What Does a Guided Conversation Look Like?

A recent interview conducted for the Département du Nord, one of our project partners in France, brings the interview process to life for those new to HAIRE and the Guided Conversation technique. The article appears below in its original language, and is followed by a translation into English by our French intern, Valentine Naude. 

Conversations guidées pour séniors isolés

25 Mai 2021

Le Département participe au projet européen HAIRE qui vise à identifier les besoins et envies des personnes âgées isolées grâce à des conversations guidées. À Arnèke, Jocelyne et Guy Deroo ont pu y participer. Rencontre.

Pour arriver chez Jocelyne et Guy Deroo, mieux vaut avoir un bon GPS. L’ancien corps de ferme qu’ils habitent est situé aux confins du village d’Arnèke, tout au bout d’un long chemin de terre.

Une fois sur place, plus que la cloche un peu fatiguée par les années, c’est “Nounours” qui se charge de prévenir de votre arrivée. L’impressionnant chien de montagne des Pyrénées (65 kg !) est l’un des nombreux animaux à tenir compagnie au couple, très isolé.

Nous sommes ici depuis 20 ans mais nous ne connaissons personne, explique Guy. Nous n’avons presque pas de famille non plus, et au fil des années, les liens se sont distendus. Et puis notre boîte aux lettres est là-bas, au bord de la route, alors je ne vois même pas le facteur. 

Jocelyne, son épouse, souffre d’importants problèmes de santé qui entravent grandement sa mobilité. Coincé dans sa maison isolée au beau milieu de la plaine flamande, le couple ne voit plus que l’auxiliaire de vie qui passe quotidiennement.

Identifier les besoins des séniors isolés

C’est dans le cadre du projet européen HAIRE (Healthy Aging Innovation in Rural Europe) que Jocelyne et Guy ont fait la connaissance d’Isabelle Poiret, évaluatrice médico-sociale au Département.

Le projet, qui s’intitule en français “Vieillir en bonne santé grâce à l’innovation dans l’Europe rurale”, consiste à mener une étude sur la situation d’isolement des personnes âgées. Il est notamment basé sur le principe de la conversation guidée.

La conversation guidée est un entretien semi-directif qui dure généralement entre deux et trois heures. À partir de thématiques larges (la vie personnelle et professionnelle, l’environnement de vie, les centres d’intérêt, etc.) et de quelques images, nous invitons les personnes à nous parler d’elles-mêmes, explique Isabelle Poiret.

Les entretiens sont ensuite retranscrits et analysés par l’université d’Artois, l’un des partenaires français du Département dans le projet HAIRE.  Avec l’aide de l’association Unis-cités, le Département a prévu de mener 150 conversations guidées. Des conversations loin d’être anodines et dans lesquelles, de l’avis même de la professionnelle du Département, il y a un investissement réciproque.

Pour Guy et Jocelyne Deroo, Isabelle Poiret a une vraie qualité d’écoute qui nous a mis en confiance. Le contact est bien passé et après sa venue, on était contents. Ce projet recrée du lien et donne envie de reprendre des activités.

Les deux séniors ne demandent pas grand chose : trouver des gens pour jouer au tarot, réapprendre à jouer aux échecs, aller au musée de Flandre à Cassel, partir quelques jours en Normandie avec leur camping-car, …  Et surtout, ne plus être esseulés.

Beaucoup de séniors se résignent et ne s’autorisent plus à dire “j’ai envie de”. Pourtant, ils ne demandent généralement que de petites choses qui nous semblent anodines mais améliorent vraiment leur quotidien. Isabelle Poiret

 Ce qui ressort le plus, c’est l’envie de sortir et de revoir ses proches. L’autre jour, j’ai juste accompagné une dame jusqu’à sa boite aux lettres : c’était son bonheur de la journée, ajoute-t-elle.

En pleine crise sanitaire, la conversation guidée a dépassé ses objectifs : elle s’est transformée en outil de lutte contre l’isolement. Pour Isabelle Poiret, c’est donc bien plus qu’une étude. C’est une action à part entière et une véritable expérience humaine.

Un rapport intermédiaire a déjà été produit afin que les partenaires puissent commencer à se mobiliser sur le territoire. À partir des envies exprimées par les séniors isolés, deux axes de travail sont envisagés : mieux faire connaître aux personnes âgées ce qui existe déjà pour elles et proposer des solutions innovantes.

Dans six mois, quand je retournerai voir Jocelyne et Guy Deroo, et tous les autres, j’espère bien pouvoir leur proposer des choses !, conclut Isabelle Poiret.

Crédits photo : C. Arnould

English Translation

Guided Conversations for isolated older people

The Département du Nord is part of the European project HAIRE, aiming to identify the needs and desires of isolated older people through Guided Conversations. In Arnèke, Jocelyne and Guy Deroo were able to participate.

If you are on your way to the Deroo’s, you’d better have a good Sat Nav. The old farm buildings they live in stand at the edge of the village of Arnèke, at the very end of a long dirt track.

Once you get there, “Nounours” (“Teddy Bear”) takes it upon himself to warn the couple of your arrival (more so than the bell, a little weathered by time). The imposing Pyrenean Mountain Dog (65 kg!) is one of the many animals that keep them company in their isolation.

“We’ve been here for 20 years now, but we don’t know anyone”, Guy explained. “We barely have any family; the bonds have stretched thin. And our letterbox is all the way over there, by the road, so I don’t even get to see the postman.”

His wife Jocelyne suffers from serious health problems that greatly hinder her mobility. The couple, being stuck in a secluded house in the middle of the Flemish region, only ever see their carer who comes by every day.

Identifying the needs of isolated older people

Jocelyne and Guy met Isabelle Poiret, the Département’s medico-social evaluator, through the European project HAIRE (Healthy Ageing through Innovation in Rural Europe).

The project involves carrying out a study on the isolated situation of older people. It notably makes use of the Guided Conversation tool.

“A Guided Conversation is a semi-structured discussion that generally lasts from two to three hours. Starting off with general themes (personal and professional life, living environment, main interests, etc) and a few images, we encourage people to tell us more about themselves”, explained Isabelle Poiret.

The discussions are then transcribed and analysed by the University of Artois, one of the Département’s French partners within the HAIRE project. With the support of the organisation Unis-cité, the Département is planning on carrying out 150 Guided Conversations. “Far from being trivial”, these conversations show there is “a mutual commitment”, said the Département’s evaluator.

According to Guy and Jocelyne Deroo, “Isabelle Poiret has a great ability to listen which got us to open up to her. There was a real connection there and we were happy after she came to see us. This project is creating bonds and is making us want to pick up activities.”

Caption: Guy Deroo and Isabelle Poiret, the Département’s medico-social evaluator, discussing in front of the farm. “Nounours” never strays far from his owner.

The two older people are not asking for much: finding people to play tarot with, learning how to play chess again, going to the Flandre museum in Cassel, going to Normandy in their camper van for a few days… But mostly, not to be lonely anymore.

“Many older people resign themselves to this and don’t allow themselves to say “I want to”. And yet, they usually only ask for small things that seem trivial to us but truly improve their everyday life.” Isabelle Poiret

“What stands out the most is the desire to go outside and see their loved ones again. The other day, all I did was walk an old lady to her letterbox, and it was the highlight of her day”, she added.

During this health crisis, the Guided Conversations have exceeded their objectives, changing into a tool for combatting isolation. Therefore, for Isabelle Poiret, this is way more than a study. “This is a fully-fledged action and a real human experience.”

An initial report has already been drafted so our partners can start going into action on the field. From the desires expressed by isolated older people, two areas of work are being considered: helping older people know what already exists, and offering innovating solutions.

“Six months from now, when I come back to see Jocelyne and Guy Deroo and all the others, I sure hope that I’ll be able to offer new things!” concluded Isabelle Poiret.

Photo credit: C. Arnould

Q-Sorting: A Participatory Method for Innovation Development

In preparation for the CREATE phase of our project – the cross border development of social innovations for older people – our Research Fellow, Shuks Esmene, produced some guidance for partners around alternative methods of approaching idea generation and prioritisation. Below is an explanation of how the Q-Sort approach can be used and adapted in relation to HAIRE and its tools.

An adapted Q-Sort

The Q-Sort approach is part of a larger methodology (Q-Methodology1). Q-Sorts involve participants arranging a set of statements into a grid based on how much they agree and disagree with the statements. Therefore, the approach is more suited for situations where stakeholders can be presented with a set of statements. This approach may be useful for collating stakeholder opinions on what types of innovations would benefit the local area the most.

Note: If you wish to engage stakeholders in a more ‘open’ activity to generate ideas, a different spotlight method (to be released in the coming weeks) may be more appropriate.

i. The participants

Traditionally, individuals carry out Q-Sorts. However, for HAIRE, it may be more appropriate to arrange small groups (around 4 people in each group) to take part in and agree on a Q-Sort. For consistency, you may choose to group stakeholders with common characteristics or those that are working in a similar field to carry out Q-Sorts together.

ii. The statements

Q-Sorts are usually carried out using around 20 to 60 statements. Based on HAIRE’s timeframes and the highly likely remote delivery of the CREATE sessions, it may be best to lead a Q-Sort with around 15-20 statements!

The statements should be easy to understand and, where possible, structured similarly. We recommend using no more than two sentences per statement. See below the examples from our imaginary pilot site, HAIREbridge:

 

The statements chosen for a Q-Sort can be led by the findings of a pilot site’s draft Community Report (these were released at the end of April 2021). However, feasibility is important, e.g., if it is unlikely that you will be able to implement a transport-related innovation / change, we recommend that a transport-related statement is not included for your Q-Sort.

iii. The grid

The grid that is used to help participants sort the statements they are presented with is usually structured as shown below:

The grid shown above may be adapted to reflect the number of statements that are presented to the participants. However, the ‘bell-shaped’ structure (i.e., where there are fewer options at the extremes of the grid compared to the middle) is important. This structure enables participants to make a judgement call (usually through discussion) as to which statements they agree and disagree with the most.

Generally, statements grouped in the categories ranging from -4 to -2 in the example show above are classed as ‘disagree’. The statements placed under -1, 0 and 1 are classed as neutral, and the statements placed under 2, 3 and 4 are classed as ‘agree’. Once more, this is not a strict rule. You may wish to adapt the numbering in your grid to make the Q-Sort easier to conduct with the specific stakeholders you wish to engage.

Note: The section at the bottom right of the image included above, listing the ‘Agree’, ‘Neutral’ and ‘Disagree’ classifications, is used to collate the statement numbers that were assigned to the respective classifications. Remember to label / number the statements you present to participants clearly!

iv. Remote delivery

A remote delivery adaptation of a Q-sort can be relatively easy to implement. A facilitator can run a Q-sort with a small group (up to 4 participants) in a break-out session. A Q-sort grid can be shared on screen and statements (referred to by their numbers) can be collectively assigned to the appropriate places on the grid through discussion. The facilitator can write the relevant statement numbers into the relevant squares of the grid as the participants agree on their position. In such a circumstance, the statements can be sent to participants prior to the session.

1 Further Notes

The Q-Sort approach is part of a larger method known as Q-Methodology. The full method involves collating all scoring grids compiled by all participants. A statistical analysis of the results is then conducted to generate a ‘best-fit’ grid for groups of participants that share certain characteristics. Further, the full method dictates that individual participants produce their own scoring grids.

Given the purpose and timeframes of HAIRE, using only the Q-Sort component of the method can help facilitate group discussions and still generate an understanding of what types of innovations would be most valued in a pilot site. Overall, we hope to build CREATE approaches that are best suited to each pilot site. Each pilot site may choose to use a combination of different participatory tasks in their CREATE activities.