This article reports on a project which trained eighteen older people as co-researchers in a study aimed at developing what has been termed “age-friendly” communities in Manchester. The project involved eighteen older people as co-researchers who took a leading role in all phases of the study. The co-researchers completed 68 interviews with residents aged 60 and over who were experiencing social isolation within their neighbourhood. This led to important findings about how the community could be made more age-friendly. In this article, the experiences of the co-researchers will be used to illustrate some of the benefits, challenges and opportunities for co-research with older people in the field of age-friendly communities.
Background to the project
Manchester was the first UK city to be admitted to the World Health Organisation’s (WHO) Global Network of Age-Friendly Cities and Communities and a priority of the work in Manchester has been to make older people central to the development of evidence-based policy at a local level. To achieve this goal, participatory methodologies were required to engage with older residents (Buffel & Phillipson, 2018; McGarry, 2018). This research project provided a direct response to this need by developing co-produced work with older people designed to implement age friendly practice at a local level (Buffel, 2018a; Buffel, 2018b).
Co-researchers were drawn from a range of networks, including a variety of voluntary organizations and community groups as well as Manchester City Council’s Age-Friendly City program. A recruitment brochure, presenting the aims of the study and the criteria to become an ‘age friendly co-researcher’, was distributed at various meetings and community fora. Criteria included: personal experiences of aging; links with different groups of older residents; good communication and listening skills; and participation in research training offered as part of the project. Strategies which enhanced the recruitment of co-researchers included: the building of trust and rapport with potential participants; promoting awareness about the project in the broader community; and developing relationships with a variety of community groups and gatekeepers (Buffel, 2018a; Buffel, 2018b).
Eighteen older adults were recruited and trained as co-researchers, who were heterogeneous in terms of age, gender and ethnicity. Participants were aged between 58 and 74 years with ten females and eight males. Nine co-investigators described themselves as White British; four as White Irish; two as Asian British; one as Black British; one as Black Caribbean; and one as Black African. Most co-researchers described themselves as being in good health with three of the participants experiencing mobility difficulties.
Training, reflection and collaborative learning formed key dimensions of the project. All co-researchers participated in two training sessions, offered by the lead academic with the support of a local community development worker. The aims of the training sessions were to work collaboratively in developing the different phases of the research, agree on roles and responsibilities and to develop a peer support network which could be drawn upon throughout the project. The format of the training workshops was adapted to suit the participants and to facilitate interaction, practice and reflective conversation.
The co-researchers collectively conducted 68 qualitative interviews with older residents at risk of social isolation and jointly identified solutions for the challenges they face. These findings were disseminated through three workshops, which brought together co-researchers with community stakeholders with the aim of developing a strategy that translated research findings into practice (Buffel, 2018a; Buffel, 2018b).
Co-researchers also took part in four reflection meetings, aimed at identifying challenges faced during interviewing, collectively analyzing the data, and encouraging critical reflection on the role of the co-researchers. The next sections will draw on the co-researchers’ reflections to highlight the benefits, challenges and opportunities of co-research for developing age friendly communities.
Benefits
The co-researchers highlighted three key benefits of their involvement in the project.
Shared experiences
Co-researchers saw the main benefit of their involvement as being able to empathize and develop trust with the interviewees because of shared experiences based on proximity in age. This was viewed as beneficial in recruiting older interviewees as well as enabling them to discuss issues that may be viewed as ‘sensitive’ or less well-understood by younger researchers:
“I don’t think the very elderly people would have disclosed as much to students or young academics, as they were often ashamed of their problems such as fear of computers, severe deafness, using a commode…” (Margaret, 71 years old).
This was also aided by the fact that co-researchers lived close to their interviewees, which created trust and enabled co-researchers to reach a “deeper understanding” about age-friendly issues in the neighbourhood. This proximity was to prove invaluable in recruiting those who were isolated within their community. Martha suggested that the people she interviewed would have never shared their views with someone they did not know personally:
“The people I interviewed would not have participated in a study with academics or students as interviewers. Particularly Rose, who doesn’t even leave the kitchen, let alone the house. You would have never found her. But she’s used to me.” (Martha, 73 years old).
Recognizing and Developing Older People’s Skills and Networks
Co-researchers also highlighted personal benefits arising from involvement in the project. The project provided an opportunity for co-researchers to build upon their existing skills, creating a bridge between working life and retirement.
“I have been able to put into practice skills that I have learnt through my working life and I have found that being able to adopt these to this research has helped my confidence.” (Dorothy, 69 years old).
The training workshops, reflection and dissemination activities following the research provided further opportunities for skills development, which were valued by co-researchers.
Building ‘Better Connected’ ‘Age-Friendly’ Communities
A final benefit was linked to the project’s potential contribution to community change. Being able to make things better for older people was very important for many of the co-researchers. They often used the plural pronoun “we” when talking about their involvement, reflecting a sense of ownership over the project. An illustration of how the project had improved the lives of older people was given by Ahmed (62 years old):
“I discovered that what people wanted were often small changes but that these could make a big difference to their lives. [Before the research] there was nowhere to go and have a cup of coffee, and now there is somewhere to go. There was a lack of transport so we campaigned for [the successful restoration of the local bus service].” (Ahmed, 62 years old).
Challenges
The co-researchers also highlighted three key challenges associated with their involvement in the project.
Proximity
The first challenge raised by co-research was linked to the benefits of shared experiences. Whilst the shared ground was valuable, such similarities could also lead to issues being dismissed or overlooked by co-researchers. Moreen suggested that co-researchers may miss opportunities to ask follow-up questions or explore a topic further when sharing similar experiences with the interviewee:
“Co-researchers may be experiencing many of the same issues and problems as the people being interviewed. It may make you ignore some things as they are just an inevitable part of growing older in an inner-city in times of austerity.” (Moreen, 66 years old).
Managing Expectations
Another challenge concerned managing expectations about the potential benefits of the research. Being transparent with communities about the potential limitations of the research was therefore seen as essential to prevent frustration and disillusion:
“It raises expectations – don’t get me wrong I think the project should try to raise expectations. But if they are not realistic, then this could lead to disillusion.” (Martin 58 years old).
While there was potential for change, some of the co-researchers also felt frustrated that age-friendly interventions were unlikely to be implemented given restrictions on public spending:
“We’re trying our best, but it’s difficult in the economic climate. There has been so much upheaval in the council. I remember when I first came here, you [to another co-researcher] were campaigning for years about getting a seat at the bus stop…. So has it got better for older people? Will it get better? No.” (Judith, 63 years old).
Ethical Considerations
An important challenge for co-research with older people relates to research ethics and the impact of the study on participants. The project’s main concern was to ensure that none of the interviewees was negatively affected by taking part in the study, and that being involved as a co-researcher was a meaningful and worthwhile experience. These aspects required constant reflection and particular attention. Moreen, in one of the reflection meetings, alerted the group to potential issues around confidentiality when co-researchers and interviewees share the same neighbourhood:
“Asking people to talk about growing older inevitably means considering one’s whole life experience, the kinship and neighbourhood networks involved and the life events which have shaped them most. Though confidentiality is important, they are neighbours and the confidences given remain with the researcher.” (Moreen, 66 years old).
Opportunities
The benefits and challenges that were highlighted by the co-researchers’ experiences on the project demonstrate the value of co-research as well as the need to think carefully about how co-researchers are involved to make the most of the benefits. If this is achieved, the opportunities of using this approach to benefit ageing research are threefold.
First, this approach provides an opportunity to innovate in ageing research, which is especially urgent given the economic, health, and social inequalities within the older population (Buffel & Phillipson, 2018). New research methods are needed to capture the range of experiences characteristic of later life. In particular, co-research methods have the potential to access and incorporate the views of populations who are likely to be distrustful of, or skeptical towards, the value of research.
Second, the co-research approach recognises that older adults are an undervalued resource, bringing valuable skills and expertise into the research process. There are now a substantial number of people in their 60s and 70s who undertook various forms of professional training and education who are available to contribute to further understanding of the changes affecting older people and the communities in which they live (Buffel, Handler and Phillipson, 2018).
Finally, the co-research approach demonstrates that older people can play a crucial role, both in shaping research agendas, but also in developing outcomes from the research. The work undertaken in this project has influenced Manchester’s Age-Friendly program, providing the Council with an evidence-base for the strategic commissioning of services relevant to older people (McGarry, 2018). The project’s findings have also led to changes within the community, including the restoration of a much-valued bus service. The co-researchers have now formed a permanent group and are applying for funding for age-friendly activities, and many of them have also gone on to be involved with other co-research projects in the local area (Buffel, 2018a; Buffel 2018b). These outcomes illustrate the potential for long-lasting impact of co-research methods on the development of age-friendly communities.