Study project – Marie-Chantal Falardeau

DEGREES GRANTED:

2022 : Third Cycle Diploma: Diploma of Higher Specialized Studies in research skill development – scientific career in academia, University of Sherbrooke

2020: Ph.D. of Humanities, social communication concentration, University of Québec at Trois-Rivières (UQTR)

2014: Master of Humanities, social communication concentration, UQTR

2012: Bachelor of Social Communication, UQTR

CURRENT STUDIES:

Postdoctoral Internship: Faculty of Arts and Humanities: School of Social Work

SUBJECT OF STUDY PROJECT:

Program to promote goodwill and counter intolerance between residents: Improving community living in private retirement residences.

SCHOLARSHIPS AND AMOUNTS RECEIVED:

Mitacs Accelerate Program (in association with the Jasmin Roy Sophie Desmarais Foundation): $70,000

COMPLETION DATE:

June 15, 2020 to December 15, 2022

ISSUE:

In Québec, resident-to-resident intolerance in private retirement residences (PRR) is an emerging preoccupation for their managers, intervenors and managers of public and community organisms, and scientists. The extent of the problem and its psychological, physical, and social consequences among mistreated older persons or witnesses of such mistreatment denotes the urgency to act. The state of knowledge indicates that the problem has been studied numerous times in long-term care facilities, but less so in PRR. Moreover, few validated practices exist to counter resident-to-resident intolerance in PRR. As a result, each case receives a piecemeal response. To our knowledge, no practice has been the object of a scientific validation process, be it a process that involves a series of qualitative research strategies: an optimal presence in the field, an expanded description of each action and its effects, or the proximity of researchers to practitioners (Creswell and Poth, 2018).

In addition to PRR practitioners and managers, persons with the community and public organisations (Goulet and Séguin, 2018) may act in these situations, each within the limits of their expertise. To our knowledge, no formal collaboration between actors aiming to offer concerted and coherent action to counter resident-to-resident intolerance and promote goodwill exists.

Consequently, this study particularly seeks to develop a program to promote goodwill and counter intolerance between residents, thereby improving the quality of community living in PRR. The project follows up on the first phase completed in 2018–2019 that addressed the representations of resident-to-resident mistreatment and the notion of “living well together” by those who live and work in PRR (residents, employees, and managers, be they general managers or corporate directors) (Beaulieu and Leboeuf, 2019).

In the first phase of the project, researchers identified situations, characteristics, effects, and actions taken concerning resident-to-resident mistreatment or intolerance and “living well together” or goodwill. The project also enabled the identification of needs and raised possible solutions. Finally, a consensus was reached between residents, employees, and managers on terminology to use when speaking of resident-to-resident mistreatment and ’living well together. For the participants in this first phase of the project, “intolerance” and “goodwill” are the terms best representing the study’s phenomenon. As mentioned above, we will build on this result going forward and use “intolerance” and “goodwill” within this study’s framework and the points resulting from this decision.

Concerned with the well-being of older adults living in PRR and improving the practices seeking to counter intolerance and promote goodwill in these facilities, the Jasmin Roy Sophie Desmarais Foundation and other collaborators join the postdoctoral intern, the supervising professor, as well as the rest of the research team, to jointly lead this project using a participative research approach.

GOAL OR RESEARCH QUESTION:

This project’s principal objective is to develop and implement a program intended to promote goodwill and counter intolerance between residents in PRR.

OBJECTIVES:

The following specific objectives are sought:

1. To document practices to counter resident-to-resident intolerance and promote goodwill in PRR;
2. To develop a program to promote goodwill and counter situations of intolerance (prevention, tracking and intervention), and test it;
3. To complete an evaluation of the program’s testing.

METHODOLOGY:

Systematic Review

The project will begin by studying the state of knowledge concerning the practices and needs to counter resident-to-resident intolerance and promote goodwill. A systematic review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) method of Liberati and colleagues (2009). A systematic review summarises studies dealing with a precise research question and proposes a rigorous, transparent, and explicit methodology (Brooks and McNeely, 2013). It identifies existing discrepancies in the selected studies, synthesises these and proposes recommendations concerning the results raised.

Here, the proposed systematic review deals with two general questions and also responds to four specific questions. As the literature on this problem refers to “mistreatment” and “wellness care”, these terms guide our inquiries. However, the terms’ intolerance and “goodwill” are among the key words enabling the identification of pertinent studies:

This systematic review will deepen the knowledge of intolerance and goodwill between PRR residents, be they autonomous or semi-autonomous, identify the literature’s limits, and open pathways to broaden data collection.

Method in support of Objective 1.

To fulfill Objective 1, the documentation of practices to counter resident-to-resident intolerance and promote wellness care in PRR, interviews will be conducted with diverse actors. In total, 24 semi-directed interviews of these individuals, lasting 60 to 90 minutes, will be conducted using a narrative approach, with in-depth attention to individual experiences (Creswell and Poth, 2018), and thereafter, undergo a thematic analysis (Paillé and Mucchielli, 2012). Specifically:

• Twelve (12) separate interviews with residents living in the three participating PRR who have already experienced a situation of resident-to-resident intolerance;
• Six (6) separate interviews with diverse staff members of the three participating PRR (e.g., nurses, personal support workers, recreations managers, dining room staff, etc.) who have all intervened in these types of situations;
• Six (6) separate interviews with persons from key partners (community, public, and other organisations) working to counter resident-to-resident intolerance and promote goodwill and have personally intervened in these types of situations.

Considering the study’s sensitive subject matter, especially for residents who have personally experienced such situations, semi-directed individual interviews are preferred. The choice to conduct semi-directed interviews allows us to approach the central themes while offering the participant the freedom to discuss similar subjects, which may prove rich in pertinent information for the study (Poupart et al., 1997). The interview canvas will also have open-ended questions prompting fuller responses and be open to other themes considered important by the participants.

These interviews allow for a better understanding of existing practices in the fight against resident-to-resident intolerance and the promotion of goodwill in PRR. Specific practices may also emerge depending on the type of intolerance and the type of potential intervenor and identify orientations concerning goodwill. Specifically, the interview themes address situations of intolerance and mistreatment experienced or witnessed by the participants themselves. It is also a question of understanding how the situation was de-escalated and the measures implemented to resolve it. Another planned theme examines existing tools in PRR to understand their actual use and better define the deficiencies to be improved by the proposed program. Within the program, particular attention will be directed to the needs of the participants (for example, what it should or should not contain).

Method in support of Objective 2.

The fulfillment of Objective 2, the development and implementation of the program, is anchored in a participative approach where PRR stakeholders work in concert with the research team in the project’s development and implementation. They play a decisive role in the orientation and realisation of each step of the project (Corwall and Jewekes, 1995). To ensure coordination between all actors in the planning process, a working group composed of three (3) residents and three (3) employees in each participating PRR will work in concert with a steering committee composed of the research team (i.e., the postdoctoral intern and the supervising researcher), Jasmin Roy, president of the Jasmin Roy Sophie Desjardins Foundation, and the general managers of the PRR where the program will be implemented. Together, these two committees will oversee the program’s planning, development, implementation, and evaluation.

PRR managers will recruit residents and employees taking part in the working group. Each residence will liberate an employee during work hours to collaborate in the development and implementation of the program. With their expertise and knowledge of the residents, the managers can submit to the research team the names of those residents who might be interested in taking part in the program’s development and implantation at their residence. The postdoctoral intern will then make contact with them to form the working group.

The Intervention Mapping approach (Bartholomew Eldrigde et al., 2016) will guide the program’s development and implementation. It describes an iterative process, where theory, literature and empirical data collected from targeted participants are integrated. Specifically, this approach is eco-sociological, allowing for an understanding of the context of the individuals and their environment.

Six steps make up Intervention Mapping, laying out the iterative process from identification of the problem to resolution (Bartholomew Eldrigde et al., 2016, https://interventionmapping.com/):

1. Conduct a needs assessment or problem analysis, identifying what, if anything, needs to be changed and for whom; 2. Create matrices of change objectives by combining (sub-) behaviours (performance objectives) with behavioural determinants, identifying which beliefs should be targeted by the intervention; 3. Select theory-based intervention methods that correspond to the determinates into which the identified beliefs aggregate, and translate these into practical applications that satisfy the parameters for the effectiveness of the selected methods; 4. Integrate methods and the practical applications into an organised program; 5. Plan for the adoption, implementation, and sustainability of the program in real-life contexts; 6. Generate an evaluation plan to conduct effect and process evaluations.

The completion of these six steps leads to the conception, implementation, and evaluation of the intervention, as shown in Objective 3.

The working groups and the steering committee will also take into account previous results defining the problem and the needs to promote goodwill and counter intolerance. They will elaborate the objectives of change and the intervention targets, choosing the best strategies and activities, consequently developing tools and intervention methods, integrating these methods within the program, planning the parameters to ensure the program’s adoption, integration, and long-term viability in PRR. Therefore, the assessment of the implementation will be determined according to the content of the program, for example, the number of selected activities, the quality of the tools, receptivity to the message, etc.

Method in support of Objective 3.

To fulfill Objective 3, the program, in both French and English versions, will be implemented as a six-month pilot project at all three participating residences

A developmental evaluation aims to support the institution’s process of change and innovation in its activities. It is useful when management is uncertain or less structured than in other situations where it may resort to a formative or summative evaluation. A developmental evaluation allows the chosen direction and the destination to evolve simultaneously. Furthermore, it perfectly fits an iterative cycle and collaborative dynamic, as is the case with this study.

An appreciative inquiry seeks to “strengthen a system’s capacity to apprehend, anticipate and heighten its potential” (Gamble, 2008, p. 51). This type of analysis focuses on the positive and supportive aspects of the organisation rather than its failures.

Working alongside the Jasmin Roy Sophie Desmarais Foundation and stakeholders in the field (residents, employees, PRR managers, partners) to promote communities of goodwill in PRR, this type of evaluation also allows the postdoctoral intern, the supervising professor, the research team, and partners to work in concert to develop a program to counter intolerance and promote goodwill, always respecting the needs of those principally concerned – the residents.

To do so, interviews of groups and individuals, each lasting from 60 to 90 minutes, will be conducted within a semi-directed interview framework. More specifically:

• Group interviews of 10 residents from each PRR (n = 30);
• Group interviews with six employees from each PRR (n = 18);
• Individual interviews with the managers of each PRR (n = 4).

Group interviews with residents and employees are favoured since they promote the expression and enhancement of various ideas and encourage a group dynamic that may offer a feeling of security to participants (Desrosiers and Larivière, 2014). Also, a group interview brings together small groups of people and leads them to discuss several specific subjects openly and better understand the diversity of behaviours and opinions concerning the subjects under discussion (Deslauriers, 1991).

On the other hand, considering their small numbers (n = 3), individual interviews with the PRR managers are envisaged. Indeed, for group interviews, a grouping of five (5) to 11 participants is recommended (Corbin and Strauss, 2015). Also, as we wish to understand the effects of the program in each residence, we must consequently interview the managers individually.

This new, qualitative data collection in the form of interviews broadens the knowledge of the program’s effects on the various stakeholders involved. This final step seeks to enhance the program’s final version and refine its method of implementation.

WORK PROGRESS:

The systematic review is underway. The objectives 1 and 2 were achieved.

Data collection in support of Objective 3 is in progress.

COMMUNICATIONS:

PUBLICATIONS:

Scientific articles:

Falardeau, M-C., Beaulieu, M., Carbonneau, H., & Levasseur, M. (Accepté février 2022). Resident-to-resident aggression in private seniors’ residences. The Journal of Gerontopsychology and Geriatric Psychiatry.

Leboeuf, R., Falardeau, M-C., & Beaulieu, M. (Accepté mai 2022). Habitation collective : maltraitance, intimidation ou intolérance entre aînés? Gérontologie et Société.

Falardeau, M-C., Beaulieu, M., Carbonneau, H., Levasseur, M., & Belley, R. (2021). Maltraitance entre résidents en temps de pandémie : Effets dans les résidences pour aînés privées au Québec. Canadian Journal on Aging / La Revue canadienne du vieillissement, 40(4), 619-627. https://doi.org/10.1017/S0714980821000428

Research report:

Beaulieu, M., Carbonneau, H., Levasseur, M. & Falardeau, M-C. (2021). Promotion de la bienveillance et lutte contre l’intolérance entre résidents en RPA. Étude des besoins en vue de l’élaboration d’un programme. Rapport de recherche synthèse. Chaire de recherche sur la maltraitance envers les personnes aînées et Chartwell résidences pour retraités. https://maltraitancedesaines.com/wp-content/uploads/2021/06/2021_Beaulieu_Falardeau_Rapport_etude_besoins.pdf

Beaulieu, M., Carbonneau, H., Levasseur, M., & Falardeau, M-C. (2021). Promoting goodwill and countering intolerance among residents in independent living facilities. Needs study with a view to developing a program. Research review report. Research Chair on Mistreatment of Older Adults and Chartwell Retirement Residences. https://maltraitancedesaines.com/wp-content/uploads/2021/11/Beaulieu-et-al.-2021-Rapport_obj1_e%CC%81tude_besoins_EN.pdf

Other publications :

Beaulieu, M., Falardeau, M-C., & Chartwell Villa de l’Estrie. (2022). Le Programme BIEN en résidence : signification et activités à venir. L’écho de la Villa, Mai 2022.

Beaulieu, M., Falardeau, M-C. & Chartwell Seigneuries du Carrefour. (2022). Le Programme BIEN en résidence : signification et activités à venir. L’Envol : La voix des Seigneuries, Mai 2022.

Beaulieu, M., Falardeau, M-C., & Chartwell Le St-Gabriel. (2022). Le Programme BIEN en résidence : signification et activités à venir. Le Journal du St-Gabriel, Janvier 2022.

Beaulieu, M., Falardeau, M-C., & Chartwell Villa de l’Estrie. (2021). Le Programme BIEN en RPA mis à l’essai à la résidence cet automne! L’écho de la Villa, Novembre 2021.

Beaulieu, M., Falardeau, M-C. & Chartwell Seigneuries du Carrefour. (2021). Le Programme BIEN en RPA mis à l’essai à la résidence cet automne! L’Envol : La voix des Seigneuries, Novembre 2021.

Beaulieu, M., Falardeau, M-C., & Chartwell Le St-Gabriel. (2021). Le Programme BIEN en RPA mis à l’essai à la résidence cet automne! Le Journal du St-Gabriel, Octobre 2021.

Beaulieu, M., Falardeau, M-C. & Chartwell Seigneuries du Carrefour. (2021). Prenons soin de nous et de ceux qui nous entourent. L’Envol : La voix des Seigneuries, Juillet-Août 2021.

Beaulieu, M., Falardeau, M-C., & Chartwell Le St-Gabriel. (2021). Prenons soin de nous et de ceux qui nous entourent. Le Journal du St-Gabriel, Août 2021.

Beaulieu, M., Falardeau, M-C., & Chartwell Villa de l’Estrie. (2021). Prenons soin de nous et de ceux qui nous entourent. L’écho de la Villa, Août 2021.