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.

 

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.

The impact of HAIRE: A profile from our Cornish pilot site in Feock, UK

Cathy Whitmore, HAIRE’s administrative officer in the Parish of Feock, UK, is a key point of contact for community members. Over the last year, Cathy has spent her time fielding phone calls and organising support for community members throughout the various lockdowns and beyond, and collating points of view from all stakeholders invested in the improvement and development of products and services that aspire to support and enhance the lives of older people – most importantly from older people themselves. HAIRE has offered residents an opportunity to speak up on matters close to their hearts.

The project has provided a sense of purpose, energy, and confidence during a difficult period for those volunteering or working in the community, including businesses, schools and faith groups. The spirit of community has been tested throughout the pandemic; in a previous post discussing the kindness of volunteers at the peak of the covid crisis, 150 volunteers come forward to help their fellow villagers. Because of that, Feock had no difficulties recruiting “HAIRE Enablers” – these are the volunteers who meet with older people to understand their needs and service desires. In fact, there was a 50% over-recruitment of volunteer HAIRE Enablers in the parish, which exceeded all expectations.

A recent interview with volunteer Sue Thomas in Feock featured in our project funder Interreg 2 Seas‘ “Virtual Voyage” online event, which was created for European Cooperation Day on September 21, 2021. Sue joined the project in order to help and support her local community. As part of the HAIRE volunteer preparation process, Sue took part in training sessions designed to provide skills in listening, interviewing, safeguarding and other skills that not only benefit the individual, but the community as a whole. With Interreg showcasing the work of people on the ground all over the 2 Seas area in Europe, we were given a glimpse into Feock volunteers’ achievements. Sue’s interview can be accessed on YouTube here.

Cathy said the project has created a rallying point for key figures in the community – social weavers and influencers. These are people already involved in volunteering, offering and running group activities, and council members, for example – all people who have a vested interested in making the lives of our older people better. To work together on the central theme of healthy ageing will ultimately enable stronger and more linked up solutions. Feock Parish is made up of several communities, and HAIRE has enabled them to envisage themselves as a family of villages within Feock Parish, with similar issues and concerns, rather than separate entities on a scale of importance and status, so that more people can benefit from local initiatives.

HAIRE has given inspiration and motivated fresh personnel to come forward with ideas and offers of support. An intergenerational project has been initiated by a local artist who discovered HAIRE through conversations with the team and they are now putting together plans for a “Memory Shanty Festival.” Older people in the community will share their life stories and unique points of view with schoolchildren, who will work with musicians to produce sea shanties based on real lives in their community. In general, HAIRE has provided people with an opportunity to be creative and innovative – there is “no such thing as a wrong idea”. There is something very powerful in seeing one’s ideas turn into positive action.

The conversations with participants have provided a better understanding of life changes and their impact on a multi-generational level. Ageing impacts us all, not just “older adults”. There is widespread recognition of the danger of a shrinking life world as we age, which puts us at risk of loneliness. Knowing this, it means individuals can start to plan for the future earlier, with the involvement of supporting organisations.

All pilot sites aim to improve the services already in place that have value and link in to them. In Feock, social prescribing’s growing importance and availability means that residents can be signposted to local activities for a range of different reasons, including bereavement, anxiety or loneliness. HAIRE’s volunteers are available “buddy up” with community members depending on their interest – such as swimming, gardening or walking.

The volunteers provide a guiding ‘hand-hold’ to help people discover or return to social activities, developing trust and relationships. The team has created a ‘What’s On’ list and ‘Directory of Groups, Service, and Helplines’ which can be sent to residents, who are later contacted by telephone and given the offer for further advice and support if required in the future. All the activities in the parish are advertised and reviewed on a regular basis in an accessible and inclusive format. They even advertise opportunities in a community phone box.

The CREATE workshops held throughout the summer months brought people together in a safe place to share ideas, voice opinions and feel listened to and respected. HAIRE has been able to respond to comments and requests to make quick wins in the short term with opportunities to grow in the long term.

We are all thankful for the work of the amazing volunteers involved in this project. During June’s National Volunteer Month, service users were asked for any comments they would like to pass on to Feock’s volunteers as well as posting on Facebook pages for anyone who would like to thank a member of the community for their support. A beautiful “thank you tree” was put together by a talented resident and used as a backdrop to the CREATE workshop sessions.

Importantly, the work to look at the relevance of services and the creation of new ones won’t just “stop” when the research comes to an end. The communities involved are developing the sorts of skills and opportunities that can really make a difference and can evolve with the times to ensure an organic, thriving culture of listening and learning for positive, age-friendly action with the voices of residents at the fore.

The HAIRE project involves its stakeholders at regular intervals and in different ways throughout the project as we continue to pursue widespread, sustainable system change and to initiate and support innovative models of service delivery. One element of this is to hold regular steering group meetings, such as the Parish of Feock’s HAIRE Action Group Meeting. This took place in September 2021.

Q-Sorting: A Participatory Method for Innovation Development

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

An adapted Q-Sort

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

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

i. The participants

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

ii. The statements

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

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

 

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

iii. The grid

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

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

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

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

iv. Remote delivery

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

1 Further Notes

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

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

Senior Cluster University

This month’s blog comes from our HAIRE colleagues at the University of Artois, who have innovated a new research institute dedicated to the study of healthy ageing.

Thanks to Julie Varlet at the University of Artois for this contribution to our team blog, and thanks to our intrepid intern Valentine for the excellent translation (which you will find if you scroll down.) Contact details for the team at the University of Artois are included at the end of the English translation. 

Permettre aux personnes âgées de rester à domicile tout en favorisant le lien social est un défi pour notre société et nécessite une gamme de services adaptés et un savoir-faire innovant. L’université d’Artois, entend y contribuer grâce au Cluster Senior University, un institut de formation et de recherche, dont la formation « Management Sectoriel – Parcours Cadres de direction des établissements du secteur social et médico-social ».

La formation se donne pour objectif de former les futurs directeurs et cadres de direction du secteur social et médico-social en assurant une montée en compétences et en qualification dans un secteur qui ne cesse d’évoluer. Elle vise à assurer une prise en charge de qualité des publics vulnérables. L’objectif de la formation est de former les professionnels de demain capables de répondre aux nouveaux besoins et aux nouvelles attentes des seniors. L’enjeu de la recherche est de permettre des innovations au service de la qualité de vie des seniors. Cependant, avant d’entreprendre toutes actions visant à favoriser leur maintien à domicile tout en luttant contre leur isolement en milieu rural, il était nécessaire de comprendre l’environnement dans lequel ces personnes évoluaient. Ce fut le challenge pour l’année 2021 pour les 22 étudiants issus du Master 1 « Management sectoriel ». Ceux-ci ont travaillé en collaboration avec les partenaires des Flandres Intérieures afin de produire un diagnostic démographique, de l’accessibilité et des services du territoire par le biais de la boite à outils HAIRE. Tout l’enjeu de ce travail repose maintenant sur les actions à mettre en œuvre afin de lutter contre cet isolement rural en Flandre Intérieure.

Favoriser le maintien des personnes âgées au domicile tout en étant en mesure de répondre aux besoins des publics fragiles et dépendants constituera d’ailleurs leur problématique future. Ce pourquoi les étudiants du Master étudient actuellement une gamme d’innovation sociale, en rupture par rapport à l’existant ou se basant sur une solution existante pour significativement l’améliorer. Ces nouvelles solutions, intégrant les besoins repérés dans le discours des personnes âgées, seront proposées aux partenaires français lors des ateliers CREATE, voués à la conception d’innovations locales.

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The Senior Cluster University: a training and research institute

Enabling older people to stay at home while strengthening their social connections constitutes a major challenge for our society, one that requires an array of tailor-made services and innovative skills. The University of Artois figured out a way to rise to the task: we created The Senior Cluster University, a training and research institute that offers the training programme ‘Leadership and Management Course in Health and Social Care’.

This course aims to:

  • train future directors and executives in Health and Social Care by improving their skills and qualifications in a sector that is constantly evolving.
  • ensure that vulnerable groups are properly taken care of.
  • train future professionals so they can tend to the ever-evolving needs and desires of older people.
  • foster innovation for the benefit of the quality of life of older people.

However, before we could undertake actions to combat isolation in rural areas and enable older people to stay at home, it was essential that we first gained a better understanding of the environment these people lived in. This is precisely what the 22 students who completed their ‘Master 1: Leadership and Management’ aimed for in 2021. They worked alongside partners in the Flandres Intérieures [area in the Hauts-de-France region] to make a ‘demographic diagnosis’ of the accessibility and services particular to each locality using the HAIRE toolkit. The study’s significance and practical utility will be brought to bear through the initiatives that are to be put in place to combat rural isolation in Flandre Intérieure.

The next challenge will be to enable older people to stay in their own homes, and to tend to the needs of vulnerable and dependent groups. The Masters students are therefore studying a wide range of innovative social initiatives; some of them are a clean break from existing solutions, while others are based on existing solutions with the aim of improving them significantly. These new solutions, which take into account the needs that older people have expressed in conversation, will be brought forward to the French partners during the “CREATE workshops”, which are all about ideating local innovations.

 

For further information, please contact:

Julie Varlet, Post-doctorante  06 37 62 59 96

Cécile Carra, Professeure des universités, responsable scientifique