Aging with disabilities: Ageism and more (2005)

Double doses of prejudice and discrimination, problems with two service systems. People who are old and who also have disabilities-a growing proportion of the population-find themselves in double jeopardy of experiencing prejudice and discrimination, which often lead to difficulty gaining access to needed healthcare and social services. This article examines that situation and suggests what must be done if those who are with disabilities are to be better served by the and service systems. With older Americans living longer and healthier lives, recent trends suggest that is declining and possibly becoming less severe. Still, the combination of large numbers of baby boomers and the increased prevalence of accompanying age means that the size of the with will grow rapidly in the next decade (Robert Wood Johnson Foundation, 1996). Currently, 32 million people (12.5 percent) living in our communities have a sensory, mental, physical, or other that impairs their ability to take care of themselves; more than one in three (38 percent) is age 65 or older. Self-care affects 6.7 million people; adults age 65 and older constitute nearly one-half (3.1 million) of this group (U. S. Bureau of the Census, 2000). While has received considerable attention, the of the disability population has gone largely without comment. In the past, people with disabilities often did not survive even into middle age because of complications related to their disability. Now, for the first time in history, an estimated one of every ioo older Americans is with a long-term such as spinal cord injury, cerebral palsy, multiple sclerosis, postpolio, and intellectual or developmental disabilities (Ansello, 2004). Fifty years ago, the average life expectancy of an individual with spinal cord injury was less than three years after the accident occurred (Wirtz, Favor, and Ang, 1996). Today 40 percent of all survivors of such injury are 45 years of age and older (Menter, 1993), and more than one-half of the estimated 600,000 to one million polio survivors are now age 55 and older (Tompkins, 1997). Approximately 526,000 Americans age 60 or older are with intellectual or developmental disabilities (Hammel and Nochajski, 2000). Other groups with include 200,000 people with spinal cord injuries (Menter, 1993) and 600,000 with cerebral palsy (Lollar, 1994). Unfortunately, increases in longevity among the have brought new challenges. Many of those with long-term disabilities are experiencing unanticipated health problems (e.g., fatigue, pain) and functional declines (e.g., muscle weakness, mobility limitations) as they reach midlife (Campbell, Sheets, and Strong, 1999). These secondary health conditions are related to the effects of superimposed on the primary disability. The conditions have been described as premature aging because they occur about fifteen to twenty years earlier than would be the case with normal (Kemp and Mosqueda, 2004). A related problem is that people with disabilities may face early and forced retirement as they become physically unable to continue working. In such cases, they often have not had time to plan for how they will address typical retirement issues such as housing, health insurance, transportation, income, and caregiving (Torres-Gil and Putnam, 2004). Yet they remain too young to qualify for the age-based service system as they shift out of the service system, with its strong vocational focus. The resulting gap in services poses a threat to independence and quality of life for people with disability. STEREOTYPES OF AGE AND DISABILITY Older adults and people with disabilities often encounter prejudice, discrimination, and stigma. Ageism refers to an unreasonable prejudice (i.e., judging before one has sufficient evidence) against people because of their age. …