Ann Leahy, PhD.
It is said that finding the words is a step in learning to see . ‘Disability’ or ‘disabled’ are words not always used about people experiencing impairment in older age. If we experience, say, mobility limitations as we age, we tend not to be considered ‘disabled’ in the same way as children or young adults might be [2,3]. This was one starting point for a study I carried out in Ireland exploring physical and sensory disability through interviews with older disabled people and people working in social care.
As in many other countries, Ireland's public services are separately organised for older people and disabled people with age 65 as the boundary. I explored this with policy-makers, social care providers and advocates in the two fields of disability and ageing .
A key finding related to language. There was often no concept of ‘disabled older person’ except for someone ageing with lifelong disability. Participants simultaneously acknowledged that older people could experience impairment or disability with ageing, but not be seen as ‘disabled’. Instead, they were seen as ‘elderly’ or ‘older’. Some stressed the importance of positive images of ageing, but lacked a language with which to discuss people who do experience disability with ageing – other than it being implicit in ideas about marginalisation or exclusion.
I found that these understandings (of what it is to be older and impaired) were related to the separate policy/service frameworks for ageing and disability within which participants worked. This meant that some considered it appropriate that services should have different aims for the two groups. For example, some characterised what people experience in older age as ‘decline,’ closely linked to end of life, and perceived that services for them were appropriately medicalized and narrowly focused. By contrast, the aims for disability services were perceived to appropriately incorporate social participation and self-direction and to include rehabilitative aspects (even if services sometimes fell short of their aims in practice). Participants sometimes made it clear that this thinking was influenced by funding pressures and their perceived need to focus on their existing client group.
Other participants took a different view. In fact, most study participants critiqued the over-medicalisation of services for older people and the consequent inattention to social and emotional needs – several instanced how this could result in a task-based approach that did not meet service-users’ needs. One stressed how the two sectors fail to learn from each other. But even participants who disputed the domination of medicalized approaches to care for older people often lacked terms with which to discuss people first experiencing impairment in older age (other than ‘elderly’ or ‘older’).
Those participants who did use the term ‘disabled’ of older people with impairments came from the non-profit disability sector and invoked a biopsychosocial model of disability. Several referred to the U.N. Convention on the Rights of Persons with Disabilities as providing a definition capable of encompassing both people experiencing disability with ageing and those ageing with long-standing disability. For example, one felt that inadequate services to support older people to live at home in Ireland was a disability issue and a human rights issue, though not generally recognised as such.
The definition of disability in the Convention on the Rights of Persons with Disabilities is a biopsychosocial one in which disability is said to arise from the interaction of individual conditions with contextual factors, including the natural and built environment, support and relationships, attitudes, services and policies . By contrast, medical definitions dominate in the field of ageing. In other words, impairment in older age is seen as an individual, bodily issue, not something contributed to by broader environments in which people live.
One of my conclusions is that different understandings, different languages and separately organised and funded policy/service frameworks are factors in the maintenance of what one of my participants called ‘false dichotomies’ operating between the fields of ageing and disability. One implication is that even though the term ‘disability’ can be contentious , applying a biopsychosocial or interactional understanding of disability to the issue of older people experiencing impairment may be a prerequisite to bridging the separate fields of disability and ageing. It might also help with identifying broader societal causes and contributions to the experience of disability in older age.
In short, shared concepts around the issue of impairment and disability are needed to open up a dialogue between the policy and scholarly fields of ageing and disability. I am reminded of the line, ‘Naming these things is the love-act and its pledge,’ from Irish Poet, Patrick Kavanagh , in which he asserts the importance and transformative power of naming ordinary things.
 Popova, M. How naming confers dignity upon life and gives meaning to existence. [Online] https://www.brainpickings.org/2015/07/23/robin-wall-kimmerer-gathering-moss-naming/Accessed May 14 2018
 Priestley, M. (2002). Whose voices? Representing the claims of older disabled people under new labour. Policy & Politics, 30(3), 361–372.
 Priestley, M. (2006). Disability and old age: or why it isn't all in the mind. In D. Goodley, & R. Lawthom (Eds.). Disability and psychology: Critical introductions and reflections (pp. 84–93). Basingstoke and New York: Palgrave MacMillan
 Leahy A, 2018. “Too many ‘false dichotomies’? Investigating the Division between Ageing and Disability in Social Care Services in Ireland: A Study with Statutory and Non-Statutory Organisations”. 44: 34-44 Journal of Aging Studies.
 World Health Organization and the World Bank (2011:5). World report on disability. Geneva: World Health Organization.
 Graby, S. (2015). Neurodiversity: Bridging the gap between the disabled people's movement and the mental health system survivors' movement? In H. Spandler, J.
Anderson, & B. Sapey (Eds.). Madness, distress and the politics of disablement. London: Policy Press.
 From Patrick Kavanagh’s poem, Hospital. See Kavanagh, P. 2004 Collected Poems. Ed, Quinn A. London: Allen Lane.