Kate’s Grand Tour Part 3: Training in Adjacent Areas

One of the objectives of our project is to extend the use of the HAIRE toolkit beyond the borders of our pilot areas. Kate’s visit to Laakdal (one of our pilot sites) included training new volunteers in the village of Bergom in the neighbouring municipality of Herselt. This region is a good example of how the toolkit can be customised to suit the community it is used in. Assisted dying is legal in Belgium, and the toolkit needed to include training volunteers in conversations about end of life. This is the third of four short blogs about Kate’s visit to Belgium in April, 2022.

On my second full day in Belgium, myself and the local project team (Katien, Sophie and Severine) train Jill Van der Auwera from the neighbouring municipality of Herselt, which comprises the villages of Herselt proper, Ramsel, Blauberg, Bergom and Varenwinkel. The sat nav takes me to an empty field about 5k from our meeting point. Thank goodness for Google Maps.  

We meet in a community hall in a small village surrounded by farmland and forests. This area feels more remote than Vorst, with more small, scattered settlements. The team in Laakdal – including the volunteers – will help to train professionals and volunteers in Herselt in the next few weeks. The issues that face their older community – especially the rising cost of living – are very familiar. We incorporate the insights from Laakdal’s volunteers into the session, which really helps with the practical aspects of applying the HAIRE toolkit elsewhere. After our session, we walk through the quiet, neat village to the magnificent Catholic Church with its lofty, modern interior and high, vaulted wooden ceiling.  In the evening, I drive to Bergom to attend the training of volunteers in conversations about end of life. This is a particular focus for Herselt and an issue for which they have adapted their Guided Conversations. Although the training is in Flemish, I keep up with the slides by putting a few key phrases from each into Google Translate. The training covers why and how we should talk about and prepare for the end of life along with useful case studies. Assisted dying is legal in Belgium, so some of the training is about that. A new model of palliative care is presented which introduces elements of palliative care alongside continuing treatment in a more gradual way. This breaks down the cure/care dualism in which only when the search for a cure ends does palliative care begins. Instead, this model seeks to open up the conversation about the journey towards the end of life more gradually and in a supportive and empathic way. It is a moving and very productive session.

 

Talking Deck to help people with life and health issues

The Talking Deck is a new resource that has been co-designed by researchers from the University of Exeter, staff and volunteers at CoLab Exeter’s wellbeing hub, people with lived experience of homelessness, and artist Hugh McCann. The project is aligned with Project HAIRE and is based on the Guided Conversation model, showing how the HAIRE toolkit can be customised for different target groups.

The Talking Deck aims to facilitate conversations that are led and shaped by individuals seeking support. Sometimes the purpose of a conversation is simply to allow individuals to share their experiences with staff and volunteers at CoLab Exeter. As seen below, the cards in the deck include a collection of symbols, words and place-based images. They are carefully curated to help people speak about the issues that are important to them.

A variety of Talking Deck cards are in the photo, e.g. a key, a heart, trainers, animals, pictures of Exeter and words such as 'yesterday', 'future' and 'fear'.

Over a series of workshops, staff, volunteers, researchers and people with lived experiences came together to co-design the Talking Deck pack.

“Listening and co-production has been at the heart of this project. We’ve created these together with people from all sectors and walks of life. The cards are a way to facilitate conversations and help people find a way forward without getting to crisis point. People want to be listened to, first and foremost. To be seen and be validated.”  — CoLab Joint CEO Fiona Carden

The project was a partnership between researchers from the University of Exeter (Catherine Leyshon and Shukru Esmene from the Social Innovation Group‘s HAIRE team and Lorraine Hansford from the Wellcome Centre for Cultures and Environments of Health), CoLab Exeter and Devon Mind, funded through HAIRE and an ESRC Impact Accelerator Account (IAA) award. The IAA helped to translate the main principle of HAIRE’s Guided Conversation tool into a resource that suited CoLab Exeter’s working culture and the individuals who use their wellbeing hub. The principle here being the use of meaningfully co-designed visuals to facilitate wellbeing-related conversations.

“Seeing the Guided Conversation transform into the Talking Deck has been an incredibly exciting and rewarding process. Transferring our tools into new settings to help different groups and organisations always depends on successful co-design. We have worked alongside staff from CoLab and people with lived experience to produce something that can genuinely help people to have more in-depth, productive conversations about their needs, aspirations, hopes and fears.” — University of Exeter researcher Professor Catherine Leyshon

CoLab Exeter’s wellbeing hub hosts around 30 voluntary sector and statutory organisations who support people in Exeter with experiences of homelessness, addiction, the criminal justice system, the care system and domestic abuse. Over a series of workshops, staff, volunteers, researchers and people with lived experiences came together to co-design the Talking Deck pack. The packs are currently being trialled by staff and volunteers at CoLab and in other organisations, for example Julian House have experimented with using the Talking Deck in key worker support sessions with young adults in supported accommodation. So far, feedback from users of the Talking Deck has focused on how the cards help facilitate conversations that are led by the individual, rather than the staff member.

“It’s been really exciting to hear people’s reactions to the new cards. Support workers who have tried them out reported back that they were surprised how well such a simple tool opened up conversations, and helped people to talk about things that were important to them that they hadn’t raised before.” — University of Exeter researcher Lorraine Hansford

Workers commented that using the cards had given them more insight into people’s interests and concerns, and ‘opened different doors’ for people to talk about what is important to them, with issues sometimes emerging that would not necessarily come up in standard assessments used by the organisations:

“I was sceptical at first… I was quite surprised at how it was more powerful than I thought.”

“It’s another way of communicating with people, pictures have a connection to memories. For people who are vulnerable, talking can be intimidating, and it can bypass that in a gentle way.”

There is still work to be done, as the project does not intend to be prescriptive about how the resource is used. Ways of using the cards need to consider how some individuals may find engaging with the entire Talking Deck overwhelming and/or feel unsure about where to start. Continued exchanges between organisations that use the cards will be valuable in promoting the flexibility of the resource and in sharing new practices. Importantly, a Mental Health Alliance, including CoLab Exeter and Devon Mind, can potentially provide a platform for practice-led exchanges and skills sharing to take place. The Talking Deck’s launch will engage members of the Mental Health Alliance in scoping the coordination of such a platform.

Overall, the Talking Deck can be used informally in different settings to help guide conversations. The cards predominantly intend to give people choice about the topics that they wish to discuss, whilst helping to start conversations that may be difficult for people to raise.

After collating a last round of feedback, the finalised Talking Deck was launched at an event at CoLab Exeter on 3rd May 2022.

For more information, contact: Professor Catherine Leyshon (c.brace@exeter.ac.uk) or Lorraine Hansford ().

Picture of collaborators from MIND, CoLab and the University of Exeter

Left to Right: Tom Cox (Devon MIND), Fiona Carden (CoLab), Lorraine Hansford and Catherine Leyshon (University of Exeter)

 

 

Kate’s Grand Tour, Part 2 of 4: Arriving in Laakdal, Belgium

Professor Catherine (Kate) Leyshon, our Principal Investigator, was able to travel for the first time since our project launch in early 2020. She referred to her trip as the “Grand Tour”! We asked her to write about her journey to East Sussex and subsequent visit to Laakdal in Belgium, and give us a writerly flavour of what those places look and feel like, since we’ve been unable to visit. Here’s part two: her first glimpse of Laakdal. More to follow!

I arrive on the Eurostar in Brussels and pick up a hire car for the drive to Diest, the town where I am staying about 25 minutes away from the municipality of Laakdal, in the province of Antwerp. The municipality comprises the towns of Eindhout, Veerle, Vorst, Varendonk and Vorst-Meerlaar, all of which are involved with HAIRE. Diest is a pretty, well-kept town with narrow cobbled streets and new buildings tastefully blended into its historic town-centre. I take a walk up through a leafy park and back through the town square, lined with canopied restaurants where diners are enjoying the warm spring evening.

The next day, I drive to Vorst in Laakdal. Initially my car’s sat nav wants to take me to Vorst near Brussels but I realise this is in completely the wrong direction! I drive out of Diest and I’m quickly into the flat, farmed landscape of this part of Belgium. The road is straight and quiet. As I reach Vorst, I notice how quiet and tidy it is. We are meeting in the fantastic Gemeentehuis. Recently constructed and serving the whole municipality, it contains the library, a post office, meeting rooms, the only bank machine in town and some local council functions.

I meet four volunteers who have some fascinating insights into their experience of using the HAIRE toolkit. They are very generous with their knowledge, and – with a retired Alderman amongst their number – we have an in-depth discussion about new models of service design and delivery. The issues in this part of rural Belgium are familiar across the project: people growing older sometimes become less confident and stop going out as much. They become isolated and suffer some consequences to their overall wellbeing. The Guided Conversation has helped to reconnect them to the community. The partners are especially looking forward to taking ownership of a new minibus; transport here is very limited – it’s no surprise that getting around is a problem in all our pilot sites.

Kate’s Grand Tour Part One: A Visit to Rother

Professor Catherine Leyshon, our Principal Investigator, was able to travel for the first time since our project launch in early 2020. She referred to her trip as the “Grand Tour”! We asked her to write about her journey to East Sussex and subsequent visit to Laakdal in Belgium, and give us a writerly flavour of what those places look and feel like, since we’ve been unable to visit. Here’s part one, starting in Rye, East Sussex. More posts to follow!

I arrive at Rye station in afternoon spring sunshine opposite Jempsons, which looks to be a well-stocked grocery store/deli with attractive displays. It’s a short walk to the Ship Inn through the historic redbrick town centre. It’s rush-hour in Rye, with children eagerly getting on the train home from school. The offices of the Bluebird care agency remind me that Rye has an aging population, many of whom suffer from isolation and loneliness. This is why Rye is part of HAIRE, along with the nearby town of Robertsbridge, both in the county of East Sussex.

I turn off the delightfully named Wish Street onto Wish Ward in the direction of a disused factory, a piece of industrial heritage referencing the area’s past. A former bakery, it now houses a pottery. I walk past picturesque redbrick and half shingle houses. The pretty townhouse along a cobbled street with a new Jaguar parked outside tells a story that I’m only too familiar with from Cornwall where the picturesque rural setting can hide great disparities in wealth. Mermaid Street, with its ancient, rounded cobbles, opens up to my left. The Ship Inn – my destination after 7 hours traveling from Cornwall, sits in an attractive riverside location. After dumping my bags, I go for a run along a levee between the river and a nature reserve. It’s a lovely part of the world – startlingly flat compared to Cornwall.

The next day, I meet four volunteers from HAIRE and the team from East Sussex County Council, Rother Voluntary Action, and Lorna Ford, the new Deptuty CEO from Rother District Council. We all feel thrilled to be able to meet up after two years on Teams. In that time, 16 volunteers have been recruited and trained, 76 Guided Conversations have been held and more than 200 hours of information about health and wellbeing have been used in the research analysis. Key themes prioritised through the innovation process are loneliness, accessing information, life transitions, and staying active.

We have a great meeting, discussing the volunteer experience of using the HAIRE toolkit – especially the Guided Conversation – and the legacy of HAIRE which will be felt through the pilot projects in Age Friendly Rother, now officially a part of the World Health Organisation’s Age Friendly Community programme.

The eight domains of Age Friendly Communities are illustrated. They are: Communication and Information, Community and Healthcare, Transportation, Housing, Civic Participation and Employment, Outdoor Spaces and Buildings, and Respect and Social Inclusion. 

Above: the eight domains are Communication and Information, Community and Healthcare, Transportation, Housing, Civic Participation and Employment, Outdoor Spaces and Buildings, and Respect and Social Inclusion. 

 

 

HAIRE is about “a good old age”: project progress in Laakdal

Thanks to our colleagues in Laakdal for sending us a news article which was published after a large stakeholder event discussing the co-creation and prioritisation of local social innovations. Below is a translation into English of the article by Annelies Frederickx published on Wednesday 20th October, 2021. You can read the original article at source here.

The seniors of Laakdal debate four themes: mobility, leisure, caring for tomorrow and communication — © AF

Laakdal is the first municipality to undertake the European participation project HAIRE.

HAIRE’s pilot site in Laakdal involves a partnership between the local government and Welzijnszorg Kempen, an organisation specialising in the health and wellbeing of the most vulnerable in society, including older people. In Laakdal, 28% of the population is senior, so the municipality is ideally suited to explore the possibilities of co-creation with older people. There is also interest from adjacent areas, Mol and Herselt, in working with HAIRE.

Katrien Serroyen of Welzijnszone Kempen takes an active part in the debate. — © AF

The first part of the started in September 2020 with a neighbourhood analysis (a mapping of resources with residents in the neighbourhood; see this earlier blog post for an overview of what this entailed in Feock, UK, one of our other pilot sites.) Volunteers were then recruited to carry out “Guided Conversations.” Sixteen volunteers set out from the community to interview 71 older people. The respondents were 60, 70, 80 and 90 years old and they lived all over Laakdal. The Guided Conversations contain place- and person-related questions, as well as a section on personal empowerment. The results yielded a long list of more than a hundred action points. In consultation with the municipal council, the project team has filtered four priorities from this: mobility, leisure, care for tomorrow (dementia and early care planning) and communication. The older people surveyed all expressed the wish to rename the HAIRE project ‘A good old age in Laakdal’, as the English acronym did not resonate as strongly.

Sofie Schepers is an expert community-oriented care provider in Laakdal. — © AF

During the kick-off in the local meeting centre, some thirty people over sixty set to work on the four priority themes. In each domain, they identified the most important difficulties and looked for possible solutions. Rosa Wilms took an active part in the debate as she has been involved from the start: “When I read the call in the municipal information sheet, I immediately applied to be a volunteer”, Rosa Wilms reveals. “I was alone and this seemed to be an ideal pastime for me. I like to chat and through the project I was also able to make new contacts. I had a total of ten conversations, four online and six at home. They were all intense but wonderful conversations.”

Rosa Wilms has been involved in every phase of the project. — © AF

“My chats showed that older people in Laakdal struggle with a lack of respect from neighbours, young people and from traffic”, Rosa Wilms adds. “Of course there’s not much a municipal council can do about that; we all have to work on that together. I completely agree with the four chosen themes. Choices must of course be made and it seems realistic to me that the municipal council can achieve things in those four domains. The most important thing for me, however, is that we are being listened to.”

Difficult points to resolve or improve were noted for each theme. — © AF

Sofie Schepers, who leads the project for the municipal government, had good news for the participants. “The municipality is buying a van and it will be available to all older people in Laakdal. It can be used to provide transport to activities in all boroughs and we are also looking at the possibility of, for example, providing transport to the local market. The aim to provide ‘A good old age in Laakdal’ has only just started, but we are well on our way.”

L’impact du projet HAIRE : un portrait de notre site pilote à Feock (Translation)

Below is the French translation of an earlier blog post in English detailing the progress of HAIRE in the parish of Feock, one of our UK pilot sites. Thanks as always to our University of Exeter intern, Valentine Naude.

Cathy Whitmore, responsable administrative dans la paroisse civile de Feock au Royaume-Uni, est une interlocutrice fondamentale pour les différents membres de sa communauté. Durant cette dernière année, elle a passé le plus clair de son temps à répondre aux appels téléphoniques et à mettre en place des mesures d’assistance pour les membres de sa communauté – tout au long des divers confinements ainsi qu’au terme de ceux-ci. Elle a également rassemblé les points de vue de tous les intervenants qui jouent un rôle dans le perfectionnement et le développement de produits et de services visant à améliorer la vie des personnes âgées – et avant tout, les points de vue des personnes âgées elles-mêmes. Le projet HAIRE a donné l’opportunité aux résidents de parler de sujets qui leur tiennent à cœur.

Pendant cette période difficile, le projet a donné de la motivation, de l’énergie, et de l’assurance à tous ceux qui ont fait du bénévolat et travaillé au sein de la communauté, y compris les commerces, les écoles et les groupes religieux. L’esprit communautaire a été mis à rude épreuve tout au long de la pandémie ; dans un précédent article qui traitait de la bonté des bénévoles au plus fort de la crise COVID, nous remarquions que 150 bénévoles se sont portés volontaires pour venir en aide aux autres villageois. Pour cette raison, Feock n’a pas eu la moindre difficulté à recruter des « Aidants HAIRE » – il s’agit des bénévoles qui viennent à la rencontre des personne âgées pour mieux comprendre leurs attentes et leurs besoins. Il y a même eu un surplus de 50% en matière d’Aidants HAIRE recrutés dans la paroisse civile, ce qui a surpassé toutes les attentes.

Une interview récente, réalisée à Feock avec la bénévole Sue Thomas, est parue durant l’évènement en ligne « Virtual Voyage », créé par Interreg 2 Mers – qui finance notre projet – à l’occasion de la Journée de la Coopération Européenne le 21 septembre 2021. Sue a rejoint le projet dans l’intention de venir en aide à la communauté locale. Dans le cadre du processus de préparation des Aidants HAIRE, elle a suivi des séances de formation visant à inculquer aux bénévoles des compétences d’écoute, d’interview, de protection et d’autres encore, qui pourraient bénéficier non seulement aux individus, mais aussi à l’ensemble de la communauté. Alors qu’Interreg mettait en valeur le travail de tous ceux qui se trouvent sur le terrain à travers la zone européenne des 2 Mers, nous avons eu un aperçu des résultats obtenus par les bénévoles de Feock. Vous pouvez accéder à l’interview de Sue sur YouTube ici.

Selon Cathy, le projet a créé un point de ralliement pour les personnalités notables de la communauté – celles qui tissent des liens sociaux et celles qui les influencent. Il s’agit de personnes qui faisaient déjà du bénévolat, en proposant et en dirigeant des activités de groupe, et les membres des conseils, par exemple – toutes des personnes qui ont un intérêt direct dans l’amélioration de la vie de nos séniors. Travailler ensemble sur le thème central du bien vieillir permettra à terme d’ouvrir la voie à des solutions plus solides et interconnectées. La paroisse civile de Feock est constituée de plusieurs communautés, et le projet HAIRE leur a permis de se considérer comme une seule famille de villages réunis dans la paroisse civile de Feock, avec des problèmes et des préoccupations similaires, plutôt que des entités indépendantes sur une échelle d’importance et de statut, afin que plus de personnes puissent bénéficier des initiatives locales.

Le projet HAIRE a inspiré ses nouveaux participants et les a incités à présenter leurs idées et proposer leur aide. Un projet intergénérationnel a été lancé par un artiste local qui a découvert le projet HAIRE en discutant avec l’équipe, et ils sont maintenant en train de planifier un « Festival Memory Shanty ». Les séniors de la communauté feront le récit de leur vie et partageront leur point de vue unique avec des écoliers, qui travailleront avec des musiciens pour composer des chansons de marin basées sur les vies réelles de leur communauté. De manière générale, le projet HAIRE a donné l’opportunité aux gens de faire preuve de créativité et d’originalité – il n’y a « pas de mauvaise idée ». Il y a quelque chose de très puissant à voir les idées des uns et des autres se transformer en action positive.

Les conversations avec les participants ont amélioré notre compréhension des changements qui jalonnent le cours d’une vie, et de leur impact à un niveau multigénérationnel. Le vieillissement nous impacte tous, pas seulement les « personnes âgées ». Le danger d’un monde qui se rétrécit au fur et à mesure que l’on vieillit, nous exposant à la solitude, est largement reconnu. Sachant cela, les individus peuvent commencer plus tôt à planifier leur avenir, avec la participation d’organismes d’assistance.

Tous les sites pilotes visent à améliorer les services qui sont déjà en place et qui jouent un rôle important, ainsi qu’à établir un lien avec eux. A Feock, l’importance et la disponibilité croissantes de la prescription sociale permet aux résidents d’être dirigés vers des activités locales pour une multitude de raisons différentes, par exemple la perte d’un être cher, l’anxiété ou la solitude. Les bénévoles du projet HAIRE sont disponibles pour se mettre en binôme avec des membres de la communauté en fonction de leurs intérêts – par exemple la natation, le jardinage ou la promenade. Les bénévoles les accompagnent en leur tenant la main (métaphoriquement) pour les aider à découvrir ou redécouvrir certaines activités sociales, et ainsi développer confiance et relations. L’équipe a développé une liste « Que se passe-t-il ? » et un « Répertoire des groupes, services, et assistances téléphoniques » pouvant être envoyés aux résidents, qui sont plus tard contactés par téléphone et se voient offrir la possibilité de conseils supplémentaires et d’assistance s’ils en ont besoin à l’avenir. Toutes les activités organisées dans la paroisse civile sont annoncées et révisées de façon régulière dans un format accessible et inclusif.

Les ateliers CREATE qui ont eu lieu pendant la période estivale ont rassemblé tous ces individus dans un espace de tolérance pour qu’ils puissent partager leurs idées, exprimer leurs opinions, et se sentir écoutés et respectés. Le projet HAIRE a pu répondre aux remarques et à la demande en solutions rapides qui pourraient être développées sur le long terme. Il faut noter que le travail de vérification autour de la pertinence des services existants et le travail de création de nouveaux services ne s’arrêteront pas quand l’étude touchera à sa fin. Les communautés impliquées sont en train de développer un type de compétences et d’opportunités qui peuvent réellement changer les choses, et qui pourront évoluer avec leur temps jusqu’à garantir une culture d’écoute et d’apprentissage aussi naturelle que florissante, qui engendrera une action positive et adaptée aux personnes âgées.

Le projet HAIRE fait appel à ses intervenants à intervalles réguliers et de façon différente tout au long du projet, tandis que nous continuons de promouvoir un changement global et durable du système ainsi que d’amorcer et de développer des modèles innovatifs de prestation des services. Dans cette perspective, nous organisons régulièrement des réunions de groupe pour établir une ligne directrice, par exemple la « HAIRE Action Group Meeting » de la paroisse civile de Feock, qui a eu lieu en Septembre 2021.

CREATE: New Models of Service Delivery (Spanish Translation)

One of the aims of HAIRE is to develop new models of service delivery for older people. In April and May of this year, we began our CREATE process, a participatory journey for stakeholders to develop social innovations. We wrote about this here in English and French (courtesy of Valentine Naude, our French intern). The university runs a Masters degree in Translation Studies, and as a result we now have this blog in a third language – Spanish! – thanks to student Amanda Ferguson.

CREATE: Nuevos modelos de prestación de servicios para personas mayores

 Ha sido una primavera fría y recia para todos los miembros de la comunidad HAIRE: el Reino Unido registró la temperatura más baja en abril desde 1922. Sin embargo, hoy brilla el sol y nos sentimos más esperanzados mientras nos preparamos para el verano y la apertura de nuestras comunidades. A finales de abril, los colaboradores de HAIRE habían elaborado los primeros borradores de los informes comunitarios de nuestras zonas piloto, que combinan la información obtenida en las conversaciones guiadas, los planes de acción y el análisis de los barrios. Nuestros colaboradores se preparan ahora para nuestro próximo gran reto: crear conjuntamente una prestación de servicios innovadora en los lugares piloto y fuera de ellos que responda a los retos identificados en sus zonas. Algunos retos son exclusivos de los centros piloto y otros se derivan de problemas comunes en la Europa rural.

A lo largo del mes de mayo, los colaboradores han recogido ideas y se han reunido con sus voluntarios, partes interesadas y comunidades de una manera extraordinaria. Por ejemplo, en East Sussex, los facilitadores de HAIRE han salido a pasear con su comunidad, y este acto de hacer que los voluntarios hablen con los miembros de la comunidad realmente los involucra en el proceso de generación de ideas y hace una aportación poderosa y profunda.

Aprovechando su experiencia en el pilotaje de acciones a nivel local, los colaboradores, las personas mayores, los colaboradores locales, los voluntarios y las agencias se reunirán en junio en un taller conjunto CREATE – Crossborder European Activity Testing Exercise (en español: Ejercicio Transfronterizo de Comprobación de la Actividad Europea) para compartir sus experiencias y apoyarse y asesorarse mutuamente. Los colaboradores se organizarán en Grupos de Aprendizaje en Acción, grupos transfronterizos que quieren trabajar juntos en innovaciones compartidas. El aprendizaje en acción es uno de los métodos que utilizan los programas eficaces para ayudar a los participantes a aplicar el aprendizaje en un grupo de apoyo. Este enfoque anima a los colaboradores a darle sentido desde la propia experiencia y apoya un auténtico intercambio transfronterizo de ideas.

También estamos aprovechando los talleres CREATE de junio para “conocernos” más personalmente. Todas las restricciones por el coronavirus han hecho que no hayamos podido viajar ni reunirnos con nuestros homólogos de los distintos países. La interacción con otros tendrá que esperar un poco más, pero hemos integrado un taller de escritura creativa en las sesiones, en el que veremos poemas sobre el envejecimiento en todos nuestros idiomas, nos escucharemos hablar en nuestras lenguas maternas y escribiremos y compartiremos nuestras propias experiencias personales y culturales sobre el envejecimiento. El ambiente de apoyo mutuo, la experiencia compartida y el aprendizaje cultural proporcionarán otra capa de profundidad y comprensión en nuestro intercambio transfronterizo mientras nos dirigimos hacia un cambio positivo para nuestras personas mayores.

Aquí está uno de nuestros poemas elegidos.

Larga vida, escrita por Elaine Feinstein

Finales de verano. El sol brilla. El eucalipto.
Es una fortuna más allá de cualquier merecedor
estar todavía aquí, sin más preocupaciones que las cotidianas,
ordenando plácidamente versos.
Contemplo un palo de canela
atado con rafia, los pinzones
en la hierba, y un arbusto rechoncho
que este año engendró un limón.
Estos días hablo menos de la muerte
que de los misterios de la supervivencia. Ya no
me siento sola, aún no soy frágil, y
después de la operación, reconozco cada respiración
como un milagro. Puede que mi generación no sea
ágil, pero perdónanos,
nos gustaría aguantar, tercamente
satisfechos – incluso mientras envejecemos.

CREATE Juin 2021 – Réflexion (French translation)

Our French intern, Valentine, has again translated this month’s blog for us into French.  It is a research reflection by Shuks Esmene, our postdoctoral research fellow. To read the original English language version, click here.

A l’occasion des ateliers CREATE, les partenaires du projet HAIRE se sont rassemblés pour discuter de leurs premières idées d’innovations destinées à améliorer le bien-être des séniors dans les sites pilotes. Les outils de recherche utilisés dans le cadre du projet représentent un aspect essentiel de l’apprentissage HAIRE. En particulier, les expériences et les idées de tous les partenaires, y compris des bénévoles et des participants, sont aussi importantes que ces outils le sont pour identifier des actions axées sur la personne et adaptées au milieu qui soient pertinentes à échelle locale.

Notre atelier de poésie a montré que les partenaires de prestation et les équipes de recherche du projet HAIRE sont parvenus à élaborer un environnement favorable à la discussion – même en ces temps troublés ! Les souvenirs de ces personnes âgées avec qui nous avons des liens privilégiés, par exemple des parents, des grands-parents, d’autres membres de la famille et des amis, ont inspiré une séance riche en émotions. Un de nos partenaires a fait remarquer :

« Ce ne sont pas des larmes de tristesse ! »

La remarque ci-dessus concernait un grand-parent défunt et résume la façon dont nos liens avec les personnes qui comptent pour nous s’étendent au-delà de leur présence physique auprès de nous. Bien qu’elles ne fussent qu’une parenthèse parmi les autres activités du projet, les réflexions que nous tirons de telles expériences peuvent aider HAIRE à amorcer des conversations relatives à l’intégration des soins dans nos communautés. Des soins plus approfondis. Des soins qui surpassent les besoins fonctionnels des individus. Ces besoins sont extrêmement importants, bien sûr. Cependant, le bien-être ne se limite pas à la somme des besoins fonctionnels d’un individu.

Les Conversations Guidées du projet HAIRE ont révélé que les activités et les passions qui importent aux participants (marcher, tricoter, lire et se rendre à des marchés locaux, entre autres) leur ont apporté de la joie et, malheureusement, de la tristesse lorsqu’ils n’ont pu s’y adonner pendant la pandémie. Ces conclusions ne sont en aucune façon propres au projet HAIRE, mais elles lui offrent plusieurs possibilités. Le réseau HAIRE, constitué de personnes soudées et attentionnées, va nous permettre de réfléchir différemment à notre façon de procéder face à ces conclusions. Certes, il est important de faire une liste des activités et des passions présentes dans une région, et de s’assurer que ces activités sont proposées à ses habitants, mais il faudrait aussi offrir l’opportunité aux séniors de développer de nouveaux centres d’intérêts et de nouvelles passions – ce serait une façon d’ajouter de la capacité à un lieu donné. La variété des activités et les activités extracurriculaires sont considérées comme une partie fondamentale du développement de l’enfant (1).

Je pense souvent à cette façon que nous avons d’essayer de trouver et de doser un assortiment d’activités spécifiques dont la population adulte puisse bénéficier – plutôt que de nous appliquer à mieux comprendre les modalités du bien-être de chaque individu. Comme nous l’avons dit durant nos discussions sur l’innovation au deuxième jour des ateliers CREATE, cela peut faire la différence d’« être prêt à commencer modestement » afin de produire des innovations qui restent ouvertes aux contributions des habitants – particulièrement si les opinions et points de vue reçoivent une réponse et ne sont pas perdus au fil des démarches administratives. A ce titre, les solutions numériques contribuent largement à améliorer la sensibilisation, mais c’était aussi encourageant de voir des idées se développer lors des ateliers autour des activités en face à face et de la notion d’« aller vers les gens ».

Dans leurs réponses aux Conversations Guidées, les participants ont communiqué l’importance qu’ils attachent aux interactions en face à face et aux évènements de rassemblement convivial. De plus, même si nous l’avons appris par le biais d’anecdotes, nous ne pouvons oublier que les commerçants et les docteurs étaient bien plus profondément intégrés dans les quartiers ruraux par le passé. Les services avaient plus souvent lieu en face à face, et ces expériences doivent être prises en compte lorsque l’on réunit des personnes âgées.

Par ailleurs, des préoccupations primordiales vis-à-vis du profil des participants recrutés jusqu’ici ont été soulevées lors des ateliers CREATE. On considère souvent qu’une méthode de communication qui attire et inclus les groupes vulnérables et marginalisés représente un défi (2). Les communautés inclusives doivent s’assurer que tout le monde sent qu’il ou elle fait partie du lieu dans lequel il ou elle vit, et que l’opportunité d’exprimer ses opinions leur soit donnée de façon à ce que tout le monde puisse contribuer à façonner l’avenir du lieu en question. Parvenir à une compréhension plus inclusive du bien-être représentera un défi important pour le projet HAIRE, et la démarche consistant à « être prêt à commencer modestement » pourra nous être bénéfique dans cette mesure également. La recherche a parfois tendance à se focaliser sur des chiffres et des objectifs à accomplir, tous les deux générés par des groupes larges et soi-disant représentatifs. Toutefois, si nous nous posons des questions essentielles sur les points de vue variés que nous avons recueillis pendant les Conversations Guidées, nous pouvons commencer modestement. Des questions telles que : comment se fait-il que quelqu’un qui s’est occupé des autres, et qui a travaillé dur dans un secteur qui n’est pas généreux économiquement, peut se retrouver dans une position financière précaire plus tard dans sa vie ?, et, que pouvons-nous faire pour impliquer quelqu’un à échelle locale quand cette personne n’a pas pu développer et/ou approfondir des centres d’intérêt à cause d’une enfance ou d’un début de vie d’adulte mouvementés ?

Enfin, la question qui selon moi ressort le plus de nos séances CREATE est :

« Pourquoi sommes-nous, en tant que société, si mauvais à cela ? »

La réponse se trouve peut-être dans une nouvelle conception des soins, une conception selon laquelle les soins seraient reçus et donnés par des individus dans leurs communautés, et ne seraient pas simplement un service dédié à répondre aux besoins fonctionnels des personnes âgées. Fait encourageant, nous avons parfois accompli cela au sein de projet HAIRE – que ce soit entre les chercheurs et les équipes de prestation, entre les équipes de prestation et les bénévoles, et/ou entre les bénévoles et les participants. Notre prochain défi sera de trouver des façons d’impliquer les donneurs de soins dans le projet, sur tous les sites pilotes, plus étroitement encore. J’ai hâte d’affronter ce défi.

Footnotes

1. Metsäpelto, R., & Pulkkinen, L. (2012). Socioemotional Behavior and School Achievement in Relation to Extracurricular Activity Participation in Middle Childhood. Scandinavian Journal Of Educational Research, 56(2), 167-182. doi: 10.1080/00313831.2011.581681

2. Meyer, C., Evans, D., Soucat, A., Dkhimi, F., Akweongo, P., & Kessy, F. et al. (2018). Leaving no one behind? Reaching the informal sector, poor people and marginalised groups with Social Health Protection. Journal Of Poverty And Social Justice. doi: 10.1332/175982718x1536143686739

CREATE Research Reflection: Caring

This month’s blog post is a research reflection penned by Shuks Esmene, our doctoral research fellow.

HAIRE’s CREATE workshops (held June 2021) brought together the partnership to discuss our initial ideas for innovations to improve the wellbeing of local older adults in our pilot sites. The research tools being used in HAIRE are a key part of the
project’s learning. Notably, the experiences and ideas of all project partners,
including volunteers and participants, are as important as these tools in
identifying person-centred and place-based actions that are locally relevant.

Our poetry workshop demonstrated that HAIRE’s delivery partners and
research teams have been able to build a comfortable environment for
discussion – even in these challenging times! Memories of older adults that we
hold special connections to, including parents, grandparents, other family
members and friends, filled the session with emotion. One of our partners
simply remarked, “These are not sad tears!”

Some of the poetry about ageing shared at our CREATE session

The remark above related to a late grandparent and sums up how connections to
people that we value go beyond being in their physical presence. Although a
small moment in HAIRE’s activities, reflections from such experiences can help
HAIRE start conversations around embedding care into communities. A deeper
care. Care that surpasses the functional needs of people. These needs are, of
course, extremely important. However, wellbeing is much more than the sum of
someone’s functional needs.

HAIRE’s Guided Conversations showed how valued activities and passions (walking, knitting, reading and going to local markets, to name a few) provided participants with joy and, unfortunately, sadness due to missing these activities and passions during the pandemic. These findings are in no way unique to HAIRE, but they do present the project with opportunities. The close-knit, caring network of people that HAIRE has engaged can help us to think differently about how we can act on these findings. A record of valued activities and passions in an area, and trying to ensure these activities are offered to locals is important, but opportunities to develop new interests and passions can be seen as a way of adding capacity to a place. Variety and extracurricular activities are regarded as a fundamental part of development in children (1).

I often reflect on why we try to find and measure a set of specific activities that show
benefit when adults are considered – rather than addressing how we can best
understand wellbeing priorities at an individual level. As stated during our
discussions about innovation on the second day of our CREATE workshops,
“…being willing to start small” to achieve innovations that stay open to input
from locals can make a difference – particularly if voices and perspectives are
responded to and not lost in bureaucratic processes. As such, digital solutions
are important in improving outreach, but it was encouraging to see ideas
develop around face-to-face activities and “going to people”.

A French Guided Conversation in action

Face-to-face interactions and events that bring people together were certainly
valued in responses to HAIRE’s Guided Conversations. Additionally, even if
revealed through anecdotes, we cannot overlook how local shop owners and
doctors used to be more deeply embedded in rural neighbourhoods. Services
were more face-to-face and such experiences need to be considered when
bringing older adults together.

Importantly, concerns around the participant profiles engaged by HAIRE so far
were raised at CREATE. Outreach that engages and is inclusive of vulnerable and marginalised groups is often referred to as challenging (2). Inclusive
communities ensure that everyone can feel part of where they live and, through
being able to voice and discuss their opinions, individuals can contribute to
shaping the future of a place. How we achieve more inclusive understandings of
wellbeing will be an important challenge for HAIRE and “…being willing to
start small” can benefit the project here too. Research can tend to focus on
numbers and achieving outcomes that are generated by large, so-called
representative groups. However, if we ask critical questions of the differing
perspectives that we have been able to gather through HAIRE’s Guided
Conversation, we can start small. Questions such as: why can someone that has
cared for others and worked hard in a sector that is not economically
generous end up in a financially precarious position in later life?, and, what
can we do to involve someone locally that has not been able to develop and/or
pursue interests due to a turbulent childhood and early adult life?

Finally, the question that stands out for me the most from our CREATE sessions
was: “Why, as a society, are we so rubbish at this?” The answer may lie in re-thinking care, where care is received and given by individuals in communities and not simply a service that aims to meet the functional needs of older adults. Encouragingly, we have examples in HAIRE where this has been achieved – whether it be between the researchers and delivery teams, between the delivery teams and the volunteers and/or between the volunteers and participants. Our next challenge is to find ways to engage the caring people on the project, across all sites, more closely. I look forward to
working on that challenge.

Footnotes

1. Metsäpelto, R., & Pulkkinen, L. (2012). Socioemotional Behavior and School Achievement in Relation to Extracurricular Activity Participation in Middle Childhood. Scandinavian Journal
 Of Educational Research, 56(2), 167-182. doi: 10.1080/00313831.2011.581681

2. Meyer, C., Evans, D., Soucat, A., Dkhimi, F., Akweongo, P., & Kessy, F. et al. (2018). Leaving no one behind? Reaching the informal sector, poor people and marginalised groups with
 Social Health Protection. Journal Of Poverty And Social Justice. doi: 10.1332/175982718x1536143686739

Shukru Esmene, s.esmene@exeter.ac.uk, University of Exeter

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.