Forty-four Ways Kids Can Engage a Person with Dementia

Elderly dementia patients have a lot in common with children. They can’t always meet all of their own needs. They don’t always get social cues. All they want is time and attention. They need social interaction, but have trouble connecting in a mature way. Often times, the guileless and accepting demeanor of a child is less threatening, and opens the door for a personal connection where adults are shut out.

But it is unreasonable to expect either a child or dementia sufferer to be skilled at beginning a friendship or even a conversation. So here are some engaging activities to aid in beginning a friendship that will be beneficial to both.


It’s important to find the right activity – try to choose something that will engage the interest of both parties and also accounts for their cognitive ability. Board games are one way to connect, and for those (young and old) who are not able to read, there are plenty that do not require reading and still offer a challenge for any age. Try Sequence for Kids, Hi Ho Cheerio, Cooties, Chutes and Ladders, Hoot Owl Hoot, or Busytown. Puzzles of all challenge levels are also a fun activity that both parties can enjoy and participate in.

Physical play is also a good endeavor. For those too advanced to join in, just watching children at play can be engaging and enjoyable. For those with a bit more agility, playing catch, shooting hoops, swinging, going for a nature walk, and dancing are great activities to bond over.


Arts and crafts can be fun for anyone, regardless of skill level, and it can strengthen fine motor skills as well (kids and the elderly need to work to keep those muscles agile). Drawing, coloring, painting, knitting, working with modelling clay, stringing beads, and painting can be done either side by side or together. Finger painting is a great sensory experience for those in more advanced stages of dementia and for very young children. Creating a memory box is a nice way for the pair to reminisce and enjoy connecting as well. Completing a craft together can give both kids and adults a sense of accomplishment, promote socialization, and teach a skill.


Both listening to music and making their own can engage dementia patients and children. They can share their favorites, listen to pieces from their respective eras, play a tune if they have the skill, or just enjoy making noise together (a great way to interact with toddlers if neither partner is irritated by loud sounds). Music also has the ability to reach dementia patients in a way words cannot, especially as the disease progresses – a nice bonus.

Brain Building

Trading stories, doing puzzles like crosswords and Sudoku, trivia, reading the paper and discussing the news…all are great ways to engage people and start a conversation. Take cognitive ability into account, and make sure the younger conversationalist has the maturity to handle whatever confusion or lapses dementia may lead to.  Even learning a new skill can help the pair connect, and that can go in both directions. Children and adults each bring value and skills to the friendship and sharing them is good relationship and brain building.

Help Out

Helping others makes people feel good. Sometimes it’s easy to overlook that a person suffering from dementia still needs to feel valuable and needed. It is also beneficial for children to participate in helping out and to see that at all stages of life people have something to give. Working together to accomplish something meaningful adds a deeper level to the relationship between two people, no matter the age. What they can do will vary depending on age, cognitive and physical ability, and the situation. Some ideas include folding laundry, preparing a meal (or helping a caregiver to do so), organizing toys, watering plants, and taking care of pets.

Having a child (of an appropriate age and maturity) help a person with grooming can be a great bonding experience as well. Simple tasks like brushing and styling hair, painting nails, applying makeup, tying shoes, or doing up buttons on a sweater can make the child feel very needed and it might feel more loving for the person in need of help. Do be certain both parties are comfortable with such close contact, and I would certainly not recommend having a child help with more personal bathing and toileting tasks.

If all else fails, a simple hug or holding hands can be a beneficial experience for a person with dementia. Physical contact is a comfort in many cases.

Every situation is unique, but remember to let each partner participate in activities as they are able and comfortable. Sometimes another functional adult will be needed to guide undertakings and sometimes the child and dementia patient can accomplish things with less supervision. And, of course, consider the safety of both the child and the adult. It can also be helpful to have some conversations with the child beforehand to ease fears and surprises related to the symptoms of dementia. Dementia steals away a person’s memories and social skills, but not their need for people and relationships. Children have a special charm that can break down personal barriers and possibly allow for a meaningful and caring relationship. For those suffering from dementia, that is life changing.

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Three Things You Didn’t Know Were Making You Fat



Does it ever seem like the scale must be wrong? Like no matter how hard you diet and exercise, your weight just keeps creeping up? Here’s a few things you might be falling victim to, without even realizing there’s a problem.


Sleep Deprivation

Unless all those extra hours are spent working out, sleep deprived people burn about the same calories as people getting enough rest. But they eat more – about 300 calories every day. Aside from having more time in the day to snack, the hormones that drive eating and tell the body to stop are off balance when tired. Studies have found that the sleep deprived have more of the “eat” hormone, and less of the “stop” hormone than rested people. Also, tired people have decreased impulse control and poorer higher-level thinking, leading to more comfort food choices than healthy ones. All this is to say we make unhealthy food choices (and more of them) when we are tired.


Next time you feel peckish, try a glass of water instead of food. This is not just to fill your empty belly; it could be that you are really thirsty instead of hungry. When cells are dehydrated they don’t get enough energy and so they send out signals for more, which the brain can interpret as hunger. Also, a thirsty body has trouble burning fat, so instead of getting that energy by using fat stores, it sends the brain signals to eat more. One study found that metabolic rates increased by 30% after drinking 2 cups of water. A thirsty body has a slower metabolism (using less of what we eat), has trouble burning fat, and is hungrier than one that is well hydrated.


Yes, obviously too much sugar can lead to extra pounds, but the situation is worse than you’d think. Human bodies love sugar, especially our brains. Eat too much and the brain starts to really like it, to the point where you need more and more to feel good, and go through withdrawal when you cut back. Not only that, but eating too much sugar is actually worse than eating too much fat. The problem with fat is that it’s dense – a little fat has more calories than the same amount ofsugar – and it’s easy to think that makes it worse. However, the difficulty is in how we process it. Human bodies are not designed for the 140 pounds of sugar the average person eats each year. All kinds of so-called healthy foods have added sugar – yogurt, cereals, granola bars, peanut butter, flavored waters, and on and on! But there’s no nutritional value to it, just extra calories. The liver processes all that sugar and turns it into low density lipoprotein particles – the kind of cholesterol that leads to blocked arteries and heart attacks. Fats, especially the right kinds, don’t contribute to high cholesterol nearly as much as excessive sugar. 

Sleep well, drink plenty, and check labels for added sugar and you may find the battle of the bulge tipping a bit more in your favor!

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(Cos)Playing in Retirement

Cosplay, or costume play, has been around for a long time, and not just on Halloween. Dressing up as a beloved character and acting out a role is more than wish fulfillment, it’s fun! For the longest time main stream society has relegated role playing to child’s play and a few special occasions, but with the recent trendiness of “geek culture” cosplay has become more common. So much so that even senior citizens are getting in the act.

Cosplay allows people to step outside their everyday lives, to shed inhibitions and be someone else for a time. For seniors who have spent their whole lives playing out the more mundane roles of worker, parent, or retiree, it is like a respite from themselves. Anyone can enjoy such a respite no matter their age, but it is particularly joyful to see the elderly continuing to branch out and enjoy life, rather than staying in the ruts that got them so far along on their journey.

Checkout some of the awesome styles these seniors have jumped into for a little role playing fun!

Grandma is fast as lightning.


Their hearts will go on.









She knows what you’ve been thinking.






Got spinach?









Darth Nana

He found the right castle.




Wait a minute…


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Are You Stressed Enough to Develop Dementia?

It’s no surprise that chronic stress is bad for you. It leads to a variety of physical ailments including indigestion, insomnia, and high blood pressure. Evidence also shows that chronic stress damages the hippocampus, a region of the brain where memory and learning are primary functions. And studies are finding a correlation between high levels of ongoing stress, like in PTSD sufferers, and development of Alzheimer’s later in life. So could it be that a stressful lifestyle increases a person’s risk for dementia?

Stress is the way we feel when something is off balance, either physically or mentally; it drives us to correct the balance and live healthier lives. It is necessary to survival, spurring us to do what is needed. It gets us moving a little quicker in dangerous situations by sending a surge of energy in the form of adrenaline. In our caveman days it kept us alert around predators, and now stress pushes us to do what needs doing in order to get by. You may not want to get up and go to work, but you need your income so you can live. Crying babies induce stress in everyone; it’s a built in response to ensure the species survives, even at 3 a.m.

But too much stress – too much imbalance – is harder to recover from and can cause permanent damage. Post-traumatic stress disorder (PTSD) occurs when the brain cannot regain its balance and the traumatic experience continues to bring stress into a person’s life. Veterans experience this in spades. Researchers have studied instances of dementia in elderly veterans and found that those with PTSD are as much as 77% more likely to have dementia.

Study of Alzheimer’s patients has found increased levels of the stress-related hormone cortisol in the bloodstream, the amount of cortisol directly related to the progression of the disease. Cells treated with excesses of cortisol have been found to produce the two proteins known to interrupt proper brain function and lead to dementia. While the connection between stress and dementia is there, prevention and a cure have not been found. Will living a more relaxed and balanced life improve your health? Definitely. Will it keep you safe from dementia? Not entirely. However, avoiding chronic stress and getting treatment for conditions like PTSD does reduce your risk for developing dementia as you age.

So how stressful is your day to day lifestyle?

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Senior Care Exposed: Sunrise Home Care Services

Inspection reports offer a glimpse into the care a prospective resident can expect to receive in a given community. Sometimes, violations are easily fixed and don’t necessarily indicate a dearth of caregiving. Other times, a particularly disturbing picture is painted by the reports, reinforcing the need for thorough research before moving into a facility. Here are some of the incidents we discovered from one of the yearly inspections at Sunrise Home Care Services in Florida.


Dining room tables are set with paper and plastic products instead of china and silverware; this is the case for every meal. Residents are not given forks and knives at all, and were observed pulling chicken off the bone with plastic spoons or their fingers. Residents were not offered a choice of meals or drinks; everyone was served the same thing and was not offered other options even though some stated that they did not like or want the meal. Fruits and vegetables are always canned; it is very rare to have fresh produce offered. At snack time staff was observed passing out two foods – a pop tart or bread with peanut butter – and no one was asked their preference. Residents were handed one of the two items without the opportunity to choose. The supervisor stated there are other options for meals (canned ravioli, peanut butter and jelly sandwiches, or canned soup), but residents interviewed were not aware they could get something different. The menu is posted in a location inaccessible to residents.

There is not always enough food prepared to satisfy residents. Those asking for seconds were not always able to get more food, especially of the main dish prepared. Butter or margarine is not provided; residents eat bread dry. The supervisor claimed this is for the health of residents. Salt and pepper is also not provided. Residents complained of getting hungry before the next meal and some were noted as losing weight, though they were not on a documented weight loss plan.


  • Facility administrator failed to provide regular meals which meet the needs of residents.
  • Facility failed to meet recommended dietary allowances by failing to allow for a variety of foods adapted to the food habits, preferences, and physical abilities of residents.


Residents clear their own tables by bringing dirty dishes to the same counter where food is distributed. Second helpings are also provided at this counter when available, and staff was observed both handling dirty dishes and serving food without changing gloves. In the kitchen dishes are washed with a bleach solution, but the water temperature and the amount of bleach in the water are not measured for sanitation.


  • Facility administrator failed to be responsible for total food services and the day to day supervision of food service staff.
  • Facility administrator failed to ensure staff performed duties in a safe and sanitary manner.


Residents are often called “baby” and “honey” instead of by name. In one observed instance, a staff member was heard encouraging a resident to go use the potty and to have her diaper changed. This was done in the dining area in hearing range of every other resident at supper.


  • Facility failed to ensure residents are treated with respect and with due recognition of personal dignity and individuality.


Several residents are owed money from an incident in their previous facility. The facility administrator says he has had their checks “maybe a couple of months;” the residents have not received their money.  The administrator also processes residents’ social security checks, giving residents a portion of their money each month. The administrator was not able to produce documentation of payments or receipts from residents who had received their money.

Some residents do not have residency agreements in place.


  • Residents have the right to manage their financial affairs unless otherwise authorized.
  • Facility failed to maintain written business records using generally accepted accounting principles which accurately reflect income from residents.
  • Facility failed to ensure that prior to or at the time of admission each resident executed a contract with the facility.


Many incidences of unsanitary and unsafe conditions are noted in the report. Furniture is indicated as worn, torn, and dirty. Bathrooms are not well supplied with towels and soap. A toilet seat is noted with a “dark substance” around the rim, and another toilet was left with feces in the bowl. One room smelled of urine and the supervisor stated that the resident is incontinent and it is hard to get the smell out of the bed. A musty/moldy smell was noted in the facility.

Floor tiles are observed to be in disrepair. Residents share adjoining bathrooms and apartment spaces; it is noted that residents of the opposite sex are able to unlock doors in their rooms and bathrooms to access each other’s rooms. Lighting does not work in all areas and exposed wires hang from the ceiling. One exit door was found to be jammed shut.

The inspector found many areas of the facility to be in general disorder, disrepair, and unpleasant condition.


  • Facility failed to ensure every resident had a safe and decent living environment.
  • Facility failed to provide a safe, clean, and hazard free environment for residents.

These egregious violations seriously bring into question the safety and well-being of residents. Reports like these reinforce the need for prospective residents to check inspection records and make a few surprise visits at a facility before choosing an assisted living community to call home.

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Dementia Day Care…At Night

Alzheimer’s sufferers don’t live by the clock the way their caregivers do. Many times they are active for hours at a time when the rest of the family wants (and needs) to be asleep. Caregivers have to be up with them, leading to exhaustion, added stress, and reduced personal capacity due to lack of sleep. In the long run this has ill effects on health. Too many high functioning patients move into nursing homes or assisted living facilities because of the inability for caregivers to function without a decent amount of sleep.

The Hebrew Home at Riverdale offers a unique solution to this problem; one that could benefit millions of Alzheimer’s patients and their caregivers if it caught on nationwide. The program has all the advantages of daytime care, but with the added bonus of operating at night. From 7 p.m. to 7 a.m. patients spend their most active hours singing, dancing, socializing, and participating in a variety of engaging activities. They are given the freedom to sleep as needed, or they may just while away the night engaging in fun, healthful activities. This is a far better experience than sitting in front of the TV or enduring a frazzled caregiver. It is a safe, engaging environment that benefits the health and mental state of participants.

The program is also extremely beneficial for caregivers, who can get a good night’s sleep and wake up truly refreshed, ready to take on the daytime challenges of caregiving. As an added bonus, participants are often returned home tired and fulfilled from an active night, making their daytimes much more pleasant and relaxed.

Hebrew Home has reaped the benefits of the program since 1998. A space that would otherwise be empty at night (the recreational areas of an assisted living community, where residents are all asleep) instead generates revenue. The biggest drawback, as with many health care solutions, is cost. Private payers are charged $215 per night (around $6500 for a month), which is far more expensive than the typical middle class family can afford. Most current participants are enrolled through Medicaid, but qualifying for Medicaid requires losing most everything a person has.

This is currently the only program of its kind nationwide, but it has the potential to spread like wildfire. It is a win-win-win situation. The Hebrew Home adds to their revenue stream. Patients benefit from the expertise of professionals, activities designed for their mental needs, and therapies built to soothe agitated sufferers. Caregivers get sleep – need I say more? The only question left is why aren’t there more of these program springing up around the world?

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Why Stop Playing?

Kids love going to the park. Running, climbing, hanging, swinging – it’s an irresistible sort of fun and it’s healthy too. All the different types of movement develop stronger muscles and bones without the dreariness of an exercise routine. Not to mention, there are other kids to play with. Parks are physically, mentally, and socially beneficial. So why do we ever stop going?

Primarily, parks are designed for little bodies. After a certain height, it’s tough to climb through the little portals and an adult weight might not be as well supported on the climbing rope or swings. But the benefits are still there. If parks were made to support grownup needs, they would still be fun and healthy places to go.

Enter the newest trend in outdoor play – specifically, play for the senior citizen crowd. Across Asia and Spain in particular, outdoor parks are being made to cater to seniors, and the idea is starting to catch on in the US. The physical benefits are all there – the equipment is designed specifically to cater to an aging body – and there are plenty of other advantages as well. For those looking to spend more time outdoors, this is a nice alternative to walking and engages a wider range of muscles, helping to reduce fall risks. These parks have also become gathering places for seniors in an area, providing opportunities for socialization, which is much needed to stave off loneliness in the 65+ community. Some of the parks even include activities like puzzles to engage the brain as well as the body.

One of the biggest differences between the trend in Europe and that in the United States is that many of the US parks are multigenerational. Grandparents in charge of the kids while mom and dad are away now have a healthier option than sitting on a bench while the kids play at the park. There is a place to go where everyone can get involved and receive the benefits of outdoor play: better health, reduced stress, and fun!

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The Cost of Hospital Budget Cuts

Hospitals are a lot more dangerous than people think, especially for the elderly. Three times as many people die from errors in hospitals than from car accidents every year. Experts in the medical field tend to agree that if someone does not absolutely have to have access to hospital grade care, they are safer recovering at home. It’s not just the exposure to infections and disease, but also a whole host of other problems that largely come from putting the budget above patient-centered care. Reducing our national health care expenditure has led to a reduction in quality of care, and while people are living longer healthier lives now more than ever before, how much better could we be doing with the appropriate attention given to each patient’s needs?

Hospital stays increase risks for ill effects in patients, especially the elderly. Just a few days of bed rest is damaging to an aging body, making it harder to get up and get moving after a stay, independent of the medical recovery needed. Patients are prone to infections, pressure ulcers, and other illnesses that add to recovery time and overall poor health. Testing and treatments can lead to unintended side effects, complicating health issues even further. The stress of the illness and the strange environment increases falls, confusion, and even delirium, which often goes unnoticed and untreated. Incontinence develops in more than 40% of elderly patients within a day of admission. It’s very difficult to get a good night’s sleep in a hospital; there is always noise, uncomfortable devices monitoring health, and often patients are woken for a test or check in – this is not good for recovery. Nobody finds hospital food appealing; add in difficulty managing a food tray while in bed and a lack of assistance to eat, and undernutrition becomes a problem for many. Prescriptions are often added or changed, and this can lead to unintended interactions with medicines the patient is taking at home. The pitfalls are many, and even with all the staff available to treat illnesses, there isn’t enough time to take care of patients.

One story from the Washington Post illustrates this point beautifully. It tells of a 91 year old woman who fell in her garage while home alone. She pressed her medical alert button and had EMTs helping her within five minutes; fifteen minutes after that she was at the hospital. From there her care devolved. She spent eight hours having tests run and waiting for a bed, with next to no attention paid to her personal needs or her pain. A chest X-ray was taken, but no one checked it for 12 hours despite her worsening cough, fever, and low blood oxygen levels. Her son, a geriatrician, asked for the results and only then was the X-ray checked, pneumonia discovered, and her condition treated. Trays of unappealing food mush were delivered to her room and left out of her reach. Equipment alarms went off regularly, but no one ever came to check on her or turn off the obnoxious, sleep-depriving noise. She was not bathed in more than a week, never repositioned, and no one came to ask if she was in pain or needed anything. The discharge planner, however, came by from the first day. The patient’s advanced directive stated that she did not want a feeding tube, but the doctors tried to order one anyway; the geriatrician son insisted that her wishes be honored and reminded them that the feeding tube would not resolve the medical issues at hand.

This woman was lucky in that her sons stayed with her and provided her care. They helped when she needed something, pestered doctors and nurses for test results, and made sure the staff knew when her condition changed. They were advocates for their mother’s care. The sons asked why their mother was not being tended to in the way they expected; more than one nurse responded, “We used to do all those things, but there is no longer any time.”

The patient’s overall health is no longer the focus at hospitals. They have shifted their attention to the bottom line in order to stay in business. Cut backs from Medicare and the skyrocketing cost of healthcare have forced cuts in hospitals that are not good for people. While there are certainly still untold numbers of dedicated doctors and nurses who go the extra mile for their patients, tighter budgets mean everyone has a heavier workload – more patients per caregiver, a wider range of responsibilities, and less time for the kind of personal attention people need. This has contributed to 100,000 deaths every year due solely to medical errors in hospitals. Unless a hospital stay is absolutely necessary, consider other options before heading to the emergency room for treatment.

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Healthcare Super Spending

A hospital superutilizer sounds like some sort of heroic patient whose experience in hospitals has earned them untold knowledge and power over their illnesses. In fact, the word is much more grim and problematic. A superutilizer is a member of the 1% of the US population that consumes nearly a quarter of the country’s health care budget. This is not the “one-percent” we all pine to be a part of. This is a group of sick people who spend an average of $97,000 per person, per year on health care. Beyond the “super” one-percent, around half of our entire health care budget is spent on just 5% of the population. This is largely a senior population; almost half of adults occupying hospital beds are over 65. Medicare spends more than $100 billion per year on hospital care. This group of people presents an enormous opportunity to cut health care costs.

Superutilizers often suffer chronic conditions that are not well managed, and their frequent hospital use tends to compound their health issues. Take Jean, for example. Over a period of 30 months, she was admitted 76 times to a total of fifteen different hospitals. She spent about two-thirds of her days in a hospital. She received many tests and treatments over that time, some of which caused further medical problems – like a dropped lung in one case – and led to longer stays. Sometimes the prescriptions she received upon discharge interacted badly with the meds she was already taking at home, and the result was another hospitalization. With so many different doctors and nurses overseeing her care, no one was watching the big picture. As so often happens in hospitals, the focus was on solving the immediate problems that present themselves, rather than improving the overall health of the patient.

What if her care was better managed? What if someone was monitoring her closely enough that small problems were treated before she ended up in the hospital? And keeping an eye on her prescriptions to prevent dangerous interactions? And checking on her during hospital stays to monitor complications the staff might not be aware of? What if there was someone she could call before going to the ER to offer medical advice based on an in depth knowledge of her case, rather than trying to inform an ER doctor of all the intricacies of her care in an emergency? Some of this sounds like her primary physician’s job, but they aren’t always available when needed, don’t always have hospital privileges, and have so many other patients that it’s difficult to keep track of everyone’s history. What’s really needed is a team of specialists, working together to manage the specialized care of people like Jean whose needs are far more complex than the typical patient. Programs like these are beginning to take off in some areas, and are showing some interesting results.

In Washington State, the top 1% of healthcare spenders were assigned teams of doctors, including their primary care provider, who were notified whenever the patient arrived at an emergency room. The team managed their care and health. Emergency room usage of this group fell 37%, saving Medicaid over $33 million right off the bat. Another home based care program cares for patients well before they even get to the ER. The team of doctors oversees their care, and meets weekly to discuss their case. Most care is given at home, and patients are instructed to call their care team before considering a trip to the emergency room. The system saves Medicare an average of $2000 per month for each patient involved and has reduced their hospital days by a third. While the model is still finding its stride in some areas, the successes are promising and offer hope of providing better care while still reducing the astronomical healthcare bill our country has been running up. No one wants to be part of this particular 1%, but finding a better way to manage healthcare for those with complicated needs is definitely heroic in my book.

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Seniors Are Going Back to Preschool

This idea is brilliant.

Nursing homes are often thought of as depressing places that no one wants to visit, never mind live in. Residents are surrounded by others in very similar situations and opportunities for social connections are limited to a small circle. Typically, joy and liveliness are not terms associated with a nursing home. This is not to say they are completely absent, but hard to come by in the least. And yet, there is an abundance of energy and excitement in your typical preschool. Very young children are so open and carefree that they bring love and laughter with them everywhere they go. So why not bring it to a nursing home?

This relatively uncommon program goes well beyond regular visits to the elderly. The Intergenerational Learning Center is a full time preschool program that is actually located within a senior center in Seattle. Elderly residents do far more than sit around and enjoy the site of children playing. They participate and share the rich experiences they have to offer, while the children light up their lives five days a week.

Social isolation is a serious problem for the elderly. It is estimated that 43% of seniors experience it and it is unhealthy in many ways, both mentally and physically. While it may be difficult to form strong connections amongst peers, especially in a place and time where the social pool is regularly shifting and too often on the brink of death, children offer an open and far less risky opportunity to bond and interact. Their innocence, simplicity, and open nature can reach into lonely hearts and bring joy.

Housing a preschool in a nursing home is a beautiful and elegant pairing that’s mutually beneficial. Seniors get value from helping others, teaching, and simply enjoying the exuberance and sincerity of children. The children benefit from the experience and love that elderly residents offer in abundance, not to mention the value of connecting with others experiencing different life situations. The following documentary showcases the incredible tenderness with which each generation interacts with the other and is a touching but powerful argument for the development of more programs like this one.

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