Aging with a Disability: Flipping the Script of the Healthy Aging Paradigm
It is inevitable that as people age, they will acquire limitations and disabilities. Conventional wisdom says that the longer a person can avoid disability as they grow old, the healthier they will be. Many Canadians age into disability, meaning that they will acquire conditions and limitations as they grow old. But what of seniors who age with a disability? Cerebral palsy and spina bifida are acquired during or even prior to birth; spinal cord injuries can occur at any point in one’s lifespan due to a traumatic accident; multiple sclerosis onset occurs anywhere between the ages of 15 and 60; many people are partially sighted or hard of hearing for the majority of their lives. Aging with a disability is a reality for a growing portion of the population; people in the aging disability community face unique healthcare needs and challenge conventional notions of “healthy aging” at every turn.
Limitations acquired through aging –fatigue, chronic pain, reduced mobility- are things that people with disabilities have been living with for the majority of their lives. Adapting to how these realities change with age allows those with pre-existing disabilities to restructure their expectations accordingly. An American study found that adults with disabilities considered themselves to be aging “successfully” when they were able to find contentedness in life and adapt to changes in their health. Because those with disabilities have lived with some degree of impairment for a longer period of time, they may have an easier time adjusting to changes in their health than other people.
Older adults with disabilities are not unlike other seniors, in that autonomy is of the utmost importance. However, autonomy isn’t always defined in terms of independence; for those with disabilities, autonomy could refer to how they interact with others (directing their own care, for example), how they wish to participate in activities and the selection of their own adaptive equipment.
Participation in activities presents a unique challenge for older people with disabilities. Physical access is a huge barrier for them, just as it is people with disabilities at any age. In a Quebec-based study of community participation of older adults with disabilities, many individuals spoke of being left out because the location of the activity was inaccessible, or otherwise could not accommodate for their different physical needs; raising these concerns and being met with resistance is often embarrassing and exacerbate systemic exclusion and isolation.
Another challenge facing the elderly disability community is access to comprehensive healthcare. Many participants in the American study spoke of having doctors who may be well versed in issues associated with aging, or challenges associated with their disability –but crucially, not in how these aspects of their health intersect and interact.
As disabled people age, they will continue to face challenges; some are not so different from the issues of the larger seniors’ community. Some challenges may seem similar, but include unique elements that necessitate a nuanced approach, like addressing barriers to access that lead to isolation, and tackling issues of inclusive healthcare for seniors with unique needs. The aging disability community is also strong and defiant in its resilience, challenging the accepted societal definitions of aging well by proving that disabilities don’t preclude people from continuing to live healthy, engaging lives at any age.
 Raymond, E. et al. (2014) “Community Participation of Older Adults with Disabilities” in Journal of Community & Applied Social Psychology. Vol. 24, no. 1 pp. 50-62.