The retirement village experiential learning journey (RV-ELJ): an Australian "case study" in university course curriculum to reduce ageism and promote working with older adults

BACKGROUND

An aging population means health services are dealing with increasing numbers of older adults, placing challenges on health care systems. Research demonstrates many students who are in the health sciences carry negative views toward older adults, affecting their choice to work with older adults. This study evaluated whether course curriculum via an experiential learning activity that exposed Pre-Medicine students to older adults in retirement villages, improves attitudes to working with older adults upon graduation.

METHODS

A survey using validated tools namely Australian Aging Sematic Differential (AASD); Relating to Older People (ROPE): Reactions to Aging Questionnaire (RAQ); Geriatric Attitudes Scale (GAS) was implemented. Thematic analysis to evaluate students' reflective essays post placement was conducted (n = 11).

RESULTS

There were significant positive shifts in attitudes toward older adults and aging (AASD/GAS), along with improvements in students' self-perceptions of aging supported by qualitative analysis.

DISCUSSION

The results support the need for educational interventions like the RV-ELJ model for reducing ageism and encouraging a mind-set shift toward working with older adults. It is important to expose students to settings where older adults live independently to build rapport and breakdown prejudices and stereotypes. This is likely to encourage interest in working with older adults.

"Live Gerontology": Understanding and Representing Aging, Loneliness, and Long-Term Care Through Science and Art

This article proposes an expansive conceptualization of gerontological research by engaging with a "live gerontology" that combines sciences and arts to better understand and represent aging and its diverse meanings and contexts. Borrowing the sociological concept of "live methods," we argue that gerontology can benefit from a "live" approach-not only methodologically, but also conceptually. To guide pathways between artistic and gerontological fields and frame its practices and outcomes, we suggest four propositions for a live gerontology: (1) using multiple genres to artfully connect the whole-interweaving micro-, meso-, and macrolevels to contextualize aging within various sociocultural milieus; (2) fostering the use of the senses to capture more than just what people say-what they do, display, and feel; (3) enabling a critical inventiveness by relying on arts' playfulness to design/refine instruments; and (4) ensuring a constant reflection on ethics of representation and public responsibility. To apply and experiment with a live gerontological approach, we describe collaborations with an award-winning writer and an illustrator. The collaborations drew on qualitative data from a study on lived experiences of loneliness in long-term care through ethnography and interviews with residents of 2 Australian facilities. The writer explored participants' accounts as creative stories, which were then illustrated. Motivated by an ethics of representation, we aimed to represent findings without othering or further marginalizing participants. The creative materials offered more than appealing representations, shining new light on the intricate nature of aging, loneliness, institutionalization, and gerontology research and practice.

An experimental investigation of a simulated online intergenerational friendship

Reducing ageism is a significant social issue. The current study involved a novel experimental examination of whether a one-time simulated online intergenerational friendship would reduce ageism. Undergraduate participants were randomly assigned to complete an interpersonal closeness exercise (the "fast friends" procedure, Aron et al., 1997; Lytle & Levy, 2015) with a confederate who used a script to answer the fast friends questions, during which they either did not reveal their age (control condition) or revealed being an older adult (age 65; experimental condition). Results indicate that experimental (vs. control) participants reported less ageism and more positive behavior (friendlier responses). These findings suggest that positive online intergenerational contact may help combat ageism. As intergenerational contact was limited before the COVID-19 pandemic and even more so during the pandemic, facilitating online intergenerational contact may be a particularly worthwhile ageism reduction strategy. Further implications of these findings and future directions are discussed.

Reducing ageism toward older adults and highlighting older adults as contributors during the COVID-19 pandemic

The COVID-19 pandemic exacerbated ageism (stereotyping, prejudice, and discrimination) toward older adults in the United States, highlighting the belief that older adults are a burden. Prior to the pandemic, a growing body of research sought to reduce ageism using the PEACE (Positive Education about Aging and Contact Experiences) model. Extending that research, participants were randomly assigned to watch three videos (less than 10 min total) that challenged stereotypes about aging and older adults, depicted positive intergenerational contact, and highlighted older adults as contributors to society (experimental condition) or three videos on wallpaper (control condition). Experimental participants (undergraduate students in Study 1 and a national community sample of young adults in Study 2) reported increased endorsement of older adults as contributors to society and positive stereotypes of older adults. In addition, in Study 2, negative stereotypes of older adults and views of intergenerational conflict were also reduced among experimental (vs. control) participants. These promising findings show that relatively brief ageism reduction interventions are effective during the pandemic and for the first time, that the perception of older adults as contributors to society can be increased. Future directions and implications for social policies are discussed.

Examining the Role of Aging Perceptions in Subjective Cognitive Decline

OBJECTIVE

While subjective cognitive decline (SCD) is gaining ground as a "preclinical" risk state for Alzheimer disease, its utility depends on our understanding of the factors linked to SCD. Rarely examined sociocultural factors including perceptions of aging may relate to the subjective experience of cognitive aging. Identifying such associations will help to refine the utility of SCD as an early marker of AD while setting the stage for addressing modifiable factors contributing to SCD.

METHODS

The study consisted of N=136 participants (68% female; 73% White; 22% Black race, age mean =74.72; education mean =16.01). Questionnaires assessed SCD, depressive symptoms, and age perceptions (essentialist aging beliefs, subjective age, age group identification, and explicit/implicit age stereotypes). Cognitive functioning was measured with a semantic interference and learning task.

RESULTS

SCD was correlated with essentialist aging beliefs, age identification, and depressive symptoms [ rrange =0.18 to 0.22, Prange =0.009 to 0.02, confidence interval (CI) range =0.00-0.39]. Essentialist aging beliefs were correlated with subjective age and age group identification ( rrange =0.22 to 0.42, Prange <0.001 to 0.003, CI range =0.08-0.57). Both age group identification and essentialism were correlated with depressive symptoms ( rrange =0.22, Prange =0.009 to 0.01, CI range =0.04-0.39). In the adjusted regression model including depressive symptoms, age perceptions, and SCD, only SCD was associated with cognition ( b =-0.31, P <0.001).

CONCLUSION

Although correlated with SCD, perceptions of aging do not explain the relationship between SCD and performance on a sensitive cognitive test among older adults.

Health Professionals Palliative Care Education for Older Adults: Overcoming Ageism, Racism, and Gender Bias

Purpose of review

Most aging Americans lack access to specialist palliative care aimed at those experiencing serious illness and/or high symptom burden at end of life. The curricula used by training programs for all healthcare professions should focus on helping learners develop the primary palliative care skills and competencies necessary to provide compassionate bias-free care for adults with serious illness. We believe there is much opportunity to improve this landscape via the incorporation of palliative care competencies throughout generalist healthcare professional programs.

Recent findings

Several recent publications highlight multiple issues with recruitment and retention of diverse students and faculty into healthcare professional training programs. There are also concerns that the curricula are reinforcing age, race, and gender biases. Due to these biases, healthcare professionals graduate from their training programs with socialized stereotypes unquestioned when caring for older adult minority patients and caregivers.

Summary

Important lessons must be incorporated to assure that bias against age, race, and gender are discovered and openly addressed in healthcare professional’s education programs. This review highlights these three types of bias and their interrelationships with the aim of revealing hidden truths in the education of healthcare professionals. Ultimately, we offer targeted recommendations of focus for programs to address implicit bias within their curricula.

Addressing stereotypes of aging and interest in careers working with older adults through education

Negative stereotypes about older adults are increasing and contributing to a shortage of professionals in gerontology. Building on the PEACE model (Positive Education about Aging and Contact Experiences), two experiments used education to address stereotypes associated with older adults. Participants were randomly assigned to read brief articles that: challenged stereotypes about older adults (condition 1), challenged stereotypes about careers working with older adults (condition 2), challenged both stereotypes (condition 3), or described careers in general (control; condition 4). In Study 1, 399 undergraduates in all 3 experimental conditions (vs. control participants) reported lower levels of ageism, more positive age perceptions, and more aging knowledge in an immediate and delayed (1-2 weeks) post-test. In Study 2, 446 national community participants (ages 18- 25) in all experimental conditions (vs. control participants) reported greater positive age perceptions, aging knowledge, and interest in psychology and social work careers with older adults in an immediate post-test. These findings highlight the promise of using brief online methods to challenge stereotypes, provide more positive and accurate views of aging and older adults, and increase interest in careers working with older adults. Implications are discussed.

Reducing Ageism With Brief Videos About Aging Education, Ageism, and Intergenerational Contact

BACKGROUND AND OBJECTIVES

With an increasing older population, ageism continues to be a significant social issue. Interventions to reduce ageism and improve intergenerational contact are needed.

RESEARCH DESIGN AND METHODS

Building on the Positive Education about Aging and Contact Experiences (PEACE) model, undergraduates in an online experiment were randomly assigned to watch videos that provided education about aging, ageism, and positive intergenerational contact (experimental condition) or education about wallpaper (control condition).

RESULTS

In Part 1, 845 undergraduates in the experimental condition (vs. control condition) reported lower levels of ageism, less negative age stereotypes, more positive age stereotypes, and more aging knowledge in an immediate post-test. In Part 2 (1-6 weeks later), undergraduates in the experimental condition (vs. control condition) reported more positive age stereotypes in a delayed post-test.

DISCUSSION AND IMPLICATIONS

These findings highlight the promise of providing information about aging and positive intergenerational contact to reduce ageism. Brief online educational videos based on the PEACE model hold promise as an effective tool to reach a wide audience and reduce ageism.

Instapals: Reducing ageism by facilitating intergenerational contact and providing aging education

Utilizing the PEACE (Positive Education about Aging and Contact Experiences) model as a theoretical foundation, Instapals was a novel ageism reduction intervention with undergraduate students in a non-gerontology course that 1) provided aging education and 2) facilitated positive 1-to-1 intergenerational relationships with older adults (individuals 65+) through daily exchanges on Instagram for 30 days and two in-person meetings. Paired t-tests demonstrate a significant decrease in aging anxiety, psychological concerns about aging, and negative stereotyping of older adults. Results from coded open-ended responses suggest an overall positive experience with Instapals and more positive attitudes toward aging and older adults across a semester. Findings from the first test of Instapals, a theoretically-driven intervention, shows promise for reducing ageism among larger samples and in other settings.

Reducing Ageism: Education About Aging and Extended Contact With Older Adults

BACKGROUND AND OBJECTIVES

Ageism is of increasing concern due to the growing older population worldwide and youth-centered focus of many societies.

RESEARCH DESIGN AND METHODS

The current investigation tested the PEACE (Positive Education about Aging and Contact Experiences) model for the first time. Two online experimental studies examined 2 key factors for reducing ageism: education about aging (providing accurate information about aging) and extended contact (knowledge of positive intergenerational contact) as well as their potential combined effect (education plus extended contact).

RESULTS AND DISCUSSION

In Study 1, 354 undergraduates in all 3 experimental conditions (vs. control participants) reported less negative attitudes toward older adults (delayed post-test) and greater aging knowledge (immediate and delayed post-tests), when controlling for pre-study attitudes. In Study 2, 505 national community participants (ages 18-59) in all experimental conditions (vs. control participants) reported less negative attitudes toward older adults (immediate post-test) and greater aging knowledge (immediate and delayed post-tests). In summary, across 2 online studies, education about aging and knowledge of intergenerational extended contact improved attitudes toward older adults and aging knowledge.

IMPLICATIONS

Thus, brief, online ageism-reduction strategies can be an effective way to combat ageism. These strategies hold promise to be tested in other settings, with other samples, and to be elaborated into more in-depth interventions that aim to reduce ageism in everyday culture.

The Underpinnings of Ageism: Multiple Mediational Model of Epistemological Style, Social Dominance Orientation, Right-Wing Authoritarianism, and Ageist Attitudes

This study seeks to understand the psychological factors that may contribute to the development and endorsement of ageist belief systems. Dual process theory is used to examine how one's worldview, beliefs in social hierarchy, authoritarian aggression, authoritarian submission, and conventionalism predict ageist attitudes. Participants living in the United States (n = 407) in 49 states and territories were recruited through this online national study and completed surveys of their ageist beliefs, epistemological style, social dominance orientation (SDO), and right-wing authoritarianism (RWA). RWA, SDO, and naïve realism were all positively associated with ageist beliefs. A hypothesized path model and two alternative models suggested the retention of a model whereby naïve realism led to RWA, which led to SDO, and finally to ageism. All possible direct and indirect effects were significant within the retained model, suggesting the presence of a multiple mediation. The fit of this model was superior to that of models testing alternative theoretical causal chains. Naïve realism may lead to authoritarian aggression, authoritarian submission, and conventionalism, which may then increase the value that people place on social hierarchies, and this may influence the development and retention of ageist beliefs. Helping people to understand what their basic beliefs about the world are and how they may play a role in the development of ageism may assist in reducing ageist attitudes.

Health professions education: Advancing geriatrics and gerontology competencies through Age-Friendly University (AFU) Principles

This article elucidates opportunities for health professions education programs to make a mark in the Age Friendly University (AFU) initiative. Specifically, key approaches are introduced for health professions education programs based on the Age Friendly University Global Network initiative and the Academy for Gerontology/Geriatrics in Higher Education (AGHE) Program of Merit for Health Professions Programs. Higher Education Institutions (HEIs) that offer health professions education, have various options to establish and enhance student gerontology/geriatrics competence and confidence. However, two options are germane to new initiatives that are making their mark in HEIs. First, Age Friendly University Guiding Principles applicable to health professions education allow health gerontology faculty to be catalysts to promote and integrate these principles within their program's curriculum contributing to their institution's readiness to apply for the Age Friendly University designation. Second, the Academy for Gerontology in Higher Education (AGHE) Program of Merit (POM) provides specific geriatrics/gerontology competencies for health professions programs to integrate into the program's curriculum along with an option to attain recognition as an AGHE Program of Merit. Attaining both designations contributes to preparing future health professions providers with improved older adult health care skills that also benefits older adults.

Toward Reducing Ageism: PEACE (Positive Education about Aging and Contact Experiences) Model

The population of older adults is growing worldwide. Negative ageism (negative attitudes and behavior toward older adults) is a serious international concern that negatively influences not only older adults but also individuals across the age continuum. This article proposes and examines the application of an integrative theoretical model across empirical evidence in the literature on ageism in psychology, medicine, social work, and sociology. The proposed Positive Education about Aging and Contact Experiences (PEACE) model focuses on 2 key contributing factors expected to reduce negative ageism: (a) education about aging including facts on aging along with positive older role models that dispel negative and inaccurate images of older adulthood; and (b) positive contact experiences with older adults that are individualized, provide or promote equal status, are cooperative, involve sharing of personal information, and are sanctioned within the setting. These 2 key contributing factors have the potential to be interconnected and work together to reduce negative stereotypes, aging anxiety, prejudice, and discrimination associated with older adults and aging. This model has implications for policies and programs that can improve the health and well-being of individuals, as well as expand the residential, educational, and career options of individuals across the age continuum.

Dementia and detectives: Alzheimer's disease in crime fiction

Fictional representations of dementia have burgeoned in recent years, and scholars have amply explored their double-edged capacity to promote tragic perspectives or normalising images of ‘living well’ with the condition. Yet to date, there has been only sparse consideration of the treatment afforded dementia within the genre of crime fiction. Focusing on two novels, Emma Healey’s Elizabeth is Missing and Alice LaPlante’s Turn of Mind, this article considers what it means in relation to the ethics of representation that these authors choose to cast as their amateur detective narrators women who have dementia. Analysing how their narrative portrayals frame the experience of living with dementia, it becomes apparent that features of the crime genre inflect the meanings conveyed. While aspects of the novels may reinforce problem-based discourses around dementia, in other respects they may spur meaningful reflection about it among the large readership of this genre.

A Systematic Review of the Effectiveness of Intergenerational Programs

Purpose of the study: The objective of the present review study is to identify the determinant elements of the effectiveness of empirically based interventions (EBI) in the field of intergenerational work, contrasting face-to-face and combined (face-to-face and virtual) intervention modalities against variables relating to this field according to EBI indicators. Design and Methods: An extensive literature search returned a total of 553 studies. Of these, just 50 studies met the inclusion criteria of being an empirical investigation of the effectiveness of intergenerational programs that contain appropriate elaboration on theoretical constructs and methods. Results: The descriptive and multivariate analysis conducted demonstrates that programs with a greater number of EBI controls have the greatest effectiveness, regardless of the intervention mode employed, and that this effectiveness is also modulated by other variables such as the participants' disabilities, their literacy level, or their membership of an organization. Conclusions: We examined the implications of these findings, noting the need to increase the number of virtual interventions that could improve the efficiency of the activities undertaken, and at the same time ensuring that EBI indicators are also fulfilled.

The Defense of My Aging Self: A Report From the Field

This article offers a field report-experiences, thoughts, and anecdotes-of my personal passage into older adulthood and my attempts to maintain a healthy sense of personhood in the context of the normative ageism in my world. Specifically, I illustrate how my career-long engagement with the scientific base of gerontology-particularly life-span developmental and social psychology-has been a key ally in informing my aging and in assisting my defense against internalization of negative stereotypes. Also, I offer some thoughts drawn from personal life experience that may inform research and application efforts designed to modify some of the psychological motives that sustain ageism in our shared environment.