Understanding the Care Priorities, Service Needs, and Lived Experiences of Rural Older Adults with Dementia and Cognitive Impairment in Canada: A Scoping Review.

BACKGROUND AND OBJECTIVES: Research on dementia care remains largely urban-centric, with limited understanding about the lived experiences and needs of people with cognitive impairment and dementia in rural communities. This scoping review aimed to understand the care priorities, service needs, and lived experiences of rural older adults with cognitive impairment and dementia in Canada. RESEARCH DESIGN AND METHODS: Following Arksey and O'Malley's scoping review framework, we searched CINAHL, PubMed, PsycINFO, Scopus, and Web of Science for journal articles published from January 2015 to January 2025. Two reviewers independently screened the articles and extracted data from the relevant articles. We used reflexive thematic analysis to analyze the data. RESULTS: The scoping review identified 616 initial articles, with 16 relevant studies included in our review. Four interconnected themes were identified: i) complex navigational pathways and barriers in rural dementia care; ii) limited dementia knowledge creates challenges across the disease trajectory; iii) gaps in access to dementia-related services and supports; and iv) dementia-related stigma, fear, and social isolation. DISCUSSION AND IMPLICATIONS: The findings revealed critical challenges in navigating rural dementia care, where geographical distance, misinformation, limited services, and dementia-related stigma exacerbate cognitive care disparities. Addressing these challenges requires ingenuity and prioritizing lived experience research to inform community-relevant solutions. Strategic investment and implementation science are needed to co-design, implement, and evaluate navigational support models and interdisciplinary dementia care hubs to improve rural access. Advancing rural dementia care requires moving beyond documenting challenges to evaluating scalable population-level interventions.