Alaska Natives (AN) view aging from a holistic perspective. One of the challenges of researching with cultural groups is the lack of data, or research, on culture and aging. This research explored successful aging from an AN perspective. A community-based participatory research (CBPR) model was used to engage participants at every stage of the research process. Semi-structured interviews were conducted with 16 AN men and 25 women. Kleinman’s Explanatory Model of Illness was adapted to gain a sense of the beliefs about aging and to guide the data analysis to establish an AN understanding of successful aging or attaining “Eldership” in Northwest Alaska. The foundation of the Norton Sound southern sub-region Model of Successful Aging is family, which contributed to Elders’ feelings of emotional well-being, ability to engage in their Native Way of life, maintain their physical health, and continue spiritual practices.
Indigenous peoples worldwide face unique challenges growing old. Many of these challenges are remnants of previous colonization practices and current oppressive systems often leading to out-migration from rural to urban environments. Despite Anchorage having the highest population of Alaska Native Elders little is known about the experience of relocation. This study investigated the impact of culture on the experience of successful aging within the Alaska Native context. Twenty-five semi-structured qualitative interviews with rural (N=13) and urban Elders (N=12; ages 48-84) were conducted. The use of Gee’s discourse analysis tools provided the framework for analyzing the discourse of Elders based on location and traditional or western influences on subjective successful aging. We explored the use of language within two identified discursive patterns: cultural discourse and Elder identity discourse. Social and contextual determinants of successful aging involve aspects of minority and majority culture and self-appraisal of successful aging based on cultural assumptions.
Stigma in the context of Alzheimer’s disease and related dementias (ADRD) is associated with a higher prevalence of depression, anxiety, social isolation, and poorer caregiver health. This is particularly true for underserved and rural communities; however, little is known about the sources of stigma and implications of stigma within these communities. This symposium explores sources of stigma along with implications of stigma in rural and/or underserved communities and introduces novel interventional considerations for addressing stigma. The first presentation by Rhodus and colleagues highlights implications of stigma in rural Appalachian communities as it relates to ADRD healthcare service and research participation. Next, Sabat and colleagues present findings of a recent intervention program, “Respite for All,” specifically, implications of this program for caregivers’ perception of stigma, as well as the person living with ADRD. This symposium also includes presentations focused on Alaska Native (AN) experiences with stigma and ADRD. Kim discusses findings of a community-based participatory research project using mixed-method to explore structural stigma in rural communities and needed initiatives for familial care partners. To conclude the program, Crouch and Rosich present results of a grounded theory, exploratory study aimed to understand the cultural practices and values that compose AN Elder beliefs and perceptions of ADRD, including stigmas. This symposium will conclude with a discussion on how researchers may begin to integrate approaches to address stigma in rural and underserved communities in order to enhance care utilization and quality of life for older adults caring for and living with ADRD.
Alaska Native (AN) Elders have historically been underrepresented in research. Innovative AN research posits that practice-based evidence is fundamental to culturally grounded, multifaceted methods. Semi-structured interviews were conducted with 34 AN Elders and 12 AN and non-Native caregivers in two studies exploring cultural understandings of memory and successful aging. The design and implementation of these studies employed Elders at every level of the research, ensuring cultural relevancy, outcomes, and dissemination activities. Findings reflect the benefits of engaging AN Elders in research and reveal methods for best practices: 1) creating Advisory councils; 2) identifying stakeholders 3) weaving together Elder and Western knowledge systems; and 4) the reciprocal nature of Elder engagement and wellbeing. This complimentary research builds on Elder-centric principles and lays the foundation for an Elder-centered research methodology that can be adapted and applied in other studies to encourage engagement of older adults in meaningful, restorative, and enculturated ways.
Challenges such as isolation, scarce resources, and limited knowledge of the disease are often the result of stigmatizing experiences from multiple systemic sources. No studies have investigated the impact of sources of stigma on the quality of life in Alaska Native (AN) ADRD caregivers. This exploratory, mixed-method study within a community-based participatory research framework assessed the experience of family stigma among 40 AN caregivers of people with ADRD across Alaska by administering a measure of systemic stigma and describes the impact of stigmatizing experiences on AN caregivers’ quality of life to develop preliminary data-driven stigma-reducing initiatives. AN caregivers completed the Family Stigma – Alzheimer’s Disease Scale (FS-ADS), assessing caregiver stigma, layperson stigma, and structural stigma. Quality of Life was assessed with the Goodness of Life for Every Alaska Native (GLEAN) scale. Preliminary data on structural stigma and its impact on caregiver quality of life will be presented.
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