Lupin Battersby

Ageing well in the right place: partnership working with older people

Purpose: The provision of home and community supports can enable people to successfully age-in-place by improving physical and mental health, supporting social participation and enhancing independence, autonomy and choice. One challenge concerns the integration of place-based supports available as older people transition into affordable housing. Sustainable solutions need to be developed and implemented with the full involvement of communities, service organisations and older people themselves. Partnership building is an important component of this process. This article details the intricacies of developing partnerships with low-income older people, local service providers and nonprofit housing associations in the context of a Canadian housing development. Design/methodology/approach: A community based participatory approach was used to inform the data collection and partnership building process. The partnership building process progressed through a series of democratized committee meetings based on the principles of appreciative inquiry, four collaboration cafes with nonprofit housing providers, and four community mapping workshops with low-income older people. Data collection also involved 25 interviews and 15 photovoice sessions with the housing tenants. The common aims of partnership and data collection were to: (i) understand the challenges and opportunities experienced by older people, service providers and nonprofit housing providers; (ii) identify the perspectives of service providers and nonprofit housing providers for the provision and delivery of senior-friendly services and resources; and (iii) determine actions that can be undertaken to better meet the needs of service providers and nonprofit housing providers in order to help them better serve older people. Findings: The partnership prioritised the generation of a shared vision together with shared values, interests and the goal of co-creating meaningful housing solutions for older people transitioning into affordable housing. Input from interviews and photovoice sessions with older people provided material to inform decision making in support of ageing well in the right place. Attention to issues of power dynamics and knowledge generation and feedback mechanisms enable all fields of expertise to be taken into account, including the experiential expertise of older residents. This resulted in functional, physical, psychological and social aspects of ageing in place to inform the new build housing complex. Research limitations/implications: The time and effort required to conduct democratized partnerships slowed the decision making process. Research limitations/implications: The time and effort required to conduct democratized partnerships slowed the decision making process. Originality/value: The findings confirm that the drive toward community partnerships is a necessary process in supporting older people to age well in the right place. This requires sound mechanisms to include the voice of older people themselves alongside other relevant stakeholders. Ageing well in a housing complex requires meaningful placemaking to include the functional, physical, psychological and social aspects of older people’s everyday life in respect to both home and community.

From Familiar Faces to Family: Staff and Resident Relationships in Long-Term Care.

Objective: Long-term care (LTC) facilities are increasingly intent on creating a “homelike” atmosphere for residents. Although residential staff are integral to the construction of a home within LTC settings, their perceptions have been relatively absent from the literature. Method: Thirty-two LTC staff participants were interviewed about their experiences and perceptions of the physical environment and conceptualizations of home, and thematic analyses were conducted. Results: An overarching category—interpersonal relationships—emerged from our analyses emphasizing the importance of relationships in creating a homelike environment within institutional settings. Sub-themes that inform our understanding include the following: (a) Staff members’ perceptions of home; (b) “Their second home”: Adjustment to and familiarity in LTC; and (c) “We become family”: Relationality makes a home. Discussion: The study provides evidence to inform current policies and practices in LTC. Specifically, enough time and space should be given to residents and staff to create and maintain personal relationships to make residential care homelike.

Co-creation Methods: Informing Technology Solutions for Older Adults

With the demographic shift towards an aging population, there is an increasing need for and interest in technologies that address challenges associated with aging. The AGE-WELL Network of Centres of Excellence is developing and building capacity in researchers and partners affiliated with the network and beyond to co-create solutions with older adults and other stakeholders. In this paper three projects using different approaches to co-creation are explored: community-based participatory research, integrated knowledge translation, and transdisciplinary working. The projects span different focus areas and disciplines: (1) a seniors’ affordable housing redevelopment evaluation; (2) a realist review of middle-aged and older adults and the digital divide; and (3) development of rehabilitation software for older adults’ cognitive health. Based on these projects, opportunities for enriching the research process through co-creation methods are highlighted. In addition, factors to consider when choosing and implementing co-creation methods, such as the type of research project, level of project development, ethical issues, and resources available will be discussed. We conclude the paper with a call for researchers using co-creation in technology development to evaluate the impact of such approaches.

Understanding the functionality of housing-related support services through mapping methods and dialogue

This article describes the experience and process of using community mapping as a tool for collecting data on the functioning of housing-related support services in Metro Vancouver. We outline our mapping methods and discuss strengths and challenges encountered during workshops aimed at understandings how the system of housing-related supports function. Strengths were that workshops provided a forum for social participation and engagement. In addition, mapping is a research tool that enables local knowledge of service functioning and service gaps to be accessed and exchanged. Challenges include ensuring diverse representation; reducing power imbalances; and having adequate space to accommodate interested participants.

Experiences of a Mass Interinstitutional Relocation for Long-Term Care Staff

ABSTRACT This research explored long-term care (LTC) staff perceptions and experiences of working in LTC and providing care to residents following a mass interinstitutional relocation. In-depth, semistructured interviews were conducted with 63 LTC workers. Thematic analyses revealed three overarching themes related to how staff members perceived their relationships with other staff members following relocation. The first theme, post-relocation relationships between staff members, included the subthemes “Staff are segregated from each other” (physical distance) and “We were a family” to “barely say hi” (psychological distance). The second theme, post-relocation stress, has two subthemes: “Staffing is our big issue” and consequences of stress: absenteeism and leave. The third theme is recommendations for improving and managing staff relationships post-relocation. Relationships among staff members are integral to working in LTC and providing care to residents following a mass interinstitutional relocation. Recommendations for improving staff relationships and morale are suggested.

Senior Services that Support Housing First in Metro Vancouver

ABSTRACT Housing First is a model and philosophy for housing homeless people in immediate and permanent housing. In order to implement and deliver Housing First, research is essential to understand the system of support services as they currently exist. Guided by principles of community-based participatory research, this paper presents the findings from a senior-focused deliberative dialogue workshop in Metro Vancouver, Canada. Participants (16 service providers and 1 service recipient) identified services and resources available to support seniors in maintaining housing and barriers and facilitators for accessing services. Broadly, data were organized into seven themes: (1) Housing; (2) Home support; (3) Transportation; (4) Information availability, accessibility, and navigation; (5) Cultural diversity; (6) Discrimination; and (7) Funding and financial support. Results found that affordable housing that adapts to changing health conditions, income supports, health services, homecare, transportation, and culturally appropriate and nondiscriminatory informational resources are among the supports most needed for persons as young as 50 years old to succeed under the Housing First model in Metro Vancouver. Barriers to Housing First service provision, including rigid eligibility criteria for chronically and episodically homeless, should be revised to better support the growing number of older adults who are newly entering homelessness in Metro Vancouver.

Intersectional policy analysis of self-directed mental health care in Canada.

Objective: Recovery from mental illness is influenced by one’s social location along multiple dimensions of identity, such as race, class, gender, age, and ability, and by how these social locations are expressed through structural and institutional barriers. This project was developed using an intersectional policy analysis framework designed to promote equity across identity locations–called the multistrand method–to examine the potential use of self-directed care financing approaches in the Canadian mental health system. Method: A panel of 16 diverse stakeholders came together 4 times at structured 6-hr meetings to examine the evidence for self-directed care and explore its application in the Canadian context. Telephone interviews with evidence panel members were conducted to assess their perceptions of the group process and outcomes. Results: Our analysis revealed ways that intersecting strand locations might differentially influence the degree of choice and recovery experienced by self-directed care participants. Individualized resource allocation, draining financial resources from ethnically specific services, unevenness in acceptance of the recovery orientation, and paucity of service options in different geographical regions were identified as contexts in which self-directed care policies could promote inequity. However, greater peer involvement in the model’s implementation, use of indigenous community supports, purchase of material goods by economically disenfranchised persons, and access to services from ethnically diverse clinicians in the private sector were identified as equity-promoting model features. Conclusion and Implications for Practice: By couching their analysis at the level of unique socially-situated perspectives, the group developed detailed policy recommendations and insights into both the potential and limitations of self-directed care. The knowledge gained from our project can be used to develop uniquely Canadian self-directed care models tailored to promote recovery through empowerment and self-determination across intersecting identity strand locations.