Day care for kids and elders is a natural.

How intergenerational care centers work for Lancaster Laboratories and Stride Rite.

Putting kids and older people together in day care has its advantages, as Stride Rite in Cambridge, Mass., and Lancaster Laboratories, in Lancaster, Pa., have proven. Both have on-site intergenerational care centers. There is a natural attraction of youngsters for elders and vice versa.

"My daughter's best friend Dewey is 94; he has to go into a nursing home now," says Carol Miller, executive vice president for human resources and administration at Lancaster Labs. Miller says employees at Lancaster reap the benefits of having the elderly near their children. The youngsters learn that people with wheelchairs or canes and wrinkled skin have much to offer, and that getting old isn't anything to be afraid of. On the whole, having children and adults interact means both groups have richer experiences.

Stride Rite, a shoe manufacturer, and Lancaster Labs, which conducts food, pharmaceutical and environmental testing, have had immensely successful on-site child-care centers. They have recently taken the plunge into providing on-site elder care. Stride Rite's elder-care program began in 1989; Lancaster Labs started its program last year. Both programs have been marketed to the community more than to employees, and neither program has elders who are relatives of employees currently in the center.

Stride Rite's facility

The impetus for Stride Rite's center began when the chairman of the board read a newspaper story about a New York family that had a child in one day-care center and an elderly adult in another across town. His suggestion that it might make sense to combine child and elder care was followed by a feasibility study and a multiyear planning period, in which Stride Rite's Karen Leibold worked with Cambridge elder services agencies and Wheelock College to look at existing programs, evaluate community need, and anticipate staffing and budgeting requirements.

"I was a skeptic at first, but little by little, as I looked at the models for intergenerational activities, it seemed that this might be doable, at least in an academic sense," Leibold says.

Eventually the government-university-corporate task force determined that Cambridge could indeed use another adult day-care center, and that an intergenerational center would work. The center was envisioned as a social day-care program where the ideal adult candidate might be an 80- to 85-year-old woman who had moved to a new city to live with her children after her husband died and was lonely in a house where both parents worked and the children were in school most of the day.

The adult part of the center is staffed by recreational therapists, gerontologists and social workers. Elders enrolled in the program must be able to feed and dress themselves. The center is separately incorporated and funding comes from the Stride Rite Charitable Foundation and from center fees.

Currently, 30 elders are enrolled, but they don't come every day. Average attendance is 20. Elders share a building with the child-care program for 55 youngsters--half of the children are from the community and half are children of employees.

"There is a great deal of informal interaction, as well as planned activities," Leibold says. "The two groups meet in the one common entrance and they eat their meals together. We've put in adjusted seating so those elders who want to eat with children can."

The 55 children interact with elders through planned activities such as reading stories or baking projects. One man at the center who doesn't speak English often paints with some of the children.

"But it's a mistake to think they are together all day long," she says. One day the two-year-olds will have planned activities that those elders who wish can join; the next day three-year-olds, and the next day four-year-olds. Some elders won't participate; it just depends on the individual's needs.

"It's a tremendous benefit to have the kids around. Elders need to be needed and valued, and kids learn that when they reach old age, they can live with value and dignity," Leibold believes.

"Because extended families aren't as close together as they've been in the past, intergenerational arrangements present some nice opportunities for both groups," says Marilyn Johnson, an educational specialist with Bright Horizons child-care services, which has some intergenerational programs. "The children get to know people who might be different from those in their immediate world, and adults react to children with a liveliness that might not have been there before."

Lancaster Labs' center

Lancaster Labs started its elder-care program to fulfill a need in the community and to provide a place for the relatives of employees. Lancaster was able to learn from studying the Stride Rite model. Lancaster's Miller says originally the company had not wanted to form a 501(c)(3) program, which gives the center nonprofit status, but found that the financial advantages were considerable. Without 501(c)(3) status, the center would not qualify for public funds, which help many community residents afford the $30 a day it costs to place an adult there.

"There are still big barriers to the financing of adult day-care centers," she says. "Medicare rules haven't caught up with this type of care yet. While it costs $80 to $100 a day to keep someone in a nursing home, the costs for adult day care are less, and the experience can be more pleasant for a certain stage in life. But most centers do not qualify for Medicare funds."

Miller says the struggle for her center has been to break even, a goal she says they are closer to accomplishing. While her focus has been on getting community elders into the program first, she wants to market more within the company during the coming year.

"We have 150 child-care slots and a waiting list of 25; someday it will be the same for elder care," she says.

The staff at the Lancaster center hears from the adult children of the elderly participants that their parents seem more lively after having been at the center. "It's a way for a family to keep an adult in a family setting as long as possible," Miller says.

Intergenerational care may be the wave of the future. A company in Maryland is looking for foster grandparents to provide child-care services, and an industrial park on Long Island, N.Y., has recently opened an intergenerational care center.

"There's just something good that happens when you put children and elders together," Johnson says. "Something in the child will speak to elderly people who haven't shown any interest in anything for a long time. It's as if the child inside them is calling to them."

Progressive Employers Wrestle with Elder-care Benefits

Employers taking the lead in work-and-family programs are thinking about how to best help their employees with elder-care responsibilities; but elder care as part of a dependent-care benefits package is still absent in the majority of companies.

A recent survey by The Conference Board's Work-Family Research and Advisory Panel, which includes companies with some of the most progressive programs, found that while elder-care programs are being implemented in many of these companies, utilization by employees is still low--an average of about 5 percent of those who have access to elder-care benefits. This is expected to change within the next five years, as more employees' parents reach the age when they will need care.

The survey, "Work-Family Roundtable: Elder Care," found that more than half of the companies surveyed offered six types of support activities: family leave, flexible work arrangements, dependent-care spending accounts, seminars on aging issues, resource and referral services, and family counseling on aging issues.

"Counseling and support groups were named one of the most important aspects of the program by those employers who offered them," said Daniel Dreyer, the primary researcher for the survey. "They allow employees to talk about their trials and successes and identify with others who may have the same situation. They are one of the easiest programs to put in place and have a great payoff."

Dreyer said that for employees, elder care is a more complicated issue emotionally than child care. Employees may wrestle with guilt or fear at the thought of asking their parents to go into an adult day-care facility or a nursing home.

In contrast to child care, which one can plan for, the time when an older adult will need care often cannot be anticipated. Many of those employees who are taking some responsibility for their parents do not see themselves as caregivers and may not recognize that they need help, Dreyer said. They may view themselves as merely fulfilling their obligation to their parents.

Coupled with the lack of information about how elder-care responsibilities affect employee productivity, these complications may help to explain why elder care as a benefit has not been as widely implemented.

The Conference Board survey found that those work and family professionals who have designed elder-care benefits are anticipating a future need and are planning to do more marketing of existing programs. These professionals also anticipate a much greater future emphasis on cooperative efforts and public/private partnerships in which employers and government will share responsibility with employees. Almost 80 percent of those surveyed thought employers should try to influence public policy in support of elder care.

Linda Thornburg is an Alexandria, Va.-based freelance writer who specializes in human resource issues.