Gray for a Day: Implementing a Curriculum to Promote Empathy for Older Adults

Many older adults experience changes to their sensory and functional well-being that can interfere with their ability to effectively and safely interact with environments, communicate with others, enjoy activities, and complete simple tasks (e.g., Boyce & Shone, 2006; Wickremaratchi & Llewelyn, 2006). These changes may even lead to reduced mobility, increased dependence on others, and decreased self-esteem (Cacchione, 2005; Heine & Browning, 2009). Undoubtedly, these sensory and functional declines can have a substantial influence on individuals' abilities to complete daily activities (e.g., walking, shopping, and meal preparation) and thrive in their homes and community environments. Individuals not yet experiencing decline may lack understanding of age-related sensory and functional decline, which may minimize their empathic attitudes and behaviors toward those who are experiencing such decline. Coupled with persistent societal ageism, a lack of understanding can result in both poorer treatment of older adults and a lack of personal effort in caring for one's own sensory and functional health (Douglass, Henry, & Kostiwa, 2008). The development and dissemination of an interactive educational program to inform individuals about age-related sensory and functional decline, increase awareness of and empathy regarding daily challenges, and promote the adoption of healthful behaviors is necessary.

Experiential and active learning techniques are commonly used within Extension's various content areas (O'Neill, 2008) and often yield positive results such as increased knowledge of, reduced anxiety about, and improved attitudes toward a given topic (Chen, Kiersma, Yehle, & Plake, 2015; Douglass et al., 2008; Eskildsen & Flacker, 2009; Pacala, Boult, & Hepburn, 2006). Furthermore, engaging in active learning promotes understanding, retention, and the broadening of one's perspective on the topic at hand (Chen et al., 2015; Diachun, Dumbrell, Byrne, Esbaugh, 2006; Douglass et al., 2008). In the context of sensory and functional aging, it has been shown that targeted education and structured activities can modify some predominately negative perceptions (Douglass et al., 2008; Henry, Ozier, & Johnson, 2011) and significantly increase empathy for individuals experiencing age-related declines (Chen et al., 2015). Such efforts have been successful in a variety of professional student audiences; however, content replicability and effectiveness with general Extension audiences have been challenging. Thus, we developed and disseminated a scripted curriculum package for Extension audiences: Gray for a Day.

Gray for a Day Program Description

Gray for a Day, a peer-reviewed and research-based curriculum, aims to educate participants on age-related sensory and functional challenges through simulations that reflect daily routines, simple tasks, and social activities. The objectives for program participants are that they

1. understand how the senses and functional abilities can decline with age,
2. experience through simulation age‐related sensory and functional decline,
3. understand the influence of sensory and functional decline on daily life,
4. gain background for developing skills needed to effectively interact with and support someone who may be experiencing age‐related sensory and functional challenges, and
5. understand how taking steps to improve or maintain one's health contributes to sensory and functional well‐being in the future.

Gray for a Day begins with 15 min of dynamic lecture that equips participants with necessary foundational knowledge on age-related sensory and functional decline; this time also allows facilitators to create a comfortable and engaged learning environment. Then, participants are instructed to "get gray" by donning the sensory simulation materials in a strategic manner and in the order of typical decline. Participants, while simulating sensory and functional decline as the program instructs, collectively engage in a variety of real-world activities that include common tasks (e.g., scheduling a doctor's appointment, sorting medications, and choosing a nutritionally sound meal by examining nutrition labels) and social activities (e.g., playing cards). Following each activity, the facilitator engages participants in purposeful dialogue about their experiences, critically analyzes myths and stereotypes, teaches participants about realistic and positive expectations, and challenges them to adopt healthful lifestyle behaviors that will support their own healthy aging.

Curriculum Delivery

The program is intended for use and has been successfully pilot tested with a variety of Extension audiences, including middle and high school students, 4-H youths, college students, those who work with older adults, older adults themselves, and intergenerational audiences. For this reason, the program includes language, materials, and activities that are easily adaptable to large and small audiences and individuals of different ages, professions, and abilities. Program instructors can choose the activities that will be implemented and structure the scripted discussion prompts to the needs of a particular audience. Additionally, program dissemination is flexible in that it can be presented by a single leader or a team of leaders, in a time span ranging from 50 to 120 min, and in a variety of physical spaces.

Curriculum Materials

A complete scripted curriculum can be accessed for no cost at http://www.aging.k-state.edu/programs/grayforaday/grayforaday.html. Materials include

• a complete leader's guide,
• a scripted PowerPoint presentation in English or Spanish,
• descriptions of program activities,
• an optional participant worksheet,
• a marketing flyer,
• an evaluation template for both youths and adults, and
• a facilitator training video.

The leader's guide details the program's purpose, objectives, facilitation process, materials, activity procedures, and evaluation procedure. Additionally, the inexpensive, easily obtainable items needed to deliver the program effectively (e.g., disposable gloves, craft sticks, cotton balls, and simulation glasses or plastic wrap) are listed, and material preparation is described.

Conclusion

Gray for a Day is an adaptable, effective curriculum that educates participants on age-related sensory and functional decline and engages individuals in interactive, deliberative learning about healthful aging. The free curriculum package includes the information needed to facilitate and evaluate the program with a wide variety of Extension audiences. Facilitation training is provided online, on-demand, and the lead author is available for all inquiries. Preliminary evaluation data show that participants have increased awareness of age-related sensory and functional decline, increased understanding of how to effectively interact with and support individuals with such declines, and improved awareness of the connection between healthful living and sensory and functional well-being and understanding of steps to take to improve their own sensory and functional well-being in the future. Additional results are forthcoming, and programmatic and evaluation details are available from the lead author.

References

Boyce, J. M., & Shone, G. R. (2006). Effects of ageing on smell and taste. Postgraduate Medical Journal, 82, 239–241. doi:10.1136/pgmj.2005.039453

Cacchione, P. Z. (2005). Nursing standard of practice protocol: Sensory changes. Retrieved from ConsultGeri, a clinical website of The Hartford Institute for Geriatric Nursing: https://consultgeri.org/geriatric-topics/sensory-changes

Chen, A. M. H., Kiersma, M. E., Yehle, K. S., & Plake, K. S. (2015). Impact of an aging simulation game on pharmacy students' empathy for older adults. American Journal of Pharmaceutical Education, 79(5), 1–10.

Diachun, L. L., Dumbrell, A. C., Byrne, K., & Esbaugh, J. (2006). . . . But does it stick? Evaluating durability of improved knowledge following an undergraduate experiential geriatrics learning session. Journal of American Geriatrics Society, 54, 696–701. doi:10.1111/j.1532-5415.2006.00656.x

Douglass, C., Henry, B. W., & Kostiwa, I. M. (2008). An aging game simulation activity for allied health students. Educational Gerontology, 34, 124–135. doi:10.1080/03601270701700417

Eskildsen, M. A., & Flacker, J. (2009). A multimodal aging and dying course for first-year medical students improves knowledge and attitudes. Journal of American Geriatrics Society, 57, 1492–1497. doi:10.1111/j.1532-5415.2009.02363.x

Heine, C., & Browning, C. J. (2009). Communication and psychological consequences of sensory loss in older adults: Overview and rehabilitation directions. Disability and Rehabilitation, 24, 763–773. doi:10.1080/09638280210129162

Henry, B. W., Ozier, A. D., & Johnson, A. (2011). Empathetic responses and attitudes about older adults: How experience with the Aging Game measures up. Educational Gerontology, 37, 924–941. doi:10.1080/03601277.2010.495540

O'Neill, B. (2008). Financial simulations for young adults: Making the "real world" real. Journal of Extension, 46(6), Article 6TOT4. Available at: https://joe.org/joe/2008december/tt4.php

Pacala, J. T., Boult, C., & Hepburn, K. (2006). Ten years' experience conducting the Aging Game workshop: Was it worth it? Journal of American Geriatrics Society, 54, 144–149. doi:10.111/j.1532-5415.2005.00531.x

Wickremaratchi, M. M., & Llewelyn, J. G. (2006). Effects of ageing on touch. Postgraduate Medical Journal, 82, 301–304. doi:10.1136/pgmj.2005.039651