Global Reach of Conceptual Models Used in Ageism and Dementia Studies: A Scoping Review

Abstract Older adults are discriminated against at different social levels- called ageism and the people living with dementia (PlwD) not only face ageism due to being elder but also encounter prejudices, negative attitudes and discrimination because they live with dementia. The purpose of this review is to highlight the different conceptual and methodological approaches used and the groups being investigated as well as the findings from studies in the combined research field of ageism and dementia. Five scientific databases were used within a timeframe between 2009 and 2018. A total number of 98 articles (quantitative, qualitative, and mixed methods) were included and analyzed based on (i) the conceptual frameworks, (ii) methodological approaches, (iii) groups studied, and (iv) findings. The result emerged six themes (i) stereotypes and attitudes in the general population; (ii) stereotypes and attitudes of themselves; (iii) stereotypes and attitudes among staff; (iv) stereotypes and attitudes as part of culture; (v) stereotypes and attitudes of family members; and (vi) miscellaneous. The principal findings identified lower education, lack of knowledge and less information about dementia as the main contributing factors to manifest stereotypes, attitudes, and ageism in society toward PlwD that leads to stigma. Moreover, this review found few studies were based on explicit conceptual frameworks but rather on descriptive understandings of relations between attitudes. There is a domination of the quantitative approach where the target populations were mostly from Western regions. The review suggests that a more conceptually coherent approach would allow for a better cumulative building of knowledge.

optimize their quality of life.Purpose: The purpose of this study was to quantify, describe, and analyze the interaction between staff and cognitively impaired residents in nursing homes, using the Quality of Interaction Schedule (QuIS).Specifically, the following aims were addressed-Aim 1: To quantify and describe the quality of interactions between staff and cognitively impaired residents in nursing homes.Aim 2: To analyze whether the quality of staff-resident interactions vary by resident cognitive status (moderate vs severe) and interaction characteristics (interaction location, interaction situation, interpersonal distance, type of staff, and resident level of participation).Method: This descriptive analysis utilized baseline data from the first 2 cohorts in a randomized clinical trial including 341 residents from 35 nursing homes.Results: Five hundred fifty-six staff-resident interactions were evaluated; majority were positive (n = 466, 83.8%) and the remaining were either neutral (n = 60, 10.8%) or negative (n = 30, 5.4%).The quality of interactions varied by interaction location, interpersonal distance, and resident participation.Conclusion: This study provides some current descriptive information about the quality of staff-resident interactions in nursing homes and the interaction characteristics that might impact these interactions.Future research should focus on decreasing the negative/neutral interactions and explore staff characteristics (e.g., gender, level of experience) and facility factors (e.g., size, ownership) that might influence the quality of interactions.

GLOBAL REACH OF CONCEPTUAL MODELS USED IN AGEISM AND DEMENTIA STUDIES: A SCOPING REVIEW
Atiqur Rahman, and Lars-Christer Hyden, Linkoping University, Norrköping, Ostergotlands Lan, Sweden Older adults are discriminated against at different social levels-called ageism and the people living with dementia (PlwD) not only face ageism due to being elder but also encounter prejudices, negative attitudes and discrimination because they live with dementia.The purpose of this review is to highlight the different conceptual and methodological approaches used and the groups being investigated as well as the findings from studies in the combined research field of ageism and dementia.Five scientific databases were used within a timeframe between 2009 and 2018.A total number of 98 articles (quantitative, qualitative, and mixed methods) were included and analyzed based on (i) the conceptual frameworks, (ii) methodological approaches, (iii) groups studied, and (iv) findings.The result emerged six themes (i) stereotypes and attitudes in the general population; (ii) stereotypes and attitudes of themselves; (iii) stereotypes and attitudes among staff; (iv) stereotypes and attitudes as part of culture; (v) stereotypes and attitudes of family members; and (vi) miscellaneous.The principal findings identified lower education, lack of knowledge and less information about dementia as the main contributing factors to manifest stereotypes, attitudes, and ageism in society toward PlwD that leads to stigma.Moreover, this review found few studies were based on explicit conceptual frameworks but rather on descriptive understandings of lations between attitudes.There is a domination of the quantitative approach where the target populations were mostly from Western regions.The review suggests that a more conceptually coherent approach would allow for a better cumulative building of knowledge.

PREDICTING DEPRESSION IN DEMENTIA CAREGIVERS: DO RELIGIOUS/SPIRITUAL STRUGGLES PLAY A ROLE?
Elizabeth MacDougall, Bridgewater College, Bridgewater, Virginia, United States Using a stress process framework model, this study is the first to comprehensively examine the role that religious/spiritual struggles play in the lives of informal dementia caregivers.A convenience sample of 156 informal dementia caregivers completed a scale measuring six domains of religious/spiritual struggles, as well as other measures of primary stressors, background/contextual variables, and mental health outcome (depression).Overall levels of religious/spiritual struggle were low, but 26 percent of the sample were classified as possible cases of clinically significant religious/spiritual struggle for at least one of the six domains.Of this group, 49 percent acknowledged struggles with ultimate meaning.Religious/spiritual struggles predicted greater self-reported depression over and above number of care recipient problem behaviors (primary stressor), caregiver sex, and caregiver personality (i.e., emotional stability).Although no individual domain of religious/spiritual struggle emerged as most salient, caregivers reported significantly more ultimate meaning struggles than demonic or interpersonal struggles.These findings support the growing body of research suggesting that religious/spiritual struggles serve as a secondary stressor, adding predictive power to background/contextual factors and to primary stressors for informal dementia caregiver mental health outcomes.Further research in this area may advance efforts to better equip both secular and religious professionals to provide evidence-based counsel to informal dementia caregivers.

RESEARCH LITERATURE ON THE INTERSECTION OF DEMENTIA, SPIRITUALITY, AND PALLIATIVE CARE:
A SCOPING REVIEW Jennifer Palmer, 1 Alyssa Smith, 2 Sara Paasche-Orlow, 3 and George Fitchett, 4 1.Hebrew SeniorLife, Boston,Massachusetts,United States,2. Independently Employed,Bethesda,Maryland,United States,3. Hebrew SeniorLife,Roslindale,Massachusetts,United States,4. Rush University Medical Center,Chicago,Illinois,United States Dementia marks an increasingly prevalent terminal illness for which palliative care, including spiritual care, could improve quality of life.Research gaps exist in understanding the intersection of dementia, spirituality, and palliative care.Thus, we conducted the first scoping review examining the nature and breadth of peer-reviewed studies across these three topics.The scoping review followed methods from The Joanna Briggs Institute Reviewers' Manual (2015).We developed a priori a scoping review protocol outlining the Population, Concept and Context for study, data sources, search strategy, inclusion/exclusion criteria, and procedure for screening, extracting, and analyzing data.The final sample consisted of 19 studies with the following themes: Characterizing Spiritual Needs, Preferences, and Resources; Characterizing Palliative or Spiritual Care; Predicting Provision of Spiritual Care; and Assessing Spiritual Care Interventions.Eighteen studies were published in the past decade, and eleven were based in Europe.The majority of studies focused on long-term care settings, grouped stages of dementia or did not specify dementia stage, and investigated interventions indirectly related to spiritual palliation.Many studies were limited in sample size and in generalizability / transferability and used less sophisticated research designs.Accordingly, research across dementia, spirituality, and palliative care needs to examine distinct stages of dementia; hospital-, home-and community-based settings; and formal spiritual care interventions (e.g., administered by chaplains) and needs to utilize rigorous study designs (e.g., randomized clinical trials).Such research could advance practice and policy that enhance quality of life for tens of millions of persons with dementia and their family members worldwide.

CLARK TIBBITTS AWARD LECTURE Chair: Cynthia Hancock
The Clark Tibbitts Award lecture will feature an address by the 2020 award recipient, Jan Abusharkrah, PhD, FAGHE.AGHE's Clark Tibbitts Award was established in 1980 and named for an architect of the field of gerontological education.The award is given each year to an individual or organization that has made an outstanding contribution to the advancement of gerontology and geriatrics education.This lecture reflects on the highlights of my journey to become a gerontologist: •Joining AGHE in 1998 as PCC explored the development of the first and only Gerontology associate degree in Oregon •Collaborating with community and academic partners to create an applied and evolving curriculum •Empowering older, encore students to translate their experience and compassion into professional careers that embodied their passion •Mentoring hundreds of students to harness their creativity and engage in bold innovation to transform aging lives •Grappling with how to measure and ensure student learning in a way that would make a difference in aging lives •Participating in the working group that developed the Gerontology Education Competencies and currently serving on the founding Board of Governors of the Accreditation for Gerontology Education Council.

HIRAM J. FRIEDSAM MENTORSHIP AWARD LECTURE Chair: Cynthia Hancock
The Hiram J. Friedsam Award lecture will feature an address by the 2020 award recipient, Karen Kopera-Frye,

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COMING OF AGING WITH GSA Jan Abushakrah, Portland Community College, Portland, Oregon, United States