“Why have you put me in a ward with all these old people?”

by Richard Pooley

My mother-in-law, Jane, will be ninety-nine years old in February. Her first forty-five years – working in the UK's Land Army during World War 2, engaged at seventeen to a man killed on the beaches of Normandy on D-Day, escaping a first marriage in Tanganyika to find a second husband in Kenya, widowed at thirty with an eighteen-month old daughter (my wife), rebuilding a life in England with almost no money, married for a third time to a man eight years younger than her – were full of pain and privation but also much joy and laughter. The second half of her life has mostly been spent frugally but contentedly on the edge of a Cotswold village, the centre of a network of devoted friends.  

But for the past three and a half years she has been imprisoned in one of Bupa Healthcare’s so-called “luxury” nursing homes just outside Bath. It’s a beautiful place, a mid-18^th Century mansion designed by John Wood the Elder, surrounded by an 8-hectare park across which you might expect a Jane Austen hero to have galloped. Thomas Gainsborough painted several canvases in the Orangery (still there, up a steep hill which no current resident can reach unaided). William Pitt was staying when he got news of Napoleon’s victory at the Battle of Austerlitz. So, why “imprisoned”? Because she can’t get out, unless an ambulance comes to take her, in a wheelchair, on the few occasions she has a hospital appointment. The lift was out of order for eight months, confining her to the first floor. The food is advertised as being “high quality”. A prison inmate would reject it, just as she sometimes does. Once the only person available to cook for the thirty residents was a cleaner. And how much does she pay for this brochure-described “paradise”? £343 (US$ 450) a day. That’ll go up by at least 7% in January.

Okay, the care home staff are…well, caring. There is none of the horrendous abuse that has occurred elsewhere. And they arrange activities for the residents. But it’s a lonely existence for an intelligent woman who can still recite poems learned by heart decades ago (those of that old curmudgeon, Philip Larkin, are her favourites) and whose daily highlight is the phone call with an old friend, also in a care home, some 30 miles away. Too late for Jane but can we really not do better for those soon to leave us? Can we not have places where the old and the young can mingle, where there is a community, where there is life before death?

Yes, we can. The Dutch have shown us the way. Twelve years ago, a Dutch nursing home — the Woon-en Zorgcentrum Humanitas in Deventer (east of Amsterdam) — made real one of those ideas so simple yet so obviously brilliant that you wonder why it wasn’t thought of long ago: in exchange for thirty hours of their time and companionship each month, local college students could live in the care home rent-free. 

“It started with the idea of ​​becoming the warmest home for seniors in Deventer,” said Gea Sijpkes, director of WZC Humanitas, earlier this year. “And we wanted to do that with the energy of the youth.”

Young (in their early twenties) and old (mostly in their eighties and nineties) mix in the communal dining room not because they have to but because often they want to.

People wishing to dampen my enthusiasm for this Dutch project doubt that the students would wish to spend any time listening to old people reciting the problems they are having with various bits of their bodies (the Organ Recital), or recounting the joys of their own youth. Wrong.

Here is what two of those Dutch students say:

“It doesn't all have to be grand and exciting. If you talk to each other and show interest in each other, that already gives so much meaning.” 

“They [the old residents]  taught me to slow down a bit more. That doesn't make me older, but more aware of life.”

And the elderly love it.

As part of their deal with the care home, the students also spend time teaching residents new skills – like how to email, and use social media, WhatsApp and Zoom. What can the old teach the young? History, life lessons, what not to do.

The quote which is the title of this article came from Alison Hesketh, founder and Chief Executive of TimeFinders, a British organisation which provides advice to old people to “do whatever is necessary to live in the right place at the right time”. I heard her tell of a 93-year old friend who upon arrival in a hospital was irritated to find that all others on the ward were also old, even though the illness she was there for was not age-related. The assumption of the hospital administrators was that old would wish to be with old.

The Netherlands is one of the most densely-populated countries in the world. At the recent general election the unavailability of affordable housing, especially for young people, was the biggest issue. This has long been the case and was the other trigger for Sijpkes’ brainwave:

“At the same time, there was a shortage of student housing, which meant that more and more young people were staying at home. I then thought: why don’t I combine the two?”

I read this and thought of the vast number of student flats built over the past decade in Bath, where I live. The city’s university, now one of the best in the country, has seen an explosion in student numbers, to the growing ire of local residents. Where, they ask, is the affordable housing so badly needed by the non-student population? My questions are a little different. Why are we providing so much student accommodation which is unused for 15 weeks of the year (the student holidays)? Why is the city’s government not doing what WZC Humanitas have done and started combining student accommodation with that for the elderly? As Sijpkes says “It does not require huge investments or complex care structures. It only requires people who are prepared to share their lives with others from a different generation.”

Apparently, WZC Humanitas’ intergenerational programme has been copied around the world in the last few years. Has it been in the UK?

I heard several years ago about a project at my old university, Exeter, which had a similar aim. Since 2011 students from the university’s Department of English and Film have donated their time to bring conversation, literature, and companionship to the elderly in over ten residential care homes in and around Exeter. About half of these residents have dementia. Research has shown that reading poetry with (not to!) dementia sufferers brings joy and comfort to them, especially as so many learned poetry by heart when young. It triggers memories just as much as old photographs can. And what do the students get out of it? Insights into other lives, other times and  other ways of looking at the world.

But during my wife’s search, close to Bath, for somewhere suitable for her mother to live, she found nothing similar to the care home in Deventer. Hence, we were both cheered when we heard that the winner of this year's Royal Institute of British Architects' (RIBA) Stirling Prize is Appleby Blue Almshouse, which provides fifty-nine affordable flats for over-65s in Southwark, south London. It has been designed to combat loneliness. Residents keep their independence and can choose to remain in their flats as long as they wish to. When they come out they can sit on a bench in the many plant-lined, window-bordered hallways and landings, observe the world go by or fall into conversation with others. There is a roof-garden to tour or to work in.

Likewise, the communal kitchen is not out-of-bounds to residents; many cook there too and give cooking lessons.

The place creates an "aspirational living environment" that stands "in stark contrast to the institutional atmosphere often associated with older people's housing” according to the RIBA judges’. Architect-speak for an enjoyable place to live out your life.