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Back to School May Help Those with Alzheimer's

Dr. Peter Whitehouse gives his elderly patients with memory loss an unexpected prescription: Stay socially active. Some of his favorite advice is to perform volunteer work, and he has even created a school where they can do just that.

Whitehouse and his wife, Cathy, founded an inner-city charter school in Cleveland called The Intergenerational School eight years ago. It's common to see the school's young students working with older volunteers, including many who have Alzheimer's disease.

Research has already shown that volunteering conveys benefits for older people who do not have dementia. One study of older individuals who did regular volunteer work in schools through a program called Experience Corps suggested that the volunteers increased their physical strength and were less likely to use a cane or fall down. The study also found that volunteering increased social activity, which may ward off depression and isolation. Volunteers also reported increases in cognitive activity, saying they read more books and watched less television.

Whitehouse is trying to prove that volunteering has health benefits for people with Alzheimer's and dementia, too.

"We presume, although we're doing the kind of research to try to demonstrate it, that engagement is not only as good but perhaps better and more necessary for older people who have what I call aging-associated cognitive challenges," he says.

Volunteering to Improve

Whitehouse doesn't like to use the terms Alzheimer's disease and dementia with his older patients because of the stigma they carry.

"I think some people who, when they get the label Alzheimer's disease, feel shame. And they themselves withdraw themselves from society," he says, adding that such withdrawal can cause health problems.

Whitehouse has been studying a group that volunteers once a week at The Intergenerational School. The dozen or so participants travel by shuttle from the Judson at University Circle retirement community to work with the children, who range from kindergarten to middle school.

Many of these volunteers have mild Alzheimer's and dementia, while some are in advanced stages of the illness. Two of the regular volunteers live in a locked dementia unit in the nursing home on the retirement community's campus. Cathy Whitehouse, a longtime educator, says an important moment for the school came with the realization that even someone with advanced dementia could still read a children's book.

On a recent day, a couple dozen teen and preteen students gathered around 10 older volunteers in a large classroom. The assignment for the volunteers was to write a letter to someone 50 to 100 years in the future who wanted to know about their lives. The task for the students was to interview the older people about lessons and wisdom they can pass on from their life experiences.

Volunteer Genevieve Miller wrote in her letter about how leaving her small town to go to college "started my life," and how she was the first woman ever to get a Ph.D. in medical history.

Merrily Hardesty, who recently turned 91, was questioned by two young girls who were mostly interested in her romances and her long marriage to her husband, a doctor.

Mac Davis, a retired dentist who now has memory problems, and his wife, Susan, who doesn't, showed postcards from their travels around the world. He told the kids about his work to provide dental care to the poor.

Davis says he can't remember that he went on a walk through the neighborhood yesterday, although he knows he did. And although it's been hard to deal with his severe loss of short-term memory, he says he makes it a point to try to "enjoy life."

The volunteer work is a big part of that. Afterward, on the shuttle bus back to their apartment, Susan Davis tells her husband that he always seems happy after he's been at the school.

"You look cheerful and up," she says. "You seem excited."

And her husband agrees: "Oh yeah, kids warm me up tremendously. The whole program, just seeing all the people working together, the cooperation. It's a lovely feeling. Sort of what I look upon as the way society should be."

He says he thinks having to respond to the kids' curiosity helps sharpen his memory, too. "It fortifies your knowledge of who you are, where you are and such. Keeps you in touch with the world. I enjoy that. I enjoy people."

At the beginning of the school year and then again at the end, Peter Whitehouse tested the volunteers on measures of depression, memory and other factors.

"We are looking at whether volunteering at The Intergenerational School improves quality of life," says Daniel George, who co-conducted the study and also co-wrote the book The Myth of Alzheimer's: What You Aren't Being Told About Today's Most Dreaded Diagnosis with Whitehouse. "And to do that we're looking at five variables: cognitive functioning, stress, depression, sense of purpose and sense of usefulness."

The two have not reached any final conclusions. And the study's size — just 20 volunteers who come to the school once a week — is too small to prove anything. But they hope it will stir more interest in the value of volunteer work.

Classroom Challenge

Not everyone is so sure that the experiment at The Intergenerational School can be broadly applied. Dr. Linda Fried, a geriatrician and dean of the Mailman School of Public Health at Columbia University, says she is intrigued by the work going on at the Cleveland school. But she also thinks it may be impractical to let people with dementia — who need help themselves — volunteer in schools.

"For cognitively impaired older adults, it can feel chaotic, just because little kids are busy," says Fried, who has researched the health benefits of one of the largest school volunteer programs for older people, Experience Corps, which she co-founded. "It can get confusing if you have memory problems and problem-solving problems. So you'd have to learn how to design the environment and have the resources to do that.

"I think what we need to learn from Dr. Whitehouse's experiment is whether cognitively impaired older adults can feel safe and actually be effective in a situation which is complicated in that way," Fried says.

Positive Change

Nonetheless, Whitehouse and George say they see a change in volunteers such as 91-year-old Hardesty.

She doesn't use the words Alzheimer's or dementia. Instead, she talks about her "problem." She says that when it developed late last year, it hit her hard.

"I thought I might as well quit," Hardesty says. "I was really down in the dumps about the whole thing. There was a time that I hated to go down to dinner because I just couldn't talk to people. It was awful."

For a while she stopped going to the dining hall. Two things lifted her from that despair: a support group for people dealing with memory loss and her volunteer work at the Cleveland school.

"The kids, you know, we always find a lot of things to laugh about," says Hardesty. "Just having kids around has always been very good for me, so it was good thing."

Not only do the volunteers get a lot from the students, but the students also get a lot back, says Cathy Whitehouse. She says that she, too, has learned from the volunteers.

Last year, 84-year-old Barbara Kelsey was given the award for the volunteer who put in the most hours. At the awards luncheon, she asked why she was being honored and was surprised to learn the amount of volunteering she had done. Sometimes Kelsey remembers her day at the school, but often she does not.

Cathy Whitehouse says it doesn't matter, because Kelsey enjoys her volunteer work and does a good job with it.

"When you see her sitting with a child and reading, she's able to interact with that child in the moment," says Whitehouse. "I firmly believe that she enjoys the time that she spends here, and if she doesn't remember it five minutes later, it doesn't matter. It's just been great to have her."

Copyright 2020 NPR. To see more, visit https://www.npr.org.

Joseph Shapiro is a NPR News Investigations correspondent.