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

CREATE: New Models of Service Delivery for Older People

(This blog is written in English and French – please scroll to the end for the French language version.)

It’s been a cold and reluctant spring for us all in the HAIRE community: the UK saw the lowest April temperature since 1922. The sun is shining today, however, and we are feeling more hopeful as we get ready for summer and the opening up of our communities. By the end of April, HAIRE partners had compiled the initial Community Report drafts for our pilot areas, which combines information gleaned from Guided Conversations, Action Plans and Neighbourhood Analysis. Our partners are now preparing for our next major challenge: co-creating innovative service delivery in the pilot sites and beyond that respond to the challenges identified in their areas. Some challenges are unique to the pilot sites and some stem from issues that are commonplace in rural Europe.

For the past several weeks, the University of Exeter has been hosting drop-in Teams sessions for all partners to discuss progress and to share participatory methods for innovation and idea generation. We’ve looked at such techniques as mind-mapping and Q-sorting. We’ve discussed key practical considerations, such as tailoring sessions to different audiences and sizes and making sure all the exercises are inclusive. Our colleague Femke Verthé at iDROPS – a Belgian organisation skilled in social innovation development – led sessions on Human Centred Design Thinking, a participatory tool for inspiration, ideation, focusing and prototyping.

Throughout May, partners have been gathering ideas and meeting with their volunteers, stakeholders and communities in unique ways. For example, in East Sussex, the HAIRE enablers have been going on walks with their community, and this act of getting volunteers to talk to the community members really engages them in the idea generation process and makes for powerful, insightful input.

Drawing on their experience of piloting actions locally, the partners, older people, local partners, volunteers and agencies will come together in June in a joint CREATE workshop (Crossborder European Activity Testing Exercise) to share their experiences and support and mentor each other. Partners will organise themselves into Action Learning Sets, cross-border groups that want to work on shared innovations together. Action Learning is one of the methods effective programmes use to help participants apply learning in a support group. This approach encourages partners to make meaning from direct experience and supports genuine cross-border idea exchange.

We are also taking the time during the June CREATE workshops to “get to know each other” more personally. All the Covid restrictions have meant we haven’t been able to travel or meet with our counterparts in different countries. The socialising will have to wait a little longer, but we’ve integrated a creative writing workshop into the sessions, in which we’ll look at poems about ageing in all our languages, listen to each other speak in our native tongues, and write and share our own personal and cultural experiences of ageing. The atmosphere of mutual support, shared experience and cultural learning will provide another layer of depth and understanding in our cross-border exchange as we drive towards positive change for our older people.

Here’s one of our chosen poems.

Long Life, by Elaine Feinstein

Late Summer. Sunshine. The eucalyptus tree.
It is a fortune beyond any deserving
to be still here, with no more than everyday worries,
placidly arranging lines of poetry.

I consider a stick of cinammon
bound in raffia, finches
in the grass, and a stubby bush
which this year mothered a lemon.

These days I speak less of death
than the mysteries of survival. I am
no longer lonely, not yet frail, and
after surgery, recognise each breath

as a miracle. My generation may not be
nimble but, forgive us,
we’d like to hold on, stubbornly
content – even while ageing.

French Translation follows:

Ce fut un printemps frileux pour la communauté HAIRE, le Royaume-Uni ayant connu ses températures les plus basses depuis 1922 pour un mois d’avril. Aujourd’hui cependant, le soleil brille, et l’optimisme est lui aussi au rendez-vous alors que nous nous préparons en vue de l’été et de la réouverture de nos communautés. D’ici la fin du mois d’avril, les partenaires du projet HAIRE auront compilé les versions préliminaires des premiers rapports communautaires de nos sites pilotes, qui cumulent les informations récoltées lors des Conversations Guidées, des Plans d’Actions et des Analyses de Voisinage. Nos partenaires se préparent désormais à affronter notre prochain grand défi : non seulement cocréer une prestation des services innovante au sein de chaque site pilote, mais aussi résoudre les problèmes qu’ils ont distingués dans leur région respective. Certains problèmes sont propres à leur site pilote tandis que d’autres découlent de problèmes répandus en Europe rurale.

Ces dernières semaines, l’Université d’Exeter a animé des séances de discussion ouvertes sur Microsoft Teams, afin que tous les partenaires puissent discuter de l’avancée du projet et partager des méthodes participatives d’innovation et de conception de nouvelles idées. Nous avons testé des techniques comme la carte heuristique ou le Q-sort. Nous avons débattu de sujets clefs d’ordre pratique, par exemple comment adapter les séances à des publics différents et des groupes de tailles différentes, et comment s’assurer que tous les exercices sont inclusifs. Notre collègue Femke Verthé, de la société belge iDROPS – spécialisée dans le développement de l’innovation sociale –, a animé des séances sur le Design Centré sur l’Humain, un outil participatif d’inspiration, d’idéation, de concentration et de prototypage.

Au cours du mois de mai, nos partenaires ont recueilli les idées des uns et des autres et ont rencontré bénévoles, intervenants et communautés par le biais de méthodes uniques. Par exemple, dans le Sussex de l’Est, les Aidants HAIRE font régulièrement des promenades avec les membres de leur communauté. Cette démarche d’échange entre les bénévoles et la communauté les implique réellement dans le processus de conception de nouvelles idées, apportant au projet une contribution percutante et instructive.

Mettant à profit leur expérience pour mener des actions à l’échelle locale, les partenaires, les personnes âgées, les partenaires locaux, les bénévoles et les organismes se réuniront en juin lors d’un atelier CREATE (« Crossborder European Activity Testing Exercise ») commun, afin de partager leurs expériences ainsi que se soutenir et se guider mutuellement. Les partenaires se répartiront dans des « Sets de formation-action », des groupes transnationaux désirant travailler ensemble sur des innovations communes. La formation-action est l’une des méthodes que les programmes efficaces utilisent pour aider les participants à appliquer les notions apprises dans un groupe de soutien. Cette approche encourage les partenaires à trouver du sens dans leurs expériences directes et promeut un véritable échange d’idées à travers les frontières.

Pendant les ateliers CREATE de juin, nous prenons également le temps « d’apprendre à se connaître » de façon plus personnelle. Toutes les restrictions relatives au COVID19 nous ont empêchés de voyager ou de rencontrer nos homologues d’autres pays. Le retour de la vie sociale devra attendre encore un peu, mais nous avons mis en place un atelier de création littéraire parmi les différentes sessions. Cet atelier nous donnera l’occasion de découvrir des poèmes sur le vieillissement dans toutes nos langues, d’écouter les uns et les autres parler dans leur langue maternelle, et d’écrire et de partager notre propre expérience personnelle et culturelle du vieillissement. Cette atmosphère de soutien mutuel, de partage d’expérience et d’apprentissage culturel apportera une nouvelle dimension de profondeur et de compréhension à notre échange transnational, alors que nous avançons vers un changement positif pour nos personnes âgées.

Voici l’un des poèmes que nous avons choisis:

Longue vie, par Elaine Feinstein

 

Fin d’été. Soleil. L’eucalyptus.

C’est une chance que nul ne mérite

d’être encore ici, avec des soucis de tous les jours et rien de plus,

à placidement accorder des vers de poésie.

 

J’examine un bâton de cannelle

enroulé de raphia, des pinsons

sur l’herbe, et le buisson râblé

qui cette année a donné naissance à un citron.

 

Ces temps-ci je parle moins de la mort

que des mystères de la survie. Je ne suis

plus seul, pas encore chétif, et

depuis l’opération, je réalise que chaque souffle

 

Est un miracle. Ma génération n’est peut-être pas

preste mais, pardonnez-nous,

nous voulons tenir bon, obstinément

satisfaits – même en vieillissant.

 

Un an plus tard : Qu’avons-nous accompli ?

The HAIRE team at Exeter is pleased to have an MA Translation Studies intern, Valentine Naude, on board for a few months. This is the first of our dual language blogs. Welcome, Valentine!

Il y a un an de cela, le 10 février 2020, une toute nouvelle équipe s’est réunie autour d’un repas dans un petit bistrot de Lille pour célébrer le lancement du projet HAIRE, « bien vieillir grâce à l’innovation en Europe rurale » [en anglais « Healthy Aging through Innovation in Rural Europe »]. Voilà qui semble presque décadent, désormais : personne n’aurait pu prédire l’année qui suivrait et les difficultés que nous rencontrerions tous dans les affres d’une pandémie mondiale.

Le Covid-19 a beaucoup affecté notre groupe cible, exacerbant les problèmes que le projet HAIRE était précisément destiné à résoudre. Non seulement l’accès aux soins (santé et bien-être) est devenu plus difficile, mais notre groupe cible, déjà vulnérable, a encore plus souffert de la solitude et de l’isolation dans bien des cas. Les entretiens en face à face (les « Conversations Guidées » du projet HAIRE) n’ont pas pu se dérouler comme prévu. Alors que toute l’Europe s’est confinée, il a fallu trouver en toute urgence des solutions alternatives pour communiquer avec les personnes âgées.

Le premier défi a été de mettre en place une plateforme d’interprétation simultanée à distance, afin de faciliter la communication virtuelle avec nos partenaires européens. Grâce à nos efforts communs, nous avons pu adapter les Conversations Guidées – l’outil qui nous permet d’identifier les besoins et les désirs des personnes âgées – pour qu’elles soient menées en ligne ou par téléphone, selon les préférences du participant et du bénévole. Elles ont aussi et surtout évolué en fonction de la situation propre à chaque localité. Adaptée au milieu et axée sur la personne, l’approche adoptée par le projet HAIRE a été (et continue d’être) modulée avec soin à chaque étape d’adaptation de la « boîte à outils », depuis la planification du contenu jusqu’à son exécution. Une des caractéristiques de la boîte à outils consiste à utiliser une image propre à la localité du participant, de façon à l’aider à formuler ses besoins et ses désirs vis-à-vis d’espaces autant intérieurs qu’extérieurs. Tous les partenaires du projet ont contribué à ce travail de cocréation et ont été amenés à mieux connaître les localités de chacun.

Rien ne témoigne plus de leur engagement que l’implication indéfectible dont ils ont tous fait preuve au cours de l’année 2020 en dépit des restrictions relatives au Covid-19 dans leurs pays respectifs. A l’occasion d’un « Festival Bien Vieillir » [en anglais « Ageing Well Festival »], le conseil général du Sussex de l’Est et Rother Voluntary Action [organisme bénévole de la même région] ont animé de multiples dialogues communautaires en ligne pour le projet HAIRE, auxquels d’autres partenaires ont également assisté.

Tous nos partenaires n’ont cessé de donner d’eux-mêmes, et ce malgré la nécessité d’adapter leur approche aux autres actions entreprises par le projet HAIRE et aux collectes de données, par exemple « l’Analyse du Quartier » et les rapports des collectivités. (Ces composants de la boîte à outils permettent de mesurer et d’identifier le réseau social et les connexions de chaque individu, ainsi que de déterminer les opportunités – par exemple les activités ou les services – auxquelles les participants ont accès dans chaque communauté.) Là encore, les partenaires se sont entraidés pour trouver des solutions alternatives et résoudre mutuellement les problèmes intervenus dans la collecte des données.

Lors de notre dernière réunion entre partenaires, nous avons demandé à chacun de décrire le travail réalisé par le projet HAIRE en un mot, par le biais de l’application web Slido. La bulle de mots a peu à peu pris forme et trois mots se sont démarqués : Autonomiser [en anglais « empowering »] Communauté Ensemble. A la lumière de cela, on ne s’étonnera pas de voir que nous avons dépassé notre objectif de recrutement d’Aidants en dépit des confinements et d’un contact présentiel limité avec les personnes âgées. Les Aidants sont les bénévoles et les professionnels de la santé qui ont été formés pour utiliser la boite à outils du projet HAIRE et diriger des entretiens avec les personnes âgées. Au départ, notre objectif de recrutement était de 80 Aidants ; nous en avons maintenant 147, dont 115 qui ont reçu leur formation. Bien que nous ayons été retardés, nous sommes en voie d’atteindre un total de 600 participants aux Conversations Guidées : nous avons recruté 282 participants parmi lesquels 126 ont déjà commencé leurs conversations.

Dans sa conception, le projet HAIRE prend en compte ses futurs utilisateurs ainsi que le souci de la durabilité. Nos partenaires sont déjà en train de présenter le projet à de potentiels futurs utilisateurs de la boite à outils. Au Royaume-Uni, Devon Mind [association caritative axée sur la santé mentale] a présenté le projet HAIRE et son équipe à CoLab Exeter, un centre de cotravail intersectoriel et pluri-institutions sous le toit duquel environ 35 différents projets et services travaillent ensemble. Des échanges ont également eu lieu entre le conseil général du Sussex, Rother Voluntary Action et le conseil d’arrondissement de Hastings. D’un bout à l’autre de la région des 2Mers, nos partenaires sont en conversation avec les services sociaux des autorités locales ; en Belgique, des échanges ont eu lieu avec la Province d’Anvers et LiCalab (« Living and Care Lab »). En France, l’Université d’Artois a mis en place un partenariat – baptisé le « Cluster Senior » – entre plus de 30 organismes de la région; nos partenaires français se sont aussi associés au projet Interreg TICC, dirigé par Buurtzorg. Dans tous les pays, les sites pilotes maintiennent un contact régulier avec leur partenaire observateur. Au total, plus de 350 groupes locaux, groupes de bénévoles et une grande variété d’organismes ont contribué au partenariat HAIRE.

La transférabilité du projet HAIRE n’est pas seulement géographique, mais franchit aussi les frontières de multiples secteurs jusqu’à toucher des cibles inattendues. En effet, nous estimons que notre approche axée sur la personne pourrait être appliquée de manière plus large, par exemple pour résoudre le problème des sans-abris ou de l’addiction à la drogue. Pour de nombreuses communautés, il se pourrait que l’année 2021 et les suivantes représentent un chemin parsemé d’embuches. Nous ne doutons pas que le projet HAIRE relèvera le défi, et, loin de se contenter de cela, qu’il remettra à ces communautés les solutions et les outils qui leur permettront de s’épanouir au-delà de la pandémie.

One Year On: What Have We Achieved?

A year ago on 10th February, 2020, the fledgling HAIRE team sat down to eat together in a little bistro in Lille to celebrate the launch of the project, Healthy Ageing through Innovation in Rural Europe. It almost seems decadent in retrospect. No-one could have predicted the year that was to follow and the difficulties the world would face in the throes of a global pandemic.

Covid-19 struck at the heart of our target group, exacerbating the very problems HAIRE had been designed to address. Not only was access to health and wellbeing services made more difficult, our already vulnerable target suffered increased loneliness and isolation in many cases. Face to face interviews (HAIRE’s Guided Conversations) could not go ahead as originally planned. As Europe-wide lockdowns took hold, alternative methods to talk to older people had to be found, and fast.

Our first challenge was to secure a remote simultaneous interpretation platform so that we could easily talk to all of our European partners online. Thanks to everyone working together to find solutions, the Guided Conversations – the technique used to establish older people’s needs and desires – were adapted to take place virtually or by telephone according to participant and volunteer comfort. Crucially, they evolved with the unique situation in every locality. HAIRE’s place-based, person-centred approach was (and continues to be) carefully managed at every step of the toolkit adaptation, from content planning to execution. One of the features of the toolkit is the use of a site-specific image to help participants articulate their needs and desires in relation to both interior and exterior spaces. This co-design work involved all partners and brought about a deeper understanding of each others’ localities.

It is a testament to their commitment that throughout 2020 each partner continued to be fully engaged in the project despite Covid-19 obligations in their country. East Sussex County Council and Rother Voluntary Action hosted several online HAIRE-branded community talks for an Ageing Well festival, which other partners attended as well.

The level of every partner’s commitment has not waned even though each partner has had to flex their approach to other HAIRE activities and information gathering, such as the Neighbourhood Analysis and community reports. (These elements of the toolkit establish the extent and nature of individual social networks and connections, and what opportunities, such as activities and services, are available to participants in each community.) There too, partners have helped each other find workarounds and helped problem solve for each other in order to gather the data.

In our most recent partnership meeting, we used Sli.Do to ask partners for one word that describes the work of HAIRE. As the word bubble took shape, three words stood out: Empowering Community Together. So it is perhaps not surprising that, despite Covid-19 lockdowns and limited face to face contact with older people, we have overachieved on Enabler recruitment. Enablers are the volunteers and health professionals who are trained to use the HAIRE toolkit and conduct interviews with older people. We had an original recruitment target of 80 Enablers – and we now have 147, with 115 of them trained so far. And despite delays, we are on track to achieve 600 participants for the Guided Conversations: we have 282 recruited participants, with 126 having already started their conversations.

HAIRE is being designed with future users and sustainability in mind. Partners are already presenting the project to potential future users of the toolkit. In the UK, Devon Mind has introduced HAIRE and the team to CoLab Exeter, a cross-sector, multi-agency co-working hub that is home to some 35 different projects and services that work collaboratively. Other conversations have taken place between Sussex County Council, Rother Voluntary Action and Hastings Borough Council.

Across the 2Seas region, our partners have been talking to local governments’ social services departments; in Belgium, conversations have taken place with the Province of Antwerp and LiCalab (Living and Care Lab). In France, the University of Artois has developed a partnership with 30+ organisations in their area, called ‘Cluster Senior’; our French partners have also connected with the Interreg Project TICC, led by Buurtzorg. Pilot sites in all countries have been in regular contact with their Observer Partners. In total, the HAIRE partnership has engaged over 350 local groups, voluntary groups and a variety of organisations.

The transferability of HAIRE is not just geographic but also crosses sector boundaries to unexpected targets: we are seeing opportunities for its person-centred approach to be applied widely, e.g. tackling homelessness and drug addiction. 2021 and beyond may be a tough road for many communities. We are confident that HAIRE will not only rise to the challenge, but will also offer solutions and tools for communities to thrive beyond this pandemic.

 

What is Social Network Analysis?

The post this month comes from Sebastian Stevens and Rebecca Baines from the University of Plymouth, who have developed the Social Network Analysis component of the HAIRE toolkit.

What is a social network?

The term ‘social network’ is often used to describe online and offline connections between people. For this project, we use the term social network to mean the connections people have with one another in their local community. This could be people you enjoy spending time with, call upon for help and support, or share hobbies with.

What is social network analysis (SNA)?

Social network analysis (SNA) is a method often used in social research to measure, understand and visualise connections between people and organisations. It has many applications including mapping friendships, exploring health advice seeking behaviours and tracing contact patterns during disease outbreaks such as COVID-19.

Why are we interested in social networks?

There is increasing evidence to suggest that the size and make-up of a person’s network plays a vital role in their health and well-being. For example:

“Existing research has demonstrated the significance of social networks in relation to physical and emotional wellbeing” (Heenan: 2011)

However, creating and sustaining these networks in a rural and ageing environment can be particularly difficult:

“Aging adults living in rural communities have less access to and lower utilization of health care services; they rely heavily on available peer and family networks. Although social networks have been linked to positive mental and physical health outcomes, there is a lack of understanding about social networks in rural-dwellings” (Gannon et al: 2016)

Working together to map people’s networks, identifying potential gaps and finding ways to build new connections can therefore be incredibly important in supporting peoples health and wellbeing in a rural setting.

What role does SNA play within the HAIRE toolkit?

As part of the HAIRE toolkit, we have developed a SNA ‘tool’ in collaboration with community members and project partners that will:

  • Empower individual community members to review, reflect and discuss their own social networks and consider ways of growing and/or strengthening their connections with other people
  • Allows community organisations to understand how connected people feel to one another
  • Explore how social networks may differ between settings, countries and cultures.

Combined with the neighbourhood analysis and guided conversation tools, the social network tool will help provide a holistic understanding of an individual’s social connections, loneliness and isolation.

How will we capture the social networks of community members and what will we do with this information?

We will capture peoples networks through a series of short questions. These questions will be asked by a HAIRE enabler during each guided conversation with community members. Responses to these questions may then be used to inform the action plan that is created in partnership between the HAIRE enabler and community member.

In time, community members will be able to see a visualisation of their social network. This visualisation may help individuals to identify and reflect on the strength, gaps and opportunities within their social network.

We look forward to sharing insights about social networks in rural communities across Europe with you all very soon!

Seb and Rebecca work on the HAIRE project in collaboration with project partners and pilot sites. Led by Dr Arunangsu Chatterjee, Associate Professor of Digital Health & Education and Head of Digital Education at the University of Plymouth, Seb and Rebecca are providing academic support to the HAIRE project to help explore and understand the impact of social networks on health and wellbeing. To find out more about their research or The Centre for Health Technology, please click here.  

Kindness and Coronavirus: Building Relationships using HAIRE

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.

Neighbourhood Analysis: Research in a Tea Garden

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

    

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.