Application of practices
AUDIO-PSYCHO-PHONOLOGY (APP)
Cases and experiences
The APP practice was studied during the EU common training (Brussels, June 2014) among the partners’ staff (applicants and associates) and through some further seminars and workshops realised by the expert Dr Diego Taccuso in some of the partners’ countries (Lithuania, April 2015; Italy, in May 2015 in Vicenza and in October 2015 in Rome [link to the slides prepared by Diego Taccuso]).
The APP standard protocol was adapted for this experimentation as follows:
- The caregivers were told to use LIT only with these three default settings: Motor, to stimulate the body awareness and movement; Recharge to stimulate imagination and reduce stress and anxiety; Focus to improve concentration, memory and linguistic skills.
- The caregivers were instructed to use music (Mozart or Folks songs) or sounds of nature (birds chirping, rain, ocean waves) filtered by one of the above three default settings. The music had to be listened to for 30 minutes a day for 15 days.
- It is important to notice that an APP training period generally lasts 28 hours, while in this experimentation the overall time was reduced to only 7 hours and a half; of course this must be taken into consideration during the final evaluation.
The main experiences with final beneficiaries, older and young people, were realised in:
Weak Points
- The application of the method requires trained caregivers.
- The results are conditioned by the quality of the equipment used: headphones and speakers. They have to be of good quality and in good condition, and must be kept in that way.
- In case of the use of speakers their positioning in the activity room is also very important. This means that the setting up of the proper environment requires a certain amount of evaluation and planning.
- The method only delivers the best results if applied on a regular basis.
- At the beginning guests can be skeptical about taking part in the activity, since they were not able to understand the sense. The need to deepen all the information and to introduce the connected activities (e.g. manual activities provide a clearer sense to their participation), is necessary.
- From the socialisation point of view, some guests didn’t show any special change; they were not very expansive, as before.
- The experimentation showed that it is advisable to diversify the musical input, replacing e.g. classical music by sounds of nature.
Strong Points
- The intergenerational aspect had a most positive effect on the listening process and the oral communicative skills.
- The training led to an increased perception and discrimination of sounds and to a solicitation of certain cognitive functions, such as memory, concentration and attention.
- The training had a positive effect on the communication skills: an augmented verbal interaction occurred among the majority of the guests, especially during the drawing and colouring activities.
- The application of the “Focus” track sounds had a positive effect on the communication skills.
- The training had a positive effect on the motor skills of all the guests; the physiotherapy sessions done while listening to the Motor track sound, could be prolonged up to one hour, instead of the usual 25-30 minutes. Even guests suffering from Parkinson disease showed some sensible body coordination improvements.
- All the guests showed enthusiasm, serenity and a positive mood during the training. They talked about the activity both to operators and to their relatives, giving a very positive feedback.
- The improvement of the hearing capacities brought certain guests to wish for an improvement in their visual capacities.
- Manual activities improved during the listening sessions, the abilities acquired during the age-long learning process were favourable to this evolution.
- The operators are very pleased with an application such as the APP (LIT software), which is both affordable and user friendly and brings about an important mental and physical improvement for the elders and their care givers.
- On the whole of the experiences within the centres, the reactions of the hosts were very positive. The application had a relaxing and soothing effect.
Notes on relevant events occurred during the listening sessions:
- A guest, from the 4th day on, didn’t require the sedation therapy that was given to him before on a daily basis.
- A guest with depression symptoms, showed a particular enthusiasm about the sessions. During the period of the activity her husband was admitted to the same centre, and general concern emerged that this might destabilise her. On the contrary she accepted the new situation with serenity and a positive attitude.
Figure 2 The video-tutorial for APP method
TRANSCULTURAL BIOGRAPHY WORK (TBW)
Cases and experiences
The TBW practice was studied during the EU common training (Brussels, June 2014 [link to the related documents & reports]) among the partners’ staff (applicants and associates) and deepened through the following pilots:
- Austria – Graz. A team of 2 trainers, Andrea Gaal and Elisabeth Schrattner, worked together in workshops with residents of day care centres and other social facilities to find out about topics of large interest for the elderly. They used creative methods to engage elderly people. An important role played the method of transcultural biographical work (TBW). It was used in common talks to exchange memories, record them, and make them available in the form of interviews. Altogether 61 individual elderly people took part in 5 pilot group activities (12 modules) and individual activities at home. 37 of them participated twice.
- Belgium – Brussels, at the Maison des Femmes de Schaerbeeck an open institution where all generations are welcome for various emancipating activities (art, exhibitions, workshops etc.), and where Euro Idea tested the TBW, integrating the other two practices (APP and Memoro), and combining two groups of learners: older people and young migrant women. Euro Idea introduced the TBW method, by using in turns geographical maps, post cards, photos, objects that are linked to memories and first and foremost, the illustrations the participants made during the listening phase (APP).
- Iceland – Reykjavik, at Hrafnista we adapted the TBW to our own biographical work which we call Life history. We were already working with Life history at the nursing home, especially for people with dementia. First we introduced the Life history to our clients in our auditorium. Guðmunda, a staff member of the day training centre, introduced it and there where about 25 people who participated. The day training centre gives every client a handout about how they can start to make their own Life history, what questions are good to have and what are the possibilities. Most of our clients were positive and wanted to start at home with their families but others thought it was good to know, but were not interested at that time. Our goal is that when people move into a nursing home they have themselves written their story which can be introduced to the staff members. The person can benefit from it especially if the elderly person has memory loss.
- Italy - Palermo (Sicily): the TBW was mainly exploited by the educator and the social workers of the elderly nursing home for preparing the ground of sharing guests’ memories through the digital interviews of Memoro. 13 guests took part to the biographical pathway and the “remembering exercises” were related to everyday life topics: the religious celebrations, the traditional food linked to specific days, the life in the old Palermo, the working life (helped by the use of postcards, and drawing works for the preparation of the festivity of Saint Joseph).
- Lithuania – Vilnius, in September 2014 and February 2015 3° year students (26 in Lithuanian group and 13 in foreign students group) of Social work studying at Mykolas Romeris University were introduced to Transcultural Biography Work approach (aim, content, and procedures). Seminars progressed smoothly; the participants shared their experiences and feelings, actively participated in all activities. All group of participants stressed that TBW supports the enhancement of self-esteem and the awareness of one’s competences. While working biographically, especially in a group, learners and practitioners should experience optimism and vitality. A positive personal condition motivates to make decisions to learn and to create visions for ones future.
Weak Points
- Participants can be distracted by new rooms or people. Self-consciousness does easily appear within familiar surroundings, where they can concentrate on what is asked for: focus on their stories, focus on inter-personal relationships.
- The contact persons within the respective organisations need to be very well informed. Elderly people very often have a high trust in their caretakers. It may be difficult for new trainers offering new things to be met with openness from participants if the confidence basis has not been established via the local practitioners.
- The main concern regarding the use of TBW methods and techniques is the provocation or recollection of unpleasant or sometimes traumatic memories experiences and fears. In such cases, it could be difficult to control and manage the situation.
- The TBW approach involves several techniques requiring the sharing of autobiographic life experiences and very personal data. This necessitates that the information shared be kept within and shared only among the group.
- Personal exchange of information in TBW seminars requires that trainers take the needed time to explain the logic of TBW approach, get people feel comfortable with each other and let them explore the TBW techniques.
Strong Points
- The evocative capacities stimulate the communicative ones. The exchanges between the participants become richer and more complex and the users switch easily from the factual communication to a more personal and empathic one.
- This results in a revitalization of the socialization based on recognition and acceptance of each individuality.
- This highly improves the self-esteem of the participants.
- The younger participants showed a keen interest in the TWB method, thus sharing and appreciating the experiences of the elderly participants.
- In the context of multicultural learning, the transcultural dimension of the biographic account awakens interest and stimulates the intellectual curiosity of the group.
- Interviews partly lead to a reflection of one´s own coping strategies with illnesses.
“Thank you very much, you´re welcome to come back!”
The participants were happy to be visited by the practitioners within their own environment and be able to present themselves as hosts.
- The participants can think back to significant moments of their existence in application of TBW, in order to identify situations in which they learned, built, or elaborated new knowledge or abilities.
- TBW helps to create a sense of being part and of living together in the new larger social life.
- Practitioners and students accept this method as useful in their own job and studies.
- Social workers and students gained knowledge and gained positive experience with the application of the method.
- The tools proposed were really interesting for operators and experts working with elderly persons, so it was also easy to involve them in the different phases of the validation process.
- Clients, mainly the guests of the daily centres, can involve their family members and perhaps make a memory book of their life.
DIGITAL INTERVIEWS (MEMORO)
Cases and experiences
The Memoro practice was studied during the EU common training (Brussels, June 2014 [link to the related documents & reports]) among the partners’ staff (applicants and associates) and deepened through the following pilots:
- Austria - Graz: Altogether 61 individual elderly people took part in 5 pilot group activities (12 modules) and individual activities at home. 37 of them participated twice, 29 of them consented to individual interviews being captured either on video or sound file. The youngest participant was born in 1949, the oldest in 1919. Results can be seen also on the Austrian site of Memoro at: http://www.memoro.org/at-at/
- Belgium - Brussels, to provide material for the memory bank, Euro-Idea interviewed the artist, Mrs. Francine Somers and made 3 videos of these contacts. Mrs. Somers was eager to share her life-experience and memories, she insisted that it is very important for her to pass this on to the next generations.
- Iceland - Reykjavík, at Hrafnista the Memoro interviews were planned by Oddur Albertsson and took place in our day training centre. Oddur introduced the project for all of our day training centre clients at the auditorium. About 15 people listen to his lecture and there where a group discussion about memories and the old times. Later Oddur and two high school students interviewed three of our clients and made a video recording of the session.
- Italy - Palermo (Sicily) after a workshop with 10 young volunteers we realised the video-interviews without their support, as with the nursing home social workers the residents were more confident to share memories and stories [link to the INNOMEC page on Memoro/Sicily interviews]. A targeted observation tool was implemented and applied to monitor the progress of the older guests involved in the testing. Their stories were related to everyday life topics: giving birth at home, the period of Word War II, or the experience of leaving the family home for a love story (in Sicilian dialect “fuitina”, the “little escape”).
- Italy - Vicenza (Veneto), StudioCentro engaged in this testing Foundation OASI and the ASTER TRE Association, realising a preliminary workshop with the Memoro expert with about 30 participants. Fondazione OASI has been able to involve 3 different elderly centres: Soave, San Bonifacio, Gazzo Veronese in the experimentation of MEMORO methodology. Recording sessions about the years spent at school, the first years of work, weddings, etc. are still ongoing in Fondazione OASI structures; but thanks to the involvement of Consulta Anziani of Vicenza Municipality and IPAB Vicenza, a further elderly centre has been involved – “Isituto Salvi” - where 3 video-interviews were realised and uploaded on Memoro website. These interviews were basically dealing with the role of football in elderly people’s life [link to the INNOMEC page on Memoro/Veneto interviews].
- Lithuania - Vilnius the 3rd year students of Social work studying at Mykolas Romeris University were introduced Memoro approach (aim, content, and procedures). After small experiments of interviewing each other students discussed difficulties of doing digital interview. Students received an assignment to make one digital interview with an older person residing in elderly care home or in a private dwelling unit. Special attention was paid to ensure the quality of the pilot study: quality assurance methods were employed such as reflections of older persons (provided to interviewers), oral feed-back of interviewers in classroom after doing interview; survey questionnaire for interviewers, discussion in multidisciplinary focus group, self-study of MEMORO approach by trainers, learning with the instructor, making a pilot interview, analysis of success and difficulties experienced by trainers, multidisciplinary peer-review by trainers.
Weak Points
- Young volunteers, almost often university students, gave priority to their studies instead of a constant relationship with the older guests of the nursing home.
- People who still live alone at home are more critical about video-taking or the internet than people who already experience some kind of care.
- Good functioning technical equipment plays an important role which is especially valid for speakers. Sound problems we had during the first interviews could afterwards only be solved using software.
- To record an individual interview while the other participants are present needs information for the non-participants by attaching for example a note at the door saying
“Please, do not disturb. Filming in progress.”
The local staff shall be asked not to serve drinks or meals during filming. And all present participants have to be able to understand that they cannot talk to each other while filming is going on.
- Stakeholders could decide to quit the idea to test Memoro because of the privacy problems that could rise, especially from relatives of elderly people, due to the video recording process.
- To some extent for some students it was a problem to find older people who would agree to participate in the digital interview.
- For some students it was challenging to cope with technicalities - video making software, because it was their very first experience.
- Since it was the very first experience for all students, the quality of some digital interviews could be better (sometimes there were side sounds, sometimes interviewers’ ice-breaking skills, skills of giving correct questions for qualitative interview, and listening skills could be improved).
- Suggestions for future would be as follows: to devote more specialised time to preparation for technical and socio-psychological skills of conducting and recording an interview; to teach and train students be empathic to the wish of older person to (not) participate in interview.
- To draw attention to the importance of good-quality-sound of interview.
- The contact people within the respective organisations need to be very well informed. Elderly people very often have a high trust in their caretakers. It may be difficult for new trainers offering new things to be met with openness from participants if the confidence basis had not been established via the local practitioners.
- People are afraid of the camera and are self-conscious. They do not want to look “stupid” and do not understand the internet. They are afraid of how the material will be used.
Strong Points
- Interviews lead by example to a common plan of measures related to actual problems and wishes. Those measures helped to improve the quality of life and wellbeing.
- Often told:
“Yes, surely, my children know this already!”
/ Seldom told: “Who really wants to hear that”
, “I don´t want to burden someone with that!”
, “No one talked about that!”
/ Never told: “I have to tell you something that I haven´t told anyone before. (But not in front of the camera, please!)”
– The participants appreciated telling things they wouldn´t tell otherwise.
- The recording of videos got positive feedback throughout. Practitioners reported that especially relatives were happy with the recorded memories of their loved ones.
- Contacts established during the project life and the MEMORO-site offer interesting possibilities for further cooperation in other projects.
- When put in front of a video camera, elderly people can really surprise you, becoming really eager to tell you their stories.
- Although some technical problems existed, all students who started their digital interviews succeeded in finishing them.
- The tools proposed were really interesting for operators and experts working with elderly persons, so it was also easy to involve them in the different phases of the validation process.
- Feedback were all positive after the experience. They could tell about many interesting things from their childhood and their life. They found it a positive experience and were proud of the outcome.