Improving participatory practice and well-being with older people
Submitting InstitutionUniversity of Brighton
Unit of AssessmentSocial Work and Social Policy
Summary Impact TypeSocietal
Research Subject Area(s)
Medical and Health Sciences: Public Health and Health Services
Summary of the impact
Research into participative practice and well-being with older people has
contributed directly to the development and application of an ethic of
care in policy and service delivery, as well as to practices in older
people's participation, locally, nationally and internationally. The
research has directly impacted on practitioners and practice developments
in services for older people, with learning resources (co-designed with
practitioners and older people) being used in professional education and
training across the UK and in New Zealand. An innovative participatory
methodology has both enhanced older people's participation locally and
been adopted more widely by university community research collaborators
working to enhance older people's citizenship and well-being (eg in
Netherlands). Research has directly informed policy concerning older
people's needs assessments by recognising the centrality of relationships
to well-being in older age. The well-being research involving
collaboration with service users and providers has been described as
`exemplary' by the leading national charity Age UK.
Context and origins: Recent policy on older people's involvement
and participation, on active ageing and on well-being has a high profile
in view of the changing demography across the globe. Policy has focused on
promoting choice and independence for individual older people, in order to
reduce their dependencies on health and care services in later life. At
the same time, there has been continuing evidence of abuse and poor
practice in the care of older people within hospitals and residential
homes. The research underpinning the impact claimed in this case study
builds on a body of work conducted over 20 years within the School of
Applied Social Science (SASS) on user involvement, public participation,
partnership working, older people and care. BARNES' appointment in 2006
strategically enhanced this work, further developing her internationally
recognised research on public participation, participatory research
methods and care ethics. Since the early 1990s, BARNES' work has included
DH-funded evaluation of user involvement in community care, ESRC-funded
case study research on public participation, and action research involving
frail older people in user panels. Her reflective monograph [reference
3.1] and journal article [3.2] provide a sustained critique of the
individualised, choice-based approaches dominating policy and practice.
The monograph develops an alternative relational approach, based in an
ethic of care that is applied to social care practice, social policies and
the practice of deliberative policymaking. This internationally recognised
scholarship is reflected in, and has been further developed through, a
series of participative research projects involving older people as
co-researchers to understand well-being in later life [3.3, 3.4, 3.5].
Participatory research and translation: The interaction of
reflective work and scholarship with participatory empirical research has
been central to developing the involvement of older people in the impacts
of the research on practice, and critical policy thinking. Four key
participative research projects involving MURRAY and WARD (see section 3
for funding details) underpin the impact:
Growing Older, Being Heard: Exploring older people's experience of
and motivations for taking part in groups giving a voice to older people
in local policy, drew attention to the significance of older activists'
sense of themselves as community members with commitments to achieving
broad rather than self-interested outcomes from their participation. It
identified key issues on which older people wanted to campaign,
highlighted negative experiences in relation to perceived influence and
suggested how this might be improved [3.3].
Cheers!? Older People and Alcohol Use: A project with older people
and a local partnership of service providers that produced a journal paper
co-authored with a community partner distinguishing different models of
alcohol use and emphasised the importance of relational practices in
Older People and Well-being: Research with older people in
partnership with a local Age UK office explored what well-being means to
older people and how it is generated, challenging dominant views of
well-being as relating to independence and the exercise of choice. It
demonstrated how relationships with family, friends, service providers,
strangers and places are strongly implicated in the maintenance of
well-being in old age. In a publication co-authored with a community
partner, the research de-coupled the `health and well-being' link
indicating that poor treatment rather than poor health may be more
Knowledge Exchange with Older People and an Ethic of Care
(KEOPEC): The UoB undertook translational research using ESRC funding with
local Age UK partners and partners in the statutory and voluntary sectors
and applied the findings from the Older People and Well-being
project to the development of learning resources, which are being used to
embed an ethic of care approach to service delivery in the care of older
Overall, this body of research has identified how diverse relationships
are necessary to achieve individual and collective well-being for older
people. The research's collaborative and participatory methods have
contributed to the development and application of an ethic of care,
designed to promote good care as a value in policy and service delivery,
as well as to influence practice in older people's participation and
involvement.The participatory methods were a key process underpinning the
impacts as the research was co-designed and undertaken with older people
as co-researchers. The latest project (KEOPEC) adopted a `cascade model'
to Knowledge Exchange in which intense participatory work involving
researchers, practitioners and older people had a direct influence on
those taking part. The participants then shared this experience and
learning in their educational and service provider settings, further
influencing a wider network of practitioners and practices, ensuring that
the learning resources produced in the KE are used nationally and
internationally to stimulate impact.
||Professor of Social Policy (Sept 2006–to date).
||Lecturer (July 2007–Feb 2012), Senior Lecturer (Mar 2012–to date).
||Research Officer (Sept 2007–Sept 2008), Research Fellow (Oct
2008–Feb 2012), Senior Research Fellow (Mar 2012–to date).
References to the research
[3.1] BARNES, M. (2012) Care in everyday life: an ethic of care in
practice. Bristol: Policy Press. [Quality validation: refereed book
that has been positively reviewed: for example, Professor Joan Orme,
Glasgow School of Social Work, has argued that it constitutes `a major
contribution to current debates about care ethics'.]
[3.2] BARNES, M. (2011) Abandoning care? A critical perspective on
personalisation from an ethic of care. Ethics and Social Welfare,
5(2), pp.153-167. [Quality validation: output in leading peer-reviewed
[3.3] BARNES, M., HARRISON, E. and MURRAY, L. (2012) Ageing activists:
who gets involved in older people's forums? Ageing and Society,
32, pp.261-280. [Quality validation: output in leading peer-reviewed
[3.4] WARD, L., BARNES, M. and GAHAGAN, B. (2011) Alcohol use in later
life: older people's perspectives Quality in Ageing and Older Adults,
12 (4), pp.239-247. [Quality validation: output in peer-reviewed journal.]
[3.5] WARD, L., BARNES, M. and GAHAGAN, B. (2012) Well-being in older
age: findings from a participatory research project. University of
Brighton/Age Concern Brighton & Hove. [Quality validation:
peer-reviewed project report.]
Key research grants:
BARNES (CoI), Harrison (PI at University of Sussex) and MURRAY, Growing
Older, Being Heard. Brighton and Sussex Community Knowledge, 2007-8,
total funding: £25k.
BARNES (PI) with WARD (Research Fellow), Cheers!? Older People and
Alcohol Use. Brighton and Sussex Community Knowledge Exchange,
2007-9, total funding: £24k.
BARNES (PI) with WARD, Older People and Well-being, Age UK,
2008-12, £46k, with matched funding from the University of Brighton.
BARNES (PI) and WARD (CoI), Knowledge Exchange with Older People and
an Ethic of Care (KEOPEC). ESRC follow on funding, 2011-2013,
Details of the impact
Influencing practitioners and practice developments: Practitioners
from statutory and voluntary sectors (occupational therapists (OTs),
social workers and voluntary sector workers) involved in the research and
knowledge exchange have been impacted directly through experience of
working with older people, exposure to research findings, and opportunity
for reflection provided through the KE approach. Commenting on how this
had made a difference, one voluntary sector practitioner contrasted this
`REAL' involvement with more familiar `tokenism' (source 5.1).
Practitioners have adopted the learning resources in their own
organisations across West and East Sussex as well as in Brighton. An
Operations Manager in OT claimed that they are `invaluable to our
organisation as it is an area that is relatively underdeveloped and I have
had difficulty finding suitable material' (5.2). Between January
2013, when the resources were launched at Age UK headquarters, and July
2013, the six films (5.3) were accessed a total of 486 times and the
accompanying handbook downloaded 696 times; 100 DVD versions have been
The local Age UK research partner has described how the research has
benefited the development of professional practice, service delivery and
enabled the organisation to raise its profile. Findings and learning
resources are being used in staff training, impacting on its capacity to
contribute to local planning regarding older people's services, and to
national consultations and campaigns — for example on dignity and
safeguarding (5.4). Research is also impacting on practice via its uptake
in professional education courses. There is evidence of use in social work
education in, for example Nottingham and Cambridge, psychologists training
in NHS Wales and in nurse training in New Zealand (5.5). Website evidence
shows that, during the impact period, the learning resources had been
accessed in 31 countries.
Enhancing older people's participation: The well-being research
has been acclaimed as `exemplary' by Age UK nationally (5.6) in terms of
university/Age UK collaboration and of working with older people in
research and development. More locally, research findings and innovations
in ways of working with older people are being drawn on directly in
developing Brighton and Hove Council's bid to become a World Health
Organisation (WHO) Age Friendly City; a series of `age-friendly'
indicators, based on the research, have been developed to be used in
assessing the council's progress towards the WHO criteria (5.7). In the
wider Sussex area, the Chair of the Meridian Mature Citizen's Forum
(Newhaven) states that participation in the Growing Older, Being Heard
research `gave the Forum confidence and a sense of purpose' regarding
involvement in debates with local authorities about the need for community
transport. Councillors from three towns affected by poor transport
connections now meet regularly to further this agenda (5.8).
Older people themselves, working as co-researchers, have benefited
directly through their participation in the research, developing skills
and confidence and an enhanced sense of pride in what they can achieve,
particularly regarding advocating for the rights and interests of older
people, as Film 6 in the film-based learning resources demonstrates (5.3).
Their enhanced confidence and skills are further reflected in a booklet
they produced — As time goes by: thoughts on well-being in
later years, which offers guidance to older people on strategies for
well-being (5.9); 2,000 copies of this publication have been distributed
via community organisations. Co-researchers have also presented research
findings at local and national conferences and seminars, including:
INVOLVE (a leading charity promoting participation); ESRC Social Science
Festival seminar, `Looking at Ageing Differently'; Civil Service
Pensioners Association, and; Older People's Council, Brighton and Hove.
Informing policy and stimulating policy debate: Research has
informed local policy, as indicated in Brighton and Hove's Joint Strategic
Needs Assessment, where sections on both `Ageing well' and `Older
People-Social Care' make explicit reference to the importance of the
well-being research and the centrality of relationships to well-being in
older age (5.10).
The research has stimulated policy debate by challenging assumptions
about well-being. The well-being project report was launched at an event
in April 2012 attended by 70 older people, practitioners from local
statutory and voluntary agencies, Age UK and the Social Care Institute for
Excellence; 62% of feedback forms said the research had added to
understanding or changed attendees' points of view. Responses from those
attending the national launch of learning resources were enthusiastic
about the ethic of care framework and, at a local launch in April 2013,
discussion reflected the contribution this research is making to debate on
independence versus relationality and the implications of this for policy.
International impacts: Researchers seeking to develop similar ways
of working with older people in research, policy and practice development
from the Netherlands, France, Spain and Australia are drawing directly on
this research. The professor of Client Participation in Elderly Care at
the VU University Medical Centre in Amsterdam has confirmed that the
research and collaboration with researchers has fed directly into their
own methods of working with older people, stating that: `We developed and
evaluated a work format for participation of older people in long-term
care institutions in which an ethic of care approach is central (enhancing
relational empowerment amongst older people) and building more equal
collaboration between older people and professionals'. They are also using
the learning resources directly in their collaborative work with older
people and practitioners, building explicitly on the approach developed at
Sources to corroborate the impact
5.1 Testimonial of Community Services Manager, Guild Care, Worthing,
providing evidence of the impact of an alternative approach.
5.2. Reflective log from Operations Manager, Occupational Therapy and
Sensory Impairment, Reablement Service, East Sussex County Council, that
confirms the use within their organisation in an underdeveloped area.
5.3 University of Brighton/Brighton and Hove Age UK (2013) Older
people, well-being and participation: learning resources based on
collaborative research. Handbook and video resources.
Available at: http://www.ageuk.org.uk/brightonandhove/about-age-uk-brighton-and-hove/research/
[Accessed: 8 November 2013] This includes evidence of the effect on the
older people themselves.
5.4 Agenda item from Age UK meeting, 7 June 2011 confirming the benefit
to Age UK.
5.5 Testimonial from Senior Lecturer, School of Nursing, Massey
University, Wellington, New Zealand, confirming the use of this within
5.6 Age UK national newsletter that confirms the exemplary nature of the
UoB/Age UK collaboration. Available on request.
5.7 Testimonial available from Public Health Programme Manager, Brighton
and Hove City Council, that attests to the use of the research in the bid
to become a WHO `age-friendly' city.
5.8 Testimonial from Chair, Meridian Mature Citizens Forum, testifying to
the impact on its approach to working with the local authorities.
5.9 As time goes by: thoughts on well-being in later years.
Collected and written by a group of older people. Available at: http://www.ageuk.org.uk/brightonandhove/about-age-uk-brighton-and-hove/research/
[Accessed: 8 November 2013].
5.10 Brighton and Hove, Joint Strategic Needs Assessment (2012). Research
appears in sections 7.3.9 (p.2 and `further Information') and 7.3.12
(`references'). Available on request.
5.11 Testimonial from Professor of Client Participation in Elderly Care
at the VU Medical Centre in Amsterdam confirming the use of the research
model in their own methods and within their own learning resources.