Older people are under-represented in the climate change movement yet are highly susceptible to the negative effects of climate change. This study’s objectives were to identify possible barriers faced by older persons to increase their pro-environmental behaviors and participation in the climate movement. Relying on in-depth qualitative interviews and focus groups with 50 older persons from four different population groups in Israel, we identified three themes. The first theme concerned assigning responsibility for the current climate situation. This theme addressed the question of who is seen as responsible for the current situation. The second theme covered actions taken by older persons to address the current situation. Finally, older persons view governments/municipalities, industry, and individuals as responsible for the changing climate, with a more traditional segment of the population also viewing God as responsible. Moreover, although governments were identified as important institutions with relevance to the current climate challenge, respondents mainly acknowledged the relevance of pro-environmental behaviors rather than climate change activism. In conclusion, the findings highlight the need to increase environmental activism among older persons. It is also important to increase the breadth of possible pro-environmental behaviors older persons can engage with.

Objectives: Alzheimer’s disease (AD), the most common type of dementia, is one of the most feared diseases, obstructing help-seeking, and leading to discrimination. While research interest in fear of developing AD is increasing, little is known about its characterization, triggers, and consequences, especially among different cultures. In this study, we aimed at exploring and characterizing AD fear as experienced by laypersons (LP), persons with Mild Neurocognitive Disorder (MND), and their relatives, in Israel and Germany. Design: A qualitative study using focus groups (FGs) and semi-structured interviews was used. Thematic content analysis was conducted to extract key themes. Setting: Israeli and German not yet diagnosed people. Participants: The study included a total of 130 participants (63 Israeli and 67 German participants) representing 3 groups: LP (n = 82), persons with MND (n = 28), and relatives of persons with MND (n = 20). Results: Two overarching themes were identified across groups and countries: fear of developing AD and fear of stigmatization. Other types of fear, such as fear of a person with AD, fear about the impact of a diagnosis of AD on family members, fear of becoming a caregiver, and fear of losing one’s self-determination because of developing AD, were specific to a group type or country. Different types of fear were awakened by different triggers, and were dealt with different coping strategies.

Background: Completing advance directives has been declared an essential instrument for preserving and respecting the autonomy and preferences for end-of-life care of people living with dementia. However, research deciphering the reasoning behind the decision to complete or not advance directives in the case of dementia remains limited, especially among people pertaining to different majority/minority groups.Objectives: To explore the motivations of people without dementia in Israel to complete or not to complete advance directives and to compare these motivations among the majority veteran Jewish group, the minority Jewish Former Soviet Union immigrant group, and the minority Arab group.Methods: This qualitative study used purposive sampling and focus groups with discussions elicited by a vignette. A total of 42 Israeli people without dementia participated in 6 focus groups: two with veteran Jews (n = 14), two with Jewish immigrants from the Former Soviet Union (n = 14), and two with Arabs (n = 14). The analysis followed recommended steps for thematic content analysis.Results: Four overarching themes were identified: (1) the meaning of dementia-related advance directives, (2) motivations for willingness to complete advance directives, (3) motivations for not being willing to complete advance directives, and (4) ethical dilemmas. Some of the themes were common to all groups, while others were informed by the groups' unique characteristics. Participants displayed a lack of knowledge and misunderstanding about advance directives, and central concepts such as autonomy and competence. Furthermore, stigmatic images of dementia and of the person with the diagnosis were associated to participants' motivations to complete advance directives.Conclusions: There is need to expand comparative research among culturally and socially similar and dissimilar groups within a country as well as between countries in order to better guide public health efforts to increase the rates of advance directives completion. Special attention should be paid to decreasing stigmatic beliefs and understanding unique cultural values and motivations.

Objectives: The purpose of the study was to examine and compare the dementia-related discourse and language used by people with mild neurocognitive disorder (MND), their family members, and family caregivers of people with Alzheimer’s disease in Israel and Germany. Design: This secondary qualitative analysis included focus groups and semistructured interviews. Thematic analysis was used to reveal the main discourses and stigmatic language used regarding dementia and people with dementia. Setting: Israeli and German stakeholders. Participants: Forty-four Israeli and 44 German participants: 28 people with MND, 20 family members of people with MND, and 40 family caregivers of people with Alzheimer’s disease. Results: Two main discourses were identified: the tragedy and the biomedical discourse. The tragedy discourse included several subthemes: “Dementia as the worst-case scenario,” “Nothing can be done about dementia,” and “People with dementia are not human.” The biomedical discourse stressed pathologic aspects of the condition. Similarities and differences were found between Israeli and German participants. Conclusions: The study indicates that, despite culture and language differences, the use of stigmatic discourse and stigmatizing language is common among people with close exposure to dementia in Israel and Germany. Efforts should be increased to develop a person-centered and dementia-friendly language.