Paradoxically Thinking: Ageing with Disability, Disability with Ageing

by Ann Leahy
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It has been suggested that the real distinction between ‘old’ and ‘not old’ is to be found in impairment (Oldman, 2002:798). Approaching the issue of ageing together with that of impairment and disability involves reckoning with paradox. Despite impairment often being considered a social norm of ageing, or perhaps because of it, older people with impairments are rarely regarded as ‘disabled’ in quite the same way as children, or younger adults might be (Priestley, 2002; 2006). This is so, even though disabled people age, and most people who are ageing will experience disability (barring premature death).

This paradox is reflected in, and sustained by, separate approaches to theorising, separate models employed for understanding disability, separate approaches to policy-making, service delivery and to activism.

Gerontology and disability studies exhibit intellectual similarities: both share a foundation in political economy and a range of critical perspectives are now significant in both. Critical scholars identify cultural, discursive and relational issues common to disabled people and older people. Yet while critical gerontology and critical disability studies appear to have capacity to further explore issues of disability in older age, most critical approaches focus either on disability or ageing (Grenier, Griffin and McGrath 2016).

Separate models employed for understanding disability sustain the paradox. The dominance of the biomedical view was challenged by disability activism, and disability came to be seen as a social problem not an individual one. In post-social-model or critical disability perspectives, disability is characterised as a relationship between impairment, individual response to impairment, and the social environment (see Hosking, 2008; Shakespeare 2014). Contrariwise, medical definitions continue to dominate issues of ageing, leaving little room for, amongst other things, critical analysis of disabling social environments or social policy (Estes, Biggs and Phillipson, 2003). And gerontologists often talk about disability as if it were a personal characteristic, not something experienced in and contributed to by the environment (Putnam, 2002).

The paradox is evident in public policy-making in separate fields restricted to one or other area. Thus, public policies tend to suggest that people are either disabled or older, but not both (Bigby, 2008). A person who is considered ‘disabled’ at age 64 may be classified as simply ‘old’ at age 65 (Kelley-Moore 2010). Furthermore, policy-frameworks are not well developed for those ageing with long-standing disability.

The paradox is reflected in a further division at the level of activism. Despite common concerns within representative groups of older people or disabled people, a ‘strong counter-tendency’ exists (Priestly, 2002:368). Disability activists tend to be younger, older people tend not to be involved, and the issues mainly focused on are those affecting people of working age (Priestley, 2003; Shakespeare, 2014). At the same time, representatives of older people often focus on active ageing, and both movements distance themselves from the negative imagery of dependency in deep older age (Priestley, 2006).

These bifurcated approaches do not, I suggest, do justice to the issues involved. More nuanced understandings of the relationship between ageing and disability across the lifecourse are needed (Grenier, Griffin and McGrath, 2016). I wonder if one of the reasons that there has not been more cross-over is that disability is often understood as a negative and stigmatized identity position. But, as Goodley (2014:xi) argues, disability involves something more than issues of a stigmatised identity:

“Disability asks us to consider what we value in life.”

Goodley’s reference to ‘what we value in life’ points to the fundamental nature of the issues that are at stake. One way forward may be represented by the fact that critical theorists from the two fields now identify some common and profound issues that challenge orthodoxies in their fields and that assert the need for a realistic engagement with the nature of humanity, including its limitations.

For example, Shakespeare (2014) takes issue with orthodoxies in disability studies associated with the social model that exclude accounts of the body so as to politicize disability (while also valuing an emphasis on societal factors that disable people), and also with cultural disability studies (which he also considers valuable in many respects) that can suggest that impairment is only a matter or discourse. Instead, he argues for responses that link to lived experience, account for a human nature that has limitations and vulnerabilities and is ultimately mortal, while also acknowledging that life with disability can involve possibilities for adaptation and flourishing (Shakespeare, 2014).

Somewhat similarly, from within gerontology, Grenier, Lloyd and Phillipson (2017) argue for responses to ageing that develop from an acknowledgement of fragility and limitations rather than approaches organised around concepts of productivity, success, and activity. Baars (2010:115) argues that a cultural tendency to ignore finitude and limitations can exclude both disabled people and ‘the aged’. Crucially, he goes on to suggest that we risk overlooking the potential for meaning in ageing when we assume that loss is the whole of life with ageing on the one hand, and fail to reckon with the finitude of life, on the other (Baars 2017).

There are many reasons to bring the two fields of gerontology and disability studies closer together and there are both practical and analytical implications of doing so. Amongst these is the potential to make common cause between groups who are otherwise divided, and amongst whom are individuals dealing alone with challenges that seem to require collective responses. I suggest that we attempt to do so, not so that ‘disability’ as an identity should be reinforced as an end in itself, but so that we can be better served by realistic, inclusive approaches to the human condition across the lifecourse.

For more information about this line of research see my recently published article in the Journal of Aging Studies. 

References

Baars, Jan. 2010. “Philosophy of aging, time, and finitude.” In A Guide to Humanistic Studies in Aging: What does it mean to Grow Old, edited by Thomas Cole, Ruth Ray and Robert Kastenbaum, 105-120. Baltimore: John Hopkins University Press.

Baars, Jan. 2017. “Aging: Learning to Live a Finite Life.” The Gerontologist  57 (5):969-976.

Bigby, Christine. 2008. “Beset by obstacles: A review of Australian policy development to support ageing in place for people with intellectual disability.” Journal of intellectual and developmental disability 33 (1):76-86.

Estes, Carroll L., Simon Biggs, and Chris Phillipson. 2003. Social theory, social policy and ageing: A critical introduction. Buckingham: Open University Press.

Goodley, Dan. 2014. Dis/Ability Studies: Theorising Disablism and Ableism. Oxfordshire: Routledge.

Grenier, Amanda, Meredith Griffin, and Colleen McGrath. 2016. “Aging and Disability: The Paradoxical Positions of the Chronological Life Course.” Review of Disability Studies: An International Journal 12 (2&3).

Grenier, Amanda., Liz. Lloyd, and Chris. Phillipson. 2017. “Precarity in late life: Rethinking dementia as a ‘frailed’ old age.” Sociology of Health & Illness 39 (2):318-330. doi: doi: 10.1111/1467-9566.12476.

Hosking, David L. 2008. “Critical disability theory.” 4th Biennial Disability Studies Conference, Lancaster University, UK.

Kelley-Moore, Jessica. 2010. “Disability and ageing: The social construction of causality.” In The Sage handbook of social gerontology, edited by Dale Dannefer and Chris Phillipson, 96-110. London: Sage.

Oldman, Christine. 2002. “Later life and the social model of disability: a comfortable partnership?” Ageing and Society 22 (06):791-806.

Priestley, Mark. 2002. “Whose voices? Representing the claims of older disabled people under New Labour.” Policy & Politics 30 (3):361-372.

Priestley, Mark. 2003. Disability: A life course approach. Cambridge: Polity.

Priestley, Mark. 2006. “Disability and old age: Or why it isn’t all in the mind.” In Disability and psychology: Critical introductions and reflections, edited by Dan Goodley and Rebecca Lawthom, 84-93. Basingstoke and New York: Palgrave MacMillian.

Putnam, Michelle. 2002. “Linking Aging Theory and Disability Models: Increasing the Potential to Explore Aging with Physical Impairment.” The Gerontologist 42 (6):799-806.

Shakespeare, Tom. 2014. Disability Rights and Wrongs Revisited. 2nd ed. Abingdon, Oxon.: Routledge.

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4 comments

Hamish Robertson
Hamish Robertson February 2, 2018 - 8:50 pm

This is a very timely piece, so congratulations to the editors for having the foresight to accept this very interesting article and its links. I have been suggesting something similar to anyone who would listen for some time. The false separation of things that are clearly connected does not serve or assist the group at whom policies and services are purportedly targeted. Rather, they confuse the key issues and reduce older/disabled people to their ‘pathologies’. To push this out a little further, there has been a some interesting work done in geographies of care and also in feminist theories and analysis of care and caring that I think help clarify what is going on in this space. Social policy commodifies and reduces people to (a selection of) needs rather than acknowledging that levels of dependency exist across any human being’s lifespan, from infancy to death. Now if we could normalize that idea, we might get somewhere in humanising our all too frequently inhuman systems of ‘care’..

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Ashton Applewhite February 6, 2018 - 12:22 am

Hi Ann,

I’m an author & activist against discrimination on the basis of age, and keenly interested in the intersection of ageism and ableism, which, as you note, goes almost completely undiscussed. Secondly, I’ll be speaking in Dublin on March 2 at a conference at Trinity College called Headspace2018. Any chance we could meet up there. And/or please email me: ashton@thischairrocks.com.

Ashton
http://www.thischairrocks.com

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Susan Macaulay February 18, 2018 - 3:04 am

I suggest you take a look at this blog and contact its author: https://terrywiens.com/

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Shared stigma, separate silos—more on the intersection of ageism + ableism – This Chair Rocks March 7, 2018 - 7:02 pm

[…] and policymakers approach disability and aging as separate fields, as Ann Leahy observed in this post for the International Network for Critical Gerontology (daunting name, terrific resource). Why? […]

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