Abstract
This article draws on crystallization, a qualitative framework developed by Laurel Richardson and Laura Ellingson, to show the potential of using sociological narratives and creative writing to better analyze and represent the lived experiences of loneliness among older people living in Australian care homes. Crystallization uses a multi-genre approach to study and present social phenomena. At its core is a concern for the ethics of representation, which is critical when engaging with vulnerable populations. We use two case studies from research on loneliness to illustrate an application of crystallization through different narrative types. To supplement our sociological narratives, we invited author Josephine Wilson to write creative narratives based on the case studies. Josephine was awarded the prestigious Miles Franklin Literary Award in 2017 for Extinctions, a novel exploring themes such as later life and loneliness. By contrasting the two approaches—sociological and creative narratives—we discuss the implications of crystallization for qualitative research.
Keywords
Introduction
While conducting research on lived experiences of loneliness among frail older people (aged 65+) living in care homes, we found ourselves continuously asking: how can we better understand and represent their complex voices and stories? Loneliness in later life is a growing public concern because it contributes to social exclusion and can lead to health problems requiring long-term care, such as dementia (Neves et al., 2019b). However, accounts of aging and loneliness can be patronizing due to ageist stereotypes that simplify and stigmatize later life (see also critique by Neves et al., 2018; Pikhartova and Victor, 2015). As aging is being explored in more creative ways (Bradfield, 2020; Scott, 2018), can we also use creative methods to better convey the experiences of older people who feel lonely?
A possible answer to these questions emerged when the first author read Extinctions by Australian fiction writer Josephine Wilson (2016), who was awarded the prestigious Miles Franklin Literary Award for this work. This novel captures later life, institutionalization, and loneliness in multifaceted ways, while rejecting common old age tropes such as passivity. Motivated by a crystallization approach (Ellingson, 2009; Richardson, 1994), we invited Josephine to write creative stories based on fieldwork and interview data from study participants to supplement our sociological narratives. We use the term ‘sociological narratives’ to capture our account of participants’ lived experiences of loneliness, informed by thematic narrative analysis of the data, and ‘creative narratives’ to capture Josephine’s creative non-fiction and fantasy writing. This collaborative approach shows how crystallization can be used in qualitative research to enrich analytical and representational perspectives.
Qualitative researchers constantly seek new ways of studying and representing complex social worlds (Kara, 2015). We argue that crystallization offers a framework to help achieve this methodological goal. Crystallization was broadly introduced to qualitative methodology by sociologist Laurel Richardson (1994). A crystal captures various angles; to crystallize means to deepen the understanding of a topic by analyzing and describing it in different forms, while resisting conventions regarding how findings should be presented (Ellingson, 2009; Richardson, 1994). Laura Ellingson (2009) expanded on Richardson’s work, providing practical guidelines about how to utilize crystallization in qualitative research. According to Ellingson (2009: 4), ‘crystallization combines multiple forms of analysis and multiple genres of representation into a coherent text or series of related texts, building a rich and openly partial account of a phenomenon that problematizes its own construction.’ Crystallization is not at odds with other qualitative methodologies; rather, it provides relevant links between qualitative analyses and creative genres. It encourages researchers to integrate science and art to (i) find new ways of representing experiences; (ii) cover more analytical ground; (iii) reflect on researchers’ roles and positions in the field; and (iv) critically consider how participants’ voices are represented (Ellingson, 2009).
Crystallization also draws attention to the ethical responsibility of understanding and conveying lived experiences of vulnerable groups and offers a means of reflecting on power relationships embedded in research. By engaging different genres, we can highlight the difficulties of representation (Preissle and Han, 2012) and amplify voices of vulnerable communities often presented in homogenous or unidimensional tones in traditional scientific accounts (Ellingson, 2009). Our position, role, and power as researchers is still ingrained in the stories we tell about participants—in what we decide to include, exclude, and highlight—regardless of the approach. Nonetheless, crystallization’s focus on reflexivity emphasizes the need to reflect on ourselves as researchers, gatekeepers, and storytellers (Fine et al., 2000). We argue that by combining sociological and creative narratives, we can better understand participants and their perspectives in multidimensional ways.
In the last few decades, arts have increasingly been used to enrich qualitative research (Kara, 2015; Lafrenière and Cox, 2013; Watson, 2019, 2021). Arts-based installations are used for data collection (Degarrod, 2013); poems drawing on participants’ representations employed analytically (Bradfield, 2020; Breheny, 2012); and findings are disseminated via performances and screenplays (Berbary, 2011; Lafrenière and Cox, 2013; Richardson, 2015). The role of fiction in understanding and portraying diverse social realities has also recently been explored in the literature (Agger, 2000; Becker, 2007; Brinkmann, 2009; Leavy, 2013; Vickers, 2010). Concurrently, we are witnessing a ‘narrative turn’ in social sciences, where lived experiences are seen as constructed by the stories participants tell (Berger, 2005). But work integrating diverse narrative genres and using a crystallization perspective in analysis and representation remains scant.
Research project
To understand how frail older people (aged 65+) living in aged-care facilities experience and respond to loneliness, the first and third authors conducted a qualitative study that included participant observation of two Australian care homes (101 hours) and interviews with 22 residents (2017–2018). The participant observation—conducted during meals, social activities, and informal moments—allowed comprehensive insight into residents’ social and spatial environments. The interviews explored how participants experienced, understood, lived through, and addressed loneliness. The interview sample included six men and 16 women, aged 65–95. Two were single, two married but living apart, two divorced, and 16 widowed. Interviewees were recruited with staff familiar with our research aims and selection criteria, which only included residents able to consent. The study was approved by our university’s ethics committee. Complementing procedural ethics, we also followed an ‘ethics-in-practice’ approach (Guillemin and Gillam, 2004), ensuring continuous consent and facilitating participant well-being by drawing on our backgrounds of participatory research on loneliness with this population and engagement with community work and development of care practices/policy (Neves et al., 2019a; Neves et al., 2019b).
Field notes and interview data (transcribed verbatim) were initially analyzed thematically to identify patterns and differences in understandings of and responses to loneliness (Braun and Clarke, 2006). The first and third authors coded data independently and then collectively discussed codes, themes, and analytical memos before agreeing on a final thematic codebook. We then fine-tuned the analysis by conducting thematic narrative analysis to better identify ‘what’ was being ‘told’ in the stories and experiences of interviewees (Reissman, 2008: 53–54). As narrative analysis permits pluralism (Frost, 2009), we acknowledged the interplay of contexts, different meanings, and our presence as researchers. During analysis, we merged interview and participant observation data. Narratives based on interviews and field notes can help analyze meaning, while allowing readers to feel and think with a story (Frank, 1995 cit. in Ellingson, 2009). Our sociological approach drew on Erving Goffman’s (1967) work on social interaction and self-presentation. The experience and process of making sense of loneliness is understood through stories interviewees told about themselves and their interactions with others, contexts, and living settings. Their narratives are situated in particular social contexts, ideas of the ‘self’, and how they present their stories. Goffman’s symbolic interactionism accounts for that dynamic relationship, supporting the development of sociological narratives. As noted by Ellingson (2009), it also suits crystallization approaches that integrate creative and analytic representations, because these highlight social performances of selfhood.
We selected two case studies to experiment with crystallization—Gurney and Patricia (pseudonyms). These were selected for two reasons. First, they illustrate the overall themes while providing rich accounts of lived experiences of loneliness, which are fruitful for analytical engagement. Second, their accounts seemed the loneliest we collected, showing nuanced aspects of loneliness coupled with frailty and institutionalization. We developed sociological narratives based on our analysis, and Josephine engaged with the interview transcripts, audio recordings, and fieldnotes to write creative narratives. Josephine was invited to participate in this crystallization approach as an external research partner, and her work was funded by a grant awarded to the first author. She defined her contributions as creative nonfiction (Patricia’s creative narrative; first part of Gurney’s creative narrative) and fantasy (second part of Gurney’s creative narrative). According to Josephine, ‘creative non-fiction is said to begin with the real, and to use the techniques of fiction to structure and enhance material. I use the term “fantasy” as it is used in literary theory. Rosemary Jackson writes: Fantasy is not to do with inventing another non-human world: it is not transcendental. It has to do with inverting elements of this world, re-combining its constitutive features in new relations to produce something strange, unfamiliar and apparently “new”, absolutely “other” and different. (2013: 8).’
After receiving Josephine’s stories, we employed integrated and patched crystallization. This means that, for analytical and representational purposes, we engage multi-genre texts and display two clearly demarcated genres (Ellingson, 2009). We rely on both sociological narrative and creative writing genres to show ‘multiple points on the qualitative continuum’, presenting them alongside one another (Ellingson, 2009: 97). By following this approach, we offer different forms of understanding and representing experiences of loneliness in later life while providing thick descriptions and various angles.
Narratives
Gurney: sociological narrative
Gurney walks into the care home meeting room with his bent spine slowing his steps. His entrance is marked by a smile that rarely leaves his face. Well-groomed and polite, he offers a warm greeting through a strong British accent.
Gurney is 90 and conscious of the stigma associated with his age, particularly within the care facility he has called home since becoming unwell seven years ago. ‘People are saying, “90 years old, come down a notch”, you know?’ he sighs. ‘You’re not given credit for any logical thought.’ His frustration spurs his eagerness to share his life story. ‘I was in England with the police force. I came to Australia in 1972.’ Once here, Gurney accepted what he thought would be a temporary job as a hospital cleaner. It lasted 20 years.
After retiring, Gurney turned his attention to his life’s passion: aviation. Smiling, he explains he has a computer with a flight simulator. His interest in aircraft inspired a friendship after his transition into the care home. ‘A lady came in here as a resident—she had a pilot’s license. Oh!’ he exclaims. ‘You know, excitement! She’s the only one around that I could talk to.’ But the friendship was not to be: ‘When management found out, they moved her away to the opposite end of the building.’ He shrugs, exasperated. ‘This asylum is not being run by the inmates.’ Asked whether he feels close to any staff, he firmly says no.
Gurney’s social frustrations extend to his relationships with other residents, many of whom have cognitive impairments such as dementia. He finds talking to them difficult. ‘I make a point of instigating conversation with several of the residents,’ he says, but ‘most of the time it’s just gibberish. I’ve nothing in common with the other residents.’ When asked if he has any close friends, he emphatically says: ‘Nooooo, nooooo. Pretty much a loner.’
For Gurney, being a loner corresponds with loneliness: ‘I’m lonely when I think there’s nobody I can talk to.’ He reveals he feels lonelier ‘the more I’m stuck inside this dump’. Gurney’s physical limitations and lack of car access mean he is unable to leave the facility, which he hasn’t done for a year. Given he does not have friends, close relationships with staff, or the capacity to leave, he admits he feels lonely all day—but laughs this off, joking it happens ‘no more than once a day’. The constant presence of Gurney’s smile and the laugh that punctuates the end of his sentences contrast with just how lonely and isolated he is.
Gurney first experienced loneliness when his wife passed away. They had spent most of their lives side by side and lived in the care home together. ‘My wife died in here. That’s what loneliness means. We were married something like 65 years. . .’. Again, he laughs. ‘Since I lost my wife . . . I’m not as interested in things. We used to go everywhere together.’ He pauses. ‘It was just the two of us.’
His one connection to the outside world is through his son—one of two he had, although the other has passed away. His son, however, lives in Scotland, so their contact is infrequent. He calls Gurney every Saturday. In-person visits are rare, the last being in 2015. Still, Gurney enjoys the contact, as it allows him to chat about his favourite topic: ‘Aviation!’ he laughs.
In the days between Gurney’s calls with his son, he is largely unoccupied. He takes his meals in his room—finding the lights in the dining area too bright—and is disinterested in the facility-offered activities. He describes himself as bored. ‘All the time. . . yeah’, he says, nodding. For Gurney, loneliness also feels like boredom. He is most lonely ‘at night, when I’m getting in bed by myself. After 60 odd years, it’s—you know, it’s a big change’. But when loneliness comes, he has nobody to talk to. Our interview ‘is the first time, in actual fact. The situation never arose. . .’
And then, he laughs.
Gurney: creative non-fiction and fantasy narrative
Some say old age is a narrative of steady decline, with a sudden foreclosure at the end, like a house unexpectedly taken from you by the bank.
Gurney is 90. For 23,725 days Gurney slept with his wife, but now he sleeps alone.
Gurney came from England in his thirties, after working as a traffic officer for the police. Gurney had a house, a mortgage, a temporary job as a cleaner in a hospital that became permanent. He had a job for life, as they used to say. And then he retired and his job ended. And so, it seems, did that particular story.
Gurney has been in the aged care facility for seven years. His wife was here too, but then she died. Everything has changed since he moved here, says Gurney.
Gurney describes life as boring. The word is used several times in the record: boring, boring, boring. It is a common word that is easy to pass over, describing a minor emotional state. The word suggests a lack of resources or will, rather than anything more consequential. Toddlers get bored; children on summer holidays get bored; high school maths teachers can be boring. But Gurney is neither a kid, nor on holidays, nor in high school. He is 90 years old, and he sleeps alone.
‘Boredom’, writes Lars Svendsen (2005: 93), ‘always contains an awareness of being trapped, either in a particular situation or in the world as a whole.’ When Gurney says he is bored perhaps he is really saying he is trapped in the aged care home, with no means of escape and no one to rescue him.
I’m lonely, says Gurney, the more I’m stuck inside this dump.
A carefully chosen word: dump. It is a word you might use to describe the kind of temporary accommodation you never would have chosen had you known better. The hotel turned out to be a dump. The rental was a dump. It is hard to imagine Gurney describing his family home as a dump.
How is it that Gurney ended up so alone? Gurney had two sons; one has died but we learn no details. The other one lives in Scotland, which is a very long way from Gurney.
Gurney does not feel lonely right now because he is having a conversation. Gurney clearly has a lively mind. Gurney would like to contribute. Gurney tries to speak to staff, but he says they don’t listen; he blames the stigma of old age.
Who listens to old people anyway?
Gurney feels most lonely at night when he gets into bed alone.
Gurney says he never goes out of the home.
Never?
No, never!
He had to sell the car due to vertigo.
Gurney does not have much, but he possesses two very important things that he brought with him from the past and which might ensure his escape in the future. Gurney has a hobby and a dry sense of humor. When asked what he would most like to do, Gurney says: join a youth club and go roller skating. Bingo, he announces, is sex for old people.
Gurney is interested in aviation. He has a computer with a flight simulator. In theory, Gurney can go wherever he wants. In theory, he is at the controls; he can gain altitude to avoid turbulence. Who knows if bad weather lies ahead?
He would like more privacy. He met a lady in the home who had her pilot’s licence, and they moved in close, and then, he says, they moved her.
Did I tell you she died?
Gurney Flies from Loneliness
One day Gurney woke up from a troubled dream and found himself not in his single bed topped with a rubber sheet, but in the cockpit of a Cessna 172 Skyhawk, gaining altitude. It was sunset and already the first stars were nibbling small holes in the corner of the sky. He leaned into the yoke, checked the ailerons, and banked. He could just make out the outline of the so-called Home where he had been trapped for seven years. Well, he wouldn’t be going back there. Foxtrot Uniform! He checked his fuel—a full tank—and turned north towards the future. Without even knowing it, Gurney had been preparing for this moment his whole life. Far from wasting all those years on his computer game in the spare bedroom while his wife cooked dinner, he had been preparing to take the controls. Those thousands of hours he had clocked up on the simulator were not for nothing: the past, the present, the future had miraculously converged in the cockpit. Gurney gave his ‘Home’ the two-fingered salute. He’d show them he was not just some sad, doddery, crotchety 90-year-old man whose wife of 65 years had died, who lived on the other side of the world from his remaining family and who spent his days complaining about occupational health and safety standards to anybody who would listen, which was exactly nobody. Gurney was at the controls, on the deck, and he was master of his destiny. No more doors wedged open so the staff could duck their heads into his room to tick off that box on their sheet to confirm No. 7 was still upright, semi-sentient and half-alive! No more bed baths. No more pureed food eaten under neon. No more cold tea and cheap biscuits. No more Bingo.
Bingo!
Patricia: sociological narrative
When we first meet, Patricia is seated, alone, in a plastic chair in her unit. She is looking at the view from her bedroom window. At 79, Patricia’s diminutive frame is marked by signs of frailty: huddled shoulders and bowed lips. She seems sad and rarely smiles or makes eye contact, instead gazing outside in prolonged silence. For much of the interview, her gaze is directed to a scattering of trees lining the edge of a barren sports field.
This is Patricia’s view. Despite its apparent suburban banality, she frequently speaks of its significance: ‘[The facility] wanted to put me in a nicer room, but when I went up and saw it, there was nothing out the window—no trees. And I thought, “No, I want my trees”. Came back here; I didn’t care if there was only a little tiny space.’
The trees are a steady and comforting presence in Patricia’s life. When asked how she spends her time, Patricia shares, ‘I sit in this chair, day after day, looking out the window.’ Yet, when invited to describe her loneliness, Patricia discloses, ‘[It’s] sitting here in this chair all day on your own. That’s lonely, isn’t it? And I do that quite a bit. . .’ She trails off, and we sit together in silence.
Although Patricia describes herself as ‘a loner’, loneliness was not always present in her life. As a younger adult, she was a machinist working in factories and spent her leisure time ballroom dancing. She married a ‘wonderful’ man, with whom she had four children. Like many in the care home, however, Patricia is now widowed and has minimal contact with her children; one might visit her every few weeks.
‘Your family don’t bother with you so much because you’re too old,’ she reveals. ‘That’s the main factor with all us [older] people.’ Sadness sneaks into her voice as she recalls being moved into the facility because there was ‘nobody at home to look after me’. Yet, she shrugs it off: ‘They’ve got their life to live.’
Patricia’s key connection to the outside world is her ‘beautiful son’. Although she only sees him every few weeks, she considers herself lucky: ‘Some of them [other residents] have got no-one’. Additionally, she tries to speak to one of her three siblings each day, but is worried as ‘phone bills are big’. Patricia’s relationships with close friends were also severed when she moved into the home—partly due to the cost of phone calls and partly due to a lack of access to transportation.
‘They’re old like me,’ she tells me, ‘and we can’t get around and see one another now’.
Despite these challenges, Patricia is keen to build connections. She enjoys spending time with her grandchildren, but this is infrequent, and she feels ‘it’s not so interesting for them’. In the weeks between visits from family members, Patricia tries to stay involved in activities offered at the facility and to reach out to people. ‘[I talk to] visitors when they come in. They’re not all my visitors, always, but I talk to them, and they talk to me.’ She appreciates that living in the care home means she has people to look after her and company if she wants it and remains optimistic despite her loneliness: ‘You only hear bad things, but there’s really nice people in this world.’
But her loneliness is ever-present both in Patricia’s life and our conversation. She reveals she is not close to any staff or residents, and that she has no one to talk to when these feelings arise. In part, this is a caring choice: ‘I don’t want them to be feeling miserable too, do I?’
Nevertheless, Patricia acknowledges the importance of having a support network to rely on for practical and emotional support. ‘You need people!’, she exclaims. ‘But they’re not always there. . . Sometimes when you feel real lonely, you can do with somebody [to] talk to—where are they? There’s nobody around. They’re all gone!’
Patricia’s eyes drop to the floor, and she becomes agitated, distressed. ‘Do we have to talk about that?’
We don’t.
We return our attention to the steady and comforting presence of Patricia’s trees. ‘It’s so lovely and green, everything, isn’t it?’ she sighs. ‘That’s where I get all my happiness from—I look out there when I feel lonely . . . the trees are not lonely, see? They’re all happy there, so why can’t I be happy like the trees are?’
Patricia: creative non-fiction narrative
Patricia is 79 and likes to look at trees, but Patricia is not a tree.
The first thing Patricia notices is that the woman is very young. Patricia tries to conjure up how she herself once felt in her young skin, but that youthful Patricia is as alien as the old photos stuck fast in the album at the bottom of the cardboard box in her drawer.
But Patricia was once young; as a baby she had soft skin and fat legs that kicked wildly at the air, half-terrified, half-exhilarated by the infinite possibilities of life. But space has shrunk down to a shared room in an aged care home, and the past is somewhere else and Patricia can no longer go there.
They’ve got it all wrong. There is nothing gradual or graceful in decline. We don’t age like wine in a cellar. We are not trees, adding rings of solid, healthy growth, year in and year out. Old arrives like a series of shocks that knock you off your feet. When you come to, you no longer recognize your own street, the family home, the next-door neighbor’s house, or the objects on shelves that for years you lifted up to dust. The shock might arrive at any time in any shape: it might be a fall, a stroke, the sudden death of your husband, a diagnosis of terminal illness, the loss of hearing or sight, or, as with Patricia, the fact that she is frail and there is no one left at home to look after her. And never mind how you feel inside; they all glance at you and call you old and frail.
Frail
How Patricia hates that word, but sometimes it is true: she feels as fragile as a feather, as hollow as old bone, liable to be blown off her chair, out the window and away in the blue sky. Sometimes she would like to open the window and let herself be taken, leaving her empty body sitting here on the plastic chair, like a shell washed up on the beach. No one would notice that the real Patricia, the Patricia who was just a problem to be managed, a body to be fed, wiped, and put to bed, had departed.
But this young woman would notice she was gone. Patricia really loves this girl who has come to talk to her. She loves everything about her, from the way she leans towards her in the chair, to how she carefully records Patricia’s every word, as if Patricia really mattered. This young woman is listening so hard that Patricia is afraid of disappointing her. The young woman wants to know what Patricia thinks, and when Patricia is lost for words, the woman gently prompts her. It is a long time since anyone has asked Patricia how she felt and expected that she would tell the truth. Actually, it is so long time since Patricia pressed her feelings into the shape of recognizable words, she is not sure she can do it. She speaks in bits and pieces, with pauses between, as if her life story had been in an accident and was all broken up on the ground.
You’re here on your own, she tells the woman, and nobody ever sees you. You’re just left there. And there’s a lot of them brought in here and put in a chair and just left there. Nobody comes near them.
Patricia does not include herself in this them, but how could she think about them without including herself? If she is not one of them now, she soon will be.
What is it, the young woman asks, that leads you to feeling lonely?
Do we have to get so personal, asks Patricia, do we have to talk about that?
You lose your friends, says Patricia. They are old. You don’t see them. Your family doesn’t bother with you because you’re too old.
Patricia changes the subject and shifts the point of view. That’s where I get my happiness from, she says, gesturing to the view. Why can’t I be happy like the trees?
But Patricia is not a tree.
The young woman radiates energy like an electric blanket, and Patricia would like to move her plastic chair closer. There are so many ways Patricia feels lonely, but she has never been one for words and she can’t see the point of all this talk about loneliness. Everyone knows that loneliness is the opposite of words. Loneliness doesn’t speak. It is dead silent. Loneliness is a fact. The fact is you are lonely. But loneliness is not just a fact, it’s a feeling, and how can she speak about feelings? It’s like when the whole world has migrated to another country and forgot to tell you they were going, and one day you look up and everyone is gone, taking everything with them. Try talking about that.
If she had the right words, Patricia might tell this young woman that it is not normal for us all to be turned into thems. Aren’t we all part of the same ‘us’? Isn’t that how it should be? Why should the whole world be put in a sieve and shaken about, and all the fine old dust allowed to fall to the ground, swept up and thrown into a tin with the lid screwed tight? Put in a Home. Well, that’s a bit of a joke, because it’s not a home, is it? It’s nothing like a home, at least not any home she’s ever lived in.
Instead Patricia says, I don’t see anyone unless I go out and see them. Nobody comes in here. Ever.
Patricia loves the young woman’s deep chocolate-brown hair. And her eyes. You have beautiful eyes, she tells the young woman.
Actually, I’m quite jealous of your hair, says the young woman. Patricia tells her she has always been shocked by her full head of curly hair. ‘It’s untidy! she tells the young woman, but in truth her life-long habit of self-effacement comes from her mother, along with rounding her shoulders to hide her once-full breasts. A girl mustn’t bring attention to herself, Patricia’s mother always said. Don’t you get ahead of yourself, now.
Patricia studies the young woman’s shoes. They are black penny loafers, with tassels on each vamp. When she was working these were men’s shoes, but now everyone is wearing them. Fashion has changed, and Patricia no longer understands it. All her life Patricia made shoes in a factory. Now the factories are shut down and no one remembers how it was done. All Patricia’s skills and knowledge are redundant.
And now she is 79 and sits on a plastic chair and looks out the window at what she calls a view, but which the young woman sees as a scattering of trees lining the edge of a barren sports field.
I am lucky to have a view, Patricia says. Some of them didn’t get a view. Some of them got nothing.
From the plastic chair in her room, Patricia sees things. She sees trees in the distance, and people with dogs who walk across the grass. She sits very still in one spot and watches movement and change. She sees life going forward. But nothing changes for Patricia. She is like a small pin around which the earth pivots, and yet she feels at the center of nothing. No one sees a tiny pin pressed into the knots of the carpet, hidden deep in the low pile.
Patricia tells the young woman that her lovely son visits every few weeks. I am so lucky, she says; some of them have got no one. She calls her sisters and brothers on the phone. She is not alone. She has her beautiful son. Some of them have got nothing.
Patricia must be sure to always measure her misfortune against the calamities of others; she must force herself to recalibrate and dismiss any claim to injustice, any sense of being wronged.
She is lucky, really.
I have had a full life, she tells the interviewer, a wonderful husband, four children, and she has her grandchildren around her, her beautiful son, her siblings on the phone, but the story is told in broken pieces that don’t quite fit together, and neither Patricia nor the young woman are sure what to believe.
She must let this young woman know that she is not stupid, that she understands why the grandchildren don’t want to come, that she’s on the side of her grandchildren, and that she will always defend their parents, her children, who rarely visit. What’s in it for them? Why would they want to? My son has an important job. They’ve all got their hands full.
Sometimes I join in line dancing, she tells the young woman. I always liked to dance. For a second there is a little hole in the brick wall to the past and Patricia peeks in while the young woman cranes her neck behind her. She glimpses Patricia dancing at the Town Hall, and the Masonic Hall—the waltz, the foxtrot.
Dancing is another thing no one these days knows how to do, she tells the woman.
Patricia’s favorite thing is to sit and look out the window. She looks at the cars. She looks the trees. She is lucky. Patricia does not want a better room upstairs; she just wants her trees.
Patricia is 79 and she likes to look out the window at what she calls a view, but others might not.
She would like people to talk to each other but has no idea how to make that happen.
She has four children—two girls and two boys. Sometimes she goes shopping, or to the park with the children, but when that last happened is unclear neither to Patricia nor to the young woman interviewing her.
Why do the staff walk in while Patricia is talking about her life? Why is there no knock on the door? Why is there no curtain drawn between Patricia and the other woman who shares the room, the woman who is never here?
Every few weeks her children come.
Occasionally, that’s all.
No one comes to the room.
Patricia had a husband, a once-in-a-lifetime husband. If you’ve got a good husband, look after him, says Patricia. Patricia can’t see her friends; they are too old and there is no one to take her to see them. Her son has a good job, a wonderful busy job and all. Friends? There are two or three. Down the hallway. Close friends? I don’t know. They are in here because they’ve got nowhere else to live. That’s what we talk about. We talk about having nowhere else to live.
Loneliness, says Patricia, is sitting in this chair all day on your own. That’s lonely, isn’t it? And I do that quite a bit. Every day. Do we have to talk about that?
There’s a lot of them brought in here and put in a chair and just left there and nobody comes near them in here, ever. When I feel lonely, I look out the window. Look at that: cars, people, dogs walking. You’re not lonely when you have a view. There’s a chap walking now. It’s a long walk, and they come from the houses right up to the shops. He could catch that bus, but that’s being lazy.
Why can’t I be happy like the trees are?
Discussion: what can we gain from crystallization?
In this section, we discuss analytical gains and representational aspects. We also reflect on difficulties felt during the crystallization process, providing insights that can be useful for researchers interested in this approach.
First, by bringing together sociological and creative narratives we both solidified and revised our analytical schema. The two approaches matched four overarching themes identified in the analysis, namely:
Relational loneliness: loneliness related to loss of close ties and lack of quality relationships (no one to talk to; other residents are strangers or suffer from cognitive impairments preventing meaningful conversations);
Loneliness as ‘oldering’: the connection between loneliness and being old and frail, accompanied by perceived stigma of being old (ageism) and lonely—resulting in participants not discussing loneliness or being dismissed by staff and residents if they do;
Difficulty of talking about loneliness, which might contribute to the silent suffering of loneliness that Gurney and Patricia allude to;
Socioemotional affordances of living contexts, particularly the nature of institutionalization in an aged-care facility perceived as an ‘asylum’, a ‘dump’, and a place with no privacy from which they cannot leave. In the creative narrative developed from Gurney’s interview, he’s escaping not being heard, ‘pureed food’, and ‘bed baths’; in Patricia’s, she would like to open the window and be taken out of her body so she’s not ‘a problem to be managed’ at the home that ‘is not a home’. The concept of ‘total institutions’, defined by Goffman (1961), captures the sense participants give to the care home: a controlled and controlling environment that limits social interaction and participation. Patricia also points out the benefits of living in the facility, as it means she has dedicated care and activities. Nonetheless, she continuously mentions sitting alone, not being close to staff or residents, and not having anyone to talk to. Additionally, ‘othering’—differentiating ourselves from others—is evident in both the sociological and creative narratives: you can’t converse with others—‘thems’—because of their ‘dementia’ or different interests.
In Gurney’s case, the sociological and creative narratives highlight his humor, interest in aviation, and the boredom that interplays with loneliness. In Patricia’s case, there is a focus on her frailty, ‘oldering’ circumstances, family dynamics, and the company of trees.
However, the creative stories highlight elements we did not identify or clearly emphasize in the sociological narratives, from sounds to embodiments. These are critical to a comprehensive understanding of lived experiences of loneliness in later life and within aged-care settings. In the creative accounts of Gurney and Patricia’s data we see multiple sub-stories and links between continuity/discontinuity of past and present in the aging process. These accounts seem more linear and cohesive in the sociological narratives. For instance, in Patricia’s creative narrative, there is a constant connection between past and present, such as when she sees herself dancing like she used to through a hole ‘in the brick wall’ of her room or reminiscing about the shoes she used to make. The shift into aged care cannot be described in a meaningful chronology or narrative—there is a rupture that breaks their stories, according to Josephine, fracturing the present and past and affecting ideas and presentations of a consistent self. In the sociological narrative, Gurney’s humor emerges mostly as a coping mechanism to his loneliness and sense of ‘oldering’ and boredom, whereas in the creative narratives, it is also illustrative of agency, affirmation of self, and escaping social structures.
Another important aspect that emerges from Josephine’s creative storytelling is the sensorial experience of institutionalization and loneliness: how Gurney is ‘trapped’, ‘with no means of escape’ and ‘no one to rescue him’. The fantasy story has Gurney flying away in a plane. This story captures those experiences in vivid ways while emphasizing his humor, interests, and agency. It brings sound and motion to these themes. In his interview, when asked about how it is to live in the facility Gurney said it was ‘Booooooring!’, mixing sound and humor. When asked which social activities he would like to participate in, he said a youth club and roller skating—anything but bingo. Although these elements were less evident in our sociological narrative, the creative approach brought them to light. Josephine’s ending to Gurney’s escape accentuates his sarcastic take on bingo: ‘No more Bingo. Bingo!’
In Patricia’s creative narrative there is also more sensorial engagement, from memories of dancing and working in a factory to her view of the trees, people walking their dogs, and movement outside her bedroom. Yet, she remains sitting in her plastic chair. Although loneliness is hard to describe, it is not hard to feel its ‘dead silence’, its sadness, its ‘stillness’—all of that, while movement and change surround our participants, contrasting with their resignation, coping processes, and need to ‘escape’ from it. Both the sociological and creative narratives show how Gurney and Patricia attempt to enhance their situated agency and feel about themselves and others: from feeling ‘lucky’ they are not like other residents to not wanting to burden others.
The difficulty of talking about the interplay of loneliness, oldering, and sense of self is captured in the contradictions of the stories Gurney and Patricia tell, less visible in the sociological narratives. Patricia talks about family visits but then about family absence, justifying it because the facility is an uninteresting place for children and her family is busy. Gurney talks about going outside, but then he never leaves the home. Patricia’s creative narrative comprises short sentences and repetitive accounts, mimicking the pace and flow of the interview. Close relation to death and loss is more perceptible in the creative narratives, which adds layers to feelings of loneliness in aged care. The creative narratives also communicate participants’ agency by painting a picture not only of sadness and ‘loners’, but of resilience (i.e., Gurney’s humor) and other forms of connection (i.e., Patricia’s trees).
Second, crystallization facilitated deeper engagement with reflexivity and ethics of representation. The creative stories highlighted our role as researchers—from how participants reacted to us to the demarcated differences between our positions and performances. In Patricia’s creative narrative, there is a critique of the term ‘frailty’ and our presence is noted in a comparative/contrasting way: young vs. old, thems vs. us, interviewer vs. interviewee. As expected, crystallization contributed to a richer discussion of representational ethics. While our sociological narratives seem to have ‘contained’ stories, the creative narratives challenge representing participants and their experiences as static or final; they should be approached in a dynamic and evolving way. As stressed by Frank (2005: 36), we must recognize the ‘unfinalizability’ of participants in dialogues and analyses. This does not mean the study’s qualitative resources—themes and narratives—essentialize participants and their stories. They allow us to draw conclusions and ‘come to an end’ (Frank, 2005: 36). Crystallization, however, opens further possibilities of diverse engagement with data, stories, and representations.
Despite methodological and axiological gains, our crystallization process was not free from difficulties. Bringing in an external partner when the data collection is completed can mean missing insights that could have enriched fieldwork. Josephine had to work with available data but had queries we were unable to answer as fieldwork was finalized. We relied on an emic/etic (insider/outsider) perspective to offset this issue and benefit from different views, combining the understandings of researchers involved in data collection and analysis (emic) with those of an external partner (etic). This also meant we were unable to return the creative narratives to participants to gauge their reaction and advance our understanding of representations (Fraser, 2017). Likewise, as this approach and partnership were not established from the project’s inception, we had to deal with undefined procedures and funding limitations. Although this flexibility resulted in some procedural ‘messiness’, it also created deeper relationships between partners as we were positioned as ‘equal’ in this exploration. Because we were open to different interpretations, we felt minimal tension in the process—nonetheless, aggregating new interpretations considerably added to the qualitative analysis and integration ‘load’, which is already a long and complex process.
In sum, integrating sociological and creative narratives through crystallization enhanced the richness of qualitative analysis and representation, helping address the questions outlined at the onset of this article. Crystallization presents methodological gains for qualitative researchers, including representational (e.g., showing the complexity of participants and their stories), ethical (e.g., highlighting researchers’ positions), and analytical (e.g., enlightening multiple meanings and practices). It contributed to the development of ‘creative analytical practices’ (Richardson, 2000, cit. in Ellingson, 2009)—creative in how the data is interpreted and represented via different genres, and analytic in the diverse meanings it identifies and embodies. The narrative nature of the representations may also be more familiar to—and therefore more accessible and engaging for—lay audiences. This potentially offers an effective means for disseminating results while respecting the representational values of qualitative research with vulnerable populations.
Conclusion
This innovative example of crystallization demonstrates that rich, thick, and ethical descriptions of sensitive qualitative research require analyzing data from different perspectives, upholding a multidimensional engagement with participants’ narratives (Ellingson, 2009). We show crystallization’s value in highlighting multiple meanings, experiences, everyday sense-making, and social dynamics from an analytical and representational standpoint. We used one particular form of crystallization (patched integration), but there are other forms such as dendritic (wherein multiple genres of analysis and representation are not combined into a single text). However, crystallization also entails challenges for qualitative researchers. It adds complexity (and data) to a process that is often iterative, nonlinear, and dense. It also raises questions about the capacity of qualitative researchers to write creative narratives or fiction. We chose to rely on an awarded writer, but as noted by Ellingson (2009), researchers can complete that task themselves. Each approach can entail different choices; embedded in those choices has to be a commitment to the ethos of qualitative research.
Footnotes
Acknowledgements
We would like to thank our participants for generously sharing their lived experiences with us. We are also grateful to the two aged-care facilities and their staff who welcomed our study, as part of their commitment to better understand and respond to loneliness and social isolation in later life. In addition, the first author would like to thank Marcos Caceres for the support, Ashley Barnwell and Signe Ravn for their feedback and inviting her to present the work explored in this article at a Narrative Network event, and Ash Watson for the encouragement. Finally, the authors thank the two anonymous reviewers for their helpful comments.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by a Monash Research Grant and by an Early Career Research Grant awarded by the University of Melbourne to the first author.
