Stigma and the Cultural context of Residential Settings for the Elderly

University Of Maryland Baltimore County, Baltimore MD

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Abstract

[unreadable] DESCRIPTION (provided by applicant): Stigma, the consensual reactions of groups of people toward other groups of people based on some real or perceived characteristic (Leary & Schreindorfer, 1998) plays an important role in later life. Losses in mental and physical functioning or just being "old" can lead to negative perceptions, creating stigmatizing experiences that can infuse the body as well as the core of the person. Common reactions to stigma include both group-based and individual responses. The former include disassociation from the stigmatized person(s) - that is members of "our group" not associating with members of "that group." An individual response might include social withdrawal based on the person's self-identification as a stigmatized being. Residents of senior housing environments often struggle to control or manage evidence of stigmatizing conditions that they believe might be perceived negatively by others and/or require an increased level of care. Within various types of senior housing, such as those including multiple levels of care, stigmatizing elements might be unique to the setting type (e.g., assisted living vs independent). This proposed study would examine the dynamics of stigma in various settings using ethnography to better understand cultural definitions and uses of stigma among setting stakeholders. The specific aims are to understand: 1) How older adults define stigmatizing traits in themselves and others; 2) How they act and react to stigmatizing traits in themselves and others; 3) How stigmatizing traits influence social dynamics as well as the goal of avoiding the effects of stigma; 4) How stigma is defined or operates differently in various levels of care and environmental configurations; 5) How the quality of settings and care might be improved with attention to the personal and social dynamics of stigma. The proposed 60-month ethnographic project will be undertaken consecutively in two active adult communities without services; two continuing care retirement communities with at least three levels of care; two facilities with both independent living and assisted living units; and two facilities with both assisted living and nursing homes. In addition to field observation and key informant interviews with family and staff, 160 residents will be targeted for indepth interviews and focal case development. Understanding how stigma, exists, operates, and changes in each of these environments is instrumental in developing strategies to address stigma and improve quality of life across all settings. [unreadable] [unreadable] [unreadable]