A Novel Visual Method for Studying Complex Health Transitions for Older People Living With Dementia

Abstract

Understanding the complexity of health services for older people living with dementia is a challenging research endeavor. We discuss a novel research approach that combines photographic methods with storyboarding techniques to understand the views of older people living with dementia who encounter the emergency department. A social ecological theoretical position was taken to study relationships between health care systems and processes and the social arrangements of those receiving care. The research approach uncovers complex contextual factors in health care systems that are amenable to change. The approach strengthens the contribution of older people living with dementia to have their voice included in research endeavors.Keywords dementia, aging, acute care, complex health systems, research design, photography Understanding the complexity of being an older adult living with dementia in a busy emergency department (ED) is a challenging research endeavor. The challenge comes when we enter research settings that contain complex contextual factors like physical and social age-related features possessed by older people, circumstances imposed by the condition of dementia, converging perspectives of multiple people (the older person's family and health care professionals), and the chaotic environment of the ED. The synergy of these converging factors confound research investigations.This article presents a novel research approach that evolved from a previous study . The approach combines photographic methods with storyboarding techniques to address the methodological problem of systematically incorporating the views of older people living with dementia in research. Our approach does not simply describe contextual factors but illuminates influences, relationships, and resulting synergies to mitigate harmful outcomes.

Sensitive Inquiry in Mental Health

“…Second, to generate insights that would contribute to capacity building in the partner organization including their efforts to combat stigmatization and inform policy for people with lived experience of mental illness in regional New South Wales (NSW). Policy changes are “more meaningful” when informed by the people directly impacted (Parke, Hunter, & Marck, 2015). The research design problematic therefore centered on how we give “preference, voice and visibility” (Horsfall, Carrington, & Paton, 2016, p. 10) to people with lived experience of severe and persistent mental illness and how we make it as safe as possible to do so.…”

Case study: using participatory photographic methods for the prevention of medication errors

“…Restorative health research emphasizes the dynamics of the processes and behaviors in interactions between individuals and the places where they live and work, because there is a relationship between personal characteristics and those found in the environment. This theoretical perspective is used to study complex relations between the healthcare system and the social arrangements of people who provide or receive care (5) .…”

A visual and creative approach to exploring people with dementia’s experiences of being students at a school in Denmark

“…In order to explore the students’ experiences, a creative approach was adopted, using photo-elicitation and storytelling methods (Harper, 2002; Murphy, Jordan, Hunter, Cooney, & Casey, 2015; Parke et al., 2015), see Table 2. This approach can be a way to support and prompt involvement, while acknowledging that people with dementia can experience challenges with their memory, attention and concentration (Shell, 2014).…”

“…The sessions were video recorded by two cameras and audio recorded, with permission from all participants. This provided a total of 16 hours of video and audio-recorded data (Crimmens, 2006;Parke et al, 2015).…”

“…One way to engage people with dementia in research can be through creative methods, such as photography and storytelling, which have been used successfully to hear the voice of the person with dementia, to help them become active members of the research and been found to be empowering, helping to develop a sense of identity through participation (Basting, 2011;Palibroda, Krieg, Murdock, & Havelock, 2009;Russell & Timmons, 2009;Wiersma, 2011). The use of photo-elicitation (Harper, 2002) and photovoice (Wang & Burris, 1997), as methodological techniques, is increasing in people with dementia to support their inclusion in research (Parke, Hunter, & Marck, 2015). This approach is regarded as a way of supporting the voice of those who are marginalised and often missing in research (Hodgetts, Chamberlain, & Groot, 2011).…”