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Using Participatory Approaches with Older People in a Residential Home in Guyana: Challenges and Tensions

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Abstract

Participatory approaches are a popular and entrenched strategy in community development, yet a number of unresolved issues and tensions persist regarding the definition, rationales, outcomes and ethics of participation. Despite its popularity there are relatively few examples of participatory projects with older people or in institutional settings so their potential with this group is poorly understood. This case study presents some of the practical and ethical challenges that arose over the course of a participatory project that aimed to analyse and improve quality of life in a residential home for older people in Guyana. Through a qualitative process evaluation it examines the degree of participation achieved, the determinants of the participatory process, the benefits the approach brought and the ethical dilemmas encountered. Although the degree of participation achieved was limited, beneficial outcomes were observed, notably the selection of appropriate and desirable interventions and the effect on the residents themselves, who valued their part in the project. The participatory process was unpredictable and complex, however, and key determinants of it included the organizational dynamics of the home and the skills, actions and attitudes of the researcher. Adopting a participatory approach brought valuable benefits in a residential home, but others adopting the approach should ensure they critically consider at the outset the ethical and practical dilemmas the setting and approach may produce and have realistic expectations of participation.

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References

  • Abelson, J., Forest, P.-G., Eyles, J., Smith, P., Martin, E., & Gauvin, F.-P. (2003). Deliberations about deliberative methods: issues in the design and evaluation of public participation processes. Social Science and Medicine, 57, 239–251.

    Article  Google Scholar 

  • Arnstein, S. (1969). A ladder of citizen participation. Journal of the American Institute of Planners, 35, 216–224.

    Article  Google Scholar 

  • Aubel, J., Touré, I., & Diagne, M. (2004). Senegalese grandmothers promote improved maternal and child nutrition practices: the guardians of tradition are not averse to change. Social Science & Medicine, 59, 945–959.

    Article  Google Scholar 

  • Baldwin, N., Harris, J., & Kelly, D. (1993). Institutionalisation: why blame the institution? Ageing and Society, 13, 69–81.

    Article  Google Scholar 

  • Blair, T., & Minkler, M. (2009). Participatory action research with older adults: key principles in practice. The Gerontologist, 49, 651–662.

    Article  Google Scholar 

  • Bourke, L. (2009). Reflections on doing participatory research in health: participation, method and power. International Journal of Social Research Methodology, 12, 457–474.

    Article  Google Scholar 

  • Brathwaite, F.S. (1989). Social life among females aged 75 and over in Barbados. In Mid-life and older women in Latin America and the Caribbean (pp. 253–264). Washington: Pan American Health Organization and American Association of Retired Persons.

  • Brett, E. A. (2003). Participation and accountability in development management. Journal of Development Studies, 40, 1–29.

    Article  Google Scholar 

  • Bureau of Statistics. (2007). The co-operative republic of guyana population and housing census 2002. National Census Report. Guyana: Bureau of Statistics.

    Google Scholar 

  • Chambers, R. (1997). Whose reality counts? London: ITDG Publishing.

    Google Scholar 

  • Cornwall, A. (2002). Locating citizen participation. IDS Bulletin, 33, 49–58.

    Article  Google Scholar 

  • Cornwall, A. (2008). Unpacking ‘participation’: models, meanings and practices. Community Development Journal, 43, 269–283.

    Article  Google Scholar 

  • Cornwall, A., & Jewkes, R. (1995). What is participatory research? Social Science & Medicine, 41, 1667–1676.

    Article  Google Scholar 

  • Dickson, G. (1997) Participatory action research and health promotion: the grandmothers’ story. Saskatoon: University of Saskatchewan. Available at: http://library.usask.ca/theses/available/etd-10212004-000741/ (Accessed 2nd April 2012).

  • Dickson, G. (2000). Aboriginal grandmothers’ experience with health promotion and participatory action research. Qualitative Health Research, 10, 188–213.

    Article  Google Scholar 

  • Doyle, M., & Timonen, V. (2010). Lessons from a community-based participatory research project: older people’s and researchers’ reflections. Research on Aging, 32, 244–263.

    Article  Google Scholar 

  • Draper, A. K., Hewitt, G., & Rifkin, S. (2010). Chasing the dragon: developing indicators for the assessment of community participation in health programmes. Social Science & Medicine, 71, 1102–1109.

    Article  Google Scholar 

  • Eldemire-Shearer, D. (2008). Ageing: the response yesterday, today and tomorrow. The West Indian Medical Journal, 57, 577–588.

    Google Scholar 

  • ESRC. (2005). Research ethics framework. Swindon: Economic and Social Research Council.

    Google Scholar 

  • Fiorino, D. J. (1990). Citizen participation and environmental risk: a survey of institutional mechanisms. Science, Technology and Human Values, 15, 226–243.

    Article  Google Scholar 

  • Goffman, E. (1991a). On the characteristics of total institutions. In E. G. Asylums (Ed.), Essays on the social situation of mental patients and other inmates (pp. 13–115). London: Penguin.

    Google Scholar 

  • Goffman, E. (1991b). The underlife of a public institution: a study of ways of making out in a mental hospital. In E. G. Asylums (Ed.), Essays on the social situation of mental patients and other inmates (pp. 157–280). London: Penguin.

    Google Scholar 

  • Government of Guyana. (2000) National Development Strategy (2001–2010). Available at: http://www.ndsguyana.org/document.asp (Accessed 29th March 2012)

  • Guijt, I. (1998). Participatory monitoring and impact assessment of sustainable agricultural initiatives. (SARL Discussion Paper No.1). London: International Institute for Environment and Development.

    Google Scholar 

  • HelpAge International. (2002). Participatory research with older people: a sourcebook. London: HelpAge International.

    Google Scholar 

  • Heslop, A. (1996). Report of a participatory needs assessment with muthande society for the aged in clermont township, Durban, South Africa. London: HelpAge International.

    Google Scholar 

  • Hewitt, G. (2005). Improving the health, nutrition and quality of life of elderly Guyanese living in residential homes. (PhD thesis) London: University of Westminster.

  • Hewitt, G., Draper, A., Ismail, S., & Patterson, S. (2007). Improving food provision in a Guyanese home for the elderly: a participatory approach. Public Health Nutrition, 10, 552–558.

    Article  Google Scholar 

  • Higgs, P. (1998). Risk, governmentality and the reconceptualization of citizenship. In G. Scambler & P. Higgs (Eds.), Modernity, medicine and health (pp. 176–197). London: Routledge.

    Google Scholar 

  • Hodkinson, H. (1972). Evaluation of a mental test score for assessment of mental impairment in the elderly. Age and Ageing, 1, 233–238.

    Article  Google Scholar 

  • Hoeyer, K., Dahlager, L., & Lynöe, N. (2005). Conflicting notions of research ethics. The mutually challenging traditions of social scientists and medical researchers. Social Science & Medicine, 61, 1741–1749.

    Article  Google Scholar 

  • Hudelson, P. M. (1994). Qualitative research for health programmes. Geneva: World Health Organization.

    Google Scholar 

  • Kari, N., & Michels, P. (1991). The Lazarus Project: the politics of empowerment. American Journal of Occupational Therapy, 45, 719–7725.

    Article  Google Scholar 

  • Kelley, L. S. (2005). Growing old in St. Lucia: expectations and experiences in a Caribbean village. Journal of Cross-Cultural Gerontology, 20, 67–78.

    Article  Google Scholar 

  • Khanlou, N., & Peter, E. (2005). Participatory action research: considerations for ethical review. Social Science & Medicine, 60, 2333–2340.

    Article  Google Scholar 

  • Laliberte Rudman, D. (2006). Shaping the active, autonomous and responsible modern retiree: an analysis of discursive technologies and their links with neo-liberal political rationality. Ageing & Society, 26, 181–201.

    Article  Google Scholar 

  • Langley, A., Denis, J.-L., & Lamothe, L. (2003). Process research in healthcare: towards three-dimensional learning. Policy and Politics, 31, 195–206.

    Google Scholar 

  • Laverack, G., & Wallerstein, N. (2001). Measuring community empowerment: a fresh look at organizational domains. Health Promotion International, 16, 179–185.

    Article  Google Scholar 

  • Lavoie-Tremblay, M. (2004). Creating a healthy workplace: a participatory organizational intervention. Journal of Nursing Administration, 34, 469–474.

    Article  Google Scholar 

  • Lindeman, M. A., Black, K., Smith, R., Gough, J., Bryce, A., Gilsenan, B., Hill, K., & Stewart, A. (2003). Changing practice in residential aged care using participatory methods. Education and Health, 16, 22–31.

    Article  Google Scholar 

  • Mahoney, M. E., Potter, J.-L. L., & Marsh, R. S. (2007). Community participation in HIA: discords in teleology and terminology. Critical Public Health, 17, 229–241.

    Article  Google Scholar 

  • Mays, N., & Pope, C. (1995). Qualitative research: rigour and qualitative research. British Medical Journal, 311, 109–112.

    Article  Google Scholar 

  • Michener, V. J. (1998). The participatory approach: contradiction and co-option in Burkina Faso. World Development, 26, 2105–2118.

    Article  Google Scholar 

  • Morgan, L. M. (2001). Community participation in health: perpetual allure, persistent challenge. Health Policy and Planning, 16, 221–230.

    Article  Google Scholar 

  • Mosse, D. (1995). Social analysis in participatory rural development. PLA Notes, 24, 27–33.

    Google Scholar 

  • Myers, R. (2012). Guyana’s National Report on Ageing: a review and evaluation of the Brasilia Declaration, http://www.cepal.org/celade/noticias/paginas/9/46849/Guyana.pdf (Accessed 13 September 2012).

  • Naylor, P.-J., Wharf-Higgins, J., Blair, L., Green, L., & O’Connor, B. (2002). Evaluating the participatory process in a community-based heart health project. Social Science & Medicine, 55, 1173–1187.

    Article  Google Scholar 

  • Nyanguru, A. (1987). Residential care for the destitute elderly: a comparative study of two institutions in Zimbabwe. Journal of Cross-Cultural Gerontology, 2, 345–357.

    Article  Google Scholar 

  • Patton, M. Q. (1987). How to use qualitative methods in evaluation. Newbury Park: Sage Publications.

    Google Scholar 

  • Pretty, J. N., Guijt, I., Thompson, J., & Scoones, I. (1995). Participatory learning and action: a trainer’s guide. London: IIED.

    Google Scholar 

  • Purdey, A. F., Bahadur Adhikari, G., Robinson, S. A., & Cox, P. W. (1994). Participatory health development in rural Nepal: clarifying the process of community empowerment. Health Education Quarterly, 21, 329–343.

    Article  Google Scholar 

  • Rifkin, S. B., Muller, F., & Bichmann, W. (1988). Primary health care: on measuring participation. Social Science & Medicine, 26, 931–940.

    Article  Google Scholar 

  • Rifkin, S. B., Lewando-Hunt, G., & Draper, A. K. (2000). Participatory approaches in health promotion and health planning: a literature review. London: Health Development Agency.

    Google Scholar 

  • Ritchie, M. (2000). Social capacity, sustainable development, and older people: lessons from community-based care in Southeast Asia. Development in Practice, 10, 638–649.

    Article  Google Scholar 

  • Ritchie, J., & Spencer, L. (1994). Qualitative data analysis for applied policy research. In A. Bryman & R. G. Burgess (Eds.), Analyzing qualitative data (pp. 173–194). London: Routledge.

    Chapter  Google Scholar 

  • Rowlands, J. (1997). Questioning empowerment: working with women in Honduras. Oxford: Oxfam.

    Google Scholar 

  • Shrestha, S. (2003). A conceptual model for empowerment of the female community health volunteers in Nepal. Education and Health, 16, 318–327.

    Article  Google Scholar 

  • Shura, R., Siders, R. A., & Dannefer, D. (2011). Culture change in long-term care: participatory action research and the role of the resident. The Gerontologist, 51, 212–225.

    Article  Google Scholar 

  • Theis, J., & Grady, H. M. (1991). Participatory rapid appraisal for community development. London: International Institute for Environment and Development.

    Google Scholar 

  • Townsend, P. (1962). The last refuge: a survey of residential institutions and homes for the aged in England and Wales. (Abridged edition). London: Routledge and Kegan Paul.

    Google Scholar 

  • Truman, C., & Raine, P. (2001). Involving users in evaluation: the social relations of user participation in health research. Critical Public Health, 11, 215–229.

    Article  Google Scholar 

  • UNPD. (2002). Population division of the Department of Economic and Social Affairs of the United Nations Secretariat. World Population Prospects: The 2002 Revision. http://esa.un.org/unpp (Accessed 27 October 2004).

  • UNPD. (2010). Population division of the Department of Economic and Social Affairs of the United Nations Secretariat. World Population Prospects: The 2010 Revision. http://esa.un.org/unpd/wpp (Accessed 13 September 2012).

  • van der Velde, J., Williamson, D. L., & Ogilvie, L. D. (2009). Participatory action research: practical strategies for actively engaging and maintaining participation in immigrant and refugee communities. Qualitative Health Research, 19, 1293–1302.

    Article  Google Scholar 

  • Waddington, D. (1994). Participant Observation. In C. Carsell & G. Symon (Eds.), Qualitative methods in organizational research. London: Sage Publications.

    Google Scholar 

  • Wallerstein, N. (2006). What is the evidence on effectiveness of empowerment to improve health? Copenhagen: WHO Regional Office for Europe.

    Google Scholar 

  • Yin, R. K. (1999). Enhancing the quality of case studies in health services research. Health Services Research, 34, 1209–1224.

    Google Scholar 

  • Yoo, S., Butler, J., Elias, T. I., & Goodman, R. M. (2009). The 6-step model for community empowerment: revisited in public housing communities for low-income senior citizens. Health Promotion Practice, 10, 262–275.

    Article  Google Scholar 

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Acknowledgments

We extend our thanks to the residents, staff and committee members of the home and to the GAPSW, Ms. Carlyn Fraser and the project fieldworker, Ms. Eartha Grant.

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Correspondence to Gillian Hewitt.

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Hewitt, G., Draper, A.K. & Ismail, S. Using Participatory Approaches with Older People in a Residential Home in Guyana: Challenges and Tensions. J Cross Cult Gerontol 28, 1–25 (2013). https://doi.org/10.1007/s10823-012-9182-1

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