University of the Fourth Age: Ensuring no one is left behind | Marvin Formosa

Rosette Farrugia-Bonello, Christian Vella, Prof. Marvin Formosa, Department of Gerontology and Dementia Studies

Popular and leading discourses presuppose that the notions of active ageing and lifelong learning are unsuited with the fourth age environment. Persons in the fourth age consist generally of older persons living with physical and/or cognitive disabilities as a result of which they are either almost or completely homebound, or residing in long-term care facilities. However, it is welcoming to note that recent years have witnessed the emergence of a body of research conceptualising and documenting active ageing and lifelong learning initiatives for homebound persons via the Internet, older persons living in the community experiencing some degree of physical and/or cognitive frailty and generally attending active ageing or dementia care centres, and older persons residing in care homes for older persons.

Malta is no exception to such trends and nowadays one finds a plethora of active ageing and lifelong learning initiatives in local day centres for older persons, care homes and residential long-term facilities for older persons.

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The University of the Fourth Age, founded in 2019 under the auspices of the University of Malta Outreach programme, aims precisely to facilitate the participation of largely frail older persons in active ageing and lifelong learning programmes. The U4A is poised to enhance the quality of life and wellbeing of fourth agers by improving cognitive outcomes, self-confidence, locus of control and self-efficacy and reducing agitation, neuropsychiatric symptoms and depression, as well as providing them with a safe arena where they could express themselves with confidence.

The U4A is currently operating from the dementia day centre located in the Mtarfa care home for older persons, with a new centre scheduled to open in 2023 at Dar Padova in Gozo. The Mtarfa U4A witnesses the organisation of learning activities with older persons living with dementia. The choice of activities was not chosen in a top-to-bottom fashion and emerged following a degree of discussion and negotiation between facilitators and learners during the first introductory session. The learning activities are as following:

Reminiscence. This involves discussing old photographs that depict Malta’s past way of life in the past. Topics generally focus on transportation, running errands, Malta during the war, feasts and celebrations, and traditional Maltese food, amongst others.

Tactile. Tactile and visual prompts open the door for many wonderful conversations. For example, San Martin’s Day (San Martin) provides learners with the opportunity to feel the associated traditional bag. They are led to recall what they used to fill it with, how they used to prepare it for their children, and where they use to place it.

Cognition. Learners recall Maltese proverbs and sayings, and discuss the context within which they were said. A series of short stories are also introduced to promote listening to others reading a story and to create contextual conversations.

Arts. Learners are facilitated to create cards for special occasions, such as Christmas and St. Valentine cards. They choose a favourite image and design it either by using oil-based or water colours. This enables learners to focus and concentrate on both the colour scheme and the technique used.

Drawing. Learners are asked to choose and draw from images such as vegetables, animals or musical instruments. Many opt for an image they relate with, such as potatoes in the case of families with farms, and more popular, dogs for those who kept dogs as pets. Giving someone a choice gives a sense of autonomy and a feeling of dignity.

Painting. Whilst painting represents an intimidating practice for many frail older persons, when it is attempted in the company of peers, it represents a way to share emotions. This is especially true for those who are unable to communicate verbally.

Singing. Learners are prompted to sing traditional Maltese songs which tends to results in a noticeable surge in positivity, happiness and memory. Music interventions evoke good mood, reduce emotional and behavioural disturbances, and relieve pain.

Poetry. Learners are prompted to recall poems which they recited when younger at school. Poems are quickly recited by heart as learners remember them eloquently, with facilitators using open-ended prompts to facilitate discuss.

Movement. Every session includes a number of physical exercises. Such exercises involve a series of seated workouts which also ensured the safety of participants but also allowed them to move various parts of their body and even express themselves.

The U4A thus seeks to connect persons living with dementia and to provide them with an opportunity to reminisce, socialise and to share their feelings. All human beings are first and foremost social beings. They also have the need to be listened to and to feel that they are needed and valued.

It is hoped that the U4A will lead to improved cognitive outcomes and reduced agitation and depression levels, as well as allowing fourth-agers learn new things, keep their body and mind active, and becoming more aware of what’s going on in the world. In brief, it acts as a catalyst in “learning to know” by contributing significantly to participants’ satisfaction and independence, “learning to do” by encouraging them to become digitally connected and being offered a unique person-centred approach, “learning to live together” by building bridges between generations and developing support and solidarity, and “learning to be” by developing greater autonomy, judgement and personal responsibility.

One augurs that in the foreseeable future the U4A increases the range of learning programmes for older persons in residential long-term care that revolves around drama, wine/cheese social events, gardening, dancing, wheelchair biking, crafts, poetry, fashion, walking, photography, sewing, singing, pet activities, cooking, making memory books, and reminiscing.