1. Using narratives to understand older peoples decision-making processes Josie Tetley – Senior Lecturer The Open University

2. Methodology Broadly constructivist (see Appleton and King 1997, Rodwell1998,) Socially constructed knowledge but with emphasis on co-construction between researcher and researched (Schofield-Clark 2002) Emergent design Interaction and partnership Good communication skills and empathy

3. Study design and methods Stage 2 – Member checking  Context embedded conversations during participant observation  Reflective/methodological diary.  Context embedded interviews with key participants identified through participant observation.  Individualised summaries of interview transcripts Stage 3 - Triangulation Data sources and information recorded in reflective diarying and interviews within and across study sites analysed using qualitative analysis methods. Findings pitted against one another and used to identify sources of convergence and differences. Stage 1 – Prolonged engagement Long periods of participant observation Reflective/methodological diary

4. Narratives

5. Long history in health and social care Provide insights into peoples meaning, context and perspective of their situation Can give insights into the effects of culture, history to individuals’ views of illness, care and treatments Recent renewed interest Methodologically enhance hermeneutic processes

6. Constructing joint accounts following interviews Narratives Enabled the person who had been interviewed to more easily read and comment on a structured summary of the information that they had shared with me. Helped me to see some of the key issues that people identified as affecting their decision making process, when using or contemplating using care services. Revealed issues in relation to wider life experiences and decision making processes that might not have always been immediately obvious

7. Value of 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.

8. Value of 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.

9. Josie Tetley Faculty of Health and Social Care The Open University Walton Hall Milton Keynes MK7 6AA www.open.ac.uk email j.tetley@open.ac.uk