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.

 

Extending the HAIRE toolkit: Guided Conversations with In The Mix Project

Over the past couple of months, a small team from the University of Exeter’s Social Innovation Group has been working on adapting HAIRE’s Guided Conversation tool for use in youth work. Two interns, Matilda Ferguson and Lewi Connor, have been involved in this process, and Matilda very kindly agreed to write a blog about it. Read on…

The HAIRE project aims to support older people in rural areas. One of the systems tested by the HAIRE project is Guided Conversations. These take the shape of a semi-structured discussion, prompted by images, general themes and talking points such as the local area, relationships, interests and community. Using the Guided Conversation tool, the HAIRE project has been able to explore the isolated situation of older people in rural areas, and identify their needs and desires. The Guided Conversations became not only part of a study into the rural isolation experienced by older people, but a tool for combatting it.

We have been working alongside In The Mix to explore implementing the Guided Conversations tool into youth work in rural areas. The In The Mix Project (ITMP) is based in the small town of Wiveliscombe, Taunton Deane. However, the charity provides youth and community services across Somerset. ITMP offers informal educational, activities and positive opportunities programmes to provide learning, skills and experiences, which supports young people’s personal, social, emotional and professional development, as well as boosting self-esteem and confidence. Their approach to youth work is flexible and based on issues and values prevalent to young people, their communities and their environment.

Image taken from In the Mix Project website

Working alongside the charity’s project manager John Hellier, we have tailored the prompts and structure of the HAIRE Guided Conversation to fit the focus of ITMP and context of youth work. Our version of the Guided Conversation covers three themes: place-based’, ‘people-centred’ and ‘empowerment’. We have also adapted the tool into a new format: an app. The app shows participants these themes, as well as some sub-topics, image prompts and radars which shows how positively they rate the topics discussed.

We hope that the Guided Conversations will help us to understand the situation of young people living in rural places in terms of the issues and relationships they have with their areas. This research will help youth work in rural areas to be responsive to young people’s needs. As well as this, we hope that like we have found in the HAIRE project, the Guided Conversations themselves will not just be research tools. The discussion provides opportunity for people to open up, share, connect and be heard. This itself will combat isolation and prompt discussion about solutions. The app also provides the opportunity for action through its ‘signposting’ feature, which will allow young people to find existing services to support them.

Over the last week, Lewi and Matilda went up to Exeter to meet with John to try it out. Our practice guided conversation lasted almost three hours and was a great way to understand how the tool would work in practice. After a few adjustments, the app is ready to be tested and we look forward to trying it out at ITMP sessions over the next couple of weeks.

Matilda Ferguson

Image taken from In The Mix Project website

 

 

 

 

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.

New Perspectives on Geography and Loneliness: Introduction

Jo Little, Shuks Esmene, Catherine Leyshon and Michael Leyshon, researchers at the University of Exeter, have been working on a new paper about loneliness which we introduce below. It’s one of the key issues for the rural ageing population in our study, and it’s particularly on our minds as we post, as it was recently Mental Health Awareness Week in the UK, and loneliness was the theme. For some practical tips on coping with loneliness in later life, the Mental Health Foundation has created a toolkit which you can access here.

Over recent years there has been growing recognition from government, policy makers, academics and the public of the significance of loneliness within contemporary society and with the associated deep and enduring negative consequences for wellbeing and quality of life. For example, a recent study characterises loneliness’s societal impact as follows: “Social isolation and loneliness has been classed as a major public health concern due to its negative physical and mental health implications, and living in a remote or rural area is a prominent contributing risk factor”. Loneliness has been referred to by the UK Minister for Loneliness as one of the greatest challenges of our time.

While the visibility of loneliness has increased substantially, and more understanding exists concerning its links to health, there are still important gaps in current research which we will explain and develop in our paper. We aim to develop critical scholarly understandings of loneliness that go beyond measurable indicators and risk factors (such as living in rural settings and mobility issues). While such indicators and risk factors are important in producing an overview of loneliness’s causes and impacts, loneliness is increasingly seen as not simply an individual problem and an issue that manifests due to a combination of risk factors, but as more inherently social, cultural and relational. As Geographers we are mindful of the difference that space and place make in both conceptual understandings of loneliness and its manifestation as a lived experience.

As we write, we begin with a review of the study of loneliness, summarizing some of the findings of what have been perhaps more traditional attempts to identify and measure experiences of loneliness. This provides an understanding of key trends but acts more as a springboard for the next part of the paper in which we, first, provide an improved conceptual understanding of loneliness as a dynamic part of the human condition, the definition of which derives from a set of cultural expectations as much as a lived experience which is embodied and performed in everyday life. We ask what is the connection between the apparent ‘epidemic’ of loneliness and the human condition in a world characterised by endless connection?

Second, and in a linked point, we call for more work on the multiple, shifting ways in which loneliness forms part of the lived experience. Much research implies a somewhat uncritical view of loneliness as a binary condition of being or not being lonely. This has implications for the sorts of solutions that are provided by governments, charities, communities, and individuals, which sometimes tackle ‘aloneness’ rather than ‘loneliness’. Loneliness has temporal and spatial dimensions, it comes and goes, can be experienced in a crowded place or when alone, has causes that are both identifiable and elusive, is linked to a sense of self and the place of the self in the community and wider society. Ultimately, loneliness should be understood as a profoundly subjective experience. Building on and developing Franklin’s 2009 paper, ‘On Loneliness’, we provide a critical examination of the key ‘taken for granted’ characteristics of loneliness. This will explore how loneliness is felt and experienced in contemporary society – and in particular how it relates to social bonds.

Our paper argues that a focus on space is a critical part of the complex jigsaw of loneliness – not simply that loneliness occurs more in some places than others – rather, that place can be central to the ways in which loneliness ‘sticks’ to identity. To explore these issues, we take as our focus rural spaces and the particular relationship between the constructions and contradictions of rurality and loneliness as part of its lived reality.

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. 

 

 

A systematic review on the impact of social networks on loneliness among older people in rural areas

As part of the HAIRE project, the University of Plymouth is undertaking a systematic review on the impact of social networks on loneliness among older people living in rural areas. In this month’s blog, Basharat Hussain and Mahrukh Mirza, from the University of Plymouth, explain the process and findings to date.

Healthcare related decisions are critical and therefore need to be based on high quality scientific evidence. The scientific evidence on a topic is generated through individual studies. However, evidence from a single study may not offer confidence to policy makers and practitioners to change an existing practice or adopt a new intervention. This requires an acceptable method to pool all the relevant evidence on a topic and to make the information accessible to busy policy makers and practitioners.

Systematic review is a well-recognised method of identifying, evaluating and summarising evidence from all relevant individual studies, thereby making the available evidence readily accessible to decisionmakers. In a systematic review, all studies published on a topic (in our case, healthy ageing) are searched through online bibliographic databases (e.g., MEDLINE). The online searching of databases is undertaken using a comprehensive, reproducible, and predefined search strategy. This search can result in few hundreds to thousands of studies published on the topic globally or a geographical region of interest (e.g., Europe). The searched studies are screened using strict and narrow inclusion and exclusion criteria. These criteria can consist of research participants (e.g., age over 60 years), setting (e.g., rural areas) and phenomenon of interest (e.g., impact of social network on loneliness). All studies meeting the inclusion criteria are thoroughly read, quality assessed, and their findings synthesised. The final product is a summary of findings on a topic of interest and identification of any gaps for further research in that area.

Image Source: https://libguides.library.curtin.edu.au/systematic-reviews

The review started in January 2022 and will be completed by April 2022. A comprehensive search strategy has been developed to search five main healthcare related databases on the topic. The search has identified over 38,000 published studies on the topic globally, starting from 1954 to January 2022. Screening of the published studies is underway. An interesting finding struck during the screening process is an acute lack of research on social networks and loneliness among older people in rural areas of Europe.

The findings from this review will be helpful not only for the HAIRE project, but also for policy makers, practitioners and researchers who have an interest in the topic. If you are interested in knowing more about this systematic review or would like to have copy once the findings are published, please get in touch with Dr Basharat Hussain, Research Fellow in Health Innovation, University of Plymouth (Basharat.hussain@plymouth.ac.uk), OR Dr Mahrukh Mirza, Lecturer in Clinical Education, University of Plymouth (Mahrukh.mirza@plymouth.ac.uk).

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