Lori Harper, PhD Clinical Psychologist, Geriatric Psychiatry Villa Caritas Hospital Instructor and Field Placement Coordinator MacEwan University Clinical Lecturer University of Alberta Edmonton, Alberta, Canada
Bonnie M. Dobbs, PhD Director, The Medically At-Risk Driver Centre Director of Research, Division of Care of the Elderly Professor, Department of Family Medicine University of Alberta Edmonton, Alberta, Canada
Shana D. Stites, PsyD, MS, MA Instructor, Division of Geriatrics Department of Medicine, Perelman School of Medicine University of Pennsylvania Philadelphia, Pennsylvania
Martha Sajatovic, MD Professor of Psychiatry and Neurology Willard Brown Chair in Neurological Outcomes Research Director, Neurological and Behavioral Outcomes Center University Hospitals Cleveland Medical Center Case Western Reserve University School of Medicine Cleveland, Ohio
Kathleen C. Buckwalter, PhD, RN, FAAN Professor of Research & Distinguished Nurse Scientist in Aging Donald W. Reynolds Center of Geriatric Nursing Excellence, College of Nursing Oklahoma University Health Sciences Center Oklahoma City, Oklahoma Professor and Interim Dean Emerita University of Iowa College of Nursing Iowa City, Iowa
Sandy C. Burgener, PhD, RN, FAAN Associate Professor Emerita University of Illinois College of Nursing Chicago, Illinois
Disclosures Drs. Harper, Burgener, Dobbs, Buckwalter, and Stites report no financial relationships with any companies whose products are mentioned in this article, or with manufacturers of competing products. Dr. Sajatovic receives research grants from Otsuka, Alkermes, Janssen, International Society for Bipolar Disorders, Reuter Foundation, Woodruff Foundation, Reinberger Foundation, National Institutes of Health, and the Centers for Disease Control and Prevention. She is a consultant to Bracket, Otsuka, Janssen, Neurocrine, and Health Analytics. Dr. Sajatovic receives royalties from Springer Press, Johns Hopkins University Press, Oxford Press, and UpToDate. Her CME activities include the American Physician’s Institute, MCM Education, CMEology, Potomac Center for Medical Education, Global Medical Education, and Creative Educational Concepts.
Larger studies and testing of diverse approaches are needed to better understand whether intergenerational initiatives or other approaches can genuinely modify stigmatizing attitudes in various dementia populations, especially considering language, health literacy, cultural preferences, and other needs. The identified effects on physical and mental health, quality of life, self-esteem, and behavioral symptoms further support the extensive, negative effects of self-stigma on PwD, and emphasize the need to develop and test interventions to ameliorate these effects.
We presented at a Stigma Symposium at the 2018 Gerontological Society of America Annual Scientific Meeting in Boston, Massachusetts.25 Attendees of this conference shared our concerns about the detrimental effects of stigma. The main question we were asked was “What can we do to reduce stigma?” Perhaps the most immediate response is that in order to move the stigma dial, clinicians need to recognize that stigma has multiple, broad-reaching, and negative effects on PwD and their families.6 Bringing the discussion into the open and targeting stigma at multiple levels needs to be addressed by clinicians, researchers, administrators, and society at large.
Bottom Line
Stigma has multiple, broad-reaching, and negative effects on persons with dementia and their families. In clinical practice, direct discussion that encourages reflection and the use of effective and sensitive communication can help to limit passing on stigmatizing beliefs and to reduce negative stereotypes associated with the disease. Anti-stigma messaging campaigns and public policy changes also can be used to address societal and social inequities of patients with dementia and their caregivers.
