One Year On: What Have We Achieved?

A year ago on 10th February, 2020, the fledgling HAIRE team sat down to eat together in a little bistro in Lille to celebrate the launch of the project, Healthy Ageing through Innovation in Rural Europe. It almost seems decadent in retrospect. No-one could have predicted the year that was to follow and the difficulties the world would face in the throes of a global pandemic.

Covid-19 struck at the heart of our target group, exacerbating the very problems HAIRE had been designed to address. Not only was access to health and wellbeing services made more difficult, our already vulnerable target suffered increased loneliness and isolation in many cases. Face to face interviews (HAIRE’s Guided Conversations) could not go ahead as originally planned. As Europe-wide lockdowns took hold, alternative methods to talk to older people had to be found, and fast.

Our first challenge was to secure a remote simultaneous interpretation platform so that we could easily talk to all of our European partners online. Thanks to everyone working together to find solutions, the Guided Conversations – the technique used to establish older people’s needs and desires – were adapted to take place virtually or by telephone according to participant and volunteer comfort. Crucially, they evolved with the unique situation in every locality. HAIRE’s place-based, person-centred approach was (and continues to be) carefully managed at every step of the toolkit adaptation, from content planning to execution. One of the features of the toolkit is the use of a site-specific image to help participants articulate their needs and desires in relation to both interior and exterior spaces. This co-design work involved all partners and brought about a deeper understanding of each others’ localities.

It is a testament to their commitment that throughout 2020 each partner continued to be fully engaged in the project despite Covid-19 obligations in their country. East Sussex County Council and Rother Voluntary Action hosted several online HAIRE-branded community talks for an Ageing Well festival, which other partners attended as well.

The level of every partner’s commitment has not waned even though each partner has had to flex their approach to other HAIRE activities and information gathering, such as the Neighbourhood Analysis and community reports. (These elements of the toolkit establish the extent and nature of individual social networks and connections, and what opportunities, such as activities and services, are available to participants in each community.) There too, partners have helped each other find workarounds and helped problem solve for each other in order to gather the data.

In our most recent partnership meeting, we used Sli.Do to ask partners for one word that describes the work of HAIRE. As the word bubble took shape, three words stood out: Empowering Community Together. So it is perhaps not surprising that, despite Covid-19 lockdowns and limited face to face contact with older people, we have overachieved on Enabler recruitment. Enablers are the volunteers and health professionals who are trained to use the HAIRE toolkit and conduct interviews with older people. We had an original recruitment target of 80 Enablers – and we now have 147, with 115 of them trained so far. And despite delays, we are on track to achieve 600 participants for the Guided Conversations: we have 282 recruited participants, with 126 having already started their conversations.

HAIRE is being designed with future users and sustainability in mind. Partners are already presenting the project to potential future users of the toolkit. In the UK, Devon Mind has introduced HAIRE and the team to CoLab Exeter, a cross-sector, multi-agency co-working hub that is home to some 35 different projects and services that work collaboratively. Other conversations have taken place between Sussex County Council, Rother Voluntary Action and Hastings Borough Council.

Across the 2Seas region, our partners have been talking to local governments’ social services departments; in Belgium, conversations have taken place with the Province of Antwerp and LiCalab (Living and Care Lab). In France, the University of Artois has developed a partnership with 30+ organisations in their area, called ‘Cluster Senior’; our French partners have also connected with the Interreg Project Buurtzorg. Pilot sites in all countries have been in regular contact with their Observer Partners. In total, the HAIRE partnership has engaged over 350 local groups, voluntary groups and a variety of organisations.

The transferability of HAIRE is not just geographic but also crosses sector boundaries to unexpected targets: we are seeing opportunities for its person-centred approach to be applied widely, e.g. tackling homelessness and drug addiction. 2021 and beyond may be a tough road for many communities. We are confident that HAIRE will not only rise to the challenge, but will also offer solutions and tools for communities to thrive beyond this pandemic.

 

What’s in a Place?

This month we are showcasing our place illustrations, which will be used during Guided Conversations in individual pilot sites during the research…

Depiction of the Parish of Feock, Cornwall, UK

Parish of Feock, Cornwall (UK)

A cow peers over a wooden picket fence close to a Celtic cross, one of the waymarkers in Cornwall that still stands on ancient rights of way. A ship drifts in the sky, which is punctuated with trees and cliffs, farm buildings and a Spar shop. A lone dog walker stands on the quayside, looking out across the water towards the village hall. A village signpost nudges a fairylike stone tower that sits on the edge of a National Trust garden. The Docks, an icon of Falmouth’s modern shipping industry, melds past and present, overlooking the third deepest natural harbour in the world…or is it? Maybe, to you, it’s the ferry chugging across the river; perhaps the fairytale tower brings to mind your local church and community, or the dog walker is actually not on a quayside at all, but in your local park (and just out of sight is the dog walking group you have been longing to join).

The images have all been created to bring to mind local elements in each of our project pilot sites. This image was designed for participants living in the Parish of Feock in Cornwall, which spans several villages. Some depictions, such as specific landmarks, are unmistakable; others are more malleable – in fact, the story changes depending on who is doing the viewing. That’s exactly what we want. These images are able to elicit unique responses that are beyond top of mind thoughts and feelings as participants are asked what it’s like to live in their community. They may trigger ideas and experiences that give a deeper insight into what life is like in the community in which they live – and what might be changed or added to make it better for them as they age.

Image depicting Le Nord

Le Nord (France)

As one resident puts it: “The days of “grey” skies has arrived in the Hauts-de-France region. It may be a bit “challenging” sometimes but it is part of the cycle of nature. And, it’s a beautiful region, especially in the spring…” In this image are the ubiquitous Tabac and La Poste, familiar signage to all inhabitants, with some hints to urban life, such as the Merville town hall and the station at Hazebrouck. The more rural traditions are also visible: the dresses of Flanders, for example, which are well known, and the sight of a Bailleul windmill in the distance, a feature of countryside walks.

Depiction of East Sussex, UK

East Sussex (UK)

Historic landmarks that will be familiar to residents are here: a walker crosses the moat to visit Bodiam Castle; a street sign for Playden, a village first recorded in the 1086 Domesday Book, is at the centre; transport links are evident: the bus and the train station, with links into London, suggest its position out of the city. There is evidence of the water: a playground near Camber Sands, a famous stretch of beach, is alluded to – perhaps an opportunity here to recall trips with children and grandchildren. The oast houses are a familiar sight on the horizon.

Depiction of Laakdal, Belgium

Laakdal (Belgium)

There are four small parishes conjured up in this image: Eindhout, Veerle, Groot-Vorst and Klein Vorst in the municipality of Laakdal, Flanders. Laakdal was named after the valley (dal) of the river Laak. Key landmarks include the old town hall, in the upper left, in Eindhout; the water tower (bottom right) in Veerle; dotted about the image are figurines from the garden of a building housing adults with disabilities. A man leans against a tractor, similar to those found in Groot-Vorst.

Depiction of Goes, Zeeland, in the Netherlands

Goes, Zeeland (The Netherlands)

Goes is a city within the rural municipality, criss-crossed with waterways; you can see a typical boat, train and of course, someone riding their bicycle – in this case, commuting. There is distinctive street art on the sides of buildings, evidence of the new merging with the historic architecture. Many of the graffiti murals include geese as a symbol of the area (Goes is pronounced almost like goose or “ghoosh”, with a distinctively soft ‘g’.) Two towers are included as points of reference; the water tower south of Goes, and the TV tower in the North.

Depiction of Poperinge, Belgium

Poperinge (Belgium)

Last, but not least, residents will recognise the statue of Warme William, the local mascot, seated on a park bench in the town of Poperinge (he is usually blue). He is a symbol of community connection and resilience. Other familiar features of the town include the town hall and the library, (Letterbeek). There are public art installations in the local area; a monument to the Paardenmarkt, the old horse market, is alluded to in the bottom right of the image. The rural life surrounding the town is depicted by the tractor and foliage at the top of the image, and the Vleterbeek is a waterway, with trails along streams and grassy landscapes.

We worked with design company MAP Digital to create unique stimulus materials for each location. The images are supplementary tools in our Guided Conversations to help explore people’s experiences, needs and desires for healthy ageing. The response from participants will help shape the final toolkit (including visual designs) which is due for completion in March 2022.

 

Cross-border cooperation in action: early use of the HAIRE tool in the Netherlands

    

This month our research partner Kim Boes of Solidarity University describes the adaptation of the HAIRE tool in the Netherlands in the context of COVID-19.

The Social Work and Welfare Foundation Eastern Scheldt Region (SMWO) is a broad welfare institution in the Netherlands that provides services in the fields of social work, welfare and sports and exercise. Due to the COVID-19 crisis, SMWO social workers in Goes, a HAIRE pilot site, felt the urgent need to stay in contact with elderly and vulnerable people using our Guided Conversation technique. A vital component of the HAIRE toolkit, the Guided Conversation is a person-centred tool using a variety of different prompts and imagery that allows people to reflect on their own needs, desires, interests and aspirations, so it is ideally suited to getting to the heart of what matters to people at this extraordinary time.

Training in how to use the HAIRE toolkit is planned across the partnership for autumn, but the team decided to move this process forward and let social workers in Goes use the Guided Conversation tool for the contact moments they already had planned with elderly and vulnerable people. An English-language version of the Guided Conversation had been developed with the input of all partners, but it was vital to ensure it was adapted for the current Dutch context, so we worked in close collaboration with the social workers at SMWO, since they know their community best.

By the end of May, we decided to start testing the Guided Conversation. Three social workers from SMWO were going to interview three people each in June. In early July we planned a feedback session to discuss their experiences. We were very pleased with the results. We decided the social workers would continue using the Guided Conversation over the summer since they felt these conversations really support the work they are doing. The social workers felt the Guided Conversation tool helped them get to know the participants’ needs very well, and both interviewer and participant were enthusiastic about using it:

“It was very nice and interesting to do the interviews.” (Social worker)

“It’s amazing how open people are in those conversations. Lovely conversations arise!” (Social worker)

We discussed the social workers’ first experiences and reviewed where things needed to change in the Guided Conversation as well as what aspects should be covered in the autumn training sessions. One important thing to consider further is the dependency relationship between social workers and the participant, meaning that as they get to know each other more, there is a risk that they will worry personally about each other. There is a need to make sure all volunteers have appropriate support and have clear boundaries – this is something that social work organisations have built into their practice, and we will need to ensure the volunteers are protected throughout the HAIRE network as the study moves forward.

Other partners are hoping to start working with Guided Conversations as early as they can. Our Belgian partners in Poperinge and Laakdal expressed their wish to start using the Guided Conversation tool in their communities and asked us to share our experiences with them. We have been knowledge-sharing with them as well as with our lead partner, the University of Exeter. As a result, Poperinge and Laakdal are looking into using our test version, which will need mildly adjusting to the Belgian context. We decided to have another experience-sharing session once they have conducted some Guided Conversations. This is also important for us since their experience could again help us in developing our toolkit.

The conversation is always open between all the partners as we develop and refine HAIRE’s Guided Conversation. The more they are tested and used, the more we discover how to really make the tool work best for the participants. The head start to the programme means that the learning can be incorporated into the Train the Trainers programme planned for September, and the stories of how the Guided Conversation has worked so far will be invaluable for all HAIRE partners. They can feel comfortable going out into the field.

Kim Boes is a researcher at the Solidarity University. She is involved in setting up the pilot sites in The Netherlands and works on developing the HAIRE toolbox together with all partners. Kim is also a PhD researcher at the University of Antwerp, focusing her dissertation on the micro dynamics of social innovation in rural areas.