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Persons with disabilities and the aging factor.

Much has been accomplished over the past 30 or more years vis-a-vis understanding the totality of the aging process and its impact on the individual as well as on his or her extended family. Pioneers in gerontology such as Elaine Brody, Bernice Neugarten, Robert Butler and Powell Lawton, to name just a few, have generated volumes of research relative to the impact of social, physical, psychological and environmental factors on people as they grow older. This data has also produced more precise demographic profiles of older citizens. The demographics of the older population clearly underscore the need for continuing creativity in program and service development in order to support, sustain and challenge this vital and vibrant group of citizens.

The elderly population (individuals 65 and older) numbered 28 million in 1984. This represented 11.9% of the population or approximately one out of every eight Americans. By the year 2000 individuals 65 and older are expected to represent 13% of the citizenry, and by 2030 as much as 21%, or 2.5 times the number in 1980.

Experts conclude that the older population will continue to expand wen into the 21st century. More recently a new phenomenon has caught the eye of geriatricians- the consistent increase in the numbers of persons with disabilities who are surviving into their sixth, seventh and even eighth decades of life. Virtually no data is available to those who work with persons with disabilities which would assist them in serving those who are entering their aging phase. Roberta B. Trieschman, in Aging with a Disability, wrote: "There is another population... that has been overlooked- those who experienced a major disability in the earlier years of their lives, who have adjusted to the altered lifestyle, and who are now experiencing another decline in scope and intensity of activities.... The issue of aging with a disability is a new problem for western societies, one that has caught our health care system by surprise."

Initial frames of reference could include: * Aging is a normal process which does

not inevitably result in mental

deterioration, or thwart a person's

capacity to successfully confront

life's challenges. * Older people are much more

heterogeneous than homogenous.

People and their abilities can vary

greatly between the ages of 65 and 85. * Each elderly person has his or her

own psycho-physiological "time

clock." The onset, duration and level

of any resulting dysfunction is different

for every individual. * Older persons are confronted with

varying degrees of losses (physical,

social, emotional). These losses frequently

occur in slow, even imperceptible,

increments. * As a person ages, he or she is

assulted increasingly by multiple losses,

complicating the assessment of

individual needs. * Sensory losses are disruptive, since

sight and hearing are the primary

senses which a person employs to

maintain contact with the surrounding

environment. * Elderly people do not change radi - cally simply because they are older.

Personality remains relatively constant. * Families generally act responsibly

toward elderly members. They willingly

provide economic, social and

emotional support to older members,

at times acting beyond what is realistic

or even rational.

Understanding the aging process is one constructive way that those who work with older persons with disabilities can be better prepared to help their clients cope with stress, loss and consequences of growing older.

In practical terms, any number of support groups for older residents with disabilities can be developed. Membership can consist of persons 55 years of age or older. The subject or topical content of such groups is virtually limitless. For example, topics for discussion and interaction can include: * the surfacing of sensory deficits as

one grows older; * confusion and disorientation; * feelings of increased dependency; * fear of death; * the value of a legacy; * physical aspects; * sharing personal feelings; * exercising rights as senior citizens.

Family Groups can also be created in much the same manner. Family members should be perceived by staff as partners in a combined effort to ensure that their relative's quality of life does not suffer simply because they have grown older. The topics for discussion are as extensive as those for resident groups. Pertinent subjects could include: * myths and realities of aging; * helping a relative to reminisce; * dealing with guilt; * making visits count; * dealing with a loved one's death; * the psychology of aging.

Essential to the success of any service developed to support elderly residents with disabilities is the degree of direct understanding which staff have of the processes of aging.

Increasing numbers of persons with physical disabilities are entering the aging phase of life. This phenomenon demands the immediate attention of specialty long-term care centers, as well as community agencies and professionals, to ensure the development of effective and sensitive treatment, care and support services. Our roles as healthcare providers must include advocacy to ensure society meets its responsibilities to the aging, physically disabled population.

Certain techniques can be advantageous in ensuring qualitative interactions with elderly clients: * allowing time for the older resident to

react and respond to external stimuli; * being alert to the individual's

strengths and positive capacities; * recognizing that a sense of security

and belonging can be encouraged by

the establishment of reasonable

routines; * understanding the importance of

consistency, since inconsistencies can

often interfere with appropriate

coping behavior; * respecting the elderly person's

resilience and capacity to manage

despite the assaults of aging and subsequent

losses; * assisting the older resident in accepting

their life as meaningful.

Whether aging persons with disabilities live independently, in the home of a family member, or in a specialty long-term care facility, there is an urgent need for all who come in contact with them to be conscious of the myriad of issues related to the processes of aging.

We should an be concerned about the future, after all, since we will spend the rest of our lives there.
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Article Details
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Author:Lewis, Ken
Publication:The Journal of Rehabilitation
Date:Oct 1, 1989
Previous Article:Geriatric rehab program focuses on research, training and service.
Next Article:Dr. Robert Davila: the man and his mission.

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