Kahana Eva, Kahana Jeffrey S, Kahana Boaz, Ermoshkina Polina
Department of Sociology, Case Western Reserve University, Cleveland, Ohio.
Department of History, Mount Saint Mary College, Newburgh, New York.
Innov Aging. 2019 Aug 1;3(4):igz023. doi: 10.1093/geroni/igz023. eCollection 2019 Aug.
Discussions of disability in the gerontological and the disability studies literatures have seldom considered unique perspectives and needs of older adults. Disability has often been stigmatized and viewed as antithetical to successful aging. We call for expansion of prevailing paradigms of disability to address the resilience and continuing human potential of older adults living with disabilities. In addition to recognizing the environmental context of disability, we propose greater attention to adaptive potential of disabled older adults. We discuss 6 types of proactive adaptations that can contribute to empowerment, meaning, enhanced quality of life and psychological well-being among persons living with late-life onset disabilities. These include: (a) helping others, (b) planning for future care, (c) marshaling intergenerational support, (d) self-advocacy for responsive health care, (e) making environmental modifications to improve safety and comfort of the home, and (f) finding strength in spiritual pursuits. Enacting proactive adaptations can contribute to resilience in facing late life impairments and functional limitations. Such efforts can complement utilization of services and obtaining accommodations. Maintaining life satisfaction among older adults living with disabilities also involves focus on transcendent personal goals and acceptance of an altered self. We note how a more integrative view of medical and social dimensions of disability, infused with concepts of human agency, contributes to rapprochement between alternative disciplinary orientations to late life disability. Without negating society's important responsibilities for accommodating to needs of older adults living with disability, we reaffirm their potential for greater control and self-determination through proactive adaptations.
老年学和残疾研究文献中对残疾的讨论很少考虑老年人的独特观点和需求。残疾常常受到污名化，被视为与成功老龄化背道而驰。我们呼吁扩展现有的残疾范式，以关注残疾老年人的适应力和持续的人类潜能。除了认识到残疾的环境背景外，我们建议更加关注残疾老年人的适应潜力。我们讨论了六种积极适应方式，这些方式有助于增强患有晚年残疾的人的权能、意义感、提高生活质量和心理健康。这些方式包括：(a) 帮助他人；(b) 规划未来护理；(c) 调动代际支持；(d) 自我倡导以获得响应性医疗保健；(e) 对环境进行改造以提高家庭的安全性和舒适度；(f) 在精神追求中找到力量。采取积极适应措施有助于在面对晚年损伤和功能限制时具备适应力。这些努力可以补充服务的利用和获得便利设施。维持残疾老年人的生活满意度还涉及关注超越个人的目标以及接受改变后的自我。我们指出，将人类能动性概念融入对残疾的医学和社会层面的更综合观点，有助于弥合对晚年残疾的不同学科取向之间的分歧。在不否定社会在满足残疾老年人需求方面的重要责任的情况下，我们重申他们通过积极适应获得更大控制权和自我决定权的潜力。
