Achieving partnership working with older people. Josie Tetley – Senior Lecturer Department of Nursing The Open University

Main aims of teleconference To demonstrate the ways in which older people’s views can be heard and used to improve health care services and research practice. Focus on: Methodologies Methods Practical Considerations That can help nurses achieve effective and meaningful participation and service user involvement in research

Background to involvement Current drive for user involvement stimulated in the 1990s Governments, charities, advocacy groups and service argued that consultation and user involvement could improve the quality, relevance and focus of services (Carter and Beresford, 2000; Nolan et al., 2007).

User involvement – the challenges Meaningful and active participation affected by: cultural divisions, representativeness, bias, research skills capacity, ill health, time and resources’ (Boote et al., 2002; Fudge et al., 2007).

Methodologies Many terms used to define user involvement approaches Participatory research Emancipatory research cooperative inquiry constructivism action research (collaborative action research, social action research) consumer involvement consumer consultation

Methods Participant observation Reflective diary Interviews Individual narrative stories Focus groups Creative arts/drama The ways in which we collect our data can also improve our ability to involve our research participants more fully in our research work. I have found the use of participant observation useful in terms of building up relationships with the older people I hoped to work with. I was also able to gain a wide range of insights that may not have emerged by merely conducting interviews. It also gave people time to talk to me about my study and ask me questions. I found that people then started coming up to me in the study site to share their stories and experiences that they thought would be relevant to my study. Interviews were conducted with people who I had met and we knew one another before the formal interview started. In order to get their views on the interview data I wrote individual narrative stories which I was able to take back to people. These were useful in terms of getting people to examine the issues that we had arisen in the interviews and tell me whether they felt my initial interpretation of what they had told me was accurate. I had less success with focus groups. I tried to use these to try and get the older people to think about the experience of having working as a researcher.

Putting participation into practice Narrative stories Using creative arts Research advisory committees Practical considerations and responsibilities

Narratives Enabling commentaries by participants on a structured summary of the information that they had shared with me. Identifying the factors that people identified as affecting their decision and choice-making process, when using or contemplating using care services. Unraveling wider life experiences in relation to decision and choice-making processes that might not have been immediately obvious.

Narratives Enabling a more holistic individual perspective which drew on the formal interview material and the notes that I had made during the time I had undertaken participant observation work in each setting. Enabling me to feed back to participants the value of the information that they had shared with me. Raising empowerment and ethical issues.

Promoting active ageing Nurse led multi disciplinary team worked with older people in the Sheltered Scheme in two major ways: As participants in the Activity and Culture centre and the associated activities. As advisors to the project

Involvement of older people in the project Tenants - actively selecting the choice of activities undertaken as part of the project. Consultants - regarding the design and layout of the data collection instruments, Participants in the programme will also be offered the opportunity to be involved in analysing and interpreting the data collected, should they wish to do this.

Art sessions

Art sessions

Gone to Pot

Learner Exchange

Evaluation Positive responses to the programme of activities Honest feedback about what worked and what didn’t Seasonal nature of activities see Sanders, 2006; Tetley and Mountain, 2006; Tetley et al., 2006 http://www.fons.org/ns/Dissemination_series_reports/DissSeriesVol4No4.pdf

Older people’s research advisory committee The group helped me to work effectively and sensitively with different community groups; Personal experiences as service users have benefited the research; Our work had a reciprocal element that we did not initially envisage; Engagement with a wide range of initiatives benefited us as a group. I will use some examples from our work to illustrate how: The group have helped me to work effectively and sensitively with different community groups; Personal experiences as service users have benefited the research; Our work has a reciprocal element that we did not initially envisage; our engagement with a wide range of initiatives has benefited us as a group

Practical support from research advisors Ethics paper work Help getting consent forms signed Advice to work more sensitively with black elders (see Tetley et al., 2003)

Practical considerations and responsibilities Paying people’s expenses Transport issues Suitable accommodation Good working relationship Carer relief Time for people to talk through issues Protection against exploitation Training Preparation for participation Be prepared for the unexpected

Achieving partnership working with older people. Josie Tetley – Senior Lecturer Department of Nursing The Open University