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Short abstract:

The 'Ask us!' method is a PPI method for including clients and informal carers in improving quality of long term care through sharing experiences, reflection and co-design. The method is developed from theoretical notions familiar in STS: 'tinkering', 'invisible work' and 'infrastructuring'.

Long abstract:

Narratives in which people with disabilities, serious mental illness or older persons have self-determination over their lives and care, live independently and are active in the community are dominant in governmental and organizational policies alike. These narratives cover-up the normative complexities inherent in care practices focusing on empowerment of service users. It is therefore important to foster collective tinkering. This way, these normative complexities can be better attended to in practice.

Collective tinkering requires infrastructures where service users, professionals and relatives alike are supported in developing counter narratives through which their needs and caring practices are explicated and taken-up to improve services. The ‘Ask Us!’ method provides such an infrastructure. This method includes several reflexive sessions where clients, professionals and informal carers develop themes for quality improvement and design such improvements together. These reflections are triggered by short videos of theatrical monologues based on ethnographic research on care practices. These monologues communicate the normative complexities, counter narratives of burdens and the invisible work of caring.

We approach the ‘Ask Us!’ method both in practical terms as an infrastructure for narrative, critical and participatory quality improvement and as a mode of experimentation. Implementing and evaluating this method in different care organizations brings about reflections on, and tinkering with, care practices. This generates further insight into the normative complexities of care aimed at empowering services users and how these can be tinkered with collectively.