Skills and sensitivity required – on conducting interviews with long-term care recipients

Authors: Assma Hajji, Judith Kieninger, Ruth Fulterer, and Birgit Trukeschitz (WU Vienna University of Economics and Business, Research Institute for Economics of Aging)

First interviewer experiences from the Austrian team of the EXCELC project.

 

About the interviews
So far, the team of the Research Institute for Economics of Aging has trained 25 interviewers in four of the Austrian ”Laender” to conduct interviews in Vienna, Upper Austria, Lower Austria and Vorarlberg from May 2016 to February 2017. Their task consists of interviewing recipients of long-term care and their informal carers on different aspects of their lives and home care services using a standardised questionnaire. Data collection was supported by the Austrian Federal Ministry of Labour, Social Affairs, Health and Consumer Protection, by social care organisations and local authorities.

Who are our interviewers?

Most of our interviewers have a background in the social sciences – they come from the fields of sociology, social work, business and economics, health sciences, or even law. Some are still in education and see this as a great opportunity to get some valuable first-hand experience in empirical research.  A few of them are employed in the care sector themselves – for them, doing the interviews offers an opportunity to view this field from a different angle as researchers. Two-thirds of our interviewers are women, the interviewers’ ages range from 20 to 55, with most of them being young adults.

14[1] of them agreed to answer a short survey we sent out asking them about their experiences and impressions. We have collected their statements and used them to put together the following sections on their experiences with conducting interviews with long-term care recipients.

The beginning of the interview – delving into new surroundings

Ringing the doorbell, the interviewers don’t really know what to expect on the other side of the door. All they have is a name and some contact details – and about one or two hours of time to get to know the people living within these walls.

In many cases, the participants are looking forward to being visited – after all, it’s not every day that a researcher from a university comes over to ask questions about your daily life, and the visits provide a nice break from daily routines. People talk about their lives freely, some offer tea and biscuits. Others would like to, but are not able to cater for guests anymore because of physical strain, illness or economic circumstances. Some are visibly uncomfortable because of this – such as Mr. F, who has “only water to offer” for his guests or Ms. L, who apologises for her scrawly handwriting on the informed consent form. Despite all of this, they are happy to face the challenge and contribute to the research project.

For some, however, the willingness to help out is accompanied by fear of the unknown visitors. The interviewers need a great deal of sensitivity and empathy in order to be able to counter-act those feelings, build trust and create a relaxed atmosphere. And in some cases, a familiar person – maybe a son or a daughter – will stay with the participants to make them feel more secure.

Different personalities and environments: a challenge for the interviewers

No two interviews or participants are exactly alike. The interviewers are aware of that and know that with every new interview they are expected to adapt to the situation they find themselves in and to tune into the participant’s needs and react accordingly. “I get to experience so many different settings and have to find ways of adapting to new contexts quickly – I find this really interesting and I feel I can learn a lot from it’” – this was how one of our interviewers put it after having experienced quite a few different interview situations himself.

With each interview they conduct, the interviewers get to know different conversation styles. As a result, they constantly develop new skills and strategies in order to successfully lead their counterparts through the questionnaire. The participants signal their needs both verbally and non-verbally – and for the interviewers, they need to interpret these cues and respond by speaking more clearly, loudly, faster or slower. This is what an interviewer noted after having done interviews with two very different participants – the first one very talkative, the second one not so much: “With Mr. A, I had to speak a lot more loudly and articulate very clearly. I also had to repeat the questions several times. Most importantly, I had to be very patient as it took him a long time to answer the question”. Each conversation partner – whether s/he may be reserved, timid, tired, articulate, talkative or upset – requires a different conversation strategy from the interviewer.

The interview: A balancing act between social expectations and methodological requirements

The first step before the actual interview consists of establishing a connection and feeling of mutual trust between the interviewer and interviewed person. The first few minutes, the short bits of small-talk at the beginning, all of this is essential when it comes to building trust and the basis for open and honest communication. But interviewers also need to make sure that the data collected are as valid as possible: is it, for example, really necessary for the interviewee’s husband to watch over her throughout the entire length of the interview? Is the daughter’s presence critical for her mother to take part in the interview, or is it rather a need for control on her part? The interviewers know that the presence of other people may affect how the person answers the questions. On the other hand, not having someone trusted around may lead to feelings of insecurity or irritation. Once again, it is down to the interviewers’ ability to gauge the situation and find a middle ground, establishing conditions that meet methodological requirements whilst making sure that the participants’ willingness to cooperate is not lost in the process.

Handling emotional ups and downs

The interviewers’ experiences show that their visits provide a welcome break from everyday life for the participants. However, positive and negative emotions often lie close together: excitement about the visit, happiness about the fact that someone is interested in their life stories and hope that their concerns are being heard and addressed are mixed with feelings of sadness when talking about burdensome aspects of life, or hesitation and difficulty in finding the right answers. Even though the efforts are usually rewarded, being an interviewer requires a great deal of maturity and groundedness to cope with these kinds of situations.

“Conducting” the interview: finding the right balance in providing space for personal narratives whilst maintaining methodological standards

One interviewer notes that, in order for the “message to truly get across”, eye contact between the interviewer and participant is essential. The older persons often do not like being forced into a fixed corset of pre-formulated questions and answers. They find ways to escape these constraints, giving elaborate answers dotted with personal anecdotes and life experiences. Whenever this happens, interviewers and interviewees may find themselves in conflict: while the interviewer may be focused on the questionnaire in the hopes of getting through the interview without taking too many detours, the interviewee may very well see this as an opportunity to have a lively and engaged conversation, to tell stories and share experiences.

The interview covers subjects related to the respondents’ daily lives, their care situations and quality of life, all of which are very personal topics. It is therefore not surprising that, for some of the respondents, certain questions spark the need to reflect on their personal situation and talk some more. Successfully “conducting” the interviews therefore not only implies being able to get through the survey question by question or block by block, but also to listen empathically and show interest in the respondents and their elaborations.

After the interview – what remains?

In many cases, the interviewers are left with the positive feeling of having provided participants with a nice little break from everyday life, the opportunity to voice their needs and concerns and be heard and appreciated. “I think giving the interview really made his day”, said one of our interviewers after a visit, or “Ms. M is a charming, humble woman – I believe that the interview has given her quite a bit of confidence”.

But it is not only the participants who can take something away. The participants’ life stories and wealth of experiences turn the visits into valuable moments for the interviewers as well, as one of them put it: “I found this encounter – just like every other one so far – to be truly enriching”

“I have the uttermost respect for the lifetime achievements of these persons, who have now become old and in need of care”

The field phase in Austria is expected to be completed by autumn 2017. We are looking forward to the results of the quantitative analysis of the data collected, which will be available in early summer 2018.

[1] We would like to give a special thanks to: Veronika Böhmer Maria Estella Dürnecker, Stephanie Egg, Stefan Fuchshuber, Lukas Hirsch, Martin Köpplmayr, Judith Litschauer, Franziska Maurhart, Johanna Meditz, Bernhard Prinz, Gerlinde Schröttenhamer, Eva Stiftinger, Andreas Stöger and Philipp Weber.

 

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