CREATE: New Models of Service Delivery for Older People

(This blog is written in English and French – please scroll to the end for the French language version.)

It’s been a cold and reluctant spring for us all in the HAIRE community: the UK saw the lowest April temperature since 1922. The sun is shining today, however, and we are feeling more hopeful as we get ready for summer and the opening up of our communities. By the end of April, HAIRE partners had compiled the initial Community Report drafts for our pilot areas, which combines information gleaned from Guided Conversations, Action Plans and Neighbourhood Analysis. Our partners are now preparing for our next major challenge: co-creating innovative service delivery in the pilot sites and beyond that respond to the challenges identified in their areas. Some challenges are unique to the pilot sites and some stem from issues that are commonplace in rural Europe.

For the past several weeks, the University of Exeter has been hosting drop-in Teams sessions for all partners to discuss progress and to share participatory methods for innovation and idea generation. We’ve looked at such techniques as mind-mapping and Q-sorting. We’ve discussed key practical considerations, such as tailoring sessions to different audiences and sizes and making sure all the exercises are inclusive. Our colleague Femke Verthé at iDROPS – a Belgian organisation skilled in social innovation development – led sessions on Human Centred Design Thinking, a participatory tool for inspiration, ideation, focusing and prototyping.

Throughout May, partners have been gathering ideas and meeting with their volunteers, stakeholders and communities in unique ways. For example, in East Sussex, the HAIRE enablers have been going on walks with their community, and this act of getting volunteers to talk to the community members really engages them in the idea generation process and makes for powerful, insightful input.

Drawing on their experience of piloting actions locally, the partners, older people, local partners, volunteers and agencies will come together in June in a joint CREATE workshop (Crossborder European Activity Testing Exercise) to share their experiences and support and mentor each other. Partners will organise themselves into Action Learning Sets, cross-border groups that want to work on shared innovations together. Action Learning is one of the methods effective programmes use to help participants apply learning in a support group. This approach encourages partners to make meaning from direct experience and supports genuine cross-border idea exchange.

We are also taking the time during the June CREATE workshops to “get to know each other” more personally. All the Covid restrictions have meant we haven’t been able to travel or meet with our counterparts in different countries. The socialising will have to wait a little longer, but we’ve integrated a creative writing workshop into the sessions, in which we’ll look at poems about ageing in all our languages, listen to each other speak in our native tongues, and write and share our own personal and cultural experiences of ageing. The atmosphere of mutual support, shared experience and cultural learning will provide another layer of depth and understanding in our cross-border exchange as we drive towards positive change for our older people.

Here’s one of our chosen poems.

Long Life, by Elaine Feinstein

Late Summer. Sunshine. The eucalyptus tree.
It is a fortune beyond any deserving
to be still here, with no more than everyday worries,
placidly arranging lines of poetry.

I consider a stick of cinammon
bound in raffia, finches
in the grass, and a stubby bush
which this year mothered a lemon.

These days I speak less of death
than the mysteries of survival. I am
no longer lonely, not yet frail, and
after surgery, recognise each breath

as a miracle. My generation may not be
nimble but, forgive us,
we’d like to hold on, stubbornly
content – even while ageing.

French Translation follows:

Ce fut un printemps frileux pour la communauté HAIRE, le Royaume-Uni ayant connu ses températures les plus basses depuis 1922 pour un mois d’avril. Aujourd’hui cependant, le soleil brille, et l’optimisme est lui aussi au rendez-vous alors que nous nous préparons en vue de l’été et de la réouverture de nos communautés. D’ici la fin du mois d’avril, les partenaires du projet HAIRE auront compilé les versions préliminaires des premiers rapports communautaires de nos sites pilotes, qui cumulent les informations récoltées lors des Conversations Guidées, des Plans d’Actions et des Analyses de Voisinage. Nos partenaires se préparent désormais à affronter notre prochain grand défi : non seulement cocréer une prestation des services innovante au sein de chaque site pilote, mais aussi résoudre les problèmes qu’ils ont distingués dans leur région respective. Certains problèmes sont propres à leur site pilote tandis que d’autres découlent de problèmes répandus en Europe rurale.

Ces dernières semaines, l’Université d’Exeter a animé des séances de discussion ouvertes sur Microsoft Teams, afin que tous les partenaires puissent discuter de l’avancée du projet et partager des méthodes participatives d’innovation et de conception de nouvelles idées. Nous avons testé des techniques comme la carte heuristique ou le Q-sort. Nous avons débattu de sujets clefs d’ordre pratique, par exemple comment adapter les séances à des publics différents et des groupes de tailles différentes, et comment s’assurer que tous les exercices sont inclusifs. Notre collègue Femke Verthé, de la société belge iDROPS – spécialisée dans le développement de l’innovation sociale –, a animé des séances sur le Design Centré sur l’Humain, un outil participatif d’inspiration, d’idéation, de concentration et de prototypage.

Au cours du mois de mai, nos partenaires ont recueilli les idées des uns et des autres et ont rencontré bénévoles, intervenants et communautés par le biais de méthodes uniques. Par exemple, dans le Sussex de l’Est, les Aidants HAIRE font régulièrement des promenades avec les membres de leur communauté. Cette démarche d’échange entre les bénévoles et la communauté les implique réellement dans le processus de conception de nouvelles idées, apportant au projet une contribution percutante et instructive.

Mettant à profit leur expérience pour mener des actions à l’échelle locale, les partenaires, les personnes âgées, les partenaires locaux, les bénévoles et les organismes se réuniront en juin lors d’un atelier CREATE (« Crossborder European Activity Testing Exercise ») commun, afin de partager leurs expériences ainsi que se soutenir et se guider mutuellement. Les partenaires se répartiront dans des « Sets de formation-action », des groupes transnationaux désirant travailler ensemble sur des innovations communes. La formation-action est l’une des méthodes que les programmes efficaces utilisent pour aider les participants à appliquer les notions apprises dans un groupe de soutien. Cette approche encourage les partenaires à trouver du sens dans leurs expériences directes et promeut un véritable échange d’idées à travers les frontières.

Pendant les ateliers CREATE de juin, nous prenons également le temps « d’apprendre à se connaître » de façon plus personnelle. Toutes les restrictions relatives au COVID19 nous ont empêchés de voyager ou de rencontrer nos homologues d’autres pays. Le retour de la vie sociale devra attendre encore un peu, mais nous avons mis en place un atelier de création littéraire parmi les différentes sessions. Cet atelier nous donnera l’occasion de découvrir des poèmes sur le vieillissement dans toutes nos langues, d’écouter les uns et les autres parler dans leur langue maternelle, et d’écrire et de partager notre propre expérience personnelle et culturelle du vieillissement. Cette atmosphère de soutien mutuel, de partage d’expérience et d’apprentissage culturel apportera une nouvelle dimension de profondeur et de compréhension à notre échange transnational, alors que nous avançons vers un changement positif pour nos personnes âgées.

Voici l’un des poèmes que nous avons choisis:

Longue vie, par Elaine Feinstein

 

Fin d’été. Soleil. L’eucalyptus.

C’est une chance que nul ne mérite

d’être encore ici, avec des soucis de tous les jours et rien de plus,

à placidement accorder des vers de poésie.

 

J’examine un bâton de cannelle

enroulé de raphia, des pinsons

sur l’herbe, et le buisson râblé

qui cette année a donné naissance à un citron.

 

Ces temps-ci je parle moins de la mort

que des mystères de la survie. Je ne suis

plus seul, pas encore chétif, et

depuis l’opération, je réalise que chaque souffle

 

Est un miracle. Ma génération n’est peut-être pas

preste mais, pardonnez-nous,

nous voulons tenir bon, obstinément

satisfaits – même en vieillissant.

 

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. 

 

Working Together in Lockdown

This month, Dr Shuks Esmene, HAIRE Research Fellow, provides an update on research co-design and development through lockdown.

Despite the difficulties posed by COVID-19 and the restrictions of lockdown, HAIRE’s activities around co-designing research tools appropriate to our specific pilot sites is underway and progressing. With our target group, the over 60s, among the most vulnerable, we had – and still have – to be creative and open minded about alternative ways of reaching our participants and volunteers, and planning with our research and delivery partners has, of course, been restricted to online activity only.

Thus, in the absence of being able to meet with people face to face, we adapted our partner engagement activities and co-design workshops to run virtually. We’ve done guided conversation workshops developing toolkits, discussing cultural context and sharing stories about how people use their spaces in different countries. We are working with our partners in the Netherlands, France and Belgium in new ways all the time – evidenced by our tweets!

Lockdown poses challenges around sharing highly visual and participatory materials, but we were able to receive valuable feedback through our continued and open approach to communicating with our partners. Technology has allowed us to carry on with our research despite the barriers. To date, we have produced first iterations of conversational and visual prompts that we’ll be using with participants. Each location has both shared and unique issues to explore, and the way we use the images will allow each participant to make their own connections and stories and needs and ideas. We have been working on training guidelines so that volunteers will be confident using the visual materials and prompts.

This is an example of the initial imagery inspired and created with our partners in the Cornish pilot site at Feock, which will form part of the guided conversation with older people in the local area. These images are from a specific part of the Feock pilot site. Images from other areas of the pilot site will be added to the design before a final version is produced.

Our continued and open approach to communication has helped us respond to support some partners who have asked for additional tools in the face of Covid-19. We are currently working with our Dutch partners to scope the feasibility of rolling out a conversational tool that social workers in their pilot site can use now, while issues like loneliness are starkly evident. The aim of this is to try and understand the challenges individuals have faced due to the pandemic and how local resources can be used to support them to overcome these challenges. This will also provide our partners with insights into which local resources need development, or where there are gaps that could be filled.

Radar diagrams have been developed in which participants can plot how strongly they feel about certain issues – and even create radar diagrams of their own.

So it is that despite the limitations that lockdown sets us, we are finding ways to reach older people in rural communities who need support more than ever.

Dr Shuks Esmene, Research Fellow, is working with HAIRE’s pilot site partners in the UK, Belgium, France, and the Netherlands, as well as digital design studio M-A-P to co-design guided conversations appropriate for each location. Dr Esmene is part of the University of Exeter’s Social Innovation Group (SIG). You can find out more about his work with SIG, his research interests and other SIG team members by clicking here.

What is HAIRE?

Healthy Ageing through Innovation in Rural Europe

The Social Innovation Group (SIG) at the University of Exeter is a multi-disciplinary team of researchers who work on place-based and person-centred issues. We collaborate with organisations in the third sector, health and social care, the environment sector, and local and regional government, to create positive change in communities and improve people’s wellbeing. HAIRE is designed to promote healthy ageing through innovation in rural Europe.

The HAIRE project, led by SIG, aims to bring about social innovation and empowerment for older people. Rural communities are at risk of dying out: their populations are ageing and poor public transport, lack of local support and facilities, out-migration of young people, reduced services, isolation and fragmented health and social care systems all negatively impact the health and wellbeing of older people. HAIRE will tackle the problem of loneliness and isolation amongst the older population in rural areas, leading to greater community integration, better wellbeing, social innovations and empowerment. These solutions will be based on their own individual interests, capabilities and preferences and supported by the voluntary, private and public sectors.

How will we do this?

HAIRE brings together existing tools for development and deployment in rural areas. These include the Guided Conversation, Social Network Analysis and Neighbourhood Analysis. The “Guided Conversation” has been developed by the University of Exeter in conjunction with our partners to make sure it is appropriate for each specific location. It is a person-centred tool that allows people to reflect on their own needs, desires, interests and aspirations. The other two tools (Social Network Analysis and Neighbourhood Analysis) help communities to understand their own assets, levels of vitality and the potential for social innovation from the ground up. By training volunteers to deploy these tools, HAIRE hopes to develop a genuinely grass-roots approach to communities developing solutions that reduce loneliness and isolation in villages. Meanwhile, HAIRE also brings together local people, local government, agencies, organisations and the voluntary sector to innovate in service design and delivery.

How will HAIRE be delivered?

There are 8 pilot sites – 2 each in the UK, Netherlands, Belgium and France. Volunteers in each pilot area will be trained to administer the HAIRE toolkit which comprises a Guided Conversation tool and easy-to-use Social Network Analysis and Neighbourhood Analysis tools. Each pilot site will undertake around 75 Guided Conversations with people over the age of 60 who are no longer in employment, from which action plans will be produced. Each community will receive its own Community Report based on these baseline data. Partners will get together to share their experiences and prepare new models of service design and delivery for their areas. The ultimate aim is gaining the participation of older people so that they have a voice and the power to design or improve access to services and products that meet their needs and wishes beyond the pilot project and into the future.