Guided Conversations (GC) Part 2. Designing a GC

In part two of his blog, Shuks outlines key considerations for future users of the Guided Conversation tool.

This blog post builds on Guided Conversations Part 1. We outline key considerations for communities, organisations and individuals who may be interested in designing their own GC.

Although the topics that a GC aims to explore may be complex, such as wellbeing, three main principles can inform the design of a GC.

  1. GC participants are given an open platform to talk about what is important to them.
  2. Creative prompts are used as a starting point for conversation.
  3. The creative prompts need to be relevant to an overarching open question, places that are of interest for a GC and the people who will interact with the GC.

The first principle, above, is a key ethical consideration for the study of subjective topics, like wellbeing. The open platform mentioned by the principle is not only linked to the way participants are asked questions, but to their comfort. Comfort is provided by relationship building and ensuring that participants feel at ease with the individuals who are conducting GCs and in the spaces that GCs are held. Therefore, the individuals who will conduct GCs really matter, as do the places that will be used to hold GCs.

If appropriate, GCs can be co-ordinated as a way of thinking within a community, as opposed to a sit-down, one-to-one method. The points listed below outline what individuals in a community can think about during their natural, informal conversations. The scenario links to a community space where members of the community, volunteers and health and social care professionals can meet, e.g. a Community Hub.

  • Start with an easy, open question that will encourage someone to talk about their opinion of the local area – e.g. how do you find living here / where you live?
  • When a problem comes up, we can ask individuals to talk about how they might be supported with an issue.
  • There is not always a solution, sometimes people just want to talk and that’s fine.
  • If you know of any recommendations that may help the individual, e.g. a club, social activity and/or charity that can help, feel free to tell them about it.
  • For issues that require the involvement of a professional, you can fill in an Info Postcard and pass it on to a professional that deals with welfare issues. An explanation of an Info Postcard is provided in the paragraph below these points.
  • An Info Postcard should only be filled in with the permission of the individual that it relates to and requires their approval, e.g. by signature.
  • Respect the privacy of all individuals and do not pass on any details of your conversation to anyone else without their permission.

The approach outlined above can be appropriate for a drop-in help hub or social engagements that are organised for locals. In the case above, the Info Postcard refers to a simple piece of paper that can be given to a professional that is involved in the co-ordination of social and health care support. Example of an Info Postcard:

Interestingly, in the case above, there does not seem to be any creative conversational prompts – so, what happens with the GC’s second and third principles, which are all about creativity? Here, informal conversations are taking place between locals in their neighbourhoods and/or in a space that is part of a community. The surroundings become the conversation’s creative prompts and individuals can reflect on their neighbourhood’s influence by being there. An individual might think of a time when a certain building was their favourite grocers or memories of walking in the streets with friends. Like in HAIRE’s GC, the possibilities for sparking conversation are endless. Importantly, the prompts, i.e. being in the actual spaces, are still aligned with the GC’s overarching broad question: “how do you find living here?”

The example above does not intend to underplay the role of creativity in GCs. During group and/or one-to-one interactions, creative prompts can make the GC experience more engaging. Principles two and three, as listed in this blog’s opening paragraph, invite GC co-designers to think about what would be meaningful for their participants. In HAIRE, the spaces and cultural symbols in neighbourhoods and in people’s homes guided our co-design work. Hoiw However, in other cases, images that are more open to interpretation might be suitable. An example of this is the Talking Deck that was designed to talk about wellbeing in a support hub for individuals with experiences of homelessness. A blog about the Talking Deck can be seen here: Talking Deck Blog. In this case, the broad overarching starting point was to encourage individuals to talk about their day, or their week, form their own perspective.

Additionally, creative prompts do not necessarily have to be in graphic form. If interested in culture-led influences on wellbeing, it may be more appropriate to use physical objects that are well-recognised and valued by a certain culture. An interesting study, published in 2021, explored community-level opinions about Maori culture and belonging in New Zealand. Their toolkit used a selection of physical objects. The study authors reported the following:

“The aim of this [the physical objects] is to create a unique and shared experience, where the objects are used to assist participants in connecting with each other. Participants have an opportunity to comprehend and verbalise aspects of their and others’ identity and context. This experience aims to deepen their individual understanding of what belonging means to them and others.”

[Citation: Zino, I. et al. (2021) “things for thought – a creative toolkit to explore belonging,” Design for Health, 5(1), p.93. Available at:]

Written texts, stories and poems can spark memories, opinions and emotions in relation to a topic of interest. GC co-designers can use such resources as creative prompts too. In HAIRE, Kelly Stevens (University of Exeter) used a poetry workshop to explore the meaning of ageing and care with the project’s partners. A blog on this activity can be see here: Poetry, Caring and Ageing Blog. The session was structured around the following overarching question: “what does healthy ageing mean?” See below some of the poems and thoughts that were discussed at the workshop:

Therefore, when designing a GC, it is important to think about the creative skills that are present in the local community and/or the team that is co-ordinating the design of a GC. Creativity that is embedded in a community and amongst individuals who understand a GC’s topics of interest can be used to produce prompts that are relevant in particular settings. In fact, HAIRE’s work on the GC has highlighted the value of creativity when engaging communities with topics of interest that are loaded with meaning and, at times, influenced by uniqueness. The Social Innovation Group (SIG), University of Exeter, aims to build on its work in HAIRE and further develop understanding around the ways in which creativity can enhance inclusion and meanings around wellbeing.

Guided Conversations Part 1. What happened in HAIRE?

Shuks Esmene, the postdoctoral research fellow on HAIRE, reflects on the Guided Conversation, a key part of HAIRE’s toolkit, in a two part blog.

In this blog, we document how HAIRE’s Guided Conversation (GC) shaped the project’s insights into the wellbeing of the older adults in its pilot sites. We reflect on the attributes of the GC that enabled the project to explore the deep, changeable and sometimes unique aspects of wellbeing.

HAIRE’s Guided Conversation (GC) was co-designed by the project’s partners to support older adults in discussing their needs, knowledges and skills, and aspirations. In-depth, one-to-one dialogues in community settings helped HAIRE to understand how place-based, person-centred and structural influences combine to shape wellbeing at an individual level.


  • Place-based influences refer to the places and spaces that individuals use for socialising and during their daily routines. Places and spaces that have shaped a person’s life experiences, past and present, are important too.
  • Person-centred influences encompass the life experiences that shape a person’s self-esteem, confidence and how they relate to others. Such experiences guide what a person finds meaningful and values, which can change over time.
  • Structural influences are defined by the support that is available and accessible for a person – particularly in relation to how social and health care services are organised at a local and national level.

What is HAIRE’s GC and how did it help?

HAIRE’s GC combined creative conversational prompts and broad wellbeing-related topics that were of interest to the project’s partners. In brief, partners were interested in how a person’s local neighbourhood and living spaces influence their wellbeing. The creative prompts that we co-designed reflected these interests. Essentially, the creative prompts encouraged individuals to: i) think about their wellbeing in relation to their local area and ii) think about how their living spaces influence their wellbeing.

Example of a creative conversational prompt that relates to a local area (HAIRE’s pilot site in Goes, the Netherlands):

Example of a creative conversation prompt that relates to a living space (co-designed for HAIRE’s pilot sites in Department du Nord, France):

The collages shown above were co-designed via an iterative process. Input and feedback, collected during multiple points of the design process, was provided by the project partners and the groups, organisations and individuals that they worked with in HAIRE’s pilot sites. The collages do not intend to be representative of anyone or any place. Their main purpose is to help conversation.

Ultimately, HAIRE wanted to understand wellbeing as told by the project’s participants. To do so, broad questions were posed to the older adults that resided in the project’s pilot sites. For example: “how do you feel about living in your neighbourhood?” Responses to these types of questions can be difficult to articulate – particularly if individuals have not had the time to reflect on such matters. The creative prompts provided participants with a starting point for their thoughts. The streets and spaces in the collage can remind someone of a specific experience that they had in their neighbourhood, cultural symbols may spark thoughts about belonging (positive and negative), depictions of wildlife can induce conversations about someone’s fondness for nature, or a difficult time that they had with a wild goose. The possibilities are endless!

Importantly, the materials that are co-designed for a GC need to work in combination with active listening. Active listening’s six key skills are summarised below:

In terms of active listening, a person conducting a GC can focus on:

i) Taking an active interest in what a participant is saying (1. Pay Attention);

ii) Refraining from imposing their beliefs on someone’s opinions (2. Withold Judgement);

iii) Staying attentive to what can be asked next to understand a person’s experiences and opinions in relation to what a GC aims to explore (3. Reflect);

iv) Taking notes (if relevant) that are structured to summarise the key points of what is being said – usually, capturing positives, key issues, anything that can be done to address such issues (including actions that the individual can do) and any support that can be provided to address someone’s problems works well (4. Summarise);

v) Asking follow-up questions to understand points of conversation that seem unclear (e.g. “so, you mentioned that your relationship with the local area was ‘up and down’, what do you mean by that?”). This point is important for understanding certain issues and what can be done to support a person to navigate those issues (5. Clarity);

vi) Explaining to participants the key points that were captured from the conversation. This can be done via sharing any notes that were taken and/or explaining a summary of the conversation to the participant at a later date. Here, an opportunity is provided for a participant to confirm and reflect on what is important for them (6. Share).

The creative prompts in HAIRE’s GC and active listening helped to guide conversations with older adults towards the topics that were of specific interest to the project’s partners. In all, there were 20 topics (examples include facilities and amenities, social and cultural opportunities, mobility, identity and belonging, and inclusion). Not all topics had to be covered, but they provided opportunities to build on what a participant was saying about their wellbeing. A bit like a menu for conversation that can be picked from, based on what is important to a participant.  Although, the rich menu of 20 conversational options did come with its challenges. Conversations could last up to 4 hours and remembering all of the options while a conversation was ongoing proved to be tricky.

In principle, the GC is all about allowing for deep and far-reaching conversations to take place. However, in many circumstances, other time constraints mean that conversations need to, at least, have a rough estimated duration. Such circumstances can benefit from limiting the number of specific topics in a GC and/or ensuring that a conversation is spread across multiple interactions, at different times, with a participant. In our next blog, HAIRE’s learning will be drawn on to provide an overview of key considerations for designing a GC.

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.

Celebrating HAIRE Volunteers in Rother, UK

The Rother (East Sussex, UK) Voluntary Association AGM took place on 19th October 2021 and included the first RVA Volunteer Award ceremony. The award for Outstanding Volunteers was presented by The Lord Lieutenant of East Sussex, Mr Andrew Blackman, and received on behalf of the team by volunteer Hans and Councillor Sue Prochak. The nomination for the award is printed below as it sums up beautifully the work of the volunteers. It was written by Steve Broome, HAIRE Project Manager, Policy & Strategic Development Team, Adult Social Care and Health at ESCC.


The Healthy Ageing and Innovation in Rural Europe (HAIRE) project is an Interreg-funded initiative led by the University of Exeter that works with a wide range of partners across England, France, Belgium, and the Netherlands. At the centre of the project is the importance of understanding the lived experience of ageing in multiple ways – in terms of physical health, mental and emotional wellbeing, loneliness, social relationships, connections to local organisations and services, transport, finances, and what people perceive their future might hold.

In 2020, just as the pandemic was beginning, the HAIRE project began advertising for volunteers who cared about the above issues in their Rye or Robertsbridge communities. Even in the midst of the challenges brought about by Covid, the HAIRE project was very lucky and grateful to have received interest from such an individually and collectively talented group of local people. The volunteers brought a range of professional experiences relevant to healthy ageing, and rich personal experiences of local community life and issues connected to ageing and wellbeing. All our volunteers live in the Rother area, and many have numerous voluntary and activist roles in their communities to improve wellbeing and community life in a diversity of ways.

The HAIRE volunteer team have supported the project for some 16 months and counting. The task of volunteers has been wide and complex and required flexibility.  Firstly, they undertook multiple training sessions that covered: healthy ageing theories, data, and attitudes; reflection on their own attitudes and experiences of ageing; active listening and interviewing skills; safeguarding; loneliness and mental wellbeing; understanding social networks; and action planning.

Following the training, volunteers had to put all these skills and knowledge together in conducting Guided Conversations with people aged 60+ who lived in the Rye and Robertsbridge areas. These conversations were very wide ranging, covering all the aspects of healthy ageing described above, and typically lasted 2-3 hours each. They required volunteers to build rapport and trust with others and be able to support and empathise with difficult experiences and topics, while also recording relevant information in written notes. The team have completed more than 200 hours of guided conversations, and are now repeating the exercise in going back to our 80 or so participants and seeing how things have changed for them six months on.

Beyond this, the volunteers have formed local steering groups in each of our pilot sites, meeting regularly to help guide the project, interpret data, make strategic decisions and co-produce community events. Most recently, they have helped to design and deliver events in the community with a wide range of resident and organisational stakeholders, which have resulted in innovative ideas to take forward over the remaining 18 months of HAIRE.

The volunteers have managed to do all this in the context of the COVID-19 pandemic.  This has meant having to adapt to digital ways of working, despite many volunteers not having a high degree of familiarity with the technologies we have needed to use to run many aspects of the project virtually.

To date, the HAIRE project has engaged approximately 80 local people aged 60+ and taken the time to understand their experience and situation, to reflect on it, and help identify actions and sources of support that can improve their lives and age well in place. Volunteers have helped to identify the most important themes around healthy ageing in their communities and have been a key part in designing social innovations that will meet the challenges and opportunities of ageing faced by local people.

Throughout their volunteering, they have been very generous with their time, ideas, passions and personal experience. Not only has this been key to growing a team (rather than a set of individual volunteers) and to supporting each other in the multiple and challenging tasks they have undertaken, it has directly expressed the values of the HAIRE project in a way that has been ‘socially contagious’ – because they have been passionate, committed, open, kind, and generous, others have responded similarly and felt included in the project. They have set, and continue to set, the tone of the project in a way that makes more ambitious, transformative change possible.

The project, and everything that will stem from and be influenced by it, would not have been possible without the individual and collective contributions of the HAIRE volunteers. The wide range of people involved in the HAIRE project in East Sussex and beyond are extremely grateful for their involvement in the HAIRE project and look forward to continuing to improve the lives of local people with them.

What Does a Guided Conversation Look Like?

A recent article published by 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


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Best wishes from

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