Tag Archives: Healthy Ageing

Kindness and Coronavirus: Building Relationships using HAIRE

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This article was first published on the University of Exeter’s Research and Innovation blog on 20th October, 2020. 

HAIRE (Healthy Aging through Innovation in Rural Europe) is an Interreg 2Seas funded project, which commenced on 1st Jan 2020.  The project is a partnership of 14 Local Authorities, academic institutions and voluntary and community service organisations. Partners are located in the United Kingdom (UK), France, Belgium and the Netherlands, and the University of Exeter’s Social Innovation Group (SIG), based at its Penryn Campus, UK, is the project’s lead partner. Overall, the HAIRE partnership is collaborating, co-designing and testing a person-centred, place-based toolkit, recruiting volunteers to join service providers in supporting people over 60 in rural and often isolated communities.

Before Covid-19 hit, there were already global concerns about rising levels of loneliness, particularly among older people, which is what HAIRE was designed to tackle. With increased levels of isolation, fear, local lockdowns and a second wave of the virus well underway in Europe, HAIRE’s plan to harness the power of volunteers and community kindness has become more relevant than ever. The project is all about building connections and relationships so that communities are empowered to make change.

One of our partners, East Sussex County Council, led a series of online talks with the public through September and October as part of a digital Healthy Ageing Festival. These talks provided a platform for people to share their thoughts on aspects of healthy ageing and community action at a time when the awareness of what communities can do is at its height. In all our partner countries, we have seen a significant rise in voluntary, local authority and community action. The HAIRE project’s toolkit has been developing alongside the Covid-19 response in our eight pilot sites, and its use has been started early in some locations because of its relational approach.

Our colleagues in Le Nord, France, telephoned every person over 60 living in their region during the lockdown period to check on their wellbeing and to track their needs. The parish of Feock, Cornwall, UK, saw 150 volunteers come forward to help their fellow villagers. According to the Carnegie Trust, 20% of the UK population were giving between two to four hours a week helping people cope with the pandemic during the emergency phase – going shopping and picking up prescriptions, or talking to older people over the phone so they had some human contact during months of isolation.

The levels of voluntary participation have naturally subsided as people have gone back to work, reverted to old or taken up new responsibilities, but Covid has reminded many of what’s important. We’ve had no difficulties recruiting “HAIRE Enablers” – these are the volunteers who will go out and have Guided Conversations with older people to understand their needs and service desires. Our colleagues in Feock have had a 50% over-recruitment of volunteer HAIRE Enablers, exceeding expectations. East Sussex is also ready to go forward with its brand new team of HAIRE Enablers. As the project relies a great deal on the goodwill of volunteers, this is good news.

Early action was taken in the Netherlands too. During lockdown, social workers were enthusiastic about trying one of HAIRE’s tools, the Guided Conversation, ahead of schedule. The Social Work and Welfare Foundation Eastern Scheldt Region (SMWO) is a broad welfare institution in the Netherlands that provides services in the fields of social work, welfare and sports and exercise. Their social workers went out to talk to people using the Guided Conversation tool predominantly via telephone and, where possible, in person. They felt that doing the conversations strengthened their network in the community and made their position stronger. The project has helped SMWO and the social workers to renew their connections in the community. Their activities have over the years moved away from establishing individual contact to overseeing general service delivery, meaning less interpersonal contact. With the Guided Conversations they renewed relations with individuals and gained new insights into the community. This has been an important impact of HAIRE.

The Guided Conversation’s key strength is that it is a social tool. For example, one of our partners in France, Unis-Cité, works to link younger and older people through a variety of intergenerational programmes. The HAIRE project team has linked up young people with over-60s to begin a social relationship and build trust. This trust will be key in completing Guided Conversations where older adults can openly talk about what is important to them. In order to reach these objectives, the volunteers visit older people who feel lonely every week. They do whatever the elderly participant feels able to: chatting, going out, taking part in “allowed” activities and even meeting new people. They also help elderly people who have difficulties with the internet or their computer – an increasingly important means of connection in Covid times.

Most importantly, HAIRE’s Guided Conversation is not a finished tool – it is evolving, organic, responsive to individuals and their places and uses a variety of techniques to elicit responses. We are learning as we go, but in every instance, nurturing an individual relationship is key to its success. In Laakdal, Belgium, one of our partners tested the Guided Conversation outdoors with two elderly participants who were good friends. With a Duvel in hand (a typical Belgian beer), they were encouraged to talk about themselves. Both participants agreed they learnt things about each other as a result. They reflected on life’s strains during the pandemic. All activities for elderly people have been taken away and the Guided Conversation was “the most fun they’d had in months.” Indeed, the tool itself not only helps to unpick unmet needs and identify potential solutions, it is a means of connection in and of itself – an antidote to the isolation that Covid-19 can bring.

What’s in a Place?

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

Depiction of the Parish of Feock, Cornwall, UK

Parish of Feock, Cornwall (UK)

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

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

Image depicting Le Nord

Le Nord (France)

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

Depiction of East Sussex, UK

East Sussex (UK)

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

Depiction of Laakdal, Belgium

Laakdal (Belgium)

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

Depiction of Goes, Zeeland, in the Netherlands

Goes, Zeeland (The Netherlands)

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

Depiction of Poperinge, Belgium

Poperinge (Belgium)

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

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

 

Neighbourhood Analysis: Research in a Tea Garden

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The Neighbourhood Analysis is one of the three tools being used in HAIRE to help us understand healthy ageing in rural places. The University of Exeter research team were able to visit a local pilot site in Feock parish and listen to what people had to say.

Feock’s neighbourhood analysis took place outdoors in Linden Hey Garden Tea Room in August. Linden Hey has been an important meeting place for people in the Feock parish, and for that reason might well provide a future site for other activities and meet ups. We were able to safely social distance, with three round tables at which community members were seated.

It’s a beautiful setting, and during the session we were joined by small birds, mostly robins, flying in and out of the garden. In one session, a vole even peeped out at us. We talked about the neighbourhood as we drank tea from red and gold floral china cups and ate lemon drizzle cake made by the owner of the tea garden (there may or may not have been scones with cream and jam. Local tip: jam first in Cornwall!)

Feock’s HAIRE Project Co-ordinator and Administration Assistant, Bex and Esther, put the session together. Bex put a flip chart on the glass windows of the cafe and the analysis began. This is a tool developed by our Dutch partners at Solidarity University and will be used by all the pilot sites in the HAIRE project. It involves the creation of a “rich picture” in words through brainstorming and mapping the neighbourhood. People were asked to talk about:

  • Local people who share knowledge, skills, experiences, offerings and expertise with others in the parish,
  • Physical elements of the community such as community buildings and meeting rooms where activities take place and where people organise gatherings and meetings,
  • Networks in which people can communicate in a less formal manner and the physical places where people can meet to discuss local problems and challenges,
  • Collaborative forms of organisation and local partnerships connecting the community and its members – for example, connections promoting and supporting positive change,
  • Associations, community groups, recreational groups, clubs, tenant organisations, and other services run by institutions, such as schools, health centres, general practitioners and emergency services,
  • Economic connections in the community, including local companies, business leaders and entrepreneurs, such as supermarkets, local shops and tourism related companies,
  • Identifying important places, traditions, and activities that are of cultural meaning to the community, and
  • History and heritage, including places and stories of particular local interest as well as past processes, plans, and efforts in community development.

There are many individuals who support others in the parish of Feock already. The trust and relationships within the community are important to recognise. This exercise helped us gain an understanding into these relationships as well. Questions and comments flowed, and during a break, people asked more questions about the project and chatted about local planning, who was moving into the area and other local issues.

The resources collated during the sessions will be used and and built on during the rest of the project. The information collated will provide a useful starting point to link and support, wherever possible, individuals to activities, groups and organisations they may not have been aware of and identify venues or spaces that may be appropriate for new activities, groups and organisations.

We continue to learn so much about our pilot sites from the communities themselves. It is an integral part of making sure that any innovation, new product or service is relevant, because it will come from the very people it is designed to serve.

 

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

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

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

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

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

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

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

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

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

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

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

 

Working Together in Lockdown

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

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

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

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

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

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

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

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

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

What is HAIRE?

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Healthy Ageing through Innovation in Rural Europe

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

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

How will we do this?

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

How will HAIRE be delivered?

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