BASELINE PURPOSE IN LIFE PREDICTS FUNCTIONAL HEALTH ACROSS 16 WEEKS IN OLDER ADULTS WITH PROGRESSIVE VISION LOSS

Abstract Greater purpose in life is associated with various positive outcomes in later life, such as, lower mortality risk, protection against cognitive decline, and lower spending on medical care and emergency room visits. Recent research from the Health and Retirement Study has shown that older adults with greater purpose in life have fewer physical limitations after four years. There has been no research to investigate purpose in life in older adults with progressive vision loss. The aim of this study is to examine whether purpose in life predicts functional health (i.e., activities of daily living) across a 16-week period of time in a sample of older adults (aged 60–96) with vision loss due to macular degeneration who were enrolled in a resilience building program (Nf 122). A repeated measures GLM showed that functional health did not change across 16 weeks (ns). Age (F(1, 112)=8.91, p=.003, ηp2=.07) and purpose in life (F(1,112)=13.21, p < .001, ηp2= .11) were significant overall predictors of functional health across time. Gender, education, cognition, marital status, depression, and loneliness at baseline were not associated with overall functional health. People who were younger were more likely to have better functional health over 16 weeks; purpose in life added 11% of explained variance. Because purpose in life is malleable and also significantly associated with better functional health in older adults with progressive vision loss, future interventions that enhance purpose in life should be studied with this population.


PARKINSON'S DISEASE AND STIGMA: A MULTIPLE CASE STUDY Beth Mastel-Smith, and Melinda Hermanns, The University of Texas at Tyler, Tyler, Texas, United States
Parkinson's disease (PD) is a neurodegenerative disorder caused by dopamine deficiency. PD affects emotional and physical health and causes people with PD and caregivers to experience stigma. Four types of stigma have been described: public, associated, self-, and structural. The aims of this study were to explore (a) how stigma is experienced by people with PD and caregivers, (b) whether stigma towards people with PD and caregivers is represented in the literature and social media and (c) examine whether findings support Stigma Theory and theoretical propositions. This was a multi-case qualitative study. Cases included a literature review, interviews with people with PD and caregivers, and examination of social media posts. A purposive sample included seven people with PD and five caregivers who were interviewed online using an interview guide. The study was approved by the University IRB and participants signed consent. Thematic analysis identified codes which aligned with conceptual definitions of Stigma Theory. Findings revealed that public stigma was presented in all four cases. Self-and structural stigma were represented in the literature and interviews with people with PD and caregivers. Associated stigma appeared in the literature and from caregivers' descriptions. Three of six theoretical propositions were supported. Four types of stigma toward people with PD were prevalent and interrelationships between types of stigma noted. A multipronged approach to reducing stigma is needed at the individual, organizational and community levels. Research regarding stigma experienced by diverse populations and the health effects of stigma for people with PD is recommended.

CONTEMPLATING TEMPORAL LANDMARKS, SENSING TIME, AND PURSUING A MEANINGFUL LIFE IN ADULTHOOD DaEun Kim, and Hsiao-Wen Liao, Georgia Institute of Technology, Atlanta, Georgia, United States
Research has shown that experiencing and anticipating temporal landmarks affect one's goal priorities and motivation. Particularly, milestone birthdays (MBD) remind people of where they stand in life timeline, prompting time experience that has consequences for pursuit of meaning. The current study examines this thesis in the context of adult development and aging. We tested whether (1) thinking about past and future MBDs (vs. a regular birthday) affects young, middle-aged, and older adults' possession of and search for meaning in life and (2) sense of time, and (3) the association between contemplating MBDs and meaning in life is, at least in part, explained by sense of time. Participants (N = 239) were randomly assigned to one of the three conditions to verbally visualize a past MBD, a future MBD, or an upcoming regular birthday. They then completed a meaning in life questionnaire, which assessed presence of and search for meaning (Steger et al., 2016). Future time perspective (Lang & Carstensen, 1996) and time savoring (Carstensen et al. in prep) were also measured. We found that thinking about past and future MBDs (vs. regular birthdays) prompted people to search for meaning. Thinking about past MBDs (vs. regular birthdays) also elicited a sense that time left in life is limited. Mediation analysis indicated that perceived future time constraints helped explain the relation of recalling past MBDs to search for meaning. Results held when age effects were considered. We draw on motivation theories of temporal landmarks and socioemotional selectivity to discuss the findings. Greater purpose in life is associated with various positive outcomes in later life, such as, lower mortality risk, protection against cognitive decline, and lower spending on medical care and emergency room visits. Recent research from the Health and Retirement Study has shown that older adults with greater purpose in life have fewer physical limitations after four years. There has been no research to investigate purpose in life in older adults with progressive vision loss. The aim of this study is to examine whether purpose in life predicts functional health (i.e., activities of daily living) across a 16-week period of time in a sample of older adults (aged 60-96) with vision loss due to macular degeneration who were enrolled in a resilience building program (Nf 122). A repeated measures GLM showed that functional health did not change across 16 weeks (ns). Age (F(1, 112)=8.91, p=.003, ηp2=.07) and purpose in life (F(1,112)=13.21, p < .001, ηp2= .11) were significant overall predictors of functional health across time. Gender, education, cognition, marital status, depression, and loneliness at baseline were not associated with overall functional health. People who were younger were more likely to have better functional health over 16 weeks; purpose in life added 11% of explained variance. Because purpose in life is malleable and also significantly associated with better functional health in older adults with progressive vision loss, future interventions that enhance purpose in life should be studied with this population.

TESTING A NEW MODEL OF REABLEMENT-FOCUSED INTEGRATED CARE IN ADULT DAY SERVICE USERS IN TAIWAN: A PRELIMINARY STUDY
Yu-Ting Chang, 1 Hsiao-Wei Yu, 2 and Pay-Shin Lin 1 ,

Chang Gung University, Taoyuan, Taoyuan, Taiwan (Republic of China), 2. Chang Gung University of Science and Technology, Taoyuan City, Taoyuan, Taiwan (Republic of China)
There is a growing consensus that implementing personal-centered therapeutic activities at adult day services (ADS) leads to functional improvement in care recipients and reduces the burden on caregivers. Taiwan has introduced reablement-focused integrated care (RFIC) model for ADS users, the effects of this new model merit investigation. This study aimed to examine whether the RFIC model promotes physical and mental function in care recipients and improves caregiver satisfaction. We recruited ADScare recipients and their family caregivers (N = 14 dyads) through purposive sampling for a quasiexperimental study. Six dyads were assigned to the RFIC intervention group and eight dyads to the control group. The RFIC intervention consisted of ten one-hour sessions over two months. The functional abilities of care recipients and the care satisfaction of caregivers were assessed at baseline and after the intervention. The RFIC group, compared to the control group, showed an improvement in care satisfaction score, and the group difference was significant (RFIC group: mean (SD) change score = 1.17 (2.64); control group: mean (SD) change score = −3.38 (2.20); p < 0.01). There were no differences in physical and mental function between the RFIC and control groups. These preliminary results suggest that when reablement is used as a means of personal-centered therapeutic training for ADS users, it can help caregivers cope with care problems and improve how they appraise their mastery and satisfaction as regards care. However, the effects of RFIC on the physical and mental function of care recipients require further investigation.

PHOTO-ELICITATION-A VIEW OF DEEP OLD AGE AND SOCIAL INCLUSION Elaine Eliopoulos, University College London, London, England, United Kingdom
Photo-elicitation-A View of Deep Old Age and Social Inclusion While visual methodologies have gained prominence in aging research, focus on deep old age has been uncommon. The variety of visual representations portraying a range of 'ageless aging' to frail older people may not fully capture daily lived experience. The inclusion of those in deep old age to depict their aging bodies is a crucial missing element enhancing our understanding of the nuances of deep old age. This study fills that gap. Photo-elicitation, followed by semi-structured interviews, was used to examine the role of the body for participants 80 years+ in three US island contexts to understand what impact, if any, their bodies had on their ability to be socially included in ways they chose. Digital cameras were provided to participants to photograph their lived bodily experience. Those who had visual challenges were assisted in taking photographs. Recent analysis of the photographs revealed important findings that will contribute to theoretical development of deep old age: participants who took photos without assistance did not take a single photograph of their bodies. They took photos primarily of their environment and places of community connections while minimising physical challenges. Their photos contextualised their experience of the physical challenges that played a role in their sense of inclusion within their communities. This finding questions current dominant models of the third and fourth age as dichotomous formulations related to embodied agency. In doing so it opens new possibilities for theoretical reflection on deep old age.