is concerned because her daughter always misses breakfast.

• Scenario #3: Child is frustrated that his grandparent (her primary caregiver) rarely purchases vegetables and fruits.

History of USDA’s Food Guidance

1940s

1950s-1960s

1970s

1992

2005

Food for Young

Children

1916

2010

Discussion points

• Encourage families to share their memories of dietary habits and knowledge during their childhood

• Note different emphases placed on different foods depending on the time period.

• Consider how these differences impact individual food related beliefs, and food preparation methods and recipes.

“Dinnertime” – What Does it Mean to Eat Together?

• Read the “Dinnertime poem.”

• Create your own…

Dinnertime poem— by Mary Ann Hoberman

• David asks for his dessertPeggy wants to press her

skirt• She has dance class and she’s late

David says he cannot wait• Mike is giving him a ride

he’ll just go and wait outside• Father tells him he will not

David mutters thanks a lot• Ann says she expects a call

Benjamin won’t eat at all• Mother starts to serve the pie

Benjamin begins to cry• Mother asks him what is wrong

Father says the tea’s too strong• Ann gets up to get the phone

Benjamin begins to moan

• Peggy says her tights are tornDavid says he hears a horn

• Father says to finish firstDavid says that he will burst

• Peggy says it isn’t fairAnn has on her other pair

• now she will be late for classBenjamin upsets his glass

• David’s taking tiny bitesAnn is taking off the tights

• David says the crust is toughMother says she’s had enough

• Father says it’s not too badMother says she’s going mad

• David wiggles like a mouse that is dinner at our house

Dinnertime: Hands-on activity

• Working with 1-2 people who are next to you, create a “Dinnertime” poem that captures your (shared) vision for the “ideal” dinnertime situation or encounter.

“Out with the Unhealthy and In with the Healthy”

• Have each family create an “Out with the ‘Unhealthy’” and “In with the ‘Healthy’” wardrobe of food items and behaviors.

Quotes from Participants

• “I realized that my daughter and I don’t share the same views on food and we are working on that” – Mother

• “ (What I liked most was) coming together as a family and discussing our recipe plans” – 12 year old girl

• “This helped families realize how little they knew about each other….They (parents) are assuming that they know what the kids want, and kids are assuming that parents know what they want….” – Program Facilitator

The latest news about FRIDGE:Conducted as a farm-based, weekend retreat

Taking advantage of the farm-food connection

What else we learned

Need to get the age group right. Activities need to be age- and ability-appropriate.

FRIDGE is not just about food:It can also be used to support families in transition,

e.g., relative caregiver families

Implications for working with parents and other relatives in caregiving roles

Support for:• being less rigid/authoritarian with children• Increased child involvement (re: food selection

and preparation) for better “buy-in”• More emphasis on teamwork (from an early age)

Family Communication Dynamics: Focus on Parenting Styles

• Authoritarian – high control/low nurture (most common)“I’m in charge. It’s pretty much what I say. During the week, it is whatever I cook.” (Parent)

• Authoritative“My mom says if I cook breakfast that I can pick out the stuff I want to cook. If they want eggs, I’ll choose the kind of eggs I want.” (Child)

•Other Parenting StylesoNeglectingoIndulging

(Baumrind, 1968, 1971)

How would you characterize the parenting style/strategy for the following family?

An eleven year old boy and his grandmother (primary caregiver) talk openly about how their family makes decisions about food:

Child: “Usually, my grandma and me just sit down and make a list of the things we’re going to make, like apple pie or mashed potatoes or something. And then we just go to the store and get the stuff that we’re going to make and then we just make it.”

Grandmother: “I started when they were little. You know, it’s something that we prepare the meals together. And there are sometimes that they like to do that. I was laid up last year, I had surgery and my back was out, and I could not do anything. And they just took over everything. They did the cooking. I was really surprised. I knew they could cook, but I didn’t think they could do it on their own without me being there. But they could.”

Focus on Level of Child Involvement and Empowerment

Another paradigm for examining the role of family dynamics when making decisions about food.

Child takes contro

l

Child is

full partn

er

Child is

limited partne

r

Child is Consult

ed

Child is

informed

Child is not inform

ed

Changing the Environment

• The environment as a health issue– Need for non-toxic, non-isolating, non-sedentary,

and (healthy) foods-rich settings. – Application of smart growth principles are also

good for health (e.g., walking and bike paths)

Don’t forget about the Virtual Environment?

Q & A

The Penn State Intergenerational Program

Contact Information:

Matt Kaplan, Ph.D., ProfessorIntergenerational Programs and AgingDept. of Agricultural Economics, Sociology and Education

The Pennsylvania State University7A Ferguson BuildingUniversity Park, PA 16802Phone: (814) 863-7871, Fax: (814) 863-4753E-Mail: msk15@psu.eduWeb: http://intergenerational.cas.psu.edu