CO-DESIGN AS A METHOD OF INCLUSION FOR OLDER ADULTS IN PUBLIC SOCIAL AND HEALTH CARE SERVICES?

Transcription

1 CO-DESIGN AS A METHOD OF INCLUSION FOR OLDER ADULTS IN PUBLIC SOCIAL AND HEALTH CARE SERVICES? Marjo Outila (M. Soc. Sc./researcher/social sciences) Hanna-Riina Vuontisjärvi (B. Des./industrial designer)

2 Contents Background of the research: Ikäehyt-project Service design: what, why Research question, data, central concepts Preliminary results of the study

3 Context of research Project: Promoting older adult s wellbeing and coping in Northern Finland (IKÄEHYT) Partners: Lapland University Consortium (LUC): Kemi-Tornio University of Applied Sciences Rovaniemi University of Applied Sciences University of Lapland 14 Northern Finnish municipalities 3rd sector actors (e.g. Community Colleges, Senior Citizens Councils) Funding European Social Funding (80 %), municipalities and LUC (20 %)

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5 Project targets to develop service models and methods that enhance older adults wellbeing, quality of life and independent living to use co-design in order to develop services for elderly in different settings (e.g. assisted living, day care, home care) to promote co-operation between generations by organizing shared workshops (e.g. children at day care, schoolchildren and elderly with different life situations) to organize training sessions for service users, service providers and other people in the community (e.g. use of communal art and culture based working methods, themes: leadership and interaction, respecting dignity of elderly) to pilot a broader functional capacity assessment tool at home care to involve students in the project (e.g. thesis writing and workshops) to combine research in service design, art and social and health sciences and to conduct practice-based research from service user, personnel and supervisor perspectives in numerous settings

6 Working methods 1. communal art and culture based working methods (e.g. reminiscence, music, visual arts) 2. service design methods (e.g. storytelling, character profiles, group sketching and motivation matrix) 3. education and training sessions 4. panel discussions, seminars, workshops, research: giving voice to older adults:

7 Service design.. has evolved from product design methods provides tools for visualizing intangible services is about understanding human activities, feelings, needs and motives -> user-centered perspective helps to reveal opportunities, produce ideas, solve problems and create new solutions (or improve existing ones) has usable, useful, efficient, effective and desirable outcome from the users point of view and feasible, viable and valuable outcome from the producer s point of view (Moritz 2005)

8 Service design process Service design process can be devided into six phases: (Moritz 2005)

9 Why service design? 80% 8% 95% I We have offer are experienced a customer-oriented superior 8% I have excellent experienced 80% We offer superior customer experiences customer experiences experience excellent customer experience Allen et al. 2005

10 What s new? Service design methods are used as methods for codevelopment of public sector services. Especially co-design methods are used to develop assisted living services for older persons. Co-design can be understood as a user-shared design process where the service is designed collaboratively with service users, local residents, service providers and professionals. It is a way to design solutions for a community with that community. When the users needs and way of thinking are the starting point of the design process, and users feedback is taken seriously, usability of the service is more likely achieved.

11 Roles of users, designers and researchers in design process: classical and co-design (Sanders & Stappers 2008, 11)

12 Service design methods provide an innovative way for residents to participate in the planning and development of service Increasing indoor and outdoor amenity and enhancing sense of community were the concrete development targets. Following co-design methods have been used in workshops: character profiles, storytelling, group sketching and motivation matrix.

13 Case Northwestern Finnish assisted living surrounding for older adults that are unable to live independently (e.g. because of dementia), s.c. senior citizens home population of municipality about 4000 inhabitant % population structure labour markets

14 3 co-design workshops in January, March and May 2012 total amount of participants in co-design workshops was 84 persons main participants in workshops: older adults (service users and local residents) local service providers (both public and private): elderly care workers, immediate supervisors, superiors 3 rd sector actors students designer and researcher

15 Research questions Research topic: possibilities for co-design methods to enhance older adults participation and inclusion Research questions: Do co-design methods enhance older adults inclusion? How is inclusion achieved? What are the possibilities and threats in co-design methods from the perspective of inclusion? How does interaction in co-design workshops enhance inclusion and what are the limitations or threats for achieving older adults participation?

16 Data primary data from 3 co-design workshops videotapes audiotapes observations questionnaires other documents: e.g. meeting notes, discussions, invitations and workshop outcomes (e. g. texts, pictures)

17 Research orientation qualitative case study ethnographic orientation (thick description and data triangulation) video and audio tapes: discourse analysis (e.g. Wetherell 1998, Wetherell & Potter 1988, Wetherell M. et al. 2001) data is seen as part of collective and cultural discourses that represent and reproduce our understanding of older adults and their position in society.

18 Central concepts: inclusion and participation Inclusion Concept (e.g. social inclusion) refers to the extent that individuals, families, and communities are able to fully participate in society and control their own destinies, taking into account a variety of factors related to economic resources, employment, health, education, housing, recreation, culture and civic engagement (Waeschauer 2003) Not only a matter of an adequate share of resources but also of participation in the determination of both individual and collective chances (Stewart 2000)

19 critique of inclusion concept concept diverts attention away from the possible need for radical change and encourages compliance with the status quo. (Barry 1998, 5) focuses too much on encoraging people to confirm to a common norm rather than taking account of individual difference and different social networks

20 -taking the critisim seriously and stressing exclusion (as non-participation: lack of control because of e.g. gender, disability or age) -> usefulness of the inclusion concept 1)seeing inclusion and exclusion as the outcome of the economic, political and civil institution that make up the system (Moffatt & Glasgow, 2009) 2) making the excluded visible 3) making every day excluding discourses visible and emphasising the role of those who are doing the excluding 4) contributing to solutions 5) seeing the possibility of voluntary exclusion (e.g. older person and gerotranscendence (Tornstam)

21 Participation -participation as part of inclusion -participation as (Harju 2005, 68-69; Siltaniemi ym. 2008, 43) a) emotional and experimental phenomenon: feeling of belonging and sense of inclusion b) citizen s opportunity to influence the development and decision making of society and environment in our case study the latter meaning is emphasized -the aim in increasing participation (Finnish council of state 2002) -equality -responsibility -influence -life managemet -commitment

22 Preliminary results -results presented here are based on data gathered by: questionnaires observations meeting memos, discussions video and audio tapes -more detailed discourse analysis is not yet available

23 Sense of participation in co-design workshop Questionnaire N=59 (65+ N=18) PERSONS AGED 65+ n=17 PERSONNEL n=16 OTHERS=STUDENTS, STAKEHOLDERS (e.g. LIBRARY) n=23 The atmosphere in the workshop was open and interactive. Stronly disagree (1) Disagree (2) I don t know (3) 2 5 Agree (4) Strongly agree (5) My opinions and ideas were listened to and considered important I felt that I was influencing things that are important to me There were sufficient number of older persons in the workshop

24 MENTIONS (112) PERSONS AGED 65+ PERSONNEL OTHERS (e.g. library, community/civic college, students) + (96) - (13) +/- (3) INTERACTION (7) open atmosphere (2) cheerful atmosphere (3) team spirit (1) even participation (1) TOPIC (3) thought-provoking (1) interesting (1) important (1) ACTIVITY (4) nice activity (3) inspiring activity (1) SERVICE QUALITY (7) satisfactory results (4) importance of planning (1) cooperation (2) OTHER (2) good facilitator (1) nice serving (2) -uncertainty of the implementation of plans (2) -answering the feedback questionnaires (1) INTERACTION (16) open atmosphere (2) chatty atmosphere (2) nice atmosphere (4) productive atmosphere (1) team spirit (2) setting a common goal (1) getting to know people (1) creative group (1) cooperation: stakeholders (1) multi-professionalism (1) TOPIC (3) interesting topic (2) important topic (1) SERVICE QUALITY (14) new, rich ideas (4) realistic developmental goals (1) development of services (3) satisfactory results (3) benefits for residents (1) productive cooperation (1) possibility to create cooperation (1) OTHER (1) fun activities (1) -too busy schedule (2) -doubting the implementation of plans (1) -slow progress in the development (1) -the initial tension in workshop (1) -inadequate advance familiarization to the environment by the workshop organizers (e.g. - residents situation and challenges ) (1) -giving feedback (1) INTERACTION (17) open atmosphere (2) cheerful atmosphere (2) chatty atmosphere (1) team spirit (2) discussion (3) interaction (1) enthusiasm(3) cooperation (1) cooperation of different professions (2) TOPIC (1) interesting topic (1) ACTIVITY (2) nice activities (1) satisfaction in activities (1) SERVICE QUALITY (12) new, rich ideas (3) satisfactory plans (2) planning (2) important development target(1) satisfactory results (1) forming of development groups (1) ability to contribute (1) opportunity to influence (1 OTHER (9) good facilitator (1) rewarding experience (4) lifting experience (1) beneficial for students (1) -difficulties in fully understanding the development target (2) -hope of positive outcomes (1) -hope of successful financing (1) -waiting a continuation with interest (1)

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26 Possibilities for co-design to increase inclusion Co-design workshops offer a new kind of discussion forum for the decision-makers, service users and local residents. Users voice and needs are raised and listened to at the early planning phase of services. Co-design methods are in themselves inclusive in providing sense of community, community spirit and hearing of people s voices.

27 Threats of co-design for inclusion Portion and participation of participants that are in most vulnerable position may be weak, e.g. older adults with dementia. Communication gap in design process may result in unsatisfied outcome from service user s point of view. Quality initiatives may be developed but their overall impact and implementation may remain weak. Co-design workshops remain one-time occasions regardless of the changing user needs and circumstances.

28 the voices of older people with high support needs are so quiet as to be practically silent or indistinguishable from the other people who speak on their behalf. Bowers et al. (2009, 5)

29 Thank you for your attention! For more information: Marjo Outila Hanna-Riina Vuontisjärvi University of Lapland PO Box 122 FI Rovaniemi, Finland

30 References Allen J. et al. (2005) How to achieve true customer-led growth. Closing the delivery gap. Arnstein S. (1969) "A Ladder of Citizen Participation," JAIP, Vol. 35, No. 4, July, p Barry M. (1998) Social Exclusion and Social Work: an introduction. In Barry M. & Hallett C. (eds.) Social Exclusion and Social Work. Bowers H. et al. (2009) Older people s vision for long term care. Finnish council of state 2002/Valtioneuvoston selonteko Eduskunnalle kansalaisten suoran osallistumisen kehittymisestä. Harju A. (2005) Kansalaisyhteiskunta vapaaehtoistoiminnan innoittajana. In Nylund et al. Vapaaehtoistoiminta. Anti, arvot ja osallisuus. Miettinen S. & Koivisto M. (eds.) (2009) Designing Services with Innovative Methods. Moffatt S. & Glasgow N. (2009) How useful is the concept of social inclusion when applied to rural older people in the UK and the US? Regional Studies 43, 10, Moritz S. (2005) Service design. Practical access to an evolving field. Sanders E. and Stappers P. (2008) Co-creation and the new landscapes of design. CoDesign: International Journal of CoCreation in Design and the Arts. Vol. 4, Iss. 1, Siltaniemi et al. ( 2008) Hyvinvointi ja osallisuus. Kansalaiskyselyn tuloksia. Stewart A Social inclusion: An introduction. In Social inclusion: Possibilities and tensions, ed. P. Askonas and A. Stewart, Warschauer M. (2003) Technology and social inclusion: rethinking the digital divide. Wetherell M. et al. (2001) Discourse Theory and Practice. Wetherell M. (1998). Positioning and interpretative repertoires: Conversation analysis and post-structuralism in dialogue. Discourse and Society, 9(3), Wetherell M. & Potter J. (1988). Discourse Analysis and the identification of interpretative repertoires. In C. Antaki (Ed.), Analysing everyday explanation: a casebook of methods.