This is an original story from Generation American Society on Aging
By Maurya Cockrell
October 19, 2022
Individuals can experience loss and grief at any age in life, and a loss can transcend generations to come. The power of intergenerational connections can transform how individuals, communities, and institutions approach death, dying, and grief. Connecting younger and older people can not only combat social isolation and improve health; it also can help ease fear of the end of life.
grief, intergenerational, death, end of life, connection, caregiver, Sandwich Generation, generational differences, transgenerational
There is power in intergenerational connections. Human existence revolves around connecting and building relationships with others. Social interaction, the process of connecting with others, has physical, mental, and emotional benefits. Social interaction also is a social determinant of health and should be considered a public health issue. Having sufficient social interaction can positively impact one’s quality of life. Limited social interaction can affect an individual’s mental, emotional, and physical health, potentially leading to adverse health outcomes. Connecting with others across generations adds another layer of benefits. Young people and older adults have an opportunity to leverage intergenerational relationships to improve cognitive function, increase empathy, and live longer lives.
This article uses the following terms and accompanying years to describe generations: Traditionalist (born 1928–1946), Baby Boomers (born 1946–1964), Generation X (born 1965–1980), Millennials (born 1981–1996), Generation Z (born 1997–2012), and Generation Alpha (born 2013–2024). As the pandemic brought mortality to our front door, many people are researching ways to improve community and connectedness as we approach the end of life. It is time to consider how the power of intergenerational connections can change how we approach death and dying.
In recent years, the phrase “social isolation” has become the newest buzzword, and it gained increased attention from subject experts and researchers during the pandemic. Research and grant funding have been developed to fund initiatives that help individuals combat feelings of isolation when in a time of limited in-person contact.
Human Needs and How They Relate to Intergenerational Connection
According to Maslow’s Hierarchy of Needs, there are five stages of human needs: physiological, safety, love and belonging, esteem, and self-actualization (McLeod, 2007). Primarily stages one through three are most relevant to what can be gained from intergenerational connection. McLeod states that safety and psychological needs must be met to reach the ultimate stage of self-actualization and achieve our full potential. Stage three, love and belonging, is critical to relationship building and to how individuals connect with one another. Love and belonging can be perceived as intergenerational connectors. It is essential to understand that connecting with others to build a sense of belonging is imperative to self-fulfillment.
‘CONNECTING WITH OTHERS TO BUILD A SENSE OF BELONGING IS IMPERATIVE TO SELF-FULFILLMENT.’
When understanding this concept, it becomes easier to see how a lack of social interaction can lead to lower self-esteem, poor cognitive functioning, and in worst cases, increased mortality. Studies show the benefits of increased social interaction—it can lower the risk of Alzheimer’s and dementia, improve heart health, lower the risk of depression, and lower stress. Research by Leschak and Eisenberger (2019) shows social relationships influence and can be influenced by the immune system. Increased social engagement can reduce inflammation and improve antiviral responses, while lack of engagement can suppress immunity. The need for love and belonging transcends generations and should be experienced by all ages.
When viewing connections from an intergenerational perspective, intergenerational relationships are often seen in the form of care, companionship, and then connectedness. Everyone’s first intergenerational experience occurs early on in childhood, often between children and parents or legal guardians.
Those fortunate enough to have an extended family may often have intergenerational connections with grandparents, aunts, and uncles. Within the family unit, these relationships are imperative for the transfer of knowledge, traditions, and storytelling from one generation to the next. This transfer of information is all the more critical in times of death, dying, and grief. Through the transfer of information, families preserve their identity, traditions, and culture. Multigenerational families are able to strengthen bonds because they understand their cultural heritage and the value of learning from older generations.
Building Intergenerational Relationships Outside the Family
As we age, we often find ourselves in spaces lacking age diversity, so building intergenerational relationships requires more intentional effort when outside a family unit. While living in a society that puts a high premium on youthfulness, it is essential to understand that the growth and future of nations are dependent upon the wisdom of older generations. Seeing value in aging allows individuals to look past themselves and connect to a larger purpose, building community, and documenting history for those to come.
There is power in intergenerational relationships when it comes to care. To care for someone is to invest in their health, protection, and overall well-being. We often see intergenerational care in settings such as child daycare and adult day centers. Older, seasoned professionals are trusted to care for children too young to enter the traditional school setting. Younger, yet still experienced professionals are seen in adult day settings providing services supporting participants’ medical, social, and daily emotional needs. Intergenerational care in these settings is especially important to individuals in the Sandwich Generation, who are taking care of their younger children at the same time as they care for their older parents.
Intergenerational companionship is a form of fellowship. Over the past few years, healthcare technology startups have invested millions of dollars developing technology solutions designed to combat the social isolation experienced by older adults. These solutions often leverage mobile applications, video conferencing, and digital connections to pair older adults with younger people.
‘CONNECTEDNESS IS MORE COMPLEX THAN CARE AND COMPANIONSHIP BECAUSE IT REQUIRES INTENTIONALITY FROM BOTH PARTICIPANTS.’
Medicaid is designed to cover healthcare costs for some individuals with limited income, children, pregnant women, persons older than age 65, and people with disabilities. Companion services covered under Medicaid’s community-based long-term services and supports often take place in an individual’s home or community and include nonmedical social and emotional support. This service is beneficial to older adults wanting to remain independent but who may need additional assistance when family and friends are unable to care for them. Companion care also gives family members a break to complete duties such as housekeeping and errand running that takes their attention away from providing direct care to loved ones. Younger generations, especially students or those wanting additional income, often fill the role of companions due to easy access to transportation and flexible schedules.
True power lies in intergenerational connectedness. Connections help individuals feel valued, heard, and seen. Connectedness is more complex than care and companionship because it requires intentionality from both participants. Intergenerational connections can lead to happiness, empathy, compassion, and social intelligence.
According to Brubaker and Brubaker (1999), four Rs are needed for strong intergenerational relationships: respect, reciprocity, responsibility, and resiliency. Respect is important for any relationship but is especially important in intergenerational relationships. Unfortunately, elderspeak (disrespectful and ageist communication) is often seen in intergenerational interactions in healthcare settings.
Younger generations ideally should respect older generations for their knowledge and wisdom. When looking at family relationships, children typically display respect for their parents and grandparents by seeking them out for advice and placing importance on those bonds. As parents and grandparents age, the responsibility of care often shifts to younger generations. Adult children are sometimes expected to make financial and social sacrifices to provide that care. Depending upon one’s upbringing, children may feel indebted to their parents because their parents took care of their needs when they were younger.
Responsibility in intergenerational relationships also can be shaped by race, religion, gender, socioeconomic status, and other factors.
Reciprocity is one of the most important elements of intergenerational relationships. Younger people support older adults as they age, while older adults assist younger people as they grow and develop. Long-lasting relationships need to have mutual benefit. This two-way support system can ease the emotional challenges that occur during birth, career advancement, marriage/divorce, and declining health. Each generation has its own set of strengths and weaknesses, so older adults can benefit from relationships with younger people via physical support, gaining knowledge, and being exposed to new mindsets. And younger people can benefit from older adults’ emotional support, history, and learning how to accept aging and mortality.
Resiliency is the last element of successful intergenerational relationships. Just as there are challenges and lessons to be learned from improving one’s cultural competence, individuals must be able to address issues that might arise during intergenerational encounters and recover quickly. Resilience is vital for ongoing support and long-lasting connections.
The Varied Types of Grief
When encountering grief and loss, it is important not to shut others out but to intentionally seek comfort from those around you. Emotional care can come from a well-developed circle of support. There are various types of grief such as intergenerational, multigenerational, and transgenerational.
The term intergenerational grief is often used when describing services and programs. Intergenerational grief occurs when there is an exchange of grief. In this instance, grief is a shared experience. For instance, when a nuclear family loses a grandfather; grief is a shared experience between the children and grandchildren of various generations. Grief is especially difficult for the Sandwich Generation. Adult children must balance the grieving process while still bearing responsibility for their younger children. Discussing end-of-life planning tasks can be difficult, but the burden of determining final wishes can be left on the children when not addressed earlier in life.
Multigenerational grief is usually seen in times of collective grief. One example being when a community grieves the loss of a leader or celebrity. Individuals ranging from Generation Z to Baby Boomers can feel the impact of the loss. Each generation may mourn differently depending upon what was considered acceptable during their upbringing.
‘TRANSGENERATIONAL GRIEF OCCURS WHEN A LOSS IS SO CONSEQUENTIAL THAT IT IMPACTS GENERATIONS TO COME.’
Transgenerational grief occurs when a loss is so consequential that it impacts generations to come. It can be viewed as an invisible burden. On a global scale, examples of transgenerational grief are slavery and the Holocaust. On an individual level, families might feel transgenerational grief when they encounter child loss or the loss of a sibling. When working through transgenerational grief, it is essential to reflect on which hurt to let go of and which to carry on to the next generation. This type of shared grief can be transferred through stories, artifacts, and emotional contagion.
Intergenerational, multigenerational, and transgenerational grief all can be unbalanced, based upon the generation. One might feel more grief for the loss of a parent than the loss of a cousin. When developing a circle of support to cope with one’s mortality or grieving the loss of a loved one, it is beneficial to find help from all generations. Older adults are provided the opportunity to develop and pass down a legacy, while younger people may be inspired to cherish their remaining years of life.
When researching and exploring new solutions and approaches for end-of-life care and acceptance, the power of intergenerational connections cannot be overlooked. Generativity can take place through legacy work, wherein younger people work with older people to help them use technology to document their life stories and lessons to be passed down to future generations. Co-creating art, music, and other crafts is another example used in hospice and palliative care communities.
Death Doulas and Elder Doulas
As one small positive effect of the pandemic, death doulas and elder doulas are becoming more known. Death doulas and elder doulas are trained professionals who provide non-medical support to older adults and the dying. By training younger people on the aging process and end-of-life best practices, intergenerational relationships improve, and social isolation decreases.
Studies have shown a link between ageism and end-of-life dignity (Dobson, 2005). Without the bond of intergenerational relationships, older adults may feel isolated at the end of life. Ageist mindsets can limit older adults’ exposure and access to end-of-life services. Death is a critical stage in the human growth and development process (Asatsa, 2020). It is the final stage of life and will be experienced by all. To die at an older age demonstrates a well-lived life.
In addition to death doulas and elder doulas, training programs are being developed to build community death doulas, also known as grief walkers, to enrich the dying experience and ease the grief process. These programs are primarily found in BIPOC communities. Discussing grief at an intergenerational level is a new approach for engaging younger people involved with traumatic grief and gang violence. Individuals are trained to navigate the generational differences in mourning. How one might approach a preschool-age child experiencing the loss of a grandparent can be vastly different from the approach taken with a high school–age child coping with the loss of classmates due to a school shooting. Again, death can occur at any age and any stage in life. By not discussing grief at various ages, children cannot know how to cope with loss properly.
One solution to intergenerational conflict at the end of life is changing mindsets from doing to being. Our society can place too much focus on productivity and not enough on living. Slowing down to live more intentionally is one benefit of building intergenerational connections. It is time to move past superficial and short-term relationships to true connectedness. That is where the power lies and the opportunity to transform end-of-life support. By moving past care and companionship to true connectedness, individuals from different generations can help one another to grieve, heal, and prepare for life’s ultimate transition.
End-of-life practitioners should work to increase intergenerational connections through one-on-one interactions, support groups, and community settings. The power of intergenerational connections can be the best route to a death-positive and age-friendly future.
Maurya D. Cockrell, DHPE, the founder of Leaves Speak Healthcare, Inc., located in Clayton, MO, is a 2021–22 Encore.org Gen2Gen Innovation Fellow.
Asatsa, S. (2020). Death attitudes as possible predictors of death preparedness across lifespan among nonclinical populations in Nairobi County, Kenya. Indian Journal of Palliative Care, 26(3), 287–94.
Brubaker, T. H., & Brubaker, E. (1999). The four Rs of intergenerational relationships: Implications for practice. Michigan Family Review, 4(1).
Dobson, R. (2005). Age discrimination denies people a “dignified death.” BMJ, 330(7503), 1288. Retrieved July 5, 2022, from www.ncbi.nlm.nih.gov/pmc/articles/PMC558233.
Leschak, C. J., & Eisenberger, N. I. (2019). Two distinct immune pathways linking social relationships with health: Inflammatory and antiviral processes. Psychosomatic Medicine, 81(8), 711–19.
McLeod, S. (2007). Maslow’s hierarchy of needs. Simply Psychology, 1(1–18).