THEMEANINGOFSUCCESSFULAGING
AMONG
OLDERADULTSWITHLONG‐TERMDISABILITIES
VictoriaM.Hanson
SubmittedtothefacultyoftheUniversityGraduateSchool
inpartialfulfillmentoftherequirements
forthedegree
DoctorofPhilosophy
intheSchoolofSocialWork
IndianaUniversity
October2015
AcceptedbytheGraduateFaculty,IndianaUniversity,inpartial
fulfillmentoftherequirementsforthedegreeofDoctorofPhilosophy
MargaretE.Adamek,PhD,Chair
DoctoralCommittee
RobertVernon,PhD
July30,2015
ValerieChang,PhD
LesaHuber,PhD
ii
©2015
VictoriaM.Hanson
iii
Dedication
Tomyhusband,sonanddaughter.Mayyoualwaysovercomeadversity,cope
withstrengthanddemonstrateresiliency.
iv
Acknowledgments
Iamgratefultotheprofessorswhotaughtandguidedmeduringmydoctoral
studiesatIndianaUniversitySchoolofSocialWork. Iamalsogratefultomy
dissertationcommittee–thankyouforthehoursyouspentreadingandoffering
feedbackonthisstudy.Iappreciateyourgenuineinterestinthetopicandyour
encouragementthroughouttheprocess.Dr.Adamekwastheonewholedmetothe
pathIneededtofollowwhenIwaslostandunsureofadirection. Iwasmeantto
studyolderadultsandhavelearnedatremendousamountfromthiswork.Iam
gratefultoallofthesocialworkers,physiciansandagencyemployeeswhoguided
metotheamazinggroupofolderadultswhoparticipatedinthisresearch.Iwill
alwaysrememberthestrengthandresiliencetheseolderadultstaughtmethrough
theirwordsduringtheseinterviews.
Iamalsogratefultomyparentswhomodelsuccessfulagingforme,their
grandchildrenandmysiblings. Iammostgratefultomyhusband,sonanddaughter.
Youwerepatientduringthedayswhenmommyneededtowork.
v
VictoriaM.Hanson
THEMEANINGOFSUCCESSFULAGINGAMONGOLDERADULTS
WITHLONG‐TERMDISABILITIES
Inthisstudy,Iexplorethemeaningofsuccessfulagingamongolderadults
withlong‐termdisabilities.Thestudyisareviewofscholarlyliteratureonthe
subjectofsuccessfulaging,withaspecificfocusonolderadultswithlong‐term
disabilities. Theobjectiveistoshedlightontheissuebycriticallyexaminingwhat
researchexistsandwhatresearchisstillneeded. Thepurposeofthisstudywasto
investigatethefollowingquestion: Whatdoesitmeanforanolderadultwithlong‐
termdisabilitytoagesuccessfully? Sevenolderadultswithsensoryimpairment,
eitherdeaf,hearingimpaired,blind,visuallyimpairedoracombinationofthese,
wereinterviewedusingqualitativephenomenologicalresearchmethods.Findings
includethemesofagingasinevitable,frequentactivity,socialandfamilyinteraction
asessential,senseofworth,acceptanceofdisability,copingandresilienceaswellas
advicetoothers.
MargaretE.Adamek,PhD,Chair
vi
TableofContents
ChapterI
Introduction
DemographyofAgingandDisability…………………………………………………………..1
ChapterII
ReviewoftheSuccessfulAgingLiterature…...……………………………………………11
ChapterIII
ResearchMethod…………….……………………………………...…………………..…...………38
ChapterIV
Findings………...…………………………………………………………………………………..……47
ChapterV
Discussion…………………………………………………………………………………………….…90
Appendices…………………………………………………………………………………….……….….……105
AppendixA:DemographicQuestionnaire
AppendixB:InformedConsent
References……………………………………………………………………………...………………………..110
CurriculumVitae
vii
ListofTables
Table1:DemographicInformation……………………………………………………………………..48
Table2:Themes,CodesandExamples………………………………………………………..…….…51
viii
ChapterI:Introduction
DemographyofAgingandDisability
AstheBabyBoomgenerationages,moreandmoreattentionisbeingpaidto
issuesinvolvingaging.TheBabyBoomgenerationconsistsofthoseindividuals
borninthepost‐WorldWarIIperiodbetween1946and1964. Theoldestamong
thiscohortreachedage65in2011andwillreachage85in2031;theyounger
memberswillreachage65in2029andage85in2049. BabyBoomerswill
representapproximately60millionoftheprojected69millionpeople65andover
in2030. Inthatsameperiod,theproportionoftheoldest‐old(80yearsandolder)
willincreasedramatically(U.S.CensusBureau,2010).
Associalworkers,itisimperativethatwestrivetobothmeettheneedsofthis
groupbuttoharnesstheirtalentstogivebacktotheircommunities. Onespecific
areaforsocialworkerstoconcentratetheireffortsinvolvesidentifyingwhatservices
canassistolderadultsinagingsuccessfully. Thewordagingisoftenassociatedwith
thewordproblem(Hagestad,1987;Weaver,1999),yetmanyolderadultsareactive,
healthyandinvolvedinthecommunity. Eveninadvancedoldage,manypeople
functionindependently(Haber,2007). Mostolderadultsarenotdependenton
othersandarenotadrainonfamilialandsocietalresources,butratherareavastly
underutilizedsocialresource(Hagestad,1987&Sherraden,Morrow‐Howell,
Hinterlong&Rozario,2001).
Thefollowingisareviewofscholarlyliteratureonthesubjectofsuccessful
aging,withspecificconcentrationonolderadultswithlong‐termdisabilities. The
objectiveistoshedlightontheissuebycriticallyexaminingwhatresearchexists
andwhatresearchisstillneeded. Thestudyalsoaddressestowhatextentolder
adultswithdisabilitiesviewthemselvesasabletoagesuccessfully. Muchofthe
researchavailableonsuccessfulagingdoesnotaddressolderadultswithlong‐term
disabilities. Thisresearchstudyproposedaddressesthisgapintheexisting
literature. Thisresearchaddresses,inpart,thefollowingquestion: Whatdoesit
meanforanolderadultwithalong‐termdisabilitytoagesuccessfully?
Whatisanolderadult? Definitionsofthetermvary. Forthepurposeofthis
project,olderadultsconsistofindividualsage55andolder. In1900,4.1%ofthe
UnitedStatespopulationwasage65andolder,nowthatpercentagehasmorethan
tripledto12.8percentoftheUSpopulation(AdministrationonAging,2001). In
2000,35millionadultsovertheageof65(13%)werecountedintheUSCensus(US
CensusBureau,2000). Themostrecentcensusdatashowthatthe65andover
populationwas40.3millionpersonsor13percentoftheUSpopulation(USCensus
Bureau,2010).
In2011,theUnitedStatesexperiencedthefirstwaveofbabyboomers
turning65;eachdayabout10,000Americansturn65(AdministrationonAging,
2001). ThenumberofolderAmericanswilldouble,from35millionin2000to70
millionbytheyear2030,increasingtheratioofAmericansoverage65fromoneout
ofeighttooneoutoffive(AdministrationonAging,2001;AllianceforAging
Research,2002). Thefastestgrowingsegmentwithintheolder‐adultcohortis
peopleage85andolder,thisgroupisexpectedtomorethandoubleby2030
(AdministrationonAging,2001). In2000therewere50,454Centenarians(people
100yearsandolder)intheUS,upfrom37,306in1990(USCensusBureau,2010).
2
Therapidriseinlifeexpectancy,coupledwiththedecliningfertilityrate
duringthepastcentury,hasacceleratedthegrowthintheelderlyportionofthe
population(Kaplan,Huguet,Orpana,Feeny,McFarland&Ross,2008). The
proportionofolderadults(60yearsorolder)intheworld’spopulationisexpected
toincreasefrom10%in2005to22%in2050(UnitedNations,2005).
AccordingtotheUSCensus,in2000therewere14.4millionmenand20.6
millionwomenage65andoverintheUS(USCensusBureau,2010). Withinthis
population,morementhanwomenaremarried,whilemoreolderwomenthan
oldermenarewidowed. Accordingly,mostoldermenresidewithaspousewhile
mostolderwomenresidealone.Mostolderadultsresideinmetropolitanareas.
DistributionsbyraceandethnicityshowthatHispanicsarethefastestgrowing
olderadultethnicgroup.Onlyfivepercentofolderadultsresideinnursinghomes.
Sixty‐sevenpercentofthepopulationage65andolderhaveearnedhighschool
diplomasand15%havebachelor’sdegreesorhigher. Themajorityofolderadults
havelowtomiddleincomesandpovertyaffectsolderadultsataboutthesamerate
asitdoesyoungeradults;approximately11.7%oftheolderpopulationisliving
underthepovertylevelsetbythefederalgovernment,comparedto11.9%ofthe
populationbetweentheagesof18and64(Hawkins,May&Rogers,1996). More
than12%oftheolderadultpopulationisinvolvedinthelaborforce(Hawkins,et
al,1996).
The2000Censusshowsthat49.7millionpeopleintheUnitedStatesagefive
andoverhaveadisability. ThisisnearlyoneinfiveUnitedStatesresidents. Of
those,5.2millionwerebetweentheagesoffiveand20;30.6millionwerebetween
3
theagesof21and64and14millionwere65andover(USCensusBureau,2010).
Thisisapproximatelyoneofthreeolderadults.
Worldwide,285millionpeopleareestimatedtobevisuallyimpaired.Thirty‐
ninemillionareblindand246millionhavelowvision.Eighty‐twopercentofpeople
livingwithblindnessareage50andabove.Globally,uncorrectedrefractiveerrors
(myopia,hyperopiaorastigmatism)arethemaincauseofmoderateandsevere
visualimpairment.Cataractsremaintheleadingcauseofblindnessinmiddleand
low‐incomecountries(WHO,2015a).
AccordingtotheWorldHealthOrganization(WHO,2015b)thereare360
millionpeople,overfivepercentofthepopulation,worldwidewhohavedisabling
hearingloss. 328millionofthesepeopleareadultsand32millionarechildren. It
maybeinherited,causedbymaternalrubellaorcomplicationsatbirth,certain
infectiousdiseasessuchasmeningitis,chronicearinfections,useofototoxicdrugs
orexposuretoexcessivenoise. Agingisalsoacauseofhearingloss(WHO,2015b).
Theparticipantsofthisstudyallexperiencednon‐age‐relatedhearinglossor
completedeafness.
Disabilityisademographicvariablesimilartoage,sex,racialethnicityand
socioeconomicstatus.Itisnotanegativehealthoutcome. Disabilityisamethodof
identifyingriskfactorsthatcontributetolessenedparticipationinlife. Olderadults
areoftenatriskoffacingisolationandlessenedparticipationinactivitiessuchas
working,votingandcommunitylife. Disabilityisstronglycorrelatedwithlow
education,povertyandreducedaccesstoresources (NIDRR’sDisabilityStatistics
CenterWebsitehttp://www.ed.gov/rschstat/research/pubs/research.html, 2007).
4
AgingasDecline
Ageismisthesystematicstereotypingof,anddiscriminationagainst,people
becausetheyareold(Butler,1969). Similartosexismandracism,ageismfailsto
lookatpeopleasindividuals,butinsteadjudgespeoplebyvirtueoftheir
membershipinasocialcategory. Ageismisalsoknownasprejudiceand
discriminationagainstolderpeoplebasedonthebeliefthatagingmakespeopleless
attractive,lessintelligentandlessproductive(Ferraro,1992). Ageismisa
longstandingphenomenon. Freud(1905)believed,“Psychiatrywasnotpossible
nearorabovetheageof50;theelasticityofthementalprocessesonwhichthe
treatmentdependsisasarulelacking–oldpeoplearenoteducable”(p.149). Inthe
20th centurythepredominantstereotypewasthattheagedwerepoorandfrail,and
thattheirchildrenoftendesertedthem(Quadagno,1999).
Morerecentstereotypesdepictolderadultsasaprosperous,selfishand
politicallypowerfulgroupwhoaregobblingupscarcesocietalresources(Binstock,
1996). Olderadultsarealsostereotypedas“Anunproductivesectionofthe
population,onethatdoesnotevenpromise(aschildrendo)onedaytobe
productive”(Fairlie,1988,p.19). Recentageismseesyoungerpeoplehavinga
tendencytopatronizeolderadultsandbeoverlysolicitous(Quadagno,1999). This
couldalsoincludeattitudesthatdiscourageolderadultsfromtakingrisks,dissuade
themfromexercisingandevendenytheirsexuality.
Therearemanymythsrelatedtoaging.Quadagno(1999)summarizedsome
keymythsandfacts:
5
 Myth:Mostolderpeoplearepoor. Fact: Morethan88%ofpeople
65andolderhaveincomesabovethepovertylevel.
 Myth:Theagedareisolatedfromfamilymembers. Fact: Thevast
majorityofolderpeoplehaveregularcontactwithfamily
membersandseeatleastonechildweekly.
 Myth:Mostolderpeoplearedisabled. Fact: Oldermenand
womenspendmorethan80%oftheirlivesfreeofdisability.
 Myth:Peoplebecomemoremellowastheygrowold. Fact:
Personalityisstable.Itdoesnotchangewithage.
 Myth:Nearly1/3ofpeople65andolderareinnursinghomes.
Fact:Fewerthanfivepercentofpeople65andolderareinnursing
homes.
 Myth:Theagedhavenointerestinsex. Fact: Althoughfrequency
ofsexualintercoursedeclineswithage,menandwomencontinue
tofindsatisfactionandenjoymentinsexualactivityastheyget
older.
 Myth:MostAmericansretireat65.Fact: Themajorityofmenand
womenareoutofthelaborforcebyage62.
Agingasdeclinecanbeseenasaparadigmorcommonbelief. Shiftingtoa
paradigmofsuccessfulagingnotonlyimprovesothers’viewsofagingbutwill
improveolderadults’viewsaswell,untilitisviewedasthenormtoagesuccessfully
insteadofbeingsickandalone.
Ableism
Thetermableismevolvedfromthedisabledpeoplerightsmovementsinthe
UnitedStatesandBritainduringthe1960sand1970s. Itquestionsandhighlights
theprejudiceanddiscriminationexperiencedbypersonswhosebodystructureand
abilityfunctioningwerelabeledas‘impaired’as“sub‐species.”Ableismofthistype
isasetofbeliefs,processesandpractices,whichfavorspecies‐typicalnormative
bodystructurebasedabilities.Itlabels‘sub‐normative’species‐typicalbiological
structuresas‘deficient’,asnotabletoperformasexpected(Barnes,2011).
6
Therearemythsandstereotypesthatexistrelatedtopeoplewithdisabilities.
Barnes(2011)highlightstheJudeao‐Christianreligioustraditionofjudginghuman
imperfectionsassignsofimpurity,divinejudgementanddiabolicalinfluence.He
concludes,ratherpointedly,that"prejudice,inwhateverformittakes,isnotan
inevitableconsequenceofthehumancondition,itistheproductofaparticularform
ofsocialdevelopmentassociatedwithwesterncapitalism(p.52).”
Livingwithaseveredisabilitycancauseyoutoagefaster(Kemp,2005).
Agingisanaturalandpredictableprocessoflifethatbeginsassoonastheperiodof
maturationanddevelopmentends,typicallyatabouttheageof20years.Agingcan
beviewedonanumberoflevelsincludingsubcellular,cellular,organsystem,
performance,psychologicalandsocial.Eachlevelhasitsownmeasureofaging.The
changespeoplegothroughreflectgradualdecreasesinfunctionatthecellularand
organsystemlevels(Forman,CarruthersandBondner,2009).
Overtheyearsorgansystemcapacitydeclinesgradually,overa50to60year
period,untilitreaches20%to40%ofpeak,atabouttheageof75years.Inpeople
withdisabilities,thisdeclineisacceleratedfromanaverageof1%peryearinthe
nondisabledpersontobetween1.5%and5%peryearforthedisabledindividual.
Whatisseenisthatadultswhohaveadisabilityaftermaturityseemtoageatarate
fasterthannormaladultsfromthatpointforward.Thosewhofaceadisabilityprior
tomaturitymayneverreachthatpeakcapacity(Kemp,2005).
Acceleratedagingwasfirstnoticedinpeoplewithpolioandlaterinthose
withspinalcordinjuries,traumaticbraininjuries,cerebralpalsy,amputationsand
otherconditions.Itdoesnotaffecteveryoneinthesamewayortothesamedegree,
7
butprematureagingisaproblemthatmeritsattention(Forman,etal.,2009,p.
271).
Untilabout1960,peoplewithcerebralpalsy,spinalcordinjury,Down
Syndrome,polioandotherimpairmentshadamuchshorterlifeexpectancy. Today,
mostpeoplewithmajorimpairmentscanexpecttoliveatleastintotheir60s.Some
peoplecanreachanormallifeexpectancyifgivenadequatecare(Forman,etal.,
2009). Thepotentialshorterlifeexpectancyforindividualslivingwithlong‐term
disabilityinfluencedthedecisiontodefinetheparticipantsinthisproposedstudyas
age55andolder.
Forthemostpart,thisincreaseinlifeexpectancyisduetothesamefactors
thatcontributetotheincreaseinlifeexpectanceforpeoplewithoutdisabilities.
However,increasedinterestandfundingforrehabilitation,bettertraumacare,
researchandtheenactmentofpro‐disabilitylegislationhavehadanadditional,
significantimpact.Aging,however,isstillharderandoftenfasterforpeoplewith
disabilities(Forman,etal.,2009).
Despitethegainsinlifeexpectancy,peoplewithdisabilitiesstilltendtoage
faster.Ageneralprincipleappearstobeemerging:the20/40rule.Thismeans
functionalissuesbegintoemergewhenapersonreaches40yearsofageorhas20
years’durationofdisability,whichevercomesfirst.Theseissuesgenerallyinclude
thefollowing:

Declineinphysicalfunction

Increaseinmedicalcomplications

Changesincaregiversupport
8

Declineinemotionalwell‐being(Forman,CarruthersandBondner,2009,
p.271).
Physicalcausesareusuallystraightforwardandeasytoidentify,suchas
overuseofmusclesandjointsfromyearsofusingamanualwheelchairinsteadofa
powerwheelchair.Emotionalcausesmaybemoresubtle,suchasdepressiondueto
changesincaregiversupport.Thephysicalandemotionaltollscombineandaffect
eachotherand,ifleftunchecked,cancauseadownwardspiralforbothmindand
body(Forman,etal.,2009,p.271).
Physicalcausesarerelativelyeasytofix.Forinstance,apowerwheelchair
canbeusedinconjunctionwiththemanualchair. Theuseofaself‐propelledchair
hasmanyadvantages,suchasstrengtheningoftheheart,lungsandupperbody
muscles.Theseadvantagesmustbebalancedwiththepossibilityofinjuryfrom
overuse.Exercise,massageandmonitoringofmusclesandjointscanprevent
injuries,misalignmentsandsecondarycomplicationsinwrists,elbows,shoulders
andneck.Thepowerwheelchaircanbeusedonlow‐energydaysortimeswhena
longdistancemustbetraversed.Thisway,thebestofbothworldsarebalanced
(Forman,etal.,2009,p.271).
Emotionalcausesofprematureaging,whilemorecomplexthanthephysical
ones,canalsobeaddressedandreduced.Mostpeopleconsidertheabilitytocontrol
andmanagetheirdailyactivitiestobeessentialtotheirqualityoflife.
Powerlessnessorlackofcontrolovercertainaspectsoflifeandthefuturecanbe
overwhelming.Achangeinthelevelofindependencewithaginghasbeenrelatedto
stress,depressionanddeclineinqualityoflife.Depressionoftenleadspeopleto
9
neglecttheirhealthandloseinterestinsocialactivitiesandwork,furtherincreasing
thedownwardspiral(Forman,etal.,2009,p.271).
10
ChapterII: ReviewoftheSuccessfulAgingLiterature
SuccessfulAging
Whatissuccessfulaging? Thetermfirstappearedin1961inthefirstissueof
thejournalTheGerontologist(Havinghurst,1961). Thetermisoftenused
synonymouslywiththetermsagingwellandproductiveaging. Interestinthe
determinantsofsuccessfulagingisgrowing.Moststudieshavefocusedonthe
absenceofdisabilityordeficitsinphysicalperformanceasoutcomes(Kaplanet.al.,
2008). Studiesshowthatlifestyledecisionssuchasquittingsmoking,managing
diet,exercisingandstayingactiveandinvolvedareallvastlymoreimportantthan
one'sgeneticinheritanceindetermininghowlongapersonlivesasafunctioning,
independentindividual(Vaillant,2002). JohnW.Rowe,presidentoftheMountSinai
SchoolofMedicineandMountSinaiHospitalinNewYorkCity,andRobertL.Kahn,
professoremeritusofpsychologyandpublichealthattheUniversityofMichigan,
haveamassedandanalyzedhundredsofstudiesinanattempttodepictsuccessful
aging.Theirbook,SuccessfulAging(1998),presentstheresultsoftheMacArthur
FoundationStudyofAginginAmerica,whichshowshowtomaintainoptimum
physicalandmentalstrengththroughoutone'slateryears.
TheaimoftheMacArthurFoundationStudyonSuccessfulAgingwasto
gatherknowledgetoimproveolderAmericans’physicalandmentalabilities.The
researchgroupconsistedof16scientistsdrawnacrossinterdisciplinarylines–
biology,neuroscience,neuropsychology,epidemiology,sociology,genetics,
psychology,neurology,physiologyandgeriatricmedicine.Theresearchershopedto
providefreshinsightsintosuccessfulaginginAmerica.Theyaimedtoemphasize
11
thepositiveaspectsofaging.Theresearchersworkedtowardapositive
understandingofonecentraltheme–effectivefunctioninginlaterlife,fromeachof
therespectivedisciplines.Theauthorsbelievethisstudyprovidesstrategiesfor
middle‐agedandolderpersonstoboosttheirchanceofagingsuccessfully,andthat
thestudyprovidesabasisfordevelopingeffectivepoliciesforthesuccessfulaging
ofAmericansociety.
In1987,anarticle(RoweandKahn,1987)basedonthisstudyappearedin
thejournalScienceentitled“HumanAging: UsualandSuccessful.”Theterm
successfulaginghassincebecomeapopularterminthefieldofgerontology.
Definingsuccessfulagingasenjoyingalowriskofdiseaseanddisease‐related
disability,maintaininghighmentalandphysicalfunction,continuinganactive
engagementwithlife,andavoidingunproven"remedies,"RoweandKahn(1987)
showhow,andwhy,growingold,reallyold,is,formost,anattainablegoal.Wecan
growoldnotjust"gracefully"buthappily,productivelyandsuccessfully. Itisthis
researcher’sunderlyingassumptionthatthiscanalsooccurforolderadultswho
haveadisability.
RoweandKahn(1987)indicatedsuccessfulagingmustcontainthree
components: 1)avoidingdisease,2)engagingwithlife,and3)maintaininghigh
physicalandcognitivefunction. Thisconceptualizationhowever,lacks
considerationforolderadultswithdisabilities;itassumesthatthosewith
disabilitiesareunabletoagesuccessfully.
Intheirculminatingreport,RoweandKahndiscussseveraltopics. First,they
describeagingandtheagingprocessandaddressanumberofcommonlyheld
12
beliefs,proverbsoridioms,ofaging. Bycontrastingthese(e.g.,“Tobeoldistobe
sick,”“Youcan’tteachanolddognewtricks,”“Thelightsmaybeon,butthevoltage
islow”)withscientificfindings,theauthorspositthatoursocietyisindenialof
someimportanttruthsofaging.Second,theydescribeandexplainthetermsusual
andsuccessfulaging.Third,RoweandKahnprovidepersuasiveevidencethat
environmentandlifestylearemoreimportantthangenesintermsofriskfactors
associatedwithaging.
Thefourththemeisbehavioralissuesrelatingtochangingthesethreekey
behaviorsandavoidingarangeofspecificdiseasesanddisabilitiescommoninlater
life(e.g.,cancer,heartdisease,stroke,osteoporosis). Theauthorsalsoaddressthe
importanceofexercise,nutritionandthemind‐bodyconnectioninmaintaining
physicalandmentalhealth,aswellasphysicalperformance.
RoweandKahn(1987)arguethatthemind‐bodyconnectionbecomes
increasinglypowerfulasweage.Forexample,weighttraining,evenfortheveryold,
notonlytonesmusclesandmaintainsbonemassinolderadults,italleviates
depression,creatingapositive,can‐doattitudethataddsincreasedenergyandadds
yearsofqualitylife.
TheWhitehallIIStudy(Wilcox,2012)beganrecruitingparticipantsin1985‐
1988foranobservationalepidemiologicstudy.Thestudyclinicallyexamined(at
intervalsofaboutfiveyears)acohortof10,308Britishmenandwomen,aged35‐55
yearsatbaseline,forvarioushealthoutcomes,includingdiseasesanddisabilities
thattypicallyoccurwithaging.Sabiaandcolleagues(2012)usedthesedataand
focusedonassessingsuccessfulagingfor5,100healthy,middle‐aged(42‐63year
13
old)menandwomenassessedduringthe1991‐1994examinationcycle.Strengthsof
thisstudyincludethelargenumberofparticipants(n=5,100),arelativelylong
follow‐up(median16.3years),detailedandanalysesandafocusonsuccessfulaging
astheprimaryoutcome.Moststudiesofhealthyaginghavefocusedonless
comprehensiveoutcomes,suchasaparticulardiseaseordisability(Depp&Jeste,
2006).Althoughsuchstudiesareimportant,thecollectiveoutcome(maintaining
relativelygoodhealthandhighfunctionalability)maybemostimportanttothe
agingpatientand,ultimately,isanimpactofagingonhealthcareandsocialsystems.
Despitethelimitationsoftenseeninlarge,observationalcohortstudies,
researchsuchasthisisvaluableforassessingthecomplexnatureofhumanaging.
Interventionalstudiesofagingthatcanshowcausationarepossibleinmodel
organismswithlimitedlifespans(e.g.,yeast,wormsandmice),butareimpractical
toperformwithhumans(Willcox,2012).Ofnote,thefactthatonly12%ofthe
participantsengagedinallfourhealthybehaviors(Rowe&Khan,1987)suggestswe
mayhavemuchtogainbycontinuingtoencouragepeopletodecreasesuchhabits.
Moreworkonthesocialorotherdeterminantsastowhysofewpeopleengagedin
allfourbehaviorsmayberequired.
Inanotherlargestudy,Vaillant(2002)identifiedfourfactorsthathelp
predictifapersonwillagesuccessfully. Thefactorsincludehealthyaging,
retirement,playandcreativityandacontinualsenseofintellectualandsocial
development(“generativity”). Thosefactorsincludenotsmoking(orstoppingby
age45),adaptivecopingstyle,noalcoholabuse,health,weight,stablemarriage,
14
someexercise,yearsofeducationandcultivationofarichsocialnetworkafterage
50.
Vaillant(2002)alsoidentifiedsixfactorsthatdonotpredictaging
well/successfulaging. Thesefactorsincludeancestrallongevity,cholesterol,stress,
parentalcharacteristics,childhoodtemperamentandeaseinsocialrelationships.
Thesefactorscanhaveapositiveornegativeeffectonaging.
Indeterminingthesecriteria,Vaillantdrewonthreelong‐termlongitudinal
studies:hisstudyof268Harvardmen(Vaillant,1977),astudyof456inner‐city
menatriskfordelinquency,and90womenfromtheTermanstudyofgifted
children. TheGrandStudyofHarvardmeninvolvedparticipantsanswering
questionnaireseverytwoyears,providingrecordsofphysicalexaminationsevery
fiveyearsandparticipatingininterviewsevery15years. Thesampleofinner‐city
mencompletedquestionnaireseverytwoyears. TheTermanwomenwerestudied
foralmost80yearsthroughquestionnaireseveryfiveyearsandinterviewsin1940
and1950. Allofthesestudiesfollowedtheirparticipantsfromchildhoodor
adolescencetothepresent;averagedatesofbirthrangedfrom1911forwomenin
theTermanstudyto1930fortheinner‐citymen.Thisstudyisparticularlyvaluable
becauseitpermitsexaminationofthepredictorsofhealthyagingfroma
longitudinalperspective.
Thefirstoftwomorerecentdefinitionsofsuccessfulaginginclude,“a
favorableoutcomeasperceivedbytheindividual,andhisabilitytocopeoradaptto
thecumulativechangesassociatedwiththepassageoftime,whileexperiencinga
senseofmeaningorpurposeinlife”(Flood,2002,p.105).Thesecondisthat
15
“successfulagingisnotadequatelyunderstoodasmerelongevity. Instead,itimplies
sufficientwell‐beinginanumberofspheres(mental,physical,social,spiritual,
economic)tosustainacapacitytofunctionsuccessfullyinthechanging
circumstancesofone’slife”(Inui,2003,p.391). Thesedefinitionstakeintoaccount
theentirepersonandthesystemsinwhichthepersoninteracts. Theyalsoseemto
bemoreinclusiveofdifferentgroupsofolderadults,includingthosewithdisabilities.
ThisisindirectcontrasttotheRoweandKahndefinitionwhichstatesthatonemust
avoiddiseaseandmaintainphysicalandcognitivefunction. Vaillantalsofailedto
includethosewithdisabilitiesinhissamples,thisledhimtodevelopcriteriaor
predictorsofsuccessfulagingthatexcludethosewithdisabilities.
Allofthesedefinitionsaredifficulttooperationalizeanddonottakeinto
accountnormalagingofpeoplewithdisabilities. Anotherproblemwiththeterms
successfulagingandagingwell,isthattherearethosewhoaresuccessful,orgoodat
agingandthenthosewhoareunsuccessfulorbadataging.
Giventhelackofaconsensualdefinitionofsuccessfulaging,DeppandJeste
(2006)searchedforEnglish‐languagepeer‐reviewedreportsofdata‐basedstudies
ofadultsoverage60thatincludedanoperationalizeddefinitionofsuccessfulaging.
Theauthorscategorizedthecomponentsofthesedefinitionsandindependent
variablesexaminedinrelationtosuccessfulaging(e.g.,gender,education,andsocial
contacts).DeppandJeste(2006)identified28studieswith29differentdefinitions
thatmetthecriteriaofhavinganoperationalizeddefinitionofsuccessfulaging.Most
investigationsusedlargesamplesofcommunity‐dwellingolderadults.Themean
reportedproportionofsuccessfulagerswas35.8%(standarddeviation:19.8),but
16
variedwidely(interquartilerange:31%).Multiplecomponentsofthesedefinitions
wereidentified,although26of29includeddisability/physicalfunctioning.
Themostfrequentsignificantcorrelatesofthevariousdefinitionsof
successfulagingwereage(young‐old),nonsmoking,andabsenceofdisability,
arthritis,anddiabetes.Moderatesupportwasfoundforgreaterphysicalactivity,
moresocialcontacts,betterself‐ratedhealth,absenceofdepressionandcognitive
impairment,andfewermedicalconditionsasbeingpredictiveofsuccessfulaging.
Gender,income,education,andmaritalstatusgenerallydidnotrelatetosuccessful
aging.Despitevariabilityamongdefinitions,approximatelyone‐thirdofolderadults
acrossthe28studieswereclassifiedas“agingsuccessfully.”Themajorityofthese
definitionswerebasedontheabsenceofdisabilitywithlesserinclusionof
psychosocialvariables.Predictorsofsuccessfulagingvariedyetpointtoseveral
potentiallymodifiabletargetsforincreasingthelikelihoodofsuccessfulaging.
Whileingeneraldisabilityisnot“modifiable,”thisstudywillexamineifolderadults
whohaveadisabilityseethemselvesasabletoagesuccessfully.
WilliamsandWirths(2006)lookedatstylesoflifeandsuccessfulagingasa
partofthelargerKansasCityStudyofAdultLife. Theyquantifiedwhichstylesoflife
(suchasworking,married,livingalone)wouldmakeonemorelikelytoage
successfullyorlesssuccessfully. Thisstudydidnotevaluatethoselivingwithanon‐
age‐relateddisability.
Usingafocusgroupapproach,Reichstadt,Depp,Palinkas,Folsom,andJeste
(2007)examinedtheopinionsofolderadultsaboutfactorsrelatedtosuccessful
aging.Twelvefocusgroupswereconductedwithanaverageofsixindividualsper
17
group.Participantsincluded72community‐dwellingolderadults(agerange:60‐99
years)recruitedprimarilyfromretirementcommunitiesinSanDiegoCounty,
California.Interviewtranscriptswereanalyzedusingagroundedtheoryframework
ofCodingConsensus,Co‐occurrence,andComparison. Thirty‐threefactorswere
identified,outofwhichfourmajorthemesemerged:attitude/adaptation,
security/stability,health/wellness,andengagement/stimulation.Everyfocusgroup
emphasizedtheneedforapositiveattitude,realisticperspective,andtheabilityto
adapttochange.Securityandstabilityencapsulatedone'slivingenvironment,social
support,andfinancialresources.Generalphysicalhealthandwellnesswere
frequentlymentioned,withmixedopinionsontheirnecessityforsuccessfulaging.
Finally,asenseofengagement,reflectedinpursuitofcontinuedstimulation,
learning,feelingasenseofpurposeinlife,andbeingusefultoothersandtosociety,
wasconsideredaprominentaspectofsuccessfulaging.Allfourthemesappearedto
beinterrelatedsuchthatengagementrequiredafoundationofsecurityandstability
whilepositiveattitudeandadaptationstrategiesoftencompensatedforimpaired
physicalhealth. Reichstadtandcolleagues(2007)concludedthatolderadultsplace
greateremphasisonpsychosocialfactorsasbeingkeytosuccessfulaging,withless
emphasisonfactorssuchaslongevity,genetics,absenceofdisease/disability,
functionandindependence. Theresultsaresimilartothosefoundinotherstudies
relatedtosuccessfulaging.Personsagingwithdisabilitieswerenotthetarget
populationparticipatinginthisstudy.
Theliteratureonsuccessfulagingrevealsawiderangeofdefinitions,
generallyreflectingtheacademicdisciplineoftheinvestigator.Biomedicalmodels
18
primarilyemphasizephysicalandmentalfunctioningassuccessfulaging;socio‐
psychologicalmodelsemphasizesocialfunctioning,lifesatisfactionand
psychologicalresourcesascomponentsofsuccessfulaging.Severalstudiesalso
identifythesefactorsastheprecursorsofsuccessfulaging.
Forthepastfourdecades,manystudiesseekingtodevelopadefinitionand
identifycriticaldeterminantsofsuccessfulaginghavebeenpublished.Todate,there
isstillnoconsensusonastandarddefinitionormeasureofsuccessfulaging.Most
constructshavebeenone‐dimensional,althoughafewhavebeenmultidimensional,
nonehasemergedasstandard.Themostseriouslimitationofcontemporary
successfulagingconstructsistheunduefocusonphysiologicaspectsofaging.To
movebeyondthelimitedperspectivethatstressesdiseaseandimpairment,Young,
FrickandPhelan(2009)postulatethatsuccessfulagingmaycoexistwithdiseases
andfunctionallimitationsifcompensatorypsychologicaland/orsocialmechanisms
areused.Withthispremise,theseauthorspresentanewdefinitionandconceptual
frameworkofsuccessfulaging,togetherwithanoperationaldefinitionthat
delineatestheirsuccessfulagingconcept.Theauthorsexamineifsuccessfulaging
andchronicillnesscancoexistinthesameindividual.Byallowingforthepossibility
ofchronicdiseaseandsuccesstocoexistwithinagivenindividual,thisconstruct
alsoattemptstorespondtotheconcernthatsomepublisheddescriptionsofsuccess
destinemostolderadults,whobyandlargehaveatleastonechroniccondition,to
failatagingsuccessfully.
Moreover,researchshowsthatolderpeoplegenerallyconsiderthemselves
tohaveagedsuccessfully,butclassificationsbasedontraditionalmedicalmodelsdo
19
not.Fewerstudieshaveexploredlayviews,andmostofthesehavebeen
exploratoryorrestrictedtospecificgroupsorareas(Bowling,2007). Throughout
thiscurrentresearchasocial‐psychologicalapproachisused. Noneoftheexisting
studiesfocusonolderadultswithdisabilities.
InarecentissueofTheGerontologist(February2015),SuccessfulAgingis
onceagainexaminedasthefeaturetopic.RoweandKahn’s(1987)creditremains
forpushingforththetermsuccessfulaginghowever,theycontinuetobecriticized
fortheshortcomingsintheirresearch. Severalarticlesintheissue(Riley,1998;
Katz&Calassanti,2014;Robinstein&deMedeiros,2014;Snowe&Cooney,2014)
criticizetheworkasseriouslyincomplete,asitneglectsthestructuralandsocial
factorsthatinfluencesuccessfulagingandsomecallforthetermsuccessfulagingto
beabandonedandotherssuchashealthy,positive,active,productiveandeffective
agingreplacetheterm.Theissue’seditorialmentionstheseandstates:
Itwouldbeirresponsibleforgerontologiststoabandontheconceptof
successfulaging.NearlythreedecadesafterRoweandKahn’sinitial
articlewaspublished,itisincumbentongerontologiststousethe
conceptualandempiricalknowledgebasethatnowexiststodevelop
consensusaboutwhatsuccessfulagingisandhowitshouldbe
measured.Weshouldapproachthisgoalknowingthatourmeasures
willnotbeperfect,butatleaseourfindingswillbecomparable.
Advancingthisworkwillhelpuslearnhowindividualscanexperience
successfulagingregardlessoftheirsocialorhealthconditions.Finally,
withanenhancedunderstandingofwhatsuccessfulagingis,wewill
beinastrongerpositiontodevelopinterventionsthatwillenable
morepeopletoagesuccessfully.thesheernumberofpeople
comprisingtheBabyBoomgenerationtransformedacademicinterest
insuccessfulagingtoapublicpolicyimperative.Nowmorethanever
itiscriticaltodevelopsciencethatempowerspeopletoexperience
thebestoldagepossible(Pruchno,p.4,2015).
20
ExplanatoryTheory
Successfulagingmaybeunderstoodfromtheperspectiveofseveraltheories.
Themostknownofthesetheoriesareactivity,disengagementandcontinuity
theories.
Theactivitytheoryofaging(Havinghurst&Albrecht,1953)positsthatolder
adultshavetheneedtostayactive,resistrolelossesandcompensateforlost
activitieswithnewroles. Activitytheoryviewssuccessfulagingasactiveagingand
statesthatthepsychologicalandsocialneedsofolderadultsarenodifferentfrom
thoseofmiddleagedadultsandthatitisneithernormalnornaturalforolderpeople
tobecomeisolatedandwithdrawn. Olderadultswhoremainactivearemore
satisfiedandbetteradjustedthanlessactiveolderadults.Aperson’sself‐conceptis
validatedthroughparticipationinrolesthatarecharacteristicofmiddleage. Itis
desirabletomaintainasmanymiddleageactivitiesaspossibleinlatelife. Ifa
personsubstitutesanewroleforoneofthoselost(duetowidowhoodor
retirement),theywillagemoresuccessfully. Forexample,ifoneisahomemaker
whileherhusbandworksbutthenthehusbanddies,thewidowcanbeginattending
aseniorcenterandparticipateinnumerousavailablesocialactivities. Criticsof
activitytheory(Estes,1983;Minkler,1984)arguethatitisprescriptiveinnature
becauseitadvisespeoplewhattodoandnottodotoagewell.Criticsalsoargue
thatadaptationtorolelossorrolechangeoccursbyremainingactiveandthisisnot
exclusivetoolderadults.
21
Themainideaofdisengagementtheory(Cumming,Dean,Newell,&
McCaffrey,1960;Cumming&Henry,1961)isthatthereisalossofrolesandenergy
duetoagethatmakespeopledesiretobedismissedfromtheirsocialexpectationsof
productivityandcompetitiveness. Disengagementisviewedasanadaptive
behaviorthatallowsforthemaintenanceofasenseofworthandtranquilitywhile
performingperipheralsocialroles. Disengagingisanorderlywayoftransferring
powerfromonegenerationtothenext.Thedisengagementprocessismutualand
haspositiveconsequencesforbothsocietyandtheindividual. Thepassingofalaw
practicefromfathertosonisanexampleofdisengagement. Thistheoryhasbeen
stronglycriticized(Hochschild,1975;Tornstam,1989;Achenbaum&Bengston,
1994;&Alkema&Alley,2006),includingevidenceamassedthroughstudieslikethe
DukeGeriatricProject,whichcontradictedthetheory’scorepremises.Today,
disengagementisviewedasaprocessthatsometimes,butnotalwaysornecessarily,
occurs.
Continuitytheory(Havinghurst,1968;Neugarten,Havinghurst,&Tobin,
1968)exploresthesubstitutionofroles. Agingpersonsareadvisedtosubstitute
newrolesforthosetheyhavelost.Bycontinuingtomaintaintypicalwaysof
adaptingtotheenvironment,olderadultsareabletomaintainaninner
psychologicalcontinuityaswellasanoutwardcontinuityofsocialandbehavioral
circumstances. Thetheoryrecognizeschangebutforcestheconceptofchangeinto
oneofcontinuity. Continuitytheoryassumesthatearlierstagesofdevelopmentset
thecriteriaforsuccessfulaging. Forexample,howoneadaptstostressearlyinlife
maynotbethesamelaterinlife.Theneedforcontinuitymayreduceaperson’s
22
self‐esteemwhenphysicalormentaldeclinesforceachangeinlifestylesheld
earlier. Forexample,ifoneissad,one’sadaptationstylemightbetogoshopping,
althoughheorshemightnotbeabletoaffordthepurchase. Thetheorywould
suggestthatthispersonwouldnotbesatisfiedwithlifebecauseoftheadaptation
choicesheorshemadewhentheywereyounger. Continuitytheorygetsintheway
ofapersonwhowishestostoporchangecertainbehaviorsorroles. Releasing
oneselffromformerrolescanbeliberating. Ifonefeltheorsheneededtobehave
onewayathisorherjob,thepersonmightlikethechangeofrolesinretirement.
Thetheory’sconceptofnormalandpathologicalaginghasbeencriticizedasfailing
tofocusonthemechanismspeopleusetocreatecontinuitywhenconfrontedwith
diseaseordisruption,andfordefiningnormalagingaroundamalemodel.
Insummary,activity,disengagementandcontinuitytheoriesfallshortin
explainingsuccessfulagingamongolderadultswithdisabilities. Burbank(1986)
concursinhercritiqueofthethreetheories. Sheidentifiesproblemswitheachof
thetheorieswhenthecriteriaofintersubjectivityofmeaning,testability,and
empiricaladequacyareusedintheevaluationprocess:
Ananalysisofrelevantresearchshowsthatnoneofthesethree
theoriesisclearlysupportedbyempiricalevidence.Becauseofthe
tentativenatureandlackofconclusivesupportforeachofthese
theories,furtherexplorationandtheorydevelopmentisneeded.Itis
suggestedherethataphenomenologicalapproach maybeamore
productivewaytostudythepsychosocialaspectsofaging(p.73).
Therearetwootherlesser‐knownandnotasthoroughlyresearchedtheories
relatedtosuccessfulaging:SocioemotionalSelectivityTheoryandSelection,
OptimizationandCompensationTheory(SOC). Thesearenotonlymorerecentbut
morerobustthanactivitytheory. Theyappeartoprovideamoreaccurate
23
descriptionofwhyandhowolderadultsmakedecisions,includingthose
contributingtosuccessfulaging.
ThefirstofthesetheoriesisSocioemotionalSelectivityTheory(Carstensen,
1991). Thistheorymaintainsthatperceivedlimitationsontimeleadto
motivationalshiftsthatdirectattentiontoemotionallymeaningfulgoals. Thetheory
positsthatincreasedattentiontoemotionalgoalsresultsingreatercomplexityof
emotionalexperienceandbetterregulationofemotionsexperiencedineveryday
life. Essentially,whenconcernsforthefuturearelessrelevant,attentiontocurrent
feeling‐statesheightens. Appreciationforthefragilityandvalueofhumanlife
increasesandlong‐termrelationshipswithfamilyandfriendsassumeunmatched
importance. Thetheorycontendsthatwhenperceivedlimitationsontimearemade
salient,similarshiftsbegininpeopleasyoungasadolescentsbutbecauseofthe
inextricableassociationbetweenageandtimeleftinlife,chronologicalage–on
average–isassociatedwithincreasedpreferencesforandinvestmentin
emotionallymeaningfulgoals.
ThesecondofthesetheoriesisSelectiveOptimizationandCompensation
Theory(Baltes&Baltes,1990). SelectiveOptimizationandCompensationTheory
contendsthatindividualswhoagesuccessfullyusethreestrategies:selection,
optimizationandcompensationtoachievedesiredgoals.Selectionincludes
identifyinggoals,prioritizingthem,establishingcriteriaandconditionsand
determiningthedegreeofcommitment. Optimizationreferstomaximizing
performancetofacilitatesuccess. Itinvolvesthedegreeoffocus,thetimingand
tenacityofgoalpursuit,learningnewskills,modelingotherswhoaresuccessful,
24
developingresourcesandincreasingtheamountoftimededicatedtogoals.
Compensationreferstoadaptingtolimitationsthatinterferewithgoals.Itincludes
theuseofassistivetechnology,obtaininghelpfromothers,developingnewskillsand
resources,employingpreviouslydiscardedskillsandresources,devotingmore
energyortimeandmodelingotherswhocompensatewell.Thistheoryseemsthe
mostapplicabletosuccessfulagingamongthosewithdisabilities. Itisinclusiveof
differentgroupsanddoesnotincludelanguagethatonemustbenon‐disabledin
ordertoagesuccessfully. Whileboththeoriesarelimitedbytheirlackofspecificity,
SelectiveOptimizationandCompensationTheoryappearstobethebestfittoguide
thisstudy,asitismoreinclusiveofdifferentgroups.
SuccessfulAgingandPeoplewithDisabilities
The2000Censusshowsthat49.7millionpeopleintheUnitedStatesagefive
andoverhaveadisability. Thisisnearlyone‐in‐fiveUnitedStatesresidents. Of
those,5.2millionwerebetweentheagesoffiveand20;30.6millionwerebetween
theagesof21and64and14millionwere65andover(USCensusBureau,2010). It
hasprovendifficulttoobtaintheexactextentofthepopulationdefinedinthisstudy.
Thiswillbeaddressedfurtherlaterinthisdissertation.
Whiletherehavebeennumerousstudiesrelatedtosuccessfulaging,thereis
littleresearchrelatedtosuccessfulagingamongpeoplewithdisabilities. Much
researchhasbeendonethatevaluatesage‐relateddisability,butthereisanabsence
ofresearchrelatedtoolderadultswithlong‐termdisabilityandtheirviewofaging
successfully. Thefollowingsectionhighlightspublicationsrelatedtosuccessful
aginganddisability.
25
In“SuccessfulAging:ADisabilityPerspective,”MinklerandFadem(2002)
refertothe“successfulaging”paradigmingerontologyandtheproblemsitposes
whenappliedtoagrowingpopulationofpeoplewhoareagingwithsubstantial
physicaldisabilities. Theprimaryassertionisthattheexistingdefinitionsof
successfulagingdonotaddressthoseagingwithphysicaldisabilities. Whilethis
articleidentifiestheissueofsuccessfulagingamongthosewithdisabilities,itdoes
notsupporttheseassertionswithempiricalevidence.
In“WomenwithDisabilitiesAgingWell:AGlobalView,”WalshandLeRoy
(2004)describeastudythatdrawsontheoralhistoriesof167womenin18
countries. Theinvestigatorsexaminedwhatwomenwhohaveintellectual
disabilities(i.e.,DownsSyndromeandAutism)experienceastheyageandexplores
contributingfactorstohealthyagingforthispopulation. Usinganecological
systemsframework,theyexaminedtheimportanceofeconomicfactors,healthand
nutrition,recreationandrelationships,aswellastheinfluenceofdisabilitypolicies
andprogramsonallofthesefactors. Theyinterviewedparticipantsusinga102
itemsurveygroupedintofivetopics:demographics,economicandpersonalsafety
nets,health,socialrolesandwell‐being. Theinvestigatorsemployedcollaborators
recruitedfromvariouscountriestoassistininterviewingparticipants.
Collaboratorswereaskedtorecruit10olderwomenwithintellectualdisabilitiesto
participateintheinterviews. Whiletherewasnostandardizationoftherecruitment
processforobtainingstudyparticipants,criteriaforparticipationwereset. Only
womenolderthan40withanintellectualdisabilitywereallowedtoparticipatein
thestudy. Bothqualitativeandquantitativedataanalysismethodswereused.
26
Participantsrangedinagefrom40–71yearsoldandthegeographicregions
representedinclude:NorthAmerica(UnitedStatesandCanada),Europe(Austria,
Belgium,England,Finland,France,Ireland,Italy,NorthernIreland,Norwayand
Scotland),SouthAmerica(ArgentinaandBrazil),Asia(JapanandTaiwan)and
Oceana(AustraliaandNewZealand).
Findingsrevealedthatthesewomenweredependentontheirexternal
economicandpersonalsafetynetsfortheirexistence. Respondentswerefairly
independentwithactivitiesofdailylivingandinstrumentalactivitiesofdailyliving,
however,theyacknowledgedthattheyreceiveassistancefrominformalandformal
supportsonadailybasis.
Astheauthorsacknowledge,thisstudywaslimitedbythelackof
standardizationintherecruitmentprocessoftheparticipants. Thestudy,however,
doesshedlightonwomen’sexperienceswithagingandlivingwithanintellectual
disability. However,fewerthanhalfwereovertheageof65. Thestudydidnotlook
atsimilarlysituatedmen.
Poon,GueldnerandSprouse(2003)conductedastudythatexploredthe
followingquestions:Howdoolderadultsapproachanddealwitheveryday‐life
whenaffectedbymultiplehealthproblems? Whatkindofimpactdotheyfeel
diseaseshaveontheirsuccessfulaging?Howdoexistentmodelsandtheoriesof
copingaddresstheseissues? Thestudywasbasedonasurveyof899menand
womenwhohadrespondedtoa1999follow‐upofthelongitudinalAlamedaCounty
Study. Thesedataconstitutethesecondwaveofasurveydesignedtostudythe
influenceofhealthpracticesandsocialrelationshipsonthephysicalandmental
27
healthofatypicalsampleofthepopulation.Thefirstwavecollectedinformationfor
6,928respondents(includingapproximately500womenaged65yearsandolder)on
chronichealthconditions,healthbehaviors,socialinvolvements,andpsychological
characteristics.The1974questionnairewassentto6,246olderadultswhohad
respondedin1965,andwereabletobelocated.Atotalof4,864individuals
respondedin1974.Respondentswereaskedaboutmaritalandlifesatisfaction,
parenting,physicalactivities,employment,andchildhoodexperiences.
Demographicinformationonage,race,height,weight,education,income,and
religionwasalsocollected(Kaplan,2006).
Thoseaged65orolderwhorespondedtothe1999follow‐upquestionnaire
intheAlamedaCountyStudyweresentanadditionalquestionnairewithitems
relatedtosuccessfulaging.Fiftyofthe899whocompletedsurveysalso
participatedinqualitativeinterviews. Thestudyassessedsuccessfulaging,physical
healthanddisability,mentalhealth,activitiesinoldage,healthbehaviors,qualityof
life,socialrelationships,religiosityandspirituality,neighborhoodandfinancial
problems,hearingimpairmentandvisionimpairmentwhileconsideringvariables
suchasage,sexandethnicity. Thefindingmostrelevanttothisproposalisthatof
thosewithmobilityimpairment,only17%ratedthemselvesasagingsuccessfully.
Why? Thisistheresearchstillneeded.
Arecentstudyofolderadultslookedatseverevisionimpairment,hearing
impairmentandsuccessfulaging(Wahl,Heyl,Drapaniotis,Hormann,Jonas,Plinkert,
&Rohrschneider,2013).Thequantitativestudyconsideredabroadrangeof
successfulagingindicatorsandcomparedolderadultswithvisionimpairment,
28
hearingimpairmentanddualsensoryimpairmentsandwithoutsensory
impairment.Participantsunderwentawide‐rangingassessment,coveringeveryday
competence,cognitivefunctioning,socialresources,self‐regulationstrategies,
cognitiveandaffectivewell‐beingandfour‐yearsurvivalstatus.Allofthe
participantshadlate‐lifesensoryimpairment,notalong‐termdisability. Onestudy
conclusion,relevanttothisresearch,isthatinvestinginmaintainingeveryday
functioninginrehabilitationprogramsseemscritical. Limitationsofthisstudywere
thatthesamplesizesweresmallandrelatedtothisresearch,didnotaddressolder
adultswithlong‐termhearingorvisiondisability.
Afewrecentstudieshavelookedspecificallyatthoseagingwithparticular
diseases:HIVandsicklecelldisease. Eachstudyproposesdifferenttheoretical
constructsinwhichtoevaluatesuccessfulagingamongpeoplelivingwithHIVand
sicklecelldisease. TheresearchrelatedtosuccessfulagingwithHIVproposesusing
hardinessasaconstructbywhichtoevaluatesuccessfulagingamongthoseliving
withHIV. ThefirstofthethreeHIV‐specificsuccessfulagingpublications(Vance,
Burrage,Couch&Raper,2008)isareviewofliteratureinnursing,gerontologyand
HIVrelatedtohardinessandhowitrepresentsawaytopromotewellnessand
facilitatesuccessfulagingwithHIV. Inthissynthesisoftheliterature,hardiness
servesasapsychologicalresourcetodescribe,explainandhypothesizehowpeople
mayagesuccessfullywithachronicillness,inthiscase,HIV. Articlesreviewedwere
selectedbasedontheirrelevancetotheconceptualdefinitionofhardinessand
successfulaginginreferencetoHIV. Theauthorspointoutthatduringtheselection
process,seminalarticleswereincludedbecausemorerecentstudiesonthistopic
29
werenotavailable.Theauthorsdescribehardypeopleasthosewhoexertcontrol
overcircumstancesintheirlivesandremaincommittedtotheirlivesandintricately
involvedwiththeirownactivities. Thisstudy,aswellastwosimilarstudies
publishedduring2009(Vance,Struzick&Burrage;Vance,Childs,Moneyham&
McKie‐Bell,2009)offersomeinsightintotheissuesthatmightinfluencehardiness
orsuccessfulagingwhenfacedwithachronicillnessordisability. Suchissues
includestigmaandsocialisolation,decreasedcognitiveandphysicalfunctioning
andsynergisticeffectswithage‐relatedcomorbidity.
JeneretteandLauderdale(2008)usedqualitativemethodsinapilotstudyto
informtheoryrelatedtosuccessfulagingforpeoplewithsicklecelldisease. They
interviewedsixolder‐adultwomenrecruitedfromtwourbansicklecellclinicsin
theU.S.Theyconcludedthatidentifyingvulnerabilityfactors,self‐caremanagement
resourcesandhealthoutcomesinadultswithsicklecelldiseasemayaidin
developingtheory‐basedinterventionstomeetthehealthcareneedsofyounger
individualswithsicklecelldisease. Theyconcludedthatusingalifereview
approachisausefulprocesstogaininsightintosuccessfulagingofadultswith
sicklecelldiseaseandotherchronicillnesses.
Dabelko‐Schoeny,AndersonandSparks(2010)performedapilotstudyof
civicengagementofolderadultswithfunctionallimitations.Theystudied
participantsintwoadultdaycenters. Onecenterwasusedasacontrolgroup,
measuringolderadult’scivicengagementwithusualprogramingatthecenter.The
othergroupincludedinterventionsofeducation,serviceandrecognition. These
included,amongotherthings,learningaboutmilitarypersonnelservingoverseas,
30
packingcarepackagesforthemandthenpresentingthecarepackagestothem.
Participantsinthestudyweredescribedashaving“moderatefunctional
impairment”withnomentionofthetype,causeordurationoftheimpairment.The
studywasapilotbutdidfindthatthoseintheinterventiongroupreportedhigher,
yetnon‐significant,levelsofpurposeinlife,self‐esteemandperceivedphysical
healthcomparedtothoseinthecontrolgroup.
Romo,Wallhagen,Yourman,Yeung,Eng,Micco,Perez‐StableandSmith
(2013)performedaqualitativestudyofperceptionsofsuccessfulagingamong
diverseelderswithlate‐lifedisability. Therewereseveralsimilaritiesand
significantdifferencesbetweentheRomoet.al.(2013)studyandthisstudy. Both
usequalitativeresearchmethodstointerviewolderadultswithdisabilitiesabout
theirperceptionsofsuccessfulaging.The2013studyaskedadiversegroupofolder
adultsfourquestions:
1.Researchershavecomeupwiththeterm“successfulaging.”Whatcomes
tomindwhenyouhearthatterm?
2.Whatdoesitmeantobeold?
3.Doyoufeelyou’veagedsuccessfully?
4.Doyoufeelold?
Interviewslastedanaverageof30minutes. Participantsallexperiencedsome
degreeoflate‐lifedisabilityor“agerelateddisability.”Athemeintheinterviewsis
thatmanyparticipantsfeltliketheywere“livinganewreality”relatedtotheir
disability. Therewerethosewhoacceptedoracknowledgedthenewrealityof
livingwithadisabilityandthosewhorejectedthisreality.Thosewhoacceptedthe
31
newrealityviewagingasanunavoidablenaturalprocessthatincludesage‐related
disability.Thosewhowereviewedasrejectingthenewrealityoflivingwitha
disabilitygenerallydidnotviewthemselvesasold.Theydenieddependenciesand
viewthemselvesascompletelyindependent.
Theserecentstudiesoffersomeinsightintotheissueofdisabilityand
successfulaging,butdonotfullyexplainsuccessfulagingandlivingwithlong‐term
physicaldisabilitiesamongthebroaderpopulationofagingmenandwomen.
Theabove‐mentionedstudiesfailtoaddressasignificantgapintheliterature
relatedtopersonswithlong‐termdisabilitiesagingsuccessfully. Previously,I
completedapilotstudyofsuccessfulagingandinvolvementinseniorcenters. An
outlineofthatstudyfollows.
PilotStudy
Icompletedapilotstudyduringthe2003/2004academicyearinwhichI
completedinterviewswiththreenon‐disabledolderadultmembersofasenior
center. Isoughttofindouttheirlivedexperienceofagingandwhatagingwell
meanstothem.Theinterviewquestionswereasfollows:
1. Tellmewhatitmeanstoage.
2. Describeformeatypicaldayinthelasttwoweeks. Howisthatdifferent
fromhowyoufeltonatypicalday30yearsago?
3. Thinkofagreatdayyouhavehadinthepastfewmonths. Walkme
throughthatday.
4. Doyouseeyourselfasagingsuccessfully? Whatdoesthatmeanforyou?
Whatdoesitlooklikeforonetoagewell?
32
5. Ifyoucouldpicktheperfectagetoliveforever,whatagewouldthatbe
andwhy?
6. Whatadvicecouldyougivemethatwouldhelpmeagewell?
7. Isthereanythingelseyouwouldlikemetoknowaboutaging?
Priortointerviewingthethreeolderadults,Icontactedaninformantatthe
IndianapolisSeniorCenter. Idiscussedthisstudywithherandobservedactive
olderadultsatthecenter. Icompletedaninterviewwiththeinformantand
reviewedtheinterviewquestionswithher. Iincorporatedhersuggestionsintomy
interviewplan.Theinformantalsogavemethenamesandcontactinformationof
potentialinterviewcandidatesforthisstudy. TheIndianapolisSeniorCenter
requiresthatmembersare55yearsofageorolder– thereforemystudy
participantswereatleast55yearsofage. Iaskedtheinformanttosuggest
interviewparticipantsthatsheperceivedasagingwell.
FindingsfromPilotStudy
Thetargetgroupincludedadultsage65andoverwhoweremembersofthe
IndianapolisSeniorCenter. Myparticipantsincludedthreewomenaged70,78and
78. Allwerewidowed,Caucasianandmothers. Thethreewomenparticipatedin
approximatelyonetotwohourrecordedinterviewsattheseniorcenter.
Upontranscribingtheinterviewtapesandevaluatingthosetranscripts,
severalthemesemerged. ThethemesIidentifiedincludedthefollowing:

beingneeded

interactionacrossthegenerations

impactonothers
33

feelingyoung

influenceofothersonselfworth

church/spirituality/religion

family

transition

charitywork/volunteer

keepingbusy

givingback

friendship/socialinteraction

activity

lackofstructure

touching–socialinteraction

health

aging

familyhistory

personalhistory

copingstyle

age

belonging
Ithennarrowedthesethemestoafewbroaderthemes:activity,socialinteraction,
spirituality,health,coping,senseofworthandfreedom.
34
Manyoftheinterviewresponsesrelatedtoactivity. Theseactivitiesincluded
activitiesattheseniorcenter,choirpractice,exercise,danceanddriving. For
example,whenaskedwhatatypicaldaywaslikeforher,oneparticipantstated,
Well,Mondayisareallybusyday.I’muphereallday. 10:00isa
meetingonseasonswimmerswhichisahealthylifestylesgroup.
11:00isthepianolessonandthenIdomyexercisesfromabout11:45
until12:30. AndthensometimesIusuallyhaveameetingofsome
typeataround1:30soI’musuallyhereuntilaboutthree. Otherthan
thatatypicalday…I’malwaysupat6:00.That’swhenthealarmgoes
off. Itakeadailypaperandreaditanddothecrosswordpuzzle
–religiously. ThenImaygetontothecomputer. 9:00thereisanhour
ofcraftswithCarolDuvalthatIwatch. Herprogramnowisat9and
9:30.Whichisokay.Let’ssee,IhaveBiblestudyonTuesday
morningsthatI’llgotoat10:15andthat’soutatabout11:30.Then
I’llgotothethriftstoretoseewhatbargainsarethere…
Anotherthemewassocialinteraction,whichincludedmentionoffriendships,
groupactivities,andfamilysupportandinteraction:
[agingsuccessfullyis]“Beingabletomeetnewfriendsandkeepthe
oldones.Havingfriends.Stayingsocial.”Anotherwomandescribeda
specialfriendshipformedattheseniorcenter. “ImetEmmahereand
Ipickherupandwegodancing…shealwayswatchesthebulletin
boardshereforustogotothedifferentplacesthatarefreeforusto
goto.Ilikeherasafriendbecauseshealwayswatchesthebulletin
board.
Thenextthemeidentifiedwasspirituality. ThewomendiscussedhowGod
helpsthemintimesoftrouble.Theyallmentionedthattheyareall“religious”but
notallattendchurchregularly. Allthreementionedthattheypray.“Ofcourse,Ihad
alittlehelp.[pointstowardheaven] Alotofhelp.Ifithadn’tbeenforthatIdon’t
knowwhatIwouldhavedone.”“IbelieveinGodthat’sforsure.”“IbelieveinGod
throughJesusChrist.So,wearesupposedtoglorifytheLordaren’twe,inallwedo
andallwesay.”
35
Anotherthemementionedbyeachwomanregardingagingsuccessfullywas
health.Thisincludedexercise,eatingrightandrestingwhenneeded. Allconcurred
thatpoorhealthcanslowthemdown. Twowerespeakingfromexperienceasthey
describedhavingjointproblemsthatoccasionallylimitedtheiractivity.
Ifthese(knees)didn’thurtthatwouldbegreat.Ithinkwhenyou
startandgetto55thatiswhenyoustarttofeel…youhadachesand
painswhenyouwereyoungbutyouarestartingtorealizethatthey
dohurt.Sometimesyougetupsetbecauseyouthink‘I’mgettingolder
soIcan’tdothisorthat.’Itrynottosaycan’tbutsometimesyou
can’t.It’simpossiblebecauseithurtsbad.
Anadditionalthemethroughouttheinterviewswascoping. Thewomen
describedhowtheydealtwiththelossoflovedones,specificallylossofchildrenand
spouses. Thedominantthemeintheircopingexperienceisthattheymoveon–they
donotdwellontheirproblems. Eachalsomentionedprayerasasignificantmethod
ofcoping.“Itwashardforawhilebutyousurvive.Youcan’tjustdwellonthings–
you’dbelost.”“IfIcandosomethingaboutitIdoit.IfIcan’tIsleeponit.You
know,ifyouloseyourjobyougooutandfindanotherone. Ifyouloseyourson
there’snothingyoucandosoyousleeponit.Youdothingstorememberthemin
thebestlightthatyoucan.Idon’tknow–stressfultimes…IfIcandosomething
aboutit,Idoit.IfIcan’tIsleeponitandhaveanewoutlookthenextday. AndGod
helps,someprayers.”
Anotherthemeexpressedbythewomenwasasenseofworth. Several
thingswerementionedbythewomenasimportanttoinfluencingtheirpositive
senseofworth. Theseincludedvolunteering,givingbacktoothers,beingneeded,
interactionacrossthegenerations,impactonothers(children),feelingyoungand
theinfluenceofothersorselfworth“you’reasyoungasyoufeel.”“Thereissomuch
36
workthatcanbedonetobehelpful.”“Ithinkthenicestthingwasher(childshewas
mentoring)askingmyadviceonthings. Ithinkitisnicetofeelthattheystillrespect
youropinion.”
Thefinalthemethatemergedduringtheinterviewswasasenseorfeelingof
freedomtochoosetheiractions.“NowI’malittlefreertonotdothedishesifIdon’t
wanttoforacoupleofdays.”“Ididnotjoinuntilaftermychildrenwereolder…well
IthoughtnowIhavedonethatjobsonowI’mgoingtodosomethingforme.So
that’swhyIdoit.”
Thepilotstudyprovidedvaluableinformationrelatedtowhatolderadults
viewassuccessfulaging.Hearingdirectlyfromthesewomenaddedtomy
understandingthattheseolderadultsdidnotnecessarilyseethemselvesas“aging
successfully,”however,theydescribedsimilarthemesrelatedtowhytheymightbe
perceivedbyothersassuccessfullyaging. Theysharedcommonideasandlifestyles
relatedtoactivity,socialinteraction,spirituality,health,coping,senseofworthand
freedom. Uponcompletionofthispilotstudy,Isearchedtheliteraturetodetermine
ifolderadultswithdisabilitieswouldhavethesameoutcomesasthoseliving
withoutdisabilityandfoundverylittleinformation. Thepilotstudydidnotconsider
disabilityasavariablewhenselectingthestudyparticipants. Thisstudycouldbe
takenfurther,however,andaddressthegapinthecurrentliteraturerelatedto
olderadultswithlong‐termdisabilities. Dobothgroupsviewagingsuccessfully
similarly? Dobothgroupsperceivethemselvesasagingsuccessfully? Evaluating
theseperceptionsamongolderadultswithlong‐termdisabilitiesisthefocusofmy
dissertationresearch.
37
ChapterIII: ResearchMethod
Theparticipantsofthisresearchdifferfromthepilotstudyinthattheyare
allolderadultswhohavesometypeoflong‐termphysicaldisability. Thedefinition
ofdisabilityIusedastheoperationaldefinitionforthisstudyisthatofthe
AmericanswithDisabilitiesAct(ADA),PublicLaw101‐336.TheADA’sprotection
appliesprimarily,butnotexclusively,toindividualswithdisabilities.Theterm
disabilitymeans,withrespecttoanindividual:
‐aphysicalormentalimpairmentthatsubstantiallylimitsoneormoreofthemajor
lifeactivitiesofsuchindividualssuchascaringforoneself,performingmanualtasks,
walking,seeing,hearing,speaking,breathing,learning,andworking;
‐arecordofsuchanimpairment;or
‐beingregardedashavingsuchanimpairment.
Theparticipantsinthisstudyallhavealong‐termdisabilitylasting
approximately20yearsorlonger. Thisdistinguishesthestudypopulationfrom
olderadultswithage‐relateddisability. Disabilitiesthatlimitcognitionwerenot
includedinthisstudybecauseIconductedinterviews;theparticipantsofthisstudy
neededtohavecognitivecapacitytoanswerquestions. AlimitationIpreviously
pointedoutwhendescribingcurrentliteratureavailablerelatedtosuccessfulaging
amongolderadultswithdisabilitiesisthatstudyparticipantshavemostlybeen
women. Iwasabletoincludemeninthesampleofresearchparticipants.
Participantssharedtheirthoughtsaboutsuccessfulagingandthelivedexperience
ofagingwithadisability.
38
Thisisaphenomenologicalstudyofolderadultsandtheirviewsonaging.
Informationwasgatheredthroughopen‐endedinterviewswitholderadultswith
disabilities. Followingphenomenologicalresearchmethods,Isoughtan
understandingfromin‐depthinterviewsaboutwhatitmeanstoagewell. Iwanted
tofindouttheirlivedexperienceofagingandwhatagingwellmeanstothem. The
studyparticipantsillustrateddisabledolderadults’perceptionsofaging
successfully. Theseperceptionsincludedbothpositiveandnegativecomponents.
Throughthisstudy,Ihopedtogainanunderstandingofwhatagingwell
meanstoolderadultswithalong‐termphysicaldisability. Ihopedtogain
knowledgeofwhatagingwellmeanstoolderadultswithdisabilitiesandhowthey
perceiveother’sviewsofthem.Thisinquiryisimportantbecause,asstated,the
wordagingisoftenassociatedwiththewordproblemduetoadominantimageof
oldageasoneofinevitabledecline,senilityanddependence. Whilesomeolder
adultssufferdecline,isitinevitableforallolderadultswithdisabilitiesordosome
perceivethemselvesasagingsuccessfully? Associalworkersitisimportantthatwe
haveaccurateknowledgeoftherealityofaging.Itencompassesourprofession’s
focusonthestrengthsperspective. Findingoutwhatagingwellmeanstothosewho
arelivingtheexperiencegivessocialworkersthetoolstoworkwithallolderadults.
Ihopedtoidentifythoseaspectsofolderadults’livesthatinfluencewhether
ornottheybelievetheyareagingsuccessfully. Thisprojectaddressesthequestion:
Whatdoesitmeanforanolderadultwithalong‐termdisabilitytoagesuccessfully?
Priortothisstudy,IdidnotknowifIwouldfindthemesdifferentfromthepilot
study. AbiasIholdisthatitispossibleforolderadultswithdisabilitiesperceiveto
39
themselvesasagingsuccessfully. Imanagedthisbiasbybracketingthisnotionand
learningtherealityoftheperceptionsfrommyparticipants. IexpectedthatImight
discoverdifferentthemesintheirstatementsofwhatinfluencestheirperception;I
also,however,expectedthatregardlessofability,thethemesfoundinthepilot
studyandexistingotherresearchmentionedinthisproposalwouldbeconsistent. I
believethatonelikelyneedstohavesomeamountofactivity,socialinteraction,
spirituality,health,coping,senseofworthandfreedominordertoagesuccessfully.
Therearevaryingdegreesofeachofthese,ofcourse. Ilookedforwardtofinding
outwhereolderadultswithlong‐termdisabilitiesperceivethemselvesasfitting
alongthiscontinuum.
Thisisaphenomenologicalstudyofolderadultswithdisabilityandtheir
viewsonagingwell.Aphenomenologicalstudydescribesthemeaningofthelived
experiencesforseveralindividualsaboutaconceptorthephenomenon(Creswell,
1998). Throughindividualinterviews,Iexplored,fromparticipants’perspective,
whatitmeanstoagewell.IselectedphenomenologybecauseIwantedtofindout
fromtheparticipantstheirperceptionsandthemeaningofthoseperceptions,in
theirownwordsandbasedontheirlivedexperiences. Becauseagingisoftenseen
as“decline,”Iwantedtofindoutifthosewhoarealreadylivingundercertain
limitationshandleagingdifferentlyorhaveadifferentperceptionofaging
successfully.
Phenomenologyisaprocessofexploringone’sinterestsandunderstandings
ofaphenomenon,uncoveringtheessenceofthatphenomenonbygatheringstories
fromthoselivingit,interpretingthosestoriesandofferingimplicationsforpractice.
40
Thismethodoffersauniqueapproachtounderstandingandinterpretingindividual
experiences. Phenomenologyisrootedintheideathateverydayexperienceis
worthyofexamination. Forexample,agingisaneverydayexperienceworthyof
examination. Therawdataofphenomenologicalstudyarepersonalexperiences.
Suchexperiencesmaybegatheredthroughinterviewing,observing,reading,writing
andliving(Glesne,(1999).
Thosewhousethephenomenologicalmethodarecalledtorecognizeandlive
inthestrainbetweensubjectandobject.Thescientificparadigmexpects
researcherstobeobjectiveabouttheparticipantsoftheirstudy. Yet,aresearcher
whoisphenomenologically‐orientedbelievesthatthereisnosuchthingas
objectivity.Phenomenologistsrecognizetheresearcher’sroleinshapingthe
researchprocessandinterpretingthemes. Thus,theroleoftheresearcheris
examinedwithinaphenomenologicalstudy. Theparticipantstheresearchertalks
withtogainabetterunderstandingoftheireverydayexperiencearenot“subjects,”
butactiveparticipantsinthestudy. Thegoaloftheresearchprocessisnotjustto
examinetheparticipants’experience,buttocreateasituationinwhichreciprocal
learningcanoccur(Glesne,1999).
Phenomenologistsexplorethestructuresofconsciousnessinhuman
experiences(Polkinghorne,1989). Glesne(1999)summarizesthemajorprocedural
issuesinusingphenomenology:

Theresearcherneedstounderstandthephilosophical
perspectivesbehindtheapproach,especiallytheconceptof
studyinghowpeopleexperienceaphenomenon. The
conceptofepocheiscentral,wheretheresearcherbrackets
hisorherownpreconceivedideasaboutthephenomenon
tounderstanditthroughthevoicesoftheinformants.
41




Theinvestigatorwritesresearchquestionsthatexplorethe
meaningofthatexperienceforindividualsandasksindividualsto
describetheireverydaylivedexperiences.
Theinvestigatorthencollectsdatafromindividualswhohave
experiencedthephenomenonunderinvestigation. Typically,this
informationiscollectedthroughlonginterviewswithinformants
ranginginnumberfromthreetoten.
Thephenomenologicaldataanalysisstepsaregenerallysimilarfor
allpsychologicalphenomenologistswhodiscussthemethods. The
originalprotocolsaredividedintostatementsorhorizonalization.
Then,theunitsaretransformedintoclustersofmeanings
expressedinpsychologicalandphenomenologicalconcepts.
Finally,thesetransformationsaretiedtogethertomakeageneral
descriptionoftheexperience,thetexturaldescriptionofwhatwas
experiencedandthestructuraldescriptionofhowitwas
experienced.
Thephenomenologicalreportendswiththereaderunderstanding
bettertheessential,invariantstructureoftheexperience,
recognizingthatasingleunifyingmeaningoftheexperienceexists.
Inphenomenologicalstudy,theparticipantsmaybelocatedatasinglesite,
althoughtheyneednotbe. Theymustbeindividualswhohaveexperiencedthe
phenomenonbeingexploredandabletoarticulatetheirconsciousexperiences. For
thepurposeofthisstudy,theolderadultswhoparticipateareage55orolderand
haveadisabilitythatfitstheAmericanswithDisabilitiesActdefinition. The
participantsmustbeabletomentallyandphysicallyparticipateintheinterview.
Theyalltherefore,haveexperiencedthesamephenomenonbecominganolder
adultwithadisability.
Acriterionsamplingmethodwasused. Iamfortunatetohaveclosetiesto
themedical,academicandsocialservicesinmyregion. Ireachedouttophysicians,
serviceclubsandserviceagenciesinquiringaboutpotentialparticipantsforthis
study. Iwashopefulthatthosegroupswouldrefermetootherpotential
42
participants. IanticipatedIwouldhaveadequateaccesstoparticipantstorecruit
withina150‐mileradiusofwhereIreside.Foraphenomenologicalstudy,the
processofcollectinginformationinvolvesprimarilyin‐depthinterviewswithasfew
asthreeandasmanyas10individuals. Theimportantpointistodescribethe
meaningofasmallnumberofindividualswhohaveexperiencedthephenomenon
(Glesne,1999). Withanin‐depthinterviewlastingaslongastwohours,ten
participantsinastudyrepresentsareasonablesize(Polkinghorne,1989).
Ispokewithpeoplewithdisabilitiesandthosewhoworkwithpeoplewith
disabilitieswhileplanningthisproject. Iaskedthemtoreviewtheinterview
questionsandassistmeinrevisingthesequestionsbasedontheirknowledgeand
experienceofworkingwitholderadultswithlong‐termdisabilities. Ialsoreceived
feedbackfrommydissertationcommitteeandmodifiedthequestionsbasedonthat
feedback.Ihopedtointerviewbetweenthreeandtenparticipantsforthisstudyand
obtainthoseparticipantsthroughsnowballsampling,basedonthecriteria
explainedinthepreviousparagraph. ThequestionsIaskedincluded:
1. Tellmewhatitmeanstoage.
2. Describeformeatypicaldayinthelasttwoweeks. Howisthat
differentfromhowyoufeltonatypicalday30yearsago?
3. Thinkofagreatdayyouhavehadinthepastfewmonths. Walkme
throughthatday.
4. Doyouseeyourselfasagingsuccessfully? Whatdoesthatmeanfor
you?Whatdoesitlooklikeforonetoagewell?
43
5. Ifyoucouldpicktheperfectagetoliveforever,whatagewould
thatbeandwhy?
6. Whatadvicecouldyougivemethatwouldhelpmeagewell?
7. Isthereanythingelseyouwouldlikemetoknowaboutaging?
8. Doyoufaceanybarriersrelatedtoyourdisability? Ifso,what?
9. Whateffectdoyouthinkyourdisabilityhashadonyouraging?
10.Whateffecthasaginghadonyourdisability?
11. Whatadvicewouldyougivetoayoungerpersonwithadisability
toguidethemtoagewell?
12.Whatdoyouthinkcontributedtoyouragingwell?
13.Whatdoyouwishpeopleknowaboutagingwellwithadisability?
Ialsoaskedparticipantstocompleteabriefdemographicquestionnaire(Appendix
A).
Alloftheinterviewswereaudio‐recordedwiththeparticipants’permission.
Icompletedmember‐checkswhereIaskedparticipantstoreviewthetranscript
fromtheirparticularinterviewtocheckforaccuracy. Ialsoaimedforuseofthick
descriptionwhenwritingthenarrativeofparticipant’scomments.Thick
descriptionisprovidingtheparticipant’sverbatimcomments,aswellasthingssuch
astheparticipant’smannerofdressanduseofassistivedevices,inrichdetail.The
interviewstookplacewherevertheparticipantfeltmostcomfortable. Iofferedto
meetthemintheirhomeorinapubliclocationwithaprivateroom,suchasthe
publiclibrary. Participantswerenotcompensatedfinanciallyfortakingpartinthis
44
study. OtherdetailsinvolvingparticipantbenefitsaredescribedintheInformed
Consent(AppendixB).
DataAnalysis
Inphenomenologicalresearch,thereareseveralstepsintheanalysisprocess
whichGlesne(1999)summarizedasfollows:






Theresearcherbeginswithafulldescriptionofhisorherown
experienceofthephenomenon.
Theresearcherthenfindsstatementsintheinterviewtranscripts
abouthowindividualsareexperiencingthetopic,listsoutthese
significantstatementsandtreatseachstatementashavingequal
worth,andworkstodevelopalistofnonrepetitive,
nonoverlappingstatements.
Thestatementsarethengroupedinto“meaningunits.”The
researcherliststheseunits,andwritesadescriptionofthe
“textures”oftheexperience—whathappened—including
verbatimexamples.
Theresearchernextreflectsonhisorherowndescriptionand
usesimaginativevariationorstructuraldescription,seekingall
possiblemeaningsanddivergentperspectives,varyingtheframes
ofreferenceaboutthephenomenon,andconstructinga
descriptionofhowthephenomenonwasexperienced.
Theresearcherthenconstructsanoveralldescriptionofthe
meaningandtheessenceoftheexperience.
Thisprocessisfollowedfirstfortheresearcher’saccountofthe
experienceandthenforthatofeachparticipant. Afterthis,a
“composite”descriptioniswritten(p.150).
Iusedphenomenologicaldatareduction,whichproceedsthroughthe
methodologyofreduction,theanalysisofspecificstatementsandthemes,anda
searchforallpossiblemeanings. Ididmybesttosetasideallprejudgments,
bracketingmyexperiencesandrelyingonintuition,imaginationanduniversal
structurestoobtainapictureoftheexperience(Creswell,1998).
ThedataanalysisprocessIfollowedforthisresearchstudyisasfollows:
45
IobtainedIRBapprovalfromtheIndianaUniversityInstitutionalReviewBoard.I
contactedserviceagencies,healthcareproviders,governmentagencies,senior
centersandhousingprogramsrequestingtheirassistanceinfindingparticipantsfor
thestudy.Severalinterestedpersonsdidnotmeetstudycriteriaandwerenot
interviewed. Alloftheindividualswhometthestudycriteriaandparticipatedin
interviewswere,blind,hearingimpairedoracombinationofthese.
IaskedolderadultswithdisabilitiestoparticipatebecauseIbelievethattheir
ideasandfeelingsaboutagingwellwillhelpmetobetterunderstandtheseolder
adultsandwhatagingwellmeanstothem.Thebenefitsofparticipatinginthisstudy
includelearningsomenewthingsaboutthemselves,enjoymentfromsharingtheir
ideasandfeelingsaboutagingwell.Inaddition,theirparticipationinthis
studyhelpsenhanceanunderstandingofhowtohelpolderadultsagewell. There
was,however,ariskthat,forsomepeople,talkingaboutagingandhowtheysee
themselvescanbeupsetting.
Iexplainedtoeachparticipantthattheirpersonalinformationwillremain
confidential. PriortointerviewingeachparticipantIobtainedtheirpermissionto
tape‐recordtheinterviews,andalsotakenotesasremindersofwhatwasdiscussed
duringeachinterview. Iinformedeachparticipantthatinthissituation,heorsheis
theexpert,orteacher,andtheyareexplainingtomewhatagingwellisforthem.I
alsoinformedeachparticipantthatheorshecandecidetonotparticipateinthis
study,orstopdoingsoatanytime.TheInformedConsent(AppendixB)detailsthis
informationfurther.
46
ChapterIV:Findings
Atotalofsevenpeoplecompletedinterviews.Theinterviewstookplacein
participant’shomesandatapubliclibraryinaMidwesternstate.Participants
rangedinagefrom63to83yearsold.Threeweremaleandfourwerefemale. Four
weremarried,onewasseparated,onewassingle,andonewasawidow.Fourlived
withtheirspousesandthreeresidealone.Allhadcompletedatleastoneyearof
collegeortechnicalprograms.Fivehadgraduatedfromcollegeortechnical
programsandonehadearnedcreditsbeyondherbachelor’sdegree.
Alloftheparticipantswereblind,deaf,hearingimpairedoracombinationof
thethreeandallmeetthedefinitionoftheAmericanswithDisabilitiesAct.Allbut
oneoftheparticipantswhoaredeafhavehadaCochlearImplant,allowingthemto
hearwhentheimplantisinuse,otherwisetheyaredeafwithoutit.Jimattempted
tohaveaCochlearImplantsurgery,howeveritwasunsuccessful.Jim’swifeassisted
incommunicatingduringhisinterview,whenhecouldnothearme,orweuseda
notepadbetweenustocommunicate. Allhavelivedwiththeirdisabilitybetween
eighteenandfiftyyears.Mostdescribedtheiroverallphysicalandmentalhealthas
goodorexcellent.Noneidentifiedneedingassistancefromacaregiver. Allwere
assignedpseudonymstoprotecttheiridentity. Thedemographicinformationis
describedinTable1.
47
Table1:DemographicInformation
Name
Age
(pseudonym)
Jim
83
Marital
Status
Married
Living
Status
With
Spouse
Sara
68
Married
With
Spouse
Seth
66
Single
Alone
Laura
63
Separated
Alone
Lois
77
Widowed
Alone
Lester
78
Married
With
Spouse
Jill
63
Married
With
Spouse
Education
Disability
Years
Two‐year
College
Degree
Hearing
Impaired
Vision
Impaired
Vision
Impaired
50
Deaf
50
Deaf
26
Vision
Impaired
Deaf
Vision
Impaired
Blind
40
Two‐year
College
Degree
Two‐year
College
Degree
Three‐
yearsof
college
Bachelor’s
Degree
Two‐year
College
Degree
Secretarial
School
18
55
38
Dataanalysisaimedtoanswertheresearchquestion: Whatdoesitmeanfor
anolderadultwithlong‐termdisabilitytoagesuccessfully? Dataanalysisrevealed
themeaningofthisquestionforthoseinterviewed.
Followingthestepsofphenomenologicalresearchanalysis,Ibeginwitha
descriptionofmyownexperienceofthephenomenon.Iamforty‐oneyearsoldand
donotlivewithadisabilitytherefore,myunderstandingofbeinganolderadult
livingwithalong‐termdisabilitydoesnotcomethroughexperiencingthis
phenomenon.MyexperienceisonlytheperceptionsIhaveofobservingothers
throughoutmylifetime. Mygrandfathersbothdiedofheartfailureclosetothetime
Iwasborn. Ispentalotoftimewithmygrandmothers,asbothlivedinmyhouse
48
forseveralyearswhileIwasgrowingup.Mymaternalgrandmotherdiedwith
Alzheimer’sdiseaseandmypaternalgrandmotherlivedwithschizophreniauntil
shediedafewyearsago.Iwatchedbothofthemlivethroughtheseillnessesfor
manyyears.Theseweretheolderadultsinmylifewhomadethelargestimpression
onmerelatedtoaging.
WhenIbeganthePhDprogram,myresearchinterestsdidnotinclude
successfulagingoranythingrelatedtoaging. Ihadworkedasamedicalsocial
workerforseveralyearsandmyperceptionofolderadultswaslargelythatthey
werefrail,illandinneedofhelpandresources. Duringmycoursework,I
discoveredliteraturerelatedtosuccessfulaging,whichmadeasignificantimpacton
meandchangedthecourseofmystudies.Itwasfascinatingtometobegintothink
ofolderadultsassuccessfulagers.
Thepilotstudyandresearchleadinguptoitexpandedmyknowledgeof
successfulaging.Iwasdelightedtolearnthatthesewomen,despiteexperiencing
manyhardships,wereagingsuccessfully.Therewasalargefocusintheliteratureon
activityandabsenceofdisabilitybeingrequirementsofsuccessfulaging. This
intriguedme,asIdidnotknowifpeoplewithdisabilitiescouldagesuccessfully.My
assumptionwasthattheycould,basedonwhatIhadlearnedfromotherswhohad
facedadversityandagedsuccessfully.
Thesecondstepofphenomenologicalresearchanalysisisfindingstatements
intheinterviewtranscriptsabouthowindividualsareexperiencingthetopic. These
statementsaregroupedinto“meaningunits”orthemes.Thethemesfoundinthe
analysisofthisstudy’stranscriptsareasfollows:
49

Agingasinevitable

FrequentActivity

SocialandFamilyInteractionasEssential

SenseofWorth

AcceptanceofDisability

CopingandResilience

AdvicetoOthers
Severalthemesemergedthroughoutthisstudy. Fromthosethemes,camecodes
andexamplesofthosethemesandcodes.Thefinalcodingsystem,includingmajor
themes,codesandexamples,isdescribedinTable2.
50
Table2:Themes,CodesandExamples
Meaning
Units/
Themes
Agingas
Inevitable
Examples
Feelingyoung
Negative
Positive
Transition
Acceptance
Forgetful
Wiser
NaturalProcess
SlowDown
Comfortable
ContentHappy
Independence/Freedom
InControl
It’sHappeningsoAcceptit
It’sChange,Loss
Frequent
Activity
Familyand
Social
Interaction
asEssential
Codes
Senseof
Worth
Hobbies
Charitywork/volunteer
Givingback
Keepingbusy
Structure
Joy
Strength
DamagedRelationships
Relationships
Belonging
SourceofStrength
BeingNeeded
InteractionAcross
Generations
ImpactonOthers
Influenceofothersorself‐
worth
Uniqueness
51
Golf/Walk/Bike/HorseRiding/Cards/
Woodworking
Crafting
Farming
Employed
VolunteeringatChurch,SeniorCenter,
ServiceAgencies
HouseholdChores
Love of Spouses, Parents,Siblings,
ChildrenandGrandchildren
CopingwithDisabilitywasPositiveand
Negative
Friends
Coworkers
WorkingwithYoungAdults
MaintainEmployment
MaintainSocialNetwork
LearnTechnology
RespectedbyYoungerPeople
Acceptance
ofDisability
Copingand
Resilience
Uniqueness
Fittingin
Limitations
LackofFreedom
Acceptance
Adviceto
Others
OvercomingLoss
Determination
Persistence
AdaptiveEquipment
Technology
Success
Strength
Resilience
FamilyHistory
Othersinworseshape
Noneseetheirsituationas
“thatbad”
Church
Religion
Activity
Friendships
Determination
SeekHelp
UseAdaptiveEquipment
Self‐Advocacy
SenseofHumor
PositiveAttitude
52
Disability Sets YouApart
LimitedDriving
LimitedVacations
LimitsSocialInteraction
CouldnoLongerWorkorLimitedJob
Opportunities
FitinAmongPeersNowBetterThan
WhenYoungerwithDisability
RefusedtoUseAdaptiveEquipmentat
First
Acceptance
Death of Friends andFamily
ParentsInfluencedTheirDetermination
FindEquipmentThatWorksforYou
NooneElseWilldoItForYousoYou
HavetoDoitForYourself
OneBadDayDoesn’tDefineMe
IfIWereIll
MyDisabilityIsn’tLikeOthers’
I’mNotinaWheelchairorAnything
TherearesoManyOthersWhoHaveit
aLotWorseThanMe
Blessed
MyPurpose
BeliefinGod
GodStillAcceptsMe
Integrity
Modesty
JustKeepPushing
TrytoOvercomeDisability
Don’tLetitStopYouFromDoing
Anything
EnjoyLife
Thefollowingsectionillustratesthe“textures”orcodesandexamplesofthese
themes.
Agingasinevitable
Thesevenparticipantssharedsimilaritiesandalsosignificantdifferences.All
participantsstatedthattheyfeeltheyareagingsuccessfully.Thefollowingisabrief
introductiontoeachofthesevenindividualsandtheiranswerstothefirstquestion.
Theinterviewsbeganwithasimple,open‐endedquestion,“Tellmewhatitmeansto
age.”Onethemeisthattheyallfeelagingisinevitableandtheyaretryingtomake
thebestofit.Somecouldanswerthequestionimmediatelywhileothersconsidered
theirresponsescarefully.
Jimandhiswife,Mary,metwithmeintheircomfortabletownhomeina
newersubdivisionofamid‐sizedMidwesterncity. Jimis83yearsoldandhasbeen
marriedtoMaryfor55years.TheyspendhalfofeachyearintheMidwestandthe
wintermonthsattheirhomeinasouthernstate.Jimishearingimpairedandhas
beenfor50years.Healsohasmaculardegenerationandcardiacissues.Jim’s
hearingimpairmentmadetheinterviewdifficultatfirstbutweadaptedbyusing
writtenmaterialsandhavinghiswifeassistininterpreting,attimes. Jimsharedfew
wordsinthebeginningoftheinterview,whenaskedwhatagingmeanstohim.
“NaturalprocessIguess.Whatelsecanyousayaboutit?Idon’tlikethatyoulose
yourhearingandallthat.That’saboutall.”
Sara’sinterviewtookplaceonthesun‐porchofthebeautifulsinglefamily
homesheshareswithherhusbandof48years.Sarais68yearsoldandlostone‐
thirdofhereyesightinbotheyesafterexperiencingtwostrokesatage50.
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AsIstartedaging,IfeltlikeIwasinagoodplace.Ifeltthat,youknow,
yougetwiserasyougetolder.But,asI’maging,I’mfindingIdon’tlike
it.Youjust,yougetalittleforgetful.It’snotabigthing.
Seth’sinterviewtookplaceatthekitchentableinhissinglefamilyhome.Seth
is66yearsoldandhasnevermarried.Hehaslivedwithahearingimpairmentsince
hewasinelementaryschool.
That’ssomethingthat’sinteresting.YouknowIamstillworking.Alot
ofpeopleatworkknowIcanretireandwonderwhyI’mstillworking.
IplantocontinueworkinguntilIfindmynextpageorchapterinmy
book.Youknow,asfaraswhyI’mgoingtodonext.I’mprettycontent
withwhatI’mdoing.Age–you’realwayspickinguponthingsyou
couldn’tdobefore.Ageissomething,youknow,qualityoflife.I
noticedwithmymomnow(100yearsold),she’sstartingwhereshe
can’tseeandshecan’thear.She’sgettingalittlemoreflustered,you
know,aging. Ithinkaslongasyouareabletodothethingsyouenjoy
doing,thenagingisn’treallyabigdeal.
Laura’sinterviewtookplaceinapubliclibrary’sprivateconferenceroom.
Shelivesonafarminaremoteareaandagreedtomeetwithmeintownwhenshe
wastherevisitingthedisabilityoffice. Laurais63yearsold,tallandathletic
looking.Shehasbeendeafforthepast26years.Sheiscurrentlydivorcingher
husbandof42years.Herresponsewhenaskedtodescribeagingisasfollows,
Itbites.Therearesomanythings,Ishouldn’tsaytherearesomany
things,thatIcan’tdoanymore.Ijustdon’thavethetime.Mydaysare
numberedandIknowit.PhysicallyI’mdoingamazinglywell,Ithink,
formyage.Icanstill,Iridemyhorse.I’mabletogetoffandonher.I
doallmyownchores.LikeIsaid,physicallyI’mnot,withthe
exceptionofmyhearing,therearecertainthingsIcan’tdo,likejump
upanddownoffthebackofapickuptruckorbailrack.Otherthan
thatI’mdoingprettywell.
Lois’sinterviewtookplaceinherlovelycondominiuminalargeMidwestern
city.Sheis77yearsoldandhasanartificialeyeandpartialvisioninherothereye.
Shehasbeendisabledfor40years.Shehasacollegedegreeandworkedasa
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teacherformanyyears.Sheisawidowandhasseveralchildrenwhoresidewithin
thesamestate.Loisdescribesagingbelow,
Itmeans,that’sreallyhardtodescribe.Ifeelveryfreed,Iguessfroma
lotoflife’sstruggles.It’snotanunhappytime.It’sahappytime.I’m
notlonely.Idon’treallyknowhowelsetodescribeit.I’mnotfearful.I
feelincontrol.Idon’tknowwhatmoretosay.
Iaskedhertoexplainmoreabout“freefromlife’sstruggles”andshereplied,
“IsupposeifIwereill,I’dhaveadifferentviewpoint.Forinstance,livingalone.I
don’thavetomakesureIhavedinnerready.IcanbasicallydowhateverIwantto
wheneverIwanttotypeofthing.Iguessthat’swhyIfeelfree.”
IinterviewedLesterandhiswife,Mandy,intheirhomeontheirlargefarm.
Lesteris78yearsoldandhasbeendeafsincehewasinhis20sandalsohasmacular
degeneration,whichhassignificantlydecreasedhisvision. Healsohasablood
disorderandcardiacissues.“Iguessyoujusthavetotakeitdaybydayandhope
everythinggoesokay.Getplentyofrestandenjoyeverythingthat’saroundyou.Go
toallthegrandkids’stuff.Ihavethirteengrandkids.”
Jill’sinterviewtookplaceinherlovelytwo‐storyhomeinamid‐sized
Midwesterntown.Sheis63yearsoldandhasbeenmarriedfor40years.Shelost
completevisionatage25asacomplicationfromTypeIDiabetes. Jillhadasmileon
herfacethroughoutourentireconversationandisoneofthemostpositivepeople
onecouldeverhopetomeet.
YouknowVictoria,Idon’tknow.Idon’tfeelold!Ilaughaboutit
becausethelasttimeIsawmyselfIwas25yearsold.IfIcouldsee
tomorrow,andlookinthemirror,I’dwonder,“whoisthatlittleold
lady?”BecauseIdon’tfeelold.Idon’tfeelthat.Sowhatdoesitmean
toage?Ithinkapersongetsmorecontentintheirlife.Thingsthatyou
usedtothinkwerereallyimportantaren’tprobablysoimportant
anymore.Ithinkyourprioritiesasyouagearedifferentthanwhat
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theywerewhenyouwereyoung.SoIthinkI’mmorecomfortable
gettingolder.I’mmoreconfidentwithmyself.I’mnotsocriticalwith
myself.Orwithothers.SoIthinkit’sgreatgettingolder.
Fittingthethemeofagingasinevitable,thequestion“Isthereanythingelse
youwouldlikemetoknowaboutaging?”yieldedcandidrepliesfromacoupleof
participants. Jimstated,“It’snotgood.Toobadithastohappen.Sarastated,“It’s
reallyfortheshits.Oh,Iprobablyshouldn’tsaythat.Um,no,Ijustthinkyouhaveto
takeitgracefullyandyouhavetorealizethatyoudoageandthere’snothingyoucan
doaboutit.Itgetsscary,aswegetolder,abouthowit’sgoingtoend.Butno,just
enjoylifeandstayhealthy.”
Seth’s response was a bit different: “I’m starting to learn things myself. I
thinkthat’sthebiggestthingI’mlearning.”Finally,Loisstated,“It’shappening. It’s
inevitable.Justgowithit.Youcan’tdoathingaboutitsoembraceitIguess.”
FrequentActivity
Alloftheparticipantsdescribedveryactivelifestyles.Themeaningof
“active”wasdifferentforall.Saraisveryactiveanddescribedatypicaldayinher
life.
Today?Okay,onTuesdaysIgetupinthemorning,pickuparoundthe
house.Maybedosomewash.At11:00inthemorningIgoplay
Maijonguntilwehavelunch,Iplayuntilabout4:00intheafternoon.
Comehome,fixdinner,enjoytelevisionorread;orgamesonthe
computer.
Probingabitdeeper,Iasked,“SotheothertimeIcalled,youweregolfing
duringtheday.Doyouhavealotofthings,socialthingsyoudo?”towhichSara
replied,
Yes,wekeepveryactive.I’vegotsomethingtolookforwardto,that
willbeagreatday.Intwoweeksthere’sagroupofus,there’seight
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girlsthatgotoadifferentcityandwegolf.We’vedonethisforthelast
20years.Wegooverthereandwegolfandgooutfordinnerandhave
afewcocktailsandgolfagainthenextday. Thatwillbeagreatday,or
agreatweekend.I’mtryingtothink,oh,golfingagain.Thedaythat
youtriedcallingme.Thatwasanotherdaythattheeightgirlsinthis
group.Threemonthsonthesummer,June,JulyandAugust,wehavea
get‐togetherandwegetoutoftownandgotodifferentplaces.And
whatwedoiswegolfandwehavestartedabookclub.Wegoto
someone’shomeafterwe’redonegolfing.Wedoabookclubandhave
dinnerandacoupleofcocktails.Andthatwasagoodday.Thatwasa
greatday.Thatwasfun.
Jill,whoisblind,describedatypicalday: “Mondaysaremywashdays.Itell
everyone,peopleassumethatmyhusbanddoesthehouseworkbutIdo.Idothe
cleaning,Idothecooking.Hey,Ieveniron.”Jillcontinuesdescribingsomeofher
activityandinterests,
Idon’thaveafancyhomebutIlovedecorating.Igetontheflooron
myhandsandkneesandwashandwaxthefloors.Iprobablygoover
thesamespotmanytimesbecauseIcan’tsee.I’velivedinthehouse
40yearsandlostsightoneyearlater,afterbeingmarriedoneyear. I
didknowthelayoutofthehouse.Icanpickoutcolorsandcoordinate
(carpetandwallcolors).I’msothankfulthatIhadsightatonetime
becauseIcanvisualizesomanythingsinmyhead.I’mnotsayingthey
alwaysturnoutright,butIhaveareallygoodideaofwhatIwantand
whatIlike.
Sethcontinuestoworkafull‐timejobasacustodianatalocalcollege.Hehas
noplanstoslowhislifedownanytimesoon.
I’mapersonwholikesroutine.OntheweekendsIusuallygetup
around9:00or10:00inthemorning.BecauseIwork3:00‐11:30so
usuallywhenIgetoffwork,IreadorwatchTV;somethingtorelax.I
don’tnecessarilygotobedrightaway.Andthenalotdependson
whatthesituationiswithmymom.Iusuallygoupandcheckonher.I
cleanherquiltforherorlittleoddsandendsthingsIdo. Itypically
getupinthemorningandyouknow,dosomeoddsandendsthings.
Mowthegrassorsomethingtokeepactive.ThenI’llhavelunch.Often
Ihavelunchwithfriends.YesterdayIhadlunchwithafriendofmine
andwehaven’tseeneachotherforaboutamonthorso.Itrytokeep
incontactwithpeopleandeverything. Myafternoonsareusually
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gettingreadyforwork.Iusuallygotoworkaround2:30thenIdomy
work.Itrytokeepeverythingfairlyroutine.WeekendsIusuallytryto
spendtimewithmomandthenIplaygolfordosomethinglikethat.I
trytobalanceeverything.Idon’tthinkI’vechangedthatmuchasfar
as30yearsago.I’vealwaysbeensingle.Let’ssee,thatwould’vebeen
1984.Iguess30yearsagoIwasgoingoncruisesanddifferentthings
likethat.Iwentonacoupleofsinglescruises.Ihaveafriendwhogot
mestartedonthatsortofthing.30yearsagoIguessIjustfoundout
thatasyougetolder,thingsstarttoslowdownabitandsometimes
youneedto…I’mtryingtoworkinnapsandthingslikethat.Itryto
makesomecompensationforbeingolder.OtherwiseIdon’tthinkI’ve
changedmuchin30years.
Laura’sdescribesherdivorceandthetimeitconsumesinherlife.“Igetup
andeatbreakfast.Dependingonwhat’sgoingon,divorcehasbeenalmostafull‐time
jobforme.I’mparishsecretaryatourchurch.Notahigh‐payingjob.I’vehaditfor
quiteafewyears.”
Loisisoneofthemoreactiveofalloftheparticipants.Shedescribessomeof
thisactivitybelow:
Igetupabout6:00or6:30.Makemyselfcoffeeandalittlebreakfast.
I’vebeendoingaBiblestudyinthemorning.AndthenImaybegoand
getmyhairdone,meetafriendforlunch,goshopping.RightnowI’m
lookingfornewfurnituresoI’vebeendoingthat.OfcourseIwoulddo
householdchores.Idohavesomeonewhocomesandcleansthefloors
andthosetypesofthings.Idomyownwashing,dustingthatsortof
thing.
Lesterandhiswiferesideinahomeontheirlargefarm.Heislivingwith
hearingandvisionloss.
We’vegotgrass,youwouldn’tbelievehowmuchwehavetomow.Ido
alotofmowing. I’vegotaJohnDeerelawnmowerwithasixfootdeck.
We’vegotagardenwithbeans,tomatoes,peppers,beets,lettuce,
watermelon,cabbage.Everythingisgood.Itillthatwiththetiller
that’sonthetractor.Wehavetwoswingsthat,intheeveningswhen
it’ssonice,I’llsitonandrockbackandforth.Wehavethislittle
femaledog,aBostonTerrier.She’srighttherewithmeconstantly.
Therearethreecats.Atomcatandafemaleandanotherguythatisn’t
anythingeasytolookat.Theycallhimpiratebecausehe’sblindinone
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eye.He’lljumprightuponme.Theyliketorocktoo.EverymorningI
goupandgothroughmyroutine.Takemypillsandhavemyoatmeal.
Ilikemycoffee.Takecareofallofthedogchores.Threetimesaweek
Igototownandgotocardiacrehab.Wifedrives.Wehave25,000
turkeysandthesebuildingsare560feetlongsoIalwayssaidIdidn’t
needanyexercise.Igetplentyoutthere.Nowoursonrunsthe
business.Wehave13,000pigs.Therearesemiscominginwithfeed.
Yesterdaytheyloadedatleasttwosemiloadsofmarketpigs.There’s
alwayssomething.(Heranthebusinessuntilrecently.)Istillknow
whatthehellisgoingon.Myvisionlimitsme.ForsafetyreasonsIstay
mostlyintheyard.There’salwayssomethingtofix.
Laura’shorsesholddeepmeaninginherlifeanddescribesactivityrelatedto
them:
ThatwouldbeadaywhereIwenttotheCountyFairwithmymare
andIgottoshowherandIwaswithalotoflike‐minedpeople,horse
people.Weinhabitadifferentuniverse. Itwasfun,notonlyto
participate,butalsotowatchandhavesomeonetotalkto.Thatwasa
greatday.
TheStateFairismentionedasanimportantactivityinLois’“greatday”asit
relatestotheawardoneofhercreationsreceivedattheFair:
Lastweek,thefirstdayofthefair.Iwentwithmysonandhiswife.I
wasalittleontheapprehensivesidebecauseIwasn’tsurehowIdid
ontheprojectthatIentered.WeatebreakfastandI’malwaysanxious
togetintothecreativeactivitiesbuilding.Anyway,togetthereand
seethattherewasactuallyablueribbononsomethingthatI’ddone.
Theotheryearssomeonehadhelpedmewhereasthisone,Ididallby
myself.So,IwasreallywonderinghowIwoulddoonmyownandto
getablueribbonforitwasreallyafunthingtoexperience.
Onceagain,theStateFairisanimportantpartofLester’s“greatday”and
demonstratesactivityinhislife,
They’reallgreatdays.ThekidstookmetotheStateFair.Theyputme
inawheelchairandtookmeallover.Wewentindifferent
agriculturalbuildingsandbuildingswithdifferentflowersandanimal
barns.Lookedatallthecraftbooths.Yeah,itwasprettygood.
59
Jill’spositivitycontinuesasshedescribesheractivitieswhenansweringthe
“greatday”question:
That’sreallyhardbecausetherearesomanygreatdays.WellIhada
reallygreatdayonSaturday.I’maLionandmyhusbandistoo.We
wenttothediabetesexpo.Andthatwasreallyinformative.Itwas
educational.Therewere24peoplewhoboardedthebusandwemeta
lotofreallyneatpeopleupthere.I’mreallyinvolvedindiabetes.I’ve
reallybeenfocusingonit.Idoalotofspeakingengagements,hoping
somedaytherewillbeacureforthisdisease.It’salwaysgoodtolearn
moreaboutitandaboutwhatnewproductsareavailable.Thatwasa
greatday.WespentalldayattheexpoandwesatattheLion’sbooth.
Peoplecouldcomebyandwegottomeetalotofpeople.That’swhatI
loveissittingandvisitingwithpeople.Icamehometheendoftheday
veryhappy.Iguessformostpeoplemaybeitwouldn’tbethatexciting
butIlovejustthecontactwithotherpeople.
JimandSarastatedthatactivityandhealthareimportantaspectsof
successfulaging,“Ithinkso.Istillgetaroundprettygood.I’m83yearsold.Retired.I
feelcomfortablewithmylifestyle,I’llsay.”Sarastated:
Ihavemyhealth.ItmeansIhavefriends.ItmeansIkeepbusy.Ijust
amveryfortunate.Ithinktoagewellyouhavetohaveyourhealth.I
reallydo.Ithinkthatisveryimportant.Butyoualsohavetohaveyour
friendsandyouhavetohaveinterestinlife.Imeanyoucan’tjustsit
backandnothaveanyinterestinanything.Ihavealotofinterestina
lotofdifferentthings.Ithinkthatmeansalottoo.
Seth’sresponseisfurtherdemonstrationthatheplanstocontinueanactive
andproductivelifestyle,
Yes,Ithinkso.Infactthebigthingnowis,I’mtryingtoseewhatI
wanttodonext.IknowsomethingsthatIusedtoliketodo.LikeI
said,takingcareofseniors,takingthemtothedoctororsomething,
butIthinkI’mgoingtoagesuccessfully.I’mgoingtofindthingstodo.
I’mgoingtocheckouttheseniorcenterorsomeplacelikethatand
findaplacewhereseniorshangoutandthatkindofstuff.Andthen
I’mgoingtotrytogetinvolved,eithervolunteerorfindapart‐time,
20houraweekjob.RightnowIwillcontinuetoagesuccessfully.I
thinkit’saqualityoflifeandhowcomfortableyouare.Youknow,allI
wentthroughwithmydadandthehospicething.I’veseenother
people.Ithinkaslongastheycanstayactive.Aslongastheycankeep
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doingthings.Idon’tthinkwealwayshavetobecrazyandtrytofinda
newbucketlistoranythinglikethatbutIdothinkweneedto
maintainouractivenessandeverythinglikethat.Aslongaswearen’t
restrictedinanyway.Isawthesamethingwithmygrandma.Shehad
diabetesandlostherlegandstartedtogodownhillwhenshelosther
health.Ithinkaslongasyoucanstayactiveandyourlifeissomewhat
normal,Ithinkyou’refine.Ithinkit’sjustwhendisabilitiesand,you
know,healththingsareeffectingyouthatyoureallystarthavingmore
trouble.
Alloftheparticipantshighlightedthethemeofactivityandthemeaningthat
holdsforeachofthem.Theresultisthatallareactive,intheirownway,andcredit
activityasacontributoroftheirabilitytoagesuccessfully.
SocialandFamilyInteractionasEssential
Alloftheparticipantsdescribedfamilyandsocialinteractionsasanessential
partofsuccessfulaging.Sethdescribedthespecialrelationshiphehaswithhis
motherandthemeaningthathisfamilyholdsforhim,
LaborDaywaskindofagoodday.Iwentandpickedupmomfromthe
nursinghome.Wewentoutforlunch.ShelikestogooutforCulver’s
chicken.Whereshe’sstayingtheymakethingsalittledryerand
blander.Shelikestogoforchicken.Thenwecomehome.Shelikesto
spendtimeatthehouse.Mydadbuiltthishouse.Thisiskindofoneof
thosethingswhereoffandonI’velivedinthehousealmostallmylife.
Backinthe1990swhenmydadhadthecancerandtheprognosis
didn’tlookthatgood,Itookoverthehouse.I’vebeentakingcareof
folkseversince.That’sprobablysomethingI’lldowhenIretire.Do
somekindofcaregiving,takingpeopletodoctorsoranything. So
gettingbacktowhatmomhas…sowecamebackhereandweplayed
aboutthreeorfourgamesofcribbage.Momcheckedonthehouseand
madesureI’mkeepingthehouserightandthatsortofthing.Thenat
about4:00or4:30wewentouttoBaker’sSquare.Shelikestheir
supper.ShelikestheirpancakesandIthinkshelikestheireggstoo.I
thinktheygetpowderedeggswhereshe’sat.Soanyway,wehadthat
andthenIcamehomeandwatchedabaseballgame.Thatwasagood
day.
Sethalsodescribedthatasocialnetworkisimportanttohim.“Itrytofind
outwhereIfitin.Startgettingmysocialnetworkoffriendsandacquaintancesand
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thatsortofthing.IthinkifIcanlearntobehappyandcontent.” Jimalsofindshis
friendsanimportantpartofhislife,“Wehaveanicegroupoffriendsandweare
alwayswithourfriendsandhaveagoodtime.”
Lois’circleoffriendsholdmeaningtoherandinfluenceherthoughtsofaging
successfully.
Yes.Ihavemulti‐generationalfriends.Ithinkit’sreallyimportantto
havefriendswhoaremyageandolderandtohavefriendswhoare
younger.Ifeelrespectedbyayoungerpersonandlfeellovedby
familymembersandfriends.Friendsarereallyimportanttomeso
that’sprobablywhatIwouldviewasagingwell.Havingactivitiesin
mylife.Idon’tsithomeandwishsomebodywouldcallmeorwish
somebodywoulddosomethingwithme.IfIeverfeltlonelyIwould
callsomebodymyselfandmakearrangementstodosomethingwith
someone.Formethat’sagingsuccessfullybutIthinkthat’sprobably
anindividualthing.Ithinktohavefairlydecenthealthwouldbeaway
toagesuccessfully.However,ifyouareillandyoustillhaveagood
outlookonlife,Ithinkyou’reagingsuccessfullyalso.
Relationshipswithfamilyandfriendswasathemethroughoutthe
interviews.Itwasevidentthatthisisafoundationofsuccessfulagingfortheseolder
adults.
SenseofWorth
Participantsdescribedthedevelopmentoftheirsenseofself‐worthintheir
responsestothequestion,“Ifyoucouldpicktheperfectagetoliveforever,whatage
wouldthatbeandwhy?”Theiranswersdidnotinvolveauniformageoreven
decade.Theanswerswereeachuniqueandillustratedtheirindividualsenseof
worth. Afewgenerallyinvolvedatimewhenparticipantswereactivelyrearing
theirchildrenorwhentheyfelttheyhadmoreenergy.Sara’sresponseinvolvedthe
feelingthatshehadsuccessfullyrearedherchildren,
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Iwouldsay,I’mtryingtothinkofwhatageIwaswhenthegirlsleft.
TheperfectageIthinkwouldbebetween50‐60.Ireallywould.
Becausethenyou,yourkidshavedonecollegeandhopefullyhave
establishedtheirlives.Youcangetonwithyourownlifeanddon’t
havetoworryaboutthemsomuchandyouaren’tresponsiblefor
themasmuch.
Sethdoesnothavechildrenandresponded,
That’sagoodquestion.YouknownowthatIworkupatthecollege
andIseethesekids,youknow,Iusedtothinkitwouldbefuntobe17
to25yearsoldandIthink,no,Idon’tthinkI’dwanttobethatage
again.Ithinkrightaroundyour30swouldprobablybethebest.You
know,30yearsagorightaroundmy30sbecausethenIthinkyouare
rightaroundthatagewhereyoujuststartknowingwhoyouare.You
knowhowtohandlecertainthings.You’vegotalittlebitofmaturity.I
thinksomeplaceinyour30swouldbetheperfectagetolive.
Lauradescribedthetimewhenshewasrearingherfamily,
Probably,well,probably35.Itwasthebesttimeinmylife.Iwas
raisingmyfamily.Thosewerethehappiestdaysofmylife.That’sthe
ageI’dliketobe.I’dhavehadtenkidsifIcould’ve.AsIsaid,Iwasa
stayathomeparentbecausemyhusbandalwaystoldmethatI
couldn’thaveitall.Meaning,Icouldn’thaveacareerandafamily.
Thatwassortofhismantra.Itriedtofinishmycollegedegreewhen
myoldestdaughterwasstillathomeandaftershegraduatedhigh
school,Ihadnohelpandnosupport.SoIneverdid.AnytimeIdid
haveanykindofmeaningfuljob,hewasupset.Somehowitwasa
reflectiononhismanhood,thathewasn’tabletoprovideforhis
family.HewasupsetwhenItookthejobatthechurch.ButIdigress,I
think35I’dsaywasprobablytheperfectage.
Loishaschildrenbutdescribedatimewhenshehadmoreenergy.“Ithinkit
wouldbebetween60‐65.Youhavemoreenergy. Ihadmoreenergy.Ihadmore
strength.Ihadahusbandatthatpointtoosothatmadeadifference.Iplantoliveto
100butifIcouldjuststayatoneageitwouldbe65.”
Lesterdescribedatimewhenhewasveryactiveandbegantoexperience
independence.Healsodescribestimewhenhischildrenwereyounger,
63
Isuppose21.Youcangoinanyplace.YoucanshowyourIDandyou’re
stilloldenoughtogoinandsipafew.Eventhenyouhavetoshop
aroundandseeifyoucanfindamate.Agoodageisanyageifyou’re
feelingprettygoodandhealthyenoughtokeepbeinginsocietyor
whatever.Imean,Iwasonthechurchboardandonthecountyboard
foryears.Iwasontheschoolboard,I’mjustguessing,atleast26
years.Igaveallsixofourkidstheirdiplomaatgraduation.We’ve
alwaysbeenprettyactive.Evenjustasquickasourworldhasgrown
andourboy,theonewhogotkilled,whentheygottheirdrivers
licensetheywoulddrivesowstothestockyards.Theywouldreally
helpmealot.Weweremixingfeedconstantlyandcultivating.Alotof
timesIhadthewindowsopenonthecabandhadkidssittingall
aroundinthecab.Ifwesawastonethey’djumpoutandgetit.
Whenaskedaboutthebestagetolive,Jilldidnotgiveanagebutdescribesa
timewhenshewasrearingherdaughter:
Iguessmymid‐thirties.Iwasmarried.Ihadourdaughter.Wewere,I
don’tknow.That’sarealhardonebecauseIlikealmosteveryage.
That’saveryhardone.Icouldpickmyearly20swhenIcouldsee.
Andusedtodrivemyconvertiblemustang.Icouldpicknowatthe
pointwhereI’matbecausenowI’mgoingtobeagrandmother.That’s
arealhardquestiontoanswer.
Theseresponsesdescribehoweachdevelopedtheirself‐worththrough
meaningfultimesintheirlives.
AcceptanceofDisability
Alloftheparticipantsdescribedhowtheyhavecopedwithchallengesand
lossesduringtheirlives.Specifically,theywereaskedtodescribetheimpacttheir
disabilityhashadontheirlives.Athemeforallwasthecopingandresiliency
illustratedbyeachparticipantwhenaskedtodescribetheimpacttheirdisability
hashadontheirlives.
Whilethefirsthalfofthequestionsrelatedtoaging,thesecondhalfofthe
questionswererelatedtolivingwithadisability.Thefirstofthesequestionswas,
64
“Doyoufaceanybarriersrelatedtoyourdisability? Ifso,what?”Jimreplied,“Oh
mygoodness.Allkindsofthem.”HiswifeMaryelaboratedforhim:
Icantellyousometoobecausehecan’thearonthephone.Ihaveto
doallthephonestuff.Andalotofitistechnicalstuff,likecomputers
andstuff,that,wellIknowhowtooperatethecomputerbutIdon’t
knowanythingabouthowitworksoranything.Soifhehasa
problemonthecomputer,hecallsatechnicianorsomethingandhe
can’thearwhattheyaresaying(helaughs).SoIhavetogetonthe
phoneandtheytellmeandIhavetorelayittohim.Ihavenoidea
whatI’mtalkingabout.Itdoesn’tmakeanysensetomesoIthink
that’sabigproblem.Ihavetodosomuchofeverything.Hehasalotof
phonecontactandstuff.Hegetsalotofmagazinesandstuff.Every
timethereissomethingheneedstoknowaboutIhavetocall.
Jiminterjected,“EvenwhenIgotothestoreorsomethingyouknowandhavetoask
questions,shehastobeheretoanswer.”Marythencontinued,
I’malwayshisearsnomatterwherewego.He’sbetternowbutright
afterhehadtheCochlearImplants,wehadsuchhighhopesforthat.
Hegotveryfrustratedafterthat,thatitdidn’tworkatall.He’skindof
comingoutofthatalittlebitnow.Andwewritealotofnotesback
andforthifhecan’tunderstandwhatI’msaying.Buthestillnow,I
think,he’shandlingitalittlebitbetterthanhedidbefore.Ithinkhe’s
gotagoodsenseofhumor,youknowandthatkindofhelpshimget
alongandthat’swhyeverybodyreallylikeshimandtheylikehis
senseofhumorandalotofourfriendshaveagoodsenseofhumor
tooandtheygettogetherandlaughandstuffandsoIthinkthatpartis
helpingyou. Aslongasyoukeepyoursenseofhumor.
Lauraexplained,“WhenIwakeupinthemorningIhavetomakesureIput
onmyimplantsrightawaybecauseIhaveabsolutelynohearingwithoutthem.”
Sarastated,
Yeah.WithmyeyesightIdo.Idon’tdriveatnight.Imean,andthese
aresominimalcomparedtoanyoneelse’s.Ittookmealongtimetobe
abletorecoverfromthelossoftheeyesight.Ihadto,whenIlookat
yourightnow,rightnowI’mlookingatyoustraightahead.AllIseeis
thateyeandalittlebitofthatpartofyourhead.ButnowwhatI’ve
done,Imovemyheadandyoumightnotnoticethis,butI’vemoved
myeyesightjustalittlebitandnowIseeyourwholeface.SoI’ve
learnedtoadapt.It’stheperipheralsidethatIdon’tseeoutofbut
65
becauseofthatadaptionthatI’vetaughtmyself,ImeanIdon’tknow
howyou’ddothat,Ireallydon’t.It’sjustsomethingthatItaught
myself.NowIhaveaverybigvisualfield.IhavegottensoIdon’tlook
straightaheadanymore.Iwouldsay99%ofthetimeIlookthatway.
Whenitcametimetoread,Icouldn’tfollowtheline,Icouldn’tread
andthatwasdevastating.Oneofthebigthingsthatreallytickedme
offwasWheelofFortunebecauseIcouldn’tseealloftheletters.That
reallytickedmeoff.Andwiththereading,Ijusthadtoforcemyselfto
doitandnevergaveuponit.Ineverfelt“ohwoeisme.”Ididn’tthink
Iwouldeverdriveagainsomynextthoughtwas“okayI’lljustridemy
bike”andIrodemybikeallovertown.Youknow,Ineverletanyof
thatgetmedown.Itseemedlike,iftherewasahandicap,Iwasn’t
evenpayinganyattentiontoit.Iwasgoingtotakecareofitandwork
mywaythroughit.Except,thefirsttimeIwentoutonabikeride,like,
ohitmusthavebeenabout8:00inthemorning,andIrealized,
becauseatthattimeIhadn’tlearnedtoadaptmyeyesightyet.Ididn’t
realizethatpeoplewereontheirwaytoworkandbackingoutoftheir
drivewaysandIwasn’tseeingthem.SothenIhadtowait.Imean,
nothinghappenedbutIdiscoveredthatthatiswhatwashappeningso
IhadtowaituntileverybodywenttoworkbeforeIwentonmybike
ride.
IaskedSaraifsheparticipatedinvisiontherapyorothertreatmentprogramsto
improvehervisionandshestatedthatshedidnot.Shetaughtherself.
Therewasnothingtheycoulddoforme. Whathappenedwasthe
strokewasintheoxibatallobesotheeyesarefine.It’sjustthatthere
isaballaboutthatbigthatisjustdeadmatter.Theytoldmethatifit
didn’tcomebackwithinafewdaysitwouldnevercomeback.Itnever
did.Whathappenedisthatoneofthethingsthatwasreallyironic,you
couldalmostfigureouthowPicassosawthings. BecauseIremember
layinginthehospitalandlike,ifmydaughterwouldcomeintosee
me,andmyhusbandwasstandingthere,I’dlookatherandthenI’d
gotolookathimandherhairwouldfollowonhishead.Itmust’ve
beenlikealatentimageorsomething.Therewerealotofweird
thingsthatIsawafterthestrokebutthentheyalleventuallyworked
outmore.IprettymuchonlydrivewhereIknowI’mgoing.IfIknow
whereI’mgoingthenI’mokaybutifIhavetobelookingforroadsand
findingroadsthenIcan’tdoit.I’mcomfortableifIknowwhereI’m
goingandifI’vebeentherebefore.Ihaven’thadanyaccidentsandcan
stillgetadriver’slicense.ThefirsttimeIhadtodotheeyetestIwas
petrifiedbutpasseditwithflyingcolors.
Sethalsoidentifiedbarriershefacesrelatedtohisdisability:
66
That’salwaysbeenafrustrationofmine,notbeingabletohear.It’s
troublesome.Environmentsareabigdeal.LikewhenI’dtrytotake
someoneonadate.Ifyougosomewherewheretheacousticsare
reallybadandyoucan’tcarryonaconversation.Imean,Idorealwell
inaonetooneconversationaslongasit’sanenvironmentwherethe
backgroundiscontrolled.YouknowIdorealwell.Sometimeswhen
youareoutsideandthewindisblowingandthereisbadacoustics,
everybody’stalking,thatdoesmakeitchallenging.Youhavetopick
placeswhereyou’recomfortable.Friendsofmineusuallyunderstand
that.IthinkalsothatsomeofmyfriendsknowthatIdon’thearreal
wellsoit’spartofthething.Youknowmybrotherhasthesamething.
Working,youknow,he’supontheroofandI’mtrimmingthe
branchesandI’mtalkingtohimorhe’stalkingtome,wedon’talways
hear.It’sjustoneofthosethingswhereitallpartoflife.Youknow,if
youcanacceptyourdisabilitiesandacceptyourlimitations,nomatter
whattheyare,Ithinkthat’sthekeytobeingsuccessful.
Lauradescribedmanybarriers:
Absolutely,allthetime.Evenwiththebilateralimplants.The
telephoneisstillachallenge.WiththebilateralsIstillonlyhave70%
hearing.IgotmyfirstimplantinFebof2011andmysecondonein
Febof2012.Maybeitwas2012and2013.Withinthelastfiveyears.
TherearecertainjobsIabsolutelycan’tdo.Itlimitsmyemployability
inthatregard.It’sdifficultifpeopledon’tunderstandthattheyhaveto
lookatmewhentheytalk.That’sahugethingbecauseevenwiththe
implants,thisisperfectroombecauseacousticallyit’sgood,there’sno
othernoise,I’mnothavingaproblemtalkingtoyou.Istillrelyonlip‐
reading.ThereisjustsomuchstuffIhavetodragaroundwithmeand
ithastobeworking.SinceI’vebeenlivingalone,itdawnedonmehow
vulnerableIam.OnceItaketheseoffIcan’thearanything.Ijust
recently,withinthelasttwomonths,gotadaptiveequipmentthatwill
warnmeifthesmokedetectororcarbonmonoxidedetectorgoesoff,
orifthedoorbellrings.AllwinterIreliedonmydog.Whatbothered
mewasthattheirwasn’tasoleinmyfamilythatwasconcernedabout
it.LastyearIrealizedhowvulnerableIam.
Loismodestlydescribedherbarriers:
Yes.Depthperceptionwouldbeone.Missingthingsonmyleftside.
Bumpingintothings.Missingthings.Whensomeonehandsme
somethinglikeacreditcardIdon’talwaysgetitright.Imightputmy
handunderneathitorsomethinglikethat.NobodynoticesitbutI
noticeit.
67
Iinquiredfurther,askingifhervisionimpairmenthashadanimpactonher
driving.Loisresponded,“No,wellmaybealittlebitbutIthinkI’veadjustedtothat.I
rememberwhenIfirstlostmyeye.Theysaid“besuretoturnyourhead”soIthink
I’velearnedenoughtodothattohopefullymakeadifference.”Iaskedifithas
impactedherabilitytoreadandLoisstated,“There’snoproblemwithreading.My
righteyehasmaculardegeneration.Thentherewasarealdisabilitybecause,at
times,itwasalmostblind.IlosepeoplewhenI’minacrowd.Itellmyfamilysothey
watchoutforme.”Iaskedhertoexplainherstatement“thenIalmosthadareal
disability.”Loislaughedandreplied,“Idon’tthinkofitasadisability.That’sthe
differenceIguess.”Iaskedifshethoughtofitasadisabilitywheniffirstoccurred
andshesated,
WhenitfirsthappenedIwenttotheophthalmologistandhesaid
‘thereissomethinggoingonbehindyoureyeandglasseswon’thelp.I
wantyoutogotoaspecialistsoon,assoonastomorrow.’ Andthen
thespecialist,wewenttoseehimandhemusthavehadaresidentor
someonewithhim.HeexaminedandthentookmyhusbandandIin
hisofficeintohisoffice.Hewassittingacrossfromusathisdesk,
playingsymphonymusic,brownwallsandthedrapeswerepulled.He
hadalamponhisdesk,hadabeardandsaid,‘Mrs.X(Lois)hasa
tumorinhereyethesizeofadimeincircumference,threedimesin
thicknessandIbelievehereyewillhavetoberemoved.’Atthatpoint
IwasrelievedbecauseIthoughtitwasabraintumorandwas
relievedthatitwasn’t.MyunclehadlostaneyeandsoIknewyou
couldgetalongjustfinewithoutone.AtthatpointIwasrelievedand
thankfulthatitwasjustmyeyeandnothingmore.
Lesterdescribedhisbarriers:
Youjusthavetobecarefulifyoucan’tnavigatelikeyouusedtoyou
knowwhatyoucandoandwhatyoucan’tdo.Ifyoucan’tdoitthen
staythehelloutofthere.There’salotyoucandotoo.Whenyousee
theoneswiththewhitecane.Atleastforthisgeneration,youdon’t
looseyourcompletevision.I’velostmostofit.Attemptedtogetanew
surgerybutdidn’tqualifybecausemyeyewastoosmall.Myadaptive
68
equipment(glasses,awatchthattalks).Workingwithaudiologistto
getreadingbooks.ThiswinterIcanusethem.Iusedtolovetoread.
Jillstated:
Theonlyoneprobablyistransportation.YouknowifI’mgoingto
makesomethinghereathome,yearsagoIcouldjustgetinmycarand
gogetit.Theindependenceoftransportation.Ihaveaverygood
friendofminewhoiscompletelyblindlikeIam.Weoftentalkabout,
youknow,yearsagoshewasseeingayoungman.She’dhaveto
dependonafriendtotakehertothepostofficetomailhimapackage.
You’velostyourprivacyfactor.Herfriendwouldalwayssay,“what
areyousendinghim?Whyareyousendinghimthat?”whydoyou
havetofeelthatyouhavetotellyourfriendeverything? Maybeshe
wantedtokeepthattoherself.I’mjusttheopposite.Itelleverybody
everything!Nosecrets! ButIunderstandher.It’syourprivacy,your
independence.SometimesI,IguessIusedto…sometimespeople,
whenIfirstlostmysight,peopledidn’tknowIlostmysight.Alotof
peoplethoughtIwasaloof.I’mnotaloof,it’sjustthatIcouldn’tsee
themandoncetheyunderstandthat,youknow.Irememberon
personsaid,“I’dalwayswaveatyouandyou’dneverwave.NowI
understand.Thingslikethatweremoreofabarrier.Whenpeople
realizedthatIcouldn’tsee.Therewasnoeyecontact.Therewasno
interchangeofexpression. Thatwaskindofabarrierbutoncepeople
know,thatisnotabarrieratall.Infact,tobehonestwithyouVictoria,
Ifeelthattheblindnessisablessingbecause,asyoucantell,Ilove
people.Ifyouhadtenpeoplethatwereoutgoingbutoneofthose
peoplewereablindperson,whowouldyouremember? Theblind
person,right?Icountthatblindnessasablessingbecausesomany
peoplerememberme.NomatterwhereIgo,there’salwayssomebody
whocomesoutofthecrowdandgivesmeahug.Youknow? That’s
thesilverliningtomycloud.Peoplewouldn’thavetocomeoutand
sayhello.Iwouldn’tknowthatthey’rethere,youknow?Andthey
alwaysdoandIthink,“theyrememberme.”It’speoplethatIdon’t
evenknowthatwellsometimes.Buttheydo.Iknowit’sbecauseofthe
whitecaneandIthink,“thankyouLord.”
Whenasked,“Whateffectdoyouthinkyourdisabilityhashadonyour
aging?” most of the participants thought that their disability had had little or no
effectonhisorheraging. Saraelaboratedonbarriersrelatedtoherdisability“I’m
not able to just take off and go where I want to go. I can’t. Luckily I have good
friendswhowilldriveme.Ican’tgetinthecarandjusttakeoffandgowhereIwant
69
togo.Also,Ihadtoquitwork.Icouldnolongerwork.Thatwashard.Thatwasvery
hard.” Sethstated:
Ithinkinsomewaysit’sablessingindisguise.It’soneofthosethings
whereyou,youknowmaybewhenIwasinmyteens,20sor30s,Ifelt
likeIfocusedonmydisability.Ifinallycametopeacewithmy
disabilityandthatthisiswhoIam.Ithinkithelpedmelookatother
peopletoo.Youknow,everyoneisnotperfect.Ithinkthesamething
withme.Irealized,okay,yougowithwhatyoucangowith.Youdon’t
tryto,obviously,withhearingtherewerecertainthings,youknow,I
wouldn’tbeatelemarketerorsomethinglikethat.Althoughnowthe
phonesaregettingbetter.Ihaveacaptionphonesocanhearbetter.I
thinkbecauseIhadadisabilitywhenIwasyoungerthat’seasierthan
somepeoplewhostarttolosetheirhearingnow.Theygetfrustrated,
adaptingtohearingaidsorsomething.Ididn’thavetogothrough
that.Insomewaysit’skindofnicenow,asseniors,becauseIcan’t
hearverywell,IfitinbetterthanwhenIwasyounger.NowI’mkind
ofonthesamelevelwiththemnow.
Lauradidnotfeelherdisabilityimpactedheraging.
Idon’tthinkit’shadaneffectonmyaging.Butitcertainlyhadan
effectonmyrelationships.AsIwaslosingmyhearingmyfamilywas
essentiallyunwillingtolearnanythingmoreaboutpeoplewhosuffer
hearingloss.Especiallymytwoyoungersons.I’mfindingthisoutnow
astheygetolder.WhentheythoughtIwasignoringthemandthen
whenItalkedtothemtheythoughtIwasalwaysyelling.Whatpeople
don’tunderstandisthatasyouloseyourhearing,youcan’thear
yourselfeither.Itmadeitreallyhard.Ispentthelast25yearsofmy
marriage,becauseasIsaid,IgotmyfirsthearingaidwhenIwas37,
havingtoremindmyhusbandthatheneededtolookatmewhenhe
talkedtome.Myfriendscouldrememberandhecouldn’t.Yougrieve,
asyouloseyourhearing.Unlessyou’vebeeninthatspot,you
withdrawbecauseyourealizeyoursayingstupidthingswhenyou
hearonethingandyourealizeit’snot.Youtrytogetinvolvedina
conversationandrealizeithasnothingtodowithwhattheywere
talkingabout.Eventuallyyoujustdon’ttalkanymore.
IaskedLauraifshebelievesthereisadifferenceinthisbetweenwhenshefirst
becamedisabledandnow.Shestated:
70
Itwasprogressive.Ididn’trealizeitmyselfuntilIgotmyfirstimplant.
Itwasactivatedtwodaysbeforemymom’s80th birthdayparty.When
myfamilygottogethertocelebrate,peoplewereaskingmetorepeat
myselfandspeakup.IthadbeensolongsinceIcouldhearmyselfthat
Ihadbeentalkingtoloudlymostofthetime.Thatwasaprettyradical
momentforme.IknowtheaudiologistsaidIwasaperfectcandidate
foraCochlearImplantsurgerybecauseIhadhearingandIwashighly
motivated.Infact,thedaysheactivatedthefirstimplant,ithappened
I’dseenadocumentaryaboutawomanwho’dreceivedCochlear
Implantanditwasalotlikeme.Heraudiologisthadusedan
embroideryhoopcoveredwithfabrictocoverhermouthsothis
womancouldn’tlipread.Shedidn’tdonearlyaswellasIdid.Iwas
abletounderstandwhatshesaid.ShewasamazedhowwellIdid.
Whenaskedwhatmadeher“highlymotivated”togettheCochlearImplant,Laura
responded,
Iwantedtobeabletohearmygrandchildren.Iwantedtobeableto
talktothemandthatwasarangeofhearingthat,thosefrequencies
areamongthefirstyoulose.Itwasfunny,afterIgotmyimplant,my
onegrandson,Godblesshim,said“grandmaIwantoneofthosewhen
Igrowup.”Herealizedwhatadifferenceitmade.WhenItakethem
offItellhimIcan’thearyou.
Jill’spositiveresponsewas,“Ithinkit’sbeengreat!Ican’tseemyselfwiththe
wrinkles! LikeIsaid,Idon’tseemyselfagingsoIthinkit’sbeenablessing.Ican’t
seeanynegativityinitwhatsoever.”
Similar to the preceding question, the following question, “What effect has
aging had on your disability?” did not prompt most of the participants to answer
affirmingthataginghadsignificantlyimpactedhisorherdisability. Sethstated,“In
somewaysit’sbetterbecausenowI’mstartingtogetapeergroupthatdoesn’thear
well like me. In some ways I’m getting closer to my peer group then I was whenI
wasyounger.”
Laurastated:
71
AsIgotolder,Igotmyfirstimplantatage37anditprogressedover
time.ItBecameanecessitytogetCochlearImplant.Ithaseffectedme
alloftheseyears.25years.Itsoimpairedmyabilitytointeractwith
otherpeople.IreadaquotebyHelenKellerandshewasaskedifshe
hadachoicetobeeitherdeaforblindwhichonewouldshechoose?
‘Wouldratherbeblindbecausespeechiswhatconnectsyoutoother
people.’Thatistrue.That’swhatconnectsyou.Mydisabilityhasn’t
effectedmeasI’veaged,I’vereachedaplateauhere.Evennowwhen
I’mtryingtoestablishnewrelationships,Imakeitcrystalclearfrom
thebeginning.Ifyoudon’thavethepatienceortheunderstandingto
lookatmewhenItalk,I’mnotinterestedinbeginningarelationship
withsomeone.It’stoomuchwork.
IaskedhowthatwasreceivedbypeopleandLauraresponded,
Somepeopleareveryunderstandingandothersaren’t.Iwentonan
on‐linedatingsite.Myhusbandessentiallyabandonedmeyearsago.I
canalmostpinpointittothetimeIbeganlosingmyhearing.Hewas
neverabletoacceptthefactthathehadawifewithadisabilityand
mydisabilitysentme,overtheyears,asinfactIwentonmyfirst
antidepressantwhenmydaughterwasajuniorinhighschool.Asmy
kidslefthome,Isawthehandwritingonthewall,becausemy
husbandwasaworkaholicandIknewthatandIknewIwashis
enabler.ButIkeptwaiting.Iwaitedforhimmywholelife.Isaid,now,
itwasfornothing.WhenIwentonthiswebsiteImadeitcrystalclear
inmyprofilethatIhavebilateralCochlearImplantandI’mdeaf
withoutthem.Ifthat’snotimportantenoughandyouaren’tpatient
enoughtoremembertolookatmewhenItalk,don’tbothertocontact
me.Itimpactsprettymucheveryaspectofmylife.WhenIgotbackin
theshowringafterbeingoutforalongtime,Iactuallyhadtogeta
letterfrommysurgeonandaudiologistthatIhavetogivethejudge
becausetherulesrequirethatyouwearahelmet.Ican’tbecause
thereisahighriskoftheskinerodingwheretheseattach.Thehathas
tobetighttokeepitonandiftheyarecoveredupbythehelmetthenI
can’thear.Theymakeareasonableaccommodationformebecauseof
theADA.Theyarealsorequiredtohaveclosedcaptioningforme
duringthedivorceproceedings.TheonepersonIcan’thearisthe
judge.That’sanotherthing,itwasyearsthatIdidn’tgotomovies.I
neverwenttoconcerts.Although,Ithinkmymusiciscomingback.It’s
notthewayIrememberit.TherearecertainthingsIcanhearand
certainthingsIcan’t.Losingthemusicwashuge.
Hearinghowimportantmusicistoher,IaskedLauraifsheplaysanyinstruments
andshestatedthatshedoesnot. “MyparentsweretoopoorsoIalwayssworeI
72
wouldhavemykidsplayaninstrument.Bothmygirlssingbeautifullyandplaythe
piano. Iusedtolovelisteningtothem.Myoldestdaughtermajoredinmusic.It
wasn’tuntilIgottheimplantsthatIlostthemusic.Forsomereasontheyhaven’t
beenabletotweakthemtomakethatanybetter.”
HearingwhatLaurasaidaboutwithdrawingat37,whenshelostherhearing,
Iaskedherifshethinkstheexperiencewouldhavebeendifferenthadshelosther
hearingathercurrentageversusage37andshereplied,
Theexperiencewouldbecompletelydifferentbecause,likeIsaid.My
children’simpressionofmewouldbecompletelydifferent.Iwonder
howtheirrelationshipwouldbewithmeiftheydidn’thavethe
impressionIwasignoringthemandyellingatthemallthetime.I
wentbacktoschool.Iwasgoingtobeasocialworker.Iwantedtogo
intohospiceandmyadvisoraskedmeifmyfamilywouldbe
interestedinlearningASL.Isaidtheywouldn’tevenbother.It
impactedwhatIwantedtodo.Igotfarenoughintoittoknowthat
peoplewhoaredying…Iworkedatanursinghome.Ihadahardtime
interviewingtheresidentsbecauseIcouldn’thearthem.Mydays
werenumberedthereanywaybutitmakesyouawarethatiteffects
everyaspectofyourlife.Yougrievethelossofyourhearing.Ithas
reallystruckmeandmyfamilyneverunderstoodthat.Myfriendsdid.
Ifmyfamilywouldhavebeensupportive,mywholelifewould’vebeen
different.
Whenaskedwhateffectaginghashadonherdisability,Jillanswered,
Well,it’saging,likeIsaid,it’sthelong‐termdiabetes,Ihavethe
autonomicneuropathy,Ihavethehypoglycemiaunawareness.Those
arefromlong‐term,youknow,dealingwiththisdiseaselong‐term.So
thosediseaseshavecreatedissuesformebutthereagain,I’vegotten
friendsthathavediedfromthisdisease.So,Ifeltveryfortunate.I’m
here.Soit’sveryhardformeto,um,IknowIsoundtooPollyannaish,
I’mawareofthat.Iamjustsograteful.
73
CopingandResilience
Theparticipantsillustratedcopingandresilienceasthemesinmanyoftheir
statements. Alldescribedsometypeoflossduringtheirlivesandhowthey
managedtocopethroughthatlossandotherchallenges.
Lesterdescribeslosseshehasfaced,
IfeellikeI’m90insteadof78.ItfeelslikeImightmakeitto100.It’sa
change.It’saloss.Iwasbusyalldayeveryday.Ididallthecorn,
spraying,harvesting,combiningandchisel‐plowinthefall.Weusedto
have400pluscattleandtwobigsilos.Ibasicallytookcareofthemall
thetime.Wehadpure‐breadblackanguscowsandwhenthekids
wereyoungertheywerein4Handinfairs.Wewonalltheawards.Our
oldestsonhadthegrandchampionsteeratthecountyfair.Hewas
drivinghomeinthefogthenextdayandasemihithimandkilledhim
andournephewboth.Hewas18.He’dbeenhomecomingking
andhadhisroomreadyattheUniversity.Nowthatwasasonofagun.
Theywerebothkilled.Thattookalargepartofourlife.Kidsusedto
showpigsandwehad200plusducks.Kidswongrandchampionat
fair.Wehadaveryactiveplace.IusedtomakefivetripstotheState
Fairinthesemi.
Loislostherhusbandapproximatelytenyearsagoandsated,
ThirtyyearsagoIhadahusband.Ihadonechildlivingathome.We
livedpart‐timeinFloridaandpart‐timeheresoitwasquitedifferent.
Iwashappyandcontentandfeltfulfilledthenandnow.Probablyit
wasalittlemore,mysonwasateenagerandgivingusalittlebitofa
problem,hewasalittlehardtodealwith.Thatwasprobablyalittle
morestressfulthanitisrightnow.Ihaveaprettystress‐lessliferight
now.
Lauraiscurrentlycopingwiththelossofhermarriage.Laura’sdivorce
proceedingsweighheavilyonhermindandinfluencedheranswerstomost
questions:
I’monlyemployedpart‐timebutwhenIwakeupinthemorning,I
spendmyfirstwakingmomentsthinkingofwhatI’mgoingthrough
rightnow.Thirtyyearsago,myfirstthoughtinthemorningwasn’t
thatIcouldn’tunderstandhowthiscouldhappentome.Ifoundout
74
rightafterwehadour42nd anniversary. ThirtyyearsagoIwasbusy
raisingourchildren.Thatwasafull‐timejob.Becausemyhusband
wasneverhome,Iwasessentiallyasingleparent.Wehadfour
childrenandour3rd childwasn’tthebestboy,he’sontheautistic
spectrum.Ispentabout15yearsworkingwithhim.Thirtyyearsago
whenI’dworkinthefield,I’dworkinmyhusband’sbusiness.Things
arealotdifferentnow.
Laurastated,“Ithinkit’scruelthatwhenyouareyoungandhealthyyou
don’thavethemoneytodothethingsyouwanttodoandwhenyougetolderand
do,lotsoftimes,youaredealingwithsometypeofdisabilitythatdoesn’tmakeit
possibleforyoutoenjoywhatyou’vebeenwaitingyourwholelifetodo.”When
askedwhattypesofthingsshewishedshouldcouldbedoing,shetalkedabouther
loveofmusicandhowherhearinglosshasimpactedthis.
SomethingIreallymissisbeinginvolvedwithmusic.Itwasahugepart
ofmylife,IgotmyfirsthearingaidwhenIwas37butfromthatpoint
on,Iusedtodoalotofsolowork.Isangwithachoir,Ididweddings
andfunerals.WhenIlostmyhearingandstartedusingahearingaidit
wasjustenoughdifferencethatIcouldn’tsinginagroupanymoreor
evenbymyselfbecauseyouarejustahairbehindtheaccompaniment.
Music,Ilovedlisteningtomusic.Ihadverymusicalchildren.That’sa
hugethingthat’sbeentakenawayfromme.
Despitemanychallengesandlosses,theparticipantsalldemonstrated
remarkableresiliencyandfeelthisresiliencecontributestotheirsuccessfulaging.
Sethstated,
Idon’tthinkIcangorealcrazyandlooktoofarintothefuture.Idon’t
thinkIcancomelooktolivingtobe80,90or100yearsold.Ijust
think,well,I’m66andwhatislifegoingtobelikeat70? Maybeat75?
There’sapartofmethatstillthinksI’m50yearsoldorsomething.I’m
stillakidsometimes.Igooutandplaygolf,Iplay18holesofgolfand
I’mstiffthenextday.Mybrothercamedownlastweekendandwedid
someyardwork.I’mrealizingIcan’tdothesamethingsIusedtobe
abletodophysically.
75
Lauraalsoseesherselfasagingsuccessfullydespitemanychallengesshehas
faced,
I’magingassuccessfullyasIcan.I’mstillhealthy.Iconsiderthat
successfulaging.I’mstillactive.Mylifehasn’tturnedoutthewayI
thoughtitwasgoingto.IreadaquotebyMariaShriverthatsaid,
“Whenthelifeyouareclingingtogetstakenawayyouaregiventhe
lifeyouweremeanttohave.”IlookinthemirrorandIlookatmyskin
andIwonderhowIendeduplikethisbecauseIdon’tfeelanyolder.I
knowthere’sabook“GirlswiththeGrandmotherFaces.”That’s
appropriate.IguessifIhadproblems,ifIhadhighbloodpressure,orI
hadarthritisorsomethingimpairingme,maybeI’dfeelolder,butI
don’t.
Saradescribedhowshehasadaptedafterrearingherchildren,
It’smuchmoreenjoyablenow.30yearsagoIwasworking.Iwas
workingandtryingtoraiseafamilyandallthat.NowIcanrelaxand
notworryexactlyaboutwhattimeIhavetogetupinthemorning. I
don’thavetoworryaboutmyjoborthatIonlyhavetwoorthree
weeksofvacation.Idon’thavetohoardallofthosedaysofvacation.
Everydayisvacationnow.
Sethdescribedhowhehasadaptedtothechallengeofhischangingsocial
networkthroughouttheyearswhilehemaintainedapositiveattitude,
I’veadaptedtosomepeople.I’velearnedtoothatsomeofmyfriends
havechangedtoo.Somehaveeithergottenmarriedormovedonand
that’sarealchallengeforustostayconnected.Ithinkthat’sapartof
lifenomatterwhereweare. Howtofindfriendsandhowtomoveon.
Youknow,suddenlyourfriendsgetmarriedormoveonorget
involvedinthings…sometimeswedofindoutthatcoworkersarenot
friends.Sometimeswhenweretireoursocialnetworkhaschanged.
Peoplethatweusedtoidentifywithandworkwith,suddenlytheyare
retiredandtheyarestillworkingthereanditchanges.Idon’thavethe
answertothat,I’llbeveryhonestwithyou.That’soneofthethings
I’msearchingforrightnowistryingtofindagroup.NowthatI’m
workingnightsagain,Itrytosearchandmaybeconnectwiththe
seniorcenterandsearchmyself.Ikiddedmyneighbornextdoornow
thathe’sretiredtoothatweneedtofindwheretheseniorshangout.
Doweneedtogotothecafeinthemorningandhavecoffee?Ithink
sometimesyouneedtodothatsortofthing.Youneedtochallenge
yourselfandsay,okay,Icaneitherstayathomeandfeelsorryfor
myselforIcanstartlookingaroundforpeople.Youknowthat’spart
76
offindingwhatseniorsdonow.It’salmostlikebeingthenewkidin
town.Maybethat’swhyI’mstillworking.Idon’thavethatalternative
presentedtome.Ididhearsomefriendsofminetellmethatwhen
youworkattheseniorcentertheyallgetalong.That’soneofthe
thingsthatI’mgoingtodo,ifIconnectwiththeseniorcenterorfind
mysecondjoborsomethingIenjoydoinganddoingitwithpeople.All
mylifeI’veneededajob.ThenexttimeIhaveajoborsomething,I
wanttodosomethingaroundpeopleIenjoybeingaround.That’sone
ofthethingsIenjoyaboutstillworkingattheschoolistheenergythe
kidshaveandallthat.Eventhestaffhasacertainenergythere.Even
whenyou’renothavingagooddayorsomething,youcangothere
andsuddenlytheenvironmenttherepicksyouup.
Apositiveattitudeissomethingthatwasevidentthroughouteveryevery
interviewandcontributedtothecopingstylesandresilienceofeachparticipant.
Whenaskedifshehasagoodoutlookonlifeandwhatthatis,Loisreplied,“Ibelieve
Ido,yes.Notbeingdepressed.Countingmyblessingsasopposedtothinkingofthe
negatives.”
Aformofcopingillustratedbytheparticipantsiscomparingthemselvesto
otherswhomtheyfeelarelessfortunatethantheyare.Lesterseeshimselfasaging
successfullywhenhecompareshimselftoothers.
WellItellyou.Whenwegotocardiacrehabatthehospital.WhenI
comeoutItellmywife,sometimesIthinkI’minbadshapebutwhen
youlookattheothers,HolyGod,comparedtotheotherpeople,I’m
prettygood.Somanypeople,Imean,youcangethurtjustlikethatin
anaccidentorfalldownandbreakyourhip.LikeIsay,thenyou’re
history. Alotoftimesmywifewillwaitinthecarintheparkinglot
andallthepeoplegoinginandcomingoutwithwalkers,wheelchairs
andcanes.Wehaveoneinourfamily,it’dbemysister’sson.Hejust
hadabraintumortakenoutofhishead.Whentheysentitinandgot
theresults,supposedlyit’scancer.Hehastogoforradiationandstuff
likethat.Andthenagoodfriendofours,justthisweek,hehadheart
surgery,afour‐way.Anyway,hesurvived.Helostalotofbloodand
stuff.Wehavefriendswhoarealreadyinthenursinghomeorassisted
livingfacility.
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Jill’spositiveoutlookonlifeshinesthroughinherresponsetothequestionof
whetherornotshefeelssheissuccessfullyaging,
AbsolutelyIdo.Firstofall,Ihavenoproblem,likeeveninmy
speeches,Itelleverybodymyage.Idon’tmindtellingthatbecauseI
feellikeI’veworkeddarnhardtogetthisfarandIconsideritagoal.
I’mstillindependentandstilldoingmanythingsaroundmyhome.I
justfeelagingissuchagift.Ilookatitasablessingbecausethereare
somanypeoplewhohaven’tgottenthisfar.Ithinkwhatablessingit
istoenterintothegoldenyears.Iknowtherearealotofpeoplethat
haveaheckofalothardertimethanIdowithallsortsofmedical
issues.Ijustfeel,aren’tweblessedtobethisfar? Successfulagingis
acceptinglife.Acceptingthattherearethingsthatperhapsyoucannot
do.You’renotgoingtohavetheenergyyouhadinyour20s.You’re
notgoingtobeabletoprobablydosomethings.Ijustthinkofmyself,
Victoria.Itrytodoeverything.IfIcan’tdoitmyselfI’lltryitagain.IfI
can’tdoitI’lltryitagain.IfIcan’tdoitI’llaskforhelp.Yougottacome
totherealizationsometimesthatyoudoneedsomehelp.Butdon’tbe
bitteraboutit.Don’tgetangryaboutit.Youcangetalittlefrustrated
butdon’tholdthefrustration,youknow?Ijustthinkyou’vegottago
throughlifewithanattitudeofgratitude.
Whenaskedtodescribethirtyyearsago,Jillreplied:
Ihadourdaughterandwasbusywithher.Joyofmylife.Thingshave
changed.NowI’mgoingtobeagrandmother.Whenbabycomes,they
liveinLondon,sheandherhusbandarecominghomefor
Thanksgiving.Babyisn’tdueuntilMarchbutIcan’twaituntilbaby
comes.
Eachparticipantwasaskedto,“Thinkofagreatdayyouhavehadinthepast
fewmonths. Walkmethroughthatday.”Thisquestionwasdesignedtogaina
deeperunderstandingofactivitylevelandwhatintheirlives,matteredtothese
individuals. Ultimately,thequestionagain,highlightedthepositiveattitudes
contributingtotheirsuccessfulaging. Jim’sbriefresponseistypicalofwhatyou
wouldexpectofsomeonewhoisoftenthoughtofasagingsuccessfully,“Anyday
abovegroundisagreatday.Whatelse?Neverreallyanybaddays.”Saraalso
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respondedverypositively,“Theyareallgreatdays.Theyreallyare.Imean,every
dayisgreat.”
Iaskedallparticipants“Whatdoyouthinkcontributedtoyouragingwell?”
Theiranswersillustratewhatcontributedtotheircopingstyle.Jim’sresponse
highlightshispositiveattitude,“Enjoyinglife,Iguess.Ahappymarriage.Andalways
tryingtolaugh,youknow.Havefun.Weevenhavefuntalkingaboutmyhearing
sometimes.” Sarasaid,“Itwasprobablymyattitude.IthinkthatIdoenjoylife.And
thatIhavemanyInterests.Ihavegoodfriends.Idon’tknow.It’smynaturetobeup
Ithink.”Iaskedhertodescribeherattitudeandshesaid,“IthinkIhaveagreat
attitude.Idon’tletthingsgetmedown.Well,Ido.ImeanIworryandstufflikethat.
ButIdon’tletanythingwithmydisabilitygetmedown.I’vehadagoodattitude
aboutitallalong.AndI’vehadsupportfrommyhusband,he’salwaysbeen,you
know,rightthereformetoo.”
Laurainitiallyrespondedwith“I’matoughNorwegian.”WhenIaskedwhat
thatmeantshestated,“I’vealwayshadlivestock.Igrewuponafarm.Iknowwhatit
istoworkhard.I’vealwayshadhorses.I’vestayedactive.Myanimalshaveactually
keptmeyoungerbecausehavingtodochores:liftfeedbagsandhaybalesanddo
thingslikethathelpskeepyouingoodshape.”
Loisdescribedhermother’sinfluenceonshapingwhosheis.“Ithinkmy
motherbecausesheagedwell.Ithinkthat’sprobablywhereIdevelopedit.It’sin
thegenes.OtherwiseIdon’treallyseethatI’vedoneanything.”Iaskedherwhatshe
sawhermotherdoordemonstratethatwasagingwellandsheresponded,
Atage80shewasdiagnosedwithbreastcancerandhadherbreast
removed.Shehadpracticed,beforeshehadtheoperation,movingher
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armupintheairbecausetheyclaimthatyoucan’tliftaswelloruse
yourarmaswellafterthesurgerybecauseofthedepleatedmuscles
afteramastectomy.Soshedidthatrightawayinthehospitalandgot
alongverywellwiththat.Mydaughteroftensaystome,‘Remember
grandma’wheneverI’vehadanythingtodealwith.AndIthinkmy
childrenhavehelpedmeagewell.
Iaskedherhowshethinksherchildrenhavehelpedheragewellandshe
responded:
Okay,I’llgiveyouacoupleofforinstances.Ihaveourthirdchildand
hiswife,theythinkI’mgettingold.Igetthefeelingthattheyare
watchingformetomakesomemistakesandbeold.Mydaughter,on
theotherhand,says‘goforit.’I’maleaderinbiblestudyfellowship.
At78Ididn’tknowifIshouldcontinuedoingthat.SoIcalledherand
askedifIshouldcontinue.Shesaid,‘Ofcourse.Absolutely.’Thatwas
herresponseimmediately.Iaskedmyleader,thepersonthat’sthe
teachingleader,ifIshouldcontinue.Shejustturned50thisyear. She
said‘Yes.Andwhenyoufeelyoushouldn’t,youletmeknow.I’llleave
thatuptoyou.’LastyearandthisyearIhaveamulti‐generational
groupwhichmeanstheyoungestis44andI’mtheoldestandvarious
agesinbetween.Mysonanddaughter‐in‐lawmovedtoatownhome
andchoseonewithabedroomonthemainfloorbecausemaybeI’m
toapointwhereIshouldn’tbelivingaloneanymore.Andwhenmy
husbandwasill,hesaidIshouldsellthehouseandmoveinwithour
daughter.Mydaughtersaid,‘MotherIthinkyoushouldremain
independentaslongaspossible.’Itoldmyhusbandthatandhesaid,
‘Wellyou’reindependentallright.’I’mkeepingactive,forsure.
Jilltoldofthemanychallengesshehasfacedduringherlifetimeandhow
thesechallengescontributedtohersuccessfulaging,
WhenIwas19Ilostabrother,Joe.Hewas21.Iwasquotethe‘sickly
child’inthefamily.Iwastheyoungestoffivechildren.Atthattime,
shortlyafterthat,Iwas25whenIlostmysight.Ikeptonthinking,
‘Youknowwhat,Joewouldlovetobeheresodon’tcomplain.Youare
alive.Youaregoingtomakeitthroughthis. He’salwaysbeenmy
mentor.Indeathhe’sbeenmymentor.Whenhewasalivehewasmy
mentor.WhenIgotolderIhadasisterthatwasfiveyearsolderthan
me.Shediedofovariancancerattheageof49.Ihadasister12years
olderthanme,shedevelopedlupus.That’sanautoimmunedisease
justlikeTypeIDiabetes.Ithinkourlifeguardwasouttolunchatmy
genepool.Shewentintoavegetativestateattheageof47andshe
diedwhenshewas54.I’m63andpeoplesayIhaveagoodattitude.
80
That’swhy.I’veseenitpersonally.I’veseenhow,youknowIwantto
usetheword‘blessed’butIhatetousethatword.Godhasblessedme
butheblesseseveryone.Everyoneisspecialinhiseyes.Idon’tknow
howyouarewithyourfaithbutIhaveaverystrongfaithandIfeelwe
areallspecial.Ihatetousethewordblessedbecausetheywere
blessedtoo.Hetookthemhomebuthe’sallowedmetobehereand
that’swhatgivesmestrength.That’swhatgivesmetheattitudeI
have.IlookaroundandIthink,ohgosh.Everybody’sgotproblems.No
matterwhattheyare.Someprettyminorandsomeprettymajor.ButI
thinkwhenyouthinkyouhaveaproblem,thereissomebodydying
rightnowwhowouldlovetohaveyourproblem.
Jillillustrateshowfaithisafoundationtoherabilitytoagesuccessfully. Shealso
highlightsthatshefeelsshehasnothingtocomplainabout,whencomparingherself
toothers.IaskedJillaboutfacingadversityandmovingonandnotallowing
challengestoincapacitateher.Shecontinued,
Ifeelsorryforthepeoplewho’veneverfacedachallengebecause
whenyougetolder,andyou’veneverfacedadversity,mygosh.I
wouldn’twishthatonanyone.Ithinkonceyou’vehadtofaceitthat
youbecomemorecourageousinthefaceofthefuture.I’veseentoo
manypeople,astheyageandsomethingmajorhappens,and
somethingwillinourlifetime,theydon’thavethestabilitytodeal
withit.Theydofallapartmoreeasily.Theyhaveahardertime
acceptingwhat’shappening.Ifeelsosorryforthem.Youknowit
wouldbewonderfulifweallcouldlivetobeacertainageandnever
haveanythinghitusbutsometimealongthewaysomethingwill.If
youfindout,ifyou’vegonethroughdifferentthings…ifIliveuntil
NovemberI’llhaveoutlivedmymother.Mydadliveduntilhewas86
andIhaveabrotherthatis74.Ialwaysteasemybrother.Ihopehe
livestobe100butmygoalistooutliveeveryoneinmyfamily.They
dayhediesIknowI’llhave11moreyearstogo.Ijustthinkitwould
besohorribleformetositandcomplainaboutmylifewhenIknow
mysiblingswouldlovetobehere.Adversityteachesustogrow.
Eachparticipantdescribedwhattheywishpeopleknewaboutagingwell
withadisability. Theirresponsesinvolvedthingstheyhadpreviouslystated,such
as“haveapositiveattitude,stayactiveandhavefriends.”Jimstated,“Ithinkyou
havetokeepasenseofhumor.Youjustcan’t,eventhoughyougetfrustrated,you
81
justcan’tletitgetyoudown.It’sjustsomethingyou’vegottaaccept,youknow.
Nothingyoucandoaboutit.”
Similarly,Sarastated,“Wellthere’snothingyoucandoaboutagingbecause
that’salwaysgoingtobethere.Youjustkeeponwithyourlifeandkeepgoing.Enjoy
life.Youhavetohaveagoodattitudeandnotletthingsdragyoudown.”Iprobedfor
moredepthandobtaineditinmanyoftheresponses.
Seth’sresponseisasfollows,
Forme,mydisabilitywaskindof,nowthatmyhearingwasgoingbad,
I’mstartingtofitinabit.Forsomepeoplewhoarestartingtolose
theirhearingorstartingtolosetheirsite,particularlymymom.She’s
startingtolosehersiteandcan’treadthepaper.That’ssomethingshe
enjoysdoing.Ithinkasseniors,ifyoutakesomethingawayfromthem
oryoueliminatethatfromtheirlifestyle,itmakesitchallengingfor
themtoreplacethat.Ithinkthesamethingwithmydad. Ihaveto
chuckle.HewenttotheVAandtheygavehimsomehearingaids.He
camehomeandthrewthemintheboxandthrewtheminthedrawer
andneverworethemeagain.Ithinkthat’soneofthethingsfor
seniorsthattheytrytoadapttolittlethings.Hedidhaveagoodthing.
Ashegotolderandtriedtogetoutofthecarhe’dsay‘Comeonold
man,let’sgetgoing.’Inowthinkthat’dbeagoodphraseformetosay
asIgotolderandI’mtryingtogetoutofthecarorI’malittlestiff,
‘Comeonoldman,let’sgetgoing.’Youknow,encourageyourself.
Challengeyourself,sotospeak.Idon’tknowwhatadviceyoucangive
toseniors.Everyonehandlesitdifferentlyandnoteveryonewants
help.AcoupleofmyniecesandnephewsareonmyLinkedInpage.
Theylikemyadvice.Youhavetoencourageyoungerkids.Bethereto
pickthemupwhentheyfall.Connectyoungerpeoplewithseniors
whocanbegoodrolemodels.Ilikeprogramsthatconnectdaycare
centerswithseniorcentersandwouldliketovolunteerwhenIretire.
Lauradescribedthecurrentstruggleofherdivorcebutalsooptimismforthe
future.
PhysicallyI’mdoingalrightbutemotionally,I’mnot.I’mstilltryingto
getbackonsolidfootingandrealizethatIdohavealifetoliveyet.I
should’vegottenoutofthesituationIwasin20yearsago.I’venever
feareddeath.MyphilosophyhasalwaysbeentogoashardasIcanfor
aslongasIcan.ItoldmykidsthatifIdiebecauseI’mdrivingmy
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sportscartoofastorridingmyhorse,itwillbewithasmileonmy
face.
Aswithmostofherresponses,Loismodestlydescribeshersituationwhen
askedwhatshewishedothersknewaboutagingwellwithadisability.Shestated,
“Thattheycandoit.Thatitisn’tanend‐all.Nowremember,mydisabilityisn’tlike
somebodyelse’s.I’mnotinawheelchairoranything.”IaskedLoishowdifferentshe
thinksherexperiencewouldhavebeenifshehadlosthereyeat77versusatage39
andshereplied,“That’sagoodquestion.Whenyou’reyoungIthinkyoucanaccept
thingsbetter.Ithinkitwould’vebeenharder.IthinkIwould’vefeltsorryformyself
moresothanIdidatthattime.Ithinkitwould’vebeenmoredifficult.”Lois’
daughterhadenteredtheroomforthispartoftheinterviewandaskedhermother,
“Thinkaboutwhenyouwerelosingyourvisioninyourgoodeye.Whatelsedidyou
do?”Loisrespondedthatsheboughtadaptiveequipmentanddealtwithit.Ithen
asked,tongue‐in‐cheek,“Whendidyoufeelsorryforyourself?”Loisthenlaughed
andherdaughterstated,“Youalwaysjustgoon.Youfindawaytodealwithitand
yougoon.”Loisthentoldthestoryofwhenshelostthevisioninhereyeandhow
shedealtwithit.
IhadadoctoronceinFloridawhosaidhesawspotsonmyeyeandI
couldgoblind.Itscaredmealot.Itriedputtingmakeuponinthedark
becauseIthoughtIshouldpracticebeforeithappened. Thatwas
whenIwasalotyounger.IguessIwoulddothatagainnowifit
happenednow.IalwayssaidI’dgetaseeing‐eye‐dogifIwentblind.
I’ddowhateverIcouldtogethelp.I’mreallyblessedwithagood
family.
Jill’spositiveattitudeandresilienceareevident,onceagain,inthefollowing
statement,
83
Weallhavethepowerwithinustomakechoices.That’swhyItell
people,youknow,it’sokaytofeelfrustrated.It’sokaytobeangry.It’s
okaytobesadbutdon’tholdontothosemoments.Youknowyou’ve
gottaletthemgoandgoforwardandkeepongoingforward.Andlike
Isaid,keeponrememberingallofthethingsyouhaveandnotallthat
you’velost,whichyouhave.It’snotreallyimportantwhatyou’velost.
Ialwayslookatmyselfandthink.Peoplearemultifaceted.Lackof
sightisjustasmallpartofme.Ioftentellpeopletoo,ifyoublindfold
yourselfrightnow,youarestillthepersonyouare.Whetheryouhave
sightornot.Youstilllikethesamethings,youstillthinkthesame
things,youstillwanttobeengaged.Ifyouareashypersonyou’restill
goingtobeashyperson.Ifyouareoutgoingyouarestillgoingtobe
outgoing.It’sjustasmallpartofyou.Weareallmultifaceted.ButIdo
feelsorryforthepeoplewhocan’tmovebeyondbecauseifyoucan’t
youaregoingtodigyourselfinahole.Ifyoucan’tchangeyourways
oryourattitude.Iknowtherearealotofpeopleouttherewhohaveit
alotworsethanIdosoIshouldn’ttalksosmugly.Ifacedalittlebitof
achallengetwoyearsago.Ilostmyhearingonmyleftside.Wasthat
everscary.I’dbecookingamealandIknowthatthefryingpanis
rightinfrontofmebutthesoundiscomingoverhere.Whathappened
tome,itwasmyautoimmunesystem.Igotitback80percentbutIhad
losttotalhearingontheleftside.ItwasscarybecauseIthought,what
ifIlosetotalhearing?HowamIgoingtotakecareofmyselfwith
everything?Mydailyroutine?Myinsulininjections?Ineedtoknow
whatmyglucoselevelis.IneedtoheartheclicksoftheinsulinasI
inject.Ithought,whatintheworldwouldIdowithouthearing?Well
thankGodIdidn’tfindout.Ikeptontellingmyself,there’sgottobe
someway.AndI’vegotneuropathytoosoIcan’treadbraille.I’dreally
beupacrick.Iwasconcernedaboutthat.SoIshouldn’ttalkso
smugly.I’msuretherearepeoplelikemethatthathashappenedto.
Iaskedherhowshewouldhavehandleditifthishadbeenpermanent.
Iwouldhave.I’mpersistent.Youknow,simplethingslikewritinga
grocerylist.Iwouldhavetomanuallysitdownandwritethegrocery
list.AlotoftimesI’dforgetwhatIhadonthereandprobablywriteit
overagainandsometimesI’dwriteitoversomethingelsesohe
couldn’treaditbecauseIdidn’tknowI’dwrittenontopofsomething
else.NowIjustkeepadocumentonmycomputerandarunninglistof
groceries.Ifhe’sgoingtogetgroceriesIprintitoutforhim.Simple
thingslikethatI’mjustsogratefulfor.Somanythings.
Spirituality,asafoundationforcoping,wasimportanttomanyoftheparticipants.
Sethstated,
84
IrealizethatI’mlookingatmylifeasabookwithdifferentchapters.
Somearelonger,someareshorter.Somearehappy,somearesad.You
knowIthinkIjusthavetofigureout,okay,whatdoesGodhaveforme
todoinmylife.IfIcanfindoutwhatmypurposeisforthenextfive
yearsortenyears,Ithinkthat’sfine.
Sethcontinuedtoexplainhowhisreligionandrelationshipshehashadhave
influencedhissuccessfulaging:
IthinkbeingaChristianandbelievinginGodandbelievingthatGod
hasApurposeforyouhelpsalot.Ifyou’vegotsomekindofspiritual
base,thatdoeshelpyou.Thenyourealizethatwhenyouhaveyour
bummerdaysandyou’renotfeelingsogood,yourealizethatGodstill
acceptsyou.Ithinkthat’sgoodtohaveagoodspiritualbase.Iguess,
likeIsaid,it’sgoodtohaveagoodgroupofsocialfriendsthataccept
you.Ithinkthat’salwaysgood.Youknow,justhavingthat
perseveranceandintelligencetogoonandsay‘thisbaddaydoesn’t
defineme’andthatsortofthing.Ithinksometimesit’snicethat
peoplecomealongandencourageyouorsomethinglikethat.Weare
allgoingtohaveourfrustrationsandstruggles,especiallyasweget
older.Ithinkthat’soneofthethingsyouneedtodoishavesometype
ofsocialcontactwithpeople.Infact,Ithinkthat’soneofthethings
peopledon’tknowhowtodealwith.Olderpeople.Sometimesthey
areafraidbecausesomeseniorareascostandmaybeasyougetolder
youdon’thavethefinancestobeabletodostuff.Ithinkit’dbeniceto
beabletogetinvolvedinthings.Sometimeschurch’sfocusonyouth
andyoungerpeopleanddon’talwaysfocusonolderpeople.Ithinkit’s
nicetherearestudiestolookathowseniorscanlivewell.Idothink
thatsomeseniors,afterawhile,especially,Ididthisthingonstress
onetimeandlosingaspouseisaverystressfulthing.Somepeople,
youknow,they’vebeenconnectedwithsomebodyfor40yearsand
suddenlytheydon’thaveanybodyandmaybeit’stheirsocialfriends
orweredependentontheirwork.Idon’tknowifthere’sanswers
becauseI’mkindoflookingforthoseanswersofhowtoconnectwith
peoplewhentheyareolder.Ithinksomepeoplewhentheyareolder,
youknowtheyweren’traisedinthecomputer/Facebookagesosome
ofthatstuffisforeignforus.Wedon’tgotocomputersandstuffto
lookforconnections.Itdoesgettobeachallengeonseniorstofind
outhowtoconnect.
AdvicetoOthers
85
Advicetoothersincludedmanyoftheitemstheparticipantshighlightedin
theabovethemesrelatedtosuccessfulaging.Thequestion,“Whatadvicecouldyou
givemethatwouldhelpmeagewell?”yieldedvariousanswersfromeach
participant.
Jimstated,“WellIsupposeIstaybusy.Ihavehobbies.Iusedtolikeworking
withwoodandstufflikethat.Ibuiltmyownfurniture.Ihaven’tdonethatlately.
Stilldosome.”Jimcontinued,“Ithinktoowhathelpsyouagegoodiskeepingactive
withyourfriends.Westillhavealotoffriendsandrelativesaroundhere.” Jim
finishedansweringthequestionwiththisstatement,“Youdon’twanttobecome
isolated.Whichthistendstobecome.Youtendtoisolateyourselfwhenyoucan’t
hearanymore.Youliketoavoidcommunicatingwithpeopleandstufflikethat.
That’sthebadpart.Soanyway.”
Sara’sadviceincluded“Keepactive.Havefriends.Let’ssee,stayhealthy.And
justhaveagoodoutlookonlife.Ithinkthat’srealimportant.”
Seth’sadviceinvolvedbeingcomfortablewithwhoyouare:
Ithinkfirstofall,findoutwhoyouarebecausethat’sthemost
importantthing.Weallgothroughself‐discoveriesandthingslike
that.Ithinkfindsomethingyouenjoydoing.Findsomeoneyouenjoy
spendinglifewith.Dothosesortsofthings.Justlearntoenjoythe
days.Ithinkthat’sonethingthatIalwaysdislikedwhenIworkedat
differentjobsandpeoplewouldsay‘youknowI’vegotanother20‐30
yearsuntilIcanretire.’Youknowtheyhadgoals.Justlivelifeeach
dayandtrytobecontentwithwhoyouare.Ithinkit’sfine.Youcan
alwaystrytoimproveyourself.Knowingwhoyouareandbeingat
peacewithyourself.
Laura’sadvicewasto“Stayactiveandstayinvolved.Ithinkthosearethetwo
best.Don’tcountonsomeoneelseforyourhappiness.Imadethatmistake.”
86
AfewparticipantsprovidedadvicewhenIaskedifthereisanythingelsethey
wouldlikemetoknowaboutaging.Lois’optimisticanswerwas,“Lookatthebright
sideoflife.Don’tdwellonnegatives.Thatreallytearsyoudownanddoesn’thelp
youonebit.InmyestimationIguess.That’swhatIwouldadvise.” Jill’sanswerwas
similar,“Acceptit.Keepgoingforward.Youcan’treversetime.I’djustkeepgoing
forwardandembraceit.Again,justbesogratefulthatyou’vehadtheopportunityto
reachthatlevel.”
Whenasked,“Whatadvicewouldyougivetoayoungerpersonwitha
disabilitytoguidethemtoagewell?”Mostrespondedstatingthatoneshouldaccept
his or her disability and maintain a positive attitude. Sara stated, “To just keep
pushing. To try to overcome that disability. Don’t let it stop you fromdoing
anything.Trydifferentwaysofhoweveryoucantodowhatyouwanttodo.”
Seth’s sentiment was similar but he expanded his responsewith a powerful
personalstory:
Ithinkthefirstthingistoacceptthedisability.YouknowwhenIwas
youngersometimesIwouldn’twearmyhearingaidsandthenI’dgo
toclassorsomethingandI’dbeself‐consciousandI’ddefeatmy
wholepurpose.IthinkI’velearnedtoacceptit.Wearmyhearingaids
anddomystuff.I’verealizedthatthatifpeoplearerejectingyou
becauseofyourhearing,ifpeoplearegivingyouahardtimeor
somethinglikethat,theyjustdon’tunderstandandrealizethatyou
havetohavepeacewithyourselfandthatsortofthing.It’sapartof
you,youruniqueness,notbeingabletohear.Youhavetokindof
realizethatsomethingsaregoingtobemorechallengingthanothers.
Imean,youcan’tgooutinsocialgroupswherethere’salotofnoise
andeverything.Butatthesametimethatdoesn’tnecessarilymean
youdon’ttry.Nodoubttherewillbesomejobsthatareharderforyou
todo.Butatthesametimethatdoesn’tnecessarilymean,youknow
likecellphonesandthatsortofthingthataren’tverygoodforpeople
whodon’thearverywell,thatdoesn’tmeantheywon’tbeabletofind
somethingthat’sadaptabletoyou.
87
Lauraresponded:
Useeverytypeofsupportordeviceorassistancethat’savailableto
you.Trytoconnectwithotherpeoplewhohavegonethroughthe
samething.Mydisabilitydoesn’teffectmyabilitytofunctiononaday‐
to‐daybasis,youknow,selfcareandallofthat.Ithinkthatwouldbe
thebestadviceIcouldgivethem.
Loisstated,“Iguesstolearntolivewithitandtoalmostignoreit.Acceptit.If
youdon’tacceptithowwouldyougetalongverywell?”Iaskedherhowonedoes
thatandshesaid,“Youjustmakeupyourmindyou’regoingtoandyoudo.Idon’t
know.Howwouldyoudothat? It’smindovermatter! Inlifesomanythingsare
mindovermatter.”
Lesterresponded,“You’dbettertrytotakecareofyourselfbecauseit’sgoing
togetworse.Thebestthingaboutifyouloseyourhearing,youcanhavethese
implantsineachearandyougetalongreallygood.Supposedly,thereisn’treallyany
fixingtheeyes.You’vegottokeepupwiththemoderntechnologyforyourhelp.
Follow‐upandgethelpimmediately.”
Jilldescribestheneedforapositiveattitudeaswellasperseverance.
Again,you’vegottaworkonyourattitude.Justkeepontrying.Don’tlet
otherpeopleunderestimatewhatyoucando.Alwayshaveselfworth.
Knowthatyou’recapableofdoingsomethinganddon’tassumethat
youcannot.Tryit.Giveitatry.Perhapsmaybeyoucan’tbuttheworst
thingisnottrying.Andasyouage,well,again,workonthatpositive
attitude.Itopenssomanydoorsforyouthatprobablyyoudidn’teven
realizethatyoucoulddosomething.Tomethat’ssoveryimportant.
Iaskedhertoclarifywhatshemeantby“opendoors”andJillresponded,
Youknow,don’tassumethatyoucan’tdosomething.Don’tletother
peopleassumethatyoucannot.Mygreatestexperienceis,Ialways
wantedacomputer.WhenIconsideredthecostandtrainingandthe
jobsprogramthatwouldgowithacomputerIthought,wow,that’s
justoverwhelming.That’salotofmoneyanditwouldbejustformy
88
entertainment.Itwouldn’tbejob‐related.Ikeptpushingitontheback
burner.IkeptthinkingthatitwassomethingIreallydidn’tneed.Well
thenImetsomeoneatServicesFortheBlindandshehelpedmeand
gotmetraining.Thefirstproductdidn’tworkforme.Afriend
recommendedanotherproduct.IhatedtocomplainbutthoughtI
neededtobeanadvocateandstandupformyselfandsay,youknow,
thisisn’tworking.Aftercomplainingalittlebit,thewomanatServices
FortheBlindhelpedmegetanewprogram.WithintwohoursIwas
doingdocumentsandemails.Itwaslikeawholenewworldopened
uptome.But,youneedtobeassertive.Youneedtokeepontryingto
reachyourgoal.Ifyou’rereallyinsistentandworkonit.Andyouhave
tohavethecouragetodoit.Ithinkit’simportanttohaveagoal.To
havevisionsofwhatyouwant.Whereyouseeyourselfandwork
towardsit.Anddespitewhatotherpeoplesay,unlessit’sgoingtobe
harmfultoyou.Ithinkyoujusthavetobeyourownadvocateand
havethecouragetostepupandsayno,Ireallywanttotrythis.Give
meachance.
Alloftheparticipantsillustratedthemesofwhatitmeanstothem,as
individuals,toagesuccessfully. Thesethemesincludedagingasinevitable,frequent
activity,socialandfamilyinteractionasessential,senseofworth,acceptanceof
disability,copingandresilienceaswellastheadvicetotheywouldoffertoothers.
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ChapterV: Discussion
Thisstudyexaminedthequestion:Whatdoesitmeanforanolderadultwith
long‐termdisabilitytoagesuccessfully?Sevenmenandwomenparticipatedin
recordedinterviewswiththeresearcher.Therecordingsfromtheseinterviewsand
memoswrittenbytheresearcherbecamethedatathatproducedfindingstoanswer
theresearchquestion. Severalthemesemergedfromthedata.
Participantsrangedinagefrom63to83yearsoldandhadlivedwitha
disabilityforapproximately20yearsorlonger.Threeweremaleandfourwere
female.Fourweremarried,onewasseparated,onewassingleandtheotherwasa
widow.Fourlivedwiththeirspousesandthreeresidedalone.Allhadcompletedat
leastoneyearofcollegeortechnicalprograms.Fivehadgraduatedfromcollegeor
technicalprogramsandonehadearnedcreditsbeyondherbachelor’sdegree.
Alloftheparticipantswereblind,deaf,hearingimpaired,visionimpairedor
acombinationofthese. Allhavelivedwiththeirdisabilitybetweeneighteenand
fiftyyears.Mostdescribedtheiroverallphysicalandmentalhealthasgoodor
excellent.Noneidentifiedneedingassistancefromacaregiver. Allwereassigned
pseudonymstoprotecttheiridentity.
Inthisstudy,participantssharedtheirthoughtsaboutsuccessfulagingand
thelivedexperienceofagingwithadisability. Thisisaphenomenologicalstudyof
olderadultsandtheirviewsonaging. Informationwasgatheredthroughopen‐
endedinterviewswitholderadultswithdisabilities. Followingphenomenological
researchmethods,Isoughtanunderstandingfromin‐depthinterviewsaboutwhat
itmeanstoagewell.Iwantedtofindouttheirlivedexperienceofagingandwhat
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agingwellmeanstothem.Thestudyparticipantsillustrateddisabledolderadults’
perceptionsofagingsuccessfully. Theseperceptionsincludedbothpositiveand
negativecomponents.
Respondents’everydayexperiencescameforwardtodescribeseveral
themesandthickdescriptionofwhatthismeanstothem.Thisphenomenahasnot
beenpreviouslyexaminedamongthispopulation.
WhenIbeganthisresearch,IwasunsureifIwouldfindthatthosewithlong‐
termdisabilitiesareagingassuccessfullyasthosewithoutdisabilities.One
possibilityIexpectedtoencounteristhattheywouldnotbeagingassuccessfully,
duetotheirlimitations.WhatIfoundwastheopposite. Theparticipantsofthis
studyviewthemselvesassuccessfullyagingandmuchofthismightbeduetothe
disabilitytowhichtheyhaveadaptedorovercome. Thethemesinthisstudyare
similartoothersuccessfulagingstudiesofnon‐disabledolderadults(Baltes&
Baltes,1990;Ben‐Zur,2002;Hardy&Concato,2004;McMullin,2004;Lamond&
Depp,2008;Ouwehand,deRidder&Bensing,2007&Troutman‐Jordan&Staples,
2014).
AgingasInevitable
Agingemergedasathemeasitwasdirectlyrelatedtotheresearchquestion
andquestionsaskedtoallparticipants. Theparticipantsidentifiedbothpositive
andnegativeaspectsofaging.Manyoftheparticipantsdirectlystatedthattheydo
notfeeloldandmanyfeelyoung. Theyseeageassomethingonemustacceptand
notsomethingonwhichoneshoulddwell. Theyseeagingasanaturalprocessanda
transitionallmustexperience. Thepositiveexamplesincludednotonlyfeeling
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young,butalsofeelingwiser,comfortable,content,happyandincontrol. Negative
examplesincludedasensethattheywereslowingdown;howeverthiswasalso
viewedaspositiveandcontributedtotheirbeingincontrol. Theparticipantsfelt
thattheynowhavemoreindependenceandfreedomfromresponsibilitiessuchas
rearingtheirchildren,beingemployedandworryingasmuchaboutfinances. These
findingsareconsistentwithsuccessfulagingstudiesofnon‐disabledolderadults
(Baltes&Baltes,1990;Ben‐Zur,2002;Hardy&Concato,2004;McMullin,2004;
Lamond&Depp,2008;Ouwehand,deRidder&Bensing,2007&Troutman‐Jordan&
Staples,2014).
FrequentActivity
Activityemergedasathemeandisconsistentwiththesuccessfulaging
literatureasacontributingfactortothoseagingsuccessfully.Activityincluded
hobbiessuchasgolfing,walking,biking,ridinghorses,playingcards,woodworking,
farmingandcrafting. Activityalsoincludedcharityandvolunteerwork. This
includedvolunteeringatchurches,seniorcenters,youthcentersandservice
agencies.Participantsfoundthattheyenjoyedvolunteeringbecauseitnotonlykept
thembusybutitmadethemfeelthattheyweregivingbacktoothers. All
participantsidentifiedaroutinetotheirdaysbutalsoenjoyedthefreedomtovary
fromthisstructurewhentheychose. Twooftheparticipantsareemployedandall
maintainedsomelevelofhouseholdchores. Noneofthemreliedonoutsidesupport
fortheiractivitiesofdailylivingorinstrumentalactivitiesofdailyliving. These
findingsareconsistentwithsuccessfulagingresearchconductedonnon‐disabled
olderadults(Baltes&Baltes,1990;Ben‐Zur,2002;Hardy&Concato,2004;
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McMullin,2004;Lamond&Depp,2008;Ouwehand,deRidder&Bensing,2007&
Troutman‐Jordan&Staples,2014). Thethemeoffrequentactivityoverlapswiththe
followingthemeoffamilyandsocialinteraction,astheparticipantsallfound
meaninginactivitiesinvolvingfriendsandfamily.
SocialandFamilyInteraction
Socialinteractionwithfriendsandcoworkerswasveryimportanttoall
participantsandremainedaconstantthemethroughouttheinterviews. Codes
includedrelationshipswithfamilyandfriendsasasourceofstrength,activityand
belonging.Havingfriends,beingsociallyactiveandhavingaconnectiontoothers
wasmentioned.Thisisconsistentwithsuccessfulagingliteraturethatthosewho
aremoresociallyengaged,tendtoagesuccessfully(Baltes&Baltes,1990;Ben‐Zur,
2002;Hardy&Concato,2004;McMullin,2004;Lamond&Depp,2008;Ouwehand,
deRidder&Bensing,2007).
Familywasathreadwovenintomanyanswerstotheinterviewquestions.
Forall,theirclosefamilywasthesourceofgreatjoyandsupport. Theymaintain
positiverelationshipsandspokeofoccasionswhentheyseetheirchildrenand
grandchildren. Thesetimesmeanalottothemandsignificantlyimpacttheir
positivity.Jimspokeofattendingallofhisgrandchildren’sbasketballgamesand
sharinghisfarmwithhisson.Lois,Jim,SethandLesteralldescribedtheir“great
day”asadaytheyrecentlyspentwiththeirfamilies.
Oneparticipantwasseparatedfromherspouseandintheprocessof
divorcing. Thiswasachallengingsituationforherbutonecouldunderstand,
throughoutheranswers,howsheisabletocopewiththissituationasshehas
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duringmanyotherchallengesofherlife. Herfamilyhashadadifficulttime
adjustingtoherhearinglossandhasnotdemonstratedthesupportevidentinthe
livesoftheotherparticipants.Shehasdemonstratedresilienceandhassoughtthat
supportinrelationshipswithherfriends.Shefindsgreatjoyinherchildrenbut
therehavebeenchallengeswiththeserelationships,aswillbediscussedmoreina
followingthemeofacceptanceofdisability.
SenseofWorth
Feelingthattheymatterintheworldisalsoathemethatwasprevalent
throughouttheinterviews.Allwanttofeeltheyaremakingacontributionandare
needed.Theirvolunteerwork,employment,assistingothers,friendshipsandability
tousetechnologyallcontributetotheirfeelingsofself‐worth.Severalalso
mentionedfeeling“onlyasyoungasyoufeel”andthathowothersperceivethem
beingveryimportant.Theyfeelitisimportanttoremainengagedwithpeoplewho
areyoungerthantheyare. Theytakegreatprideinbeingrespectedbyyounger
people.LoisfindsthisinthechurchBiblestudygroupsheleads.Sethfindsthisinhis
workatacollegeandinhisniecesandnephewsseekinghisadviceonsocialmedia.
Theparticipantsreflectedonrearingtheirchildren,workingandcivicengagement
activitiesduringtimesthatweremeaningfulintheirlives.
AcceptanceofDisability
Alloftheparticipantsinthisstudybecamedisabledaschildrenorasyounger
adults.Theyeachhaveastoryofhowtheirdisabilityhasimpactedtheirlives.They
allexperiencecertainlimitations,includingalackoffreedom. Conversely,asnoted
above,freedomwasalsomentionedassomethingtheyallexperiencemoreofin
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certainways,unrelatedtotheirdisability,astheyhaveaged. Thisisperceived
differentlyasitrelatestotheirdisabilities. Manyfacelimitationsrelatedtodriving,
communicating,andsocialinteraction. Somefacedlimitedorcompletelossof
employmentasaresultoftheirdisability.Someexperiencealimitedabilitytotravel
astheyusedtowhileotherscontinuetotravel,sometimesmorethanwhenthey
wereyounger.
Acceptanceofthedisabilitywasaconstantthemeamongtheseindividuals.
Theyallgrieved,thenmovedon. Apartofthatmovingonwasdiscoveringadaptive
equipment.Somefelttheywouldbeembarrassedtousetheequipment;andothers
wantedtotrytomanagewithoutit.Duringthegrievingperiod,somereportedthey
refusedoffersofadaptiveequipmenthowever,alloftheparticipantsspokeof
adaptiveequipmenttheyhaveusedtoassistthemwiththelimitationscausedby
theirdisability. Thisequipmenthasbeenanimportantpartoftheirlivesandnoted
contributiontowardtheirsuccessfulaging.Theequipmentwasusedtoadaptto
theirdisabilities,butgavethemthefreedomtobeactiveandengaged,whichtheyall
citedasimportantcomponentstoagingsuccessfully.
Asoutlinedinthepreceding“family”themesection,mostfoundtheirfamilies
tobeverysupportiveasitrelatestotheirdisability. Oneparticipantdidnotshare
thisexperience.Shelostherhearinginherthirties,whenshewasrearingher
childrenandmarried.Shebelievestheimpactofherdisabilitycontributedtothe
strainedrelationshipwithherchildrenandtheendofhermarriage.
Asurprisingandinterestingfindinginthisresearchwasthesensethe
participantssharedoftheirdisabilitybeingtheir“uniqueness.” Itissomethingthey
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feelsetsthemapartfromothers,inapositiveway.Afewoftheparticipants
identifiedtheirdisability,whilehavingitschallenges,asapositiveaspectoftheir
livesandfeelfortunatetohavethedisabilityasapartoftheiridentity.
Anothersurprisingandinterestingfindingisthatseveralbelievetheynowfit
inbetterwiththeirpeersthanwhentheywereyounger.Sethmentionedthathedid
notwanttowearhishearingaidswhenhewasinhighschoolbecausehewould
havebeenembarrassedinfrontofhisclassmates.Henowwisheshecouldgoback
andwearthemduringthattimebecausehemissedoutonalotofhiseducation
becausehecouldnothearhisteachers.Now,asheisgettingolder,manyofhis
friendsarefacinghearinglossandheseemstofitinbetter.
CopingandResilience
Copingisanotherthemeprevalentthroughouttheinterviews. Themanner
inwhichtheseolderadultscopeisconsistentwiththeliteraturesupportiveof
successfulaging(Baltes&Baltes,1990;Ben‐Zur,2002;Hardy&Concato,2004;
McMullin,2004;Lamond&Depp,2008;Ouwehand,deRidder&Bensing,2007&
Troutman‐Jordan&Staples,2014). Allexperiencedlossasitrelatestotheirvision
orhearing. Manyparticipantstoldstoriesofdeathsoffriendsandfamilymembers.
Participantslostparents,siblings,spousesandchildrenthroughouttheirlifetimes
and,consistentwiththepilotstudyparticipants,copedwiththislossinapositive
manner. TheinterviewcommentsfromJill,regardingthelossofhersiblings,and
Jim’slossofhisson,showthattheygrievedbutwereabletomoveonafterthese
difficultlosses.
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Determinationandpersistenceplayedaroleintheparticipants’useof
adaptiveequipmentandtechnology. Theytoldstoriesofhowtheywereinitially
challengedbytheuseoftheequipment,orlackofsuchequipmentandwere
persistentinmasteringtheskillsrequiredtoovercomeachallenge. Oftenthese
situationsinvolvedthemadvocatingforthemselvestofindasolutiontothe
challenge.
Severalgaveexamplesofstrongfamilyrole‐modelswhoinfluencedtheir
copingstyle.Lois’motherpracticedmovingherarmupanddownwhenshewas
toldthiswouldbedifficulttodofollowingamastectomy. Loisrememberedthis
whenshewastoldshewouldlosehervisionandpracticedputtingonmakeupina
darkbathroom.Sethtoldofhisfather’sdeterminationtocompleteevensimple
tasksforhimselfwhileonhospice.Sethhassincerepeatedhisfather’smantra,
“Comeonoldman.Let’sgetgoing.”tohimselfwhenheishavingadifficultday. He
oftensays,“Thisbaddaydoesn’tdefineme.”Manycredittheirparentsforgiving
themthestrengthandresiliencethatcontributestotheirabilitytoagesuccessfully.
Theolderadultsinterviewedforthisstudyallmentionedthattheyperceive
othersexperiencinggreaterhardshipthanthedisabilitytheyexperience.Nonesee
theirsituationas“thatbad.”Theymadestatementssuchas“IfIwereill,”“My
disabilityisn’tlikeothers’”and“therearesomanyotherswhohaveitalotworse
thanme.”Thishighlightstheirmodestyandresilienceinthefactthattheir
situationsarenotpreventingthemfromlivingtheirlivesandnotfeelingsorryfor
themselves.
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Researchrelatedtosuccessfulagingincludescopingandresilience(Baltes&
Baltes,1990;Ben‐Zur,2002;Hardy&Concato,2004;McMullin,2004;Lamond&
Depp,2008;Ouwehand,deRidder&Bensing,2007&Troutman‐Jordan&Staples,
2014)asmechanismsthathelpfosterandmaintainastateofperceivedwell‐being,
highself‐assessedqualityoflifeandastrongsenseofpersonalfulfillmentthat
reflectssuccessfulaging.Coping,resilienceareessentialinolderadults’viewsof
successfulaging(Young,Frick&Phelan,2008).
Spirituality,asafoundationforcoping,wasimportanttoallparticipants.
Mostregularlyattendchurch,identifyasChristianandhaveastrongfaithinGod.
Manydescribedthemselvesasbeing“blessed.” Therewasalsoaconsistentmessage
amongmostthatGodholdsapurposeforthemandthispurposeguidesthemto
helpothers. Thistooktheformofvolunteeringforseniorcenters,service
organizationsandchurches.Italsoinvolvedhelpingfamilyandfriends,without
hesitation. Therewasamodestyreflectedineachoftheparticipantswhenthey
spokeoftheirsituation. Therewasneverboastingorbraggingaboutalltheydofor
others,orregardingtheiraccomplishments. Theircommentsfocusedonhowthey
feltthattheyareservantsandshouldassistothers. Theyallmadetheir
accomplishmentssoundasiftheywere“nothingspecial”whichisalsoconsistent
withfindingsfromthepilotstudy.
Criticsarguethatsuccessfulagingresearchneglectslargelyspiritualityasa
factorwhichcontributestosuccessfulaging(Crowther,Parker,Achenbaum,
Larimore&Koenig,2002;Depp;Daaleman&Frey,2004&Jeste,2006). Amissing
componenttoRoweandKahn’sthree‐factormodelofsuccessfulagingisidentified
98
bycriticsandtheyproposestrengtheningthemodelwithafourthfactorofpositive
spirituality(Crowther,Parker,Achenbaum,Larimore&Koenig,2002).Positive
spiritualityinvolves,
Adevelopingandinternalizedpersonalrelationwiththesacredor
transcendentthatisnotboundbyrace,ethnicity,economicsorclass
andpromotesthewellnessandwelfareofselfandothers.Positive
spiritualityusesaspectsofbothreligionandspirituality(Crowther,
Parker,Achenbaum,Larimore&Koenig,2002,p.614).
Theyassertthatspiritualityisanimportantcomponentofhealthandwell‐being
outcomesamongolderadultsandthatinterventionsincorporatingspiritualitywith
underservedpopulationsasaguidetohealthprofessionals,religiousorganizations
andgovernmentalagencieswillimproveoutcomessuccessfulagingamongthese
olderadults(Crowther,Parker,Achenbaum,Larimore&Koenig,2002).
AdvicetoOthers
Theadvicetheparticipantsgavetootherswhofacedisabilityishowthey
describedthemselvesliving.Theyrecommendthatotherswithdisabilitiesremain
active,havefriends,bedetermined,seekhelpwhenneeded,useadaptiveequipment
anddonotworrywhatothersthinkofyou. Theyalsorecommendthatothers
advocateforthemselves,trytoovercometheirdisabilityanddonotletitstopyou
fromdoinganything.Theyalsorecommendhavingapositiveattitude,keepingtheir
senseofhumorandenjoyinglife.
Oneofthecriteriaofsuccessfulagingidentifiedinthefirstandmost
referencedliteratureonthesubject(Rowe&Kahn,1987)isthecriteriathatone
shouldbe“freefromdisability.”Theresearchsaysoneshouldnotbecomefrail,
elderly,orhaveanage‐relateddisabilityifoneistosuccessfullyage.Ididnotfind
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anywhereintheliteraturethatresearchwasbeingconductedexamininghow
peoplewithlong‐termdisabilitywereaging. Itpiquedmyinterestandbecamewhat
Iwantedtodiscovernext. Manythemeswereconsistentbetweenthepilotstudy,
andotherresearchwithnon‐disabledolderadults,andthisstudy. Oneparticular
themewasrelatedtohowsuccessfulagersbehavewhentheyfaceadversity.Theyare
resilientwhenfacedwithchallenges. ThiswasanotherreasonIwantedtostudy
olderadultswhohadfacedachallenge,suchasalong‐termdisability.Allofthe
participantsofthisstudyreportedthattheyareagingsuccessfully.EveryoneI
interviewedhadsomethinghappentothemearlierintheirlivesthatcausedtheir
disability.ItisnotbecauseIselecteditthatway;itishowithappened.Whatdo
successfulagerswhoexperienceblindnessordeafnessdowhentheyfacethislife‐
alteringdisability?Asillustratedinthisstudy,successfulagerscanrecoverand
moveon. Theyareverystrongandresilientpeople.Thesefindingspresenta
positivepictureofsuccessfulagingamongolderadultswithlong‐termdisability,
wheretheyweremostlyignoredinpreviousresearch.
SelectiveOptimizationandCompensationTheory(Baltes&Baltes,1990)
contendsthatindividualswhoagesuccessfullyusethreestrategies:selection,
optimizationandcompensationtoachievedesiredgoals.Selectionincludes
identifyinggoals,prioritizingthem,establishingcriteriaandconditionsand
determiningthedegreeofcommitment. Optimizationreferstomaximizing
performancetofacilitatesuccess. Itinvolvesthedegreeoffocus,thetimingand
tenacityofgoalpursuit,learningnewskills,modelingotherswhoaresuccessful,
developingresourcesandincreasingtheamountoftimededicatedtogoals.
100
Compensationreferstoadaptingtolimitationsthatinterferewithgoals.Itincludes
theuseofassistivetechnology,obtaininghelpfromothers,developingnewskills
andresources,employingpreviouslydiscardedskillsandresources,devotingmore
energyortimeandmodelingotherswhocompensatewell.Priortobeginningthe
interviews,thistheoryseemedthemostapplicabletosuccessfulagingamongthose
withdisabilities. Uponcompletionoftheresearch,itappearstobeasolidtheory
uponwhichtobasetheseresults.Itisinclusiveofdifferentgroupsanddoesnot
includelanguagethatonemustbenon‐disabledinordertoagesuccessfully.
SelectiveOptimizationandCompensationTheoryappearstobethebestfittothe
study’sfindings,asitismoreinclusiveofdifferentgroups. Theparticipantsinthis
studyillustratedtheiruseofthethreestrategies:selection,optimizationand
compensation.
Illustratingthistheory,eachtoldstoriesoftheirdisabilitiesandhowtheydid
notallowthemtolimiteveryaspectoftheirlives.Relatedtoselection,theyalltold
oftheimpacttheirdisabilityhadontheirlivesandthegoalstheyeachsetto
overcomelimitationsrelatedtotheirdisability. Relatedtooptimization,theyeach
toldstoriesoftheirdegreeoffocus,thetimingandtenacityofgoalpursuit,learning
newskills,modelingotherswhoaresuccessful,developingresourcesandincreasing
theamountoftimededicatedtotheirgoals.Finally,relatedtocompensation,each
toldstoriesoftheiradaptingtolimitationsthatinterferedwiththeirgoals.This
includedtheuseofassistivetechnology,obtaininghelpfromothers,developingnew
skillsandresources,employingpreviouslydiscardedskillsandresources,devoting
moreenergyortimeandmodelingotherswhocompensatewell.
101
Anewertheory,Gerotranscendence,alsoappliestothefindingsofthisstudy.
Gerotranscendencetheorydescribesa“natural”alterationofconsciousnessinold
ageleadingto“wisdom”andaqualitativebreakwithamid‐liferationaland
materialistworld‐view. Accordingtothetheory,gerotranscendenceisobstructed
byalackofalternativevaluesandrolesinoldageinWesternsocieties.
Theoreticallyandinclinicalpractice,Gerotranscendencetheoryhasbeenlinkedto
psychoanalysis(Jonson&Magnusson,2001). Severalofthestudyparticipants
mentionedthattheyaremorepeacefulandhavelessstressintheirlives.They
mentionedthedifficultyearswhentheywereyoungeroftryingtomeet
employmentdemandsandreartheirchildren. Ithinkmanywouldfeeltheyhave
gained“wisdom”inoldageandhavebrokenfromthematerialisticworld‐viewof
theirmid‐lifeyears. Jim,Sara,LoisandJillmentionedthattheynowfeelmore
independentand“free”fromdifficultiesandobligationsoftheirmid‐lifeyears.Seth
remainsemployedbutdemonstratedheistransitioningtowardthis“break”from
mid‐lifeasheconsidersretirementandwhatthenextchapterofhislifewillbe.
Criticsarguethatthetheoryis“empiricallyweak,hasparallelsintheNewAge
movementaswellasinromanticOrientalismandcanbeunderstoodasanattempt
tore‐enchantaging”(Jonson&Magnusson,2001,p.317).
StudyLimitation
Acriterionsamplingmethodwasused. Iamfortunatetohaveclosetiesto
themedical,academicandsocialservicesinmyregionandIreachedoutto
physicians,serviceclubsandserviceagenciesinquiringaboutpotentialparticipants
forthisstudy.Iwashopefulthatthosegroupswouldrefermetootherpotential
102
participants. Wordspreadratherquicklyamongthedeafandhardofhearingas
wellastheblindandhearingimpairedcommunityandIwasabletoengage
qualifiedparticipants.Ididnothaveasmuchsuccessfindingparticipantswithother
disabilitieswhoqualifiedforthestudy,whichcouldbealimitationofthestudy.
ImplicationsforFutureStudies
Basedonthelimitationcitedabove,futureresearchonsuccessfulaging
amongolderadultswithlong‐termdisabilities,otherthansensoryimpairments,
couldshedlightonpotentialdifferencesamongdisabledindividuals.
ImplicationforSocialWorkPractice,PolicyandEducation
Thisstudycancontributetoknowledgeandskilldevelopmentintheareasof
socialworkeducation,researchandpolicy. Asthebaby‐boomgenerationages,the
countryispreparingforthenextgenerationofolderadults. Associalwork
educatorsitisimperativethatwestrivetopreparestudentstomeettheneedsof
thislargegroupofolderadults. Thiswillbeaccomplishedthroughteachingsocial
workstudentsaboutagingacrossthecurriculum. Agingcontentislackinginsome
ofthecurrentsocialworkcorecurriculum. Mostsocialworkerswillbeinvolvedin
workwitholderadultsatonetimeoranotherandwillneedthetoolsinwhichto
provideappropriatesupportandservices. Finally,thisstudyillustrateshowthose
withlong‐termdisabilitiesareabletoagesuccessfully. Socialworkerscanprovide
resourcesandeducationtoassistolderadultswithlong‐termdisabilitiesage
successfully.Wecanalsoinfluencepolicydecisionsthatsupportfunding,support
andservicesforpeoplewithlong‐termdisabilities.
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Re‐ConceptualizingDefinitions
Successfulaging,productiveagingandagingwellarejustthreeoftheterms
usedtodescribethephenomenaresearchedinthisstudy.Allofthetermshavebeen
researchedoverthepastseveraldecadesandtheirdefinitionsroutinelydebated.
Therehavebeenmeta‐analysisofthedefinitionsofthesetermswithmany
suggestionsforalterations.Asthisstudyhighlights,thesedefinitionsdonotusually
refertoolderadultswithlong‐termdisabilities.Arecommendationfromthis
researchistore‐conceptualizedefinitionsofsuccessfulagingtoincorporateolder
adultswithlong‐termdisabilities.
Conclusion
Thisdissertationoutlinestheextentofpopulationagingandlong‐term
disabilityinlatelife. Italsoaddressesvariousdefinitionsofwhatitmeansforoneto
successfullyage. Thisstudyillustratesthelivedexperienceofolderadultsaging
withalong‐termdisability. Eveninadvancedoldage,millionsofpeoplefunction
independently. Thisstudyidentifiedthoseaspectsofolderadults’livesthat
influencewhetherornottheyseethemselvesasagingsuccessfully. Thisproject
addressedthequestion: Whatdoesitmeanforolderadultswithlong‐term
disabilitiestoagesuccessfully?
Thisstudyofferedinsightintowhatfactorscontributetosuccessfulagingin
thispopulation. Iwouldliketousetheinformationfromthisstudytocontributeto
theliteratureregardingpositiveagingandwhatitmeanstoagewell. Thisstudywill
contributetotheliteratureillustratingthatmanyolderadults,eventhosewithlong‐
termdisabilities,areactive,resilientandinvolvedinthecommunity.
104
AppendixA
DemographicQuestionnaire
Age:
Gender:
MaritalStatus:
Divorced
LivingwithAnother
Widowed
Married
Separated
Single
WouldRatherNotSay
LivingArrangement:
Alone
WithSpouse/SignificantOther
WithAdultChild
Congregate
Living
WithAFamilyMemberthatisNotMychild
WouldRatherNotSay
HighestLevelofEducation:
TypeofDisability:
Lengthoftimeyouhavebeendisabled:
OverallPhysicalHealth:
Excellent
Good
Fair
Poor
Fair
Poor
OverallMentalHealth:
Excellent
Good
Numberofmedications:
OtherChronicConditions:
Doyourequireassistancefromacaregiver?
105
Yes
No
Ifyes,howmanyhoursaweekdoyourequireinformalorformalsupport?
106
AppendixB
InformedConsent
IUPUIandCLARIANINFORMEDCONSENTSTATEMENTFOR
PromotingSuccessfulAgingamongOlderAdultswithDisabilities
STUDYPURPOSE:
Youareinvitedtoparticipateinaresearchstudyofolderadultsagingwell. The
purposeofthisstudyistofindoutfromolderadultswhatitmeanstoagewell.
NUMBEROFPEOPLETAKINGPARTINTHESTUDY:
Ifyouagreetoparticipate,youwillbeoneofapproximatelytensubjectswhowillbe
participatinginthisresearch.
PROCEDUREFORTHESTUDY:
Ifyouagreetobeinthestudy,youwilldothefollowingthings:
Youwillbeinvitedtoparticipateinthreeinterviews. Thefirstinterviewwillbea
briefmeeting(lessthanonehour)todiscussthestudyandyourrightsasaresearch
participant. Duringthesecondinterviewyouwillbeaskedaseriesofquestions
aboutaging.Thisinterviewwilllastapproximatelyonetotwohours. This
interviewwillbeaudiotapedandwilltakeplaceasalocationthatisconvenientfor
you,suchasinyourhomeorinaprivateroomofapubliclocation,suchasthe
library. Aftertheinterviewhasbeentranscribed,youwillbecontactedathirdtime
toreviewthecommentsyoumadeduringthesecondinterview. Duringthistime
youwillhaveanopportunitytoaddadditionalcommentsorcorrectanyerrorsin
thetranscript.
107
RISKSOFTAKINGPARTINTHESTUDY:
Whileonthestudy,therisksarethatyoumightfeeluncomfortablediscussing
certainaspectsofagingandtheriskoflossofconfidentiality. Whilecompletingthe
interview,youcantelltheresearcherthatyoufeeluncomfortableordonotcareto
answeraparticularquestion.
BENEFITSOFTAKINGPARTINTHESTUDY:
Thebenefitstoparticipationarethatyoumightlearnsomenewthingsabout
yourself,andyoumightenjoysharingyourideasandfeelingsaboutagingwell.In
addition,yourparticipationinthisstudymighthelpmeandothersbetter
understandhowtohelpolderadultsagewell.Youwillnotreceivepaymentfor
takingpartinthisstudy.
ALTERNATIVESTOTAKINGPARTINTHESTUDY:
Insteadofbeinginthestudy,youhavetheoptionofnotparticipatinginthestudy.
CONFIDENTIALITY:
Effortswillbemadetokeepyourpersonalinformationconfidential. Wecannot
guaranteeabsoluteconfidentiality. Yourpersonalinformationmaybedisclosedif
requiredbylaw.Youridentitywillbeheldinconfidenceinreportsinwhichthe
studymaybepublished.
Organizationsthatmayinspectand/orcopyyourresearchrecordsforquality
assuranceanddataanalysisincludegroupssuchastheinvestigatorandhis/her
researchassociates,thestudysponsorandtheIUPUI/ClarianInstitutionalReview
Boardoritsdesignees.
108
CONTACTSFORQUESTIONSORPROBLEMS:
ForquestionsaboutthestudycontacttheresearcherVictoriaHansonatXXX‐XXX‐
XXXXorMargaretAdamekatXXX‐XXX‐XXXX.
Forquestionsaboutyourrightsasaresearchparticipant,contacttheIndiana
UniversityOfficeofResearchComplianceAdministrationat317‐274‐8289.
VOLUNTARYNATUREOFTHESTUDY:
Takingpartinthisstudyisvoluntary. Youmaychoosenottotakepartormayleave
thestudyatanytime. Leavingthestudywillnotresultinanypenaltyorlossof
benefitstowhichyouareentitled.
SUBJECT’SCONSENT:
Inconsiderationofalloftheabove,Igivemyconsenttoparticipateinthisresearch
study.
Iacknowledgereceiptofacopyofthisinformedconsentstatement.
SUBJECTSSIGNATURE:
DATE:
SIGNATUREOFPERSONOBTAININGCONSENT:_
109
DATE:_
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CurriculumVitae
VICTORIAM.HANSON
EMPLOYMENTEXPERIENCE
MayoClinicHealthSystem,SouthwestMinnesotaRegion
ChiefOperatingOfficer(August2014topresent)
 Overseeoperationsofsixhospitalsand26ambulatorycarecenters.
MayoClinicHealthSystem,SouthwestMinnesotaRegion
VicePresidentofPracticeAdministration(January2013toAugust2014)
 Oversawpracticeoperationsofsixhospitalsand26ambulatorycare
centers.
MayoClinicHealthSystem,SouthwestMinnesotaRegion
DirectorofClinicalInstitutes(October2010toJanuary2013)
 OperationsadministrationofallPerioperativeandSurgical,Women’sand
Children’sServices.
ImmanuelSt.Joseph’s–MayoHealthSystem,Mankato,MN
DirectorofHospice,PalliativeCare,FamilyFocus,SocialServicesand
CaregiverEducation(April2010toNovember2010)
 Oversawoperationsadministrationofthedepartmentsacrossthe
southwestMinnesotaregion.
ImmanuelSt.Joseph’s–MayoHealthSystem,Mankato,MN
DirectorofBehavioralHealthServices(March2008toApril2010)
 OperationsadministrationofOutpatientBehavioralHealthServices
locatedinPrimaryCareandSpecialtyClinics;anInpatientBehavioral
Healthunit;threeoutpatientChemicalDependencyTreatmentClinics
(FamilyFocus)aswellastheSocialServicesDepartment.
 Develop,maintainandevaluatepatientcareprocessesthatpromote
desiredoutcomes.
 Evaluatethequalityandeffectivenessofpatientcarepracticeandpatient
careservicesadministration.
 PartnerswithPhysicianleadertoensureoperationalsuccessofInpatient
BehavioralHealth.
 InpartnershipwithPhysicianleader,developInpatientBehavioralHealth
strategicandtacticalplan,includingoperationalandcapitalplanning
request.
 Provideadministrativeleadershipinthedevelopmentofanintegrated
behavioralhealthpractice.
 Ensuresthecompetencyofallemployeesinareaofaccountability.
 Acquireandallocatehuman,materialandfinancialresourcesforthe
effectiveprovisionofpatientcare.
 Develop,maintainandevaluateorganizationalsystemstofacilitatethe
deliveryofpatientcare.
 Provideleadershipforassigneddivisional,departmentandinstitutional
initiativestoenhancepatientcareoutcomes.
 Develop,maintainandevaluateanenvironmentthatdevelopsand
supportsprofessionalpractice.
 Facilitateandsupportresearchandintegrateitintothedeliveryof
patientcareand/ortheadvancementofprofessionalpracticeandother
disciplines.
 Provideleadershiptothedesignandoperationofthesystemstoensure
continuouscomplianceofregulatorystandards,qualityimprovements
andinnovationinpatientcare.
ImmanuelSt.Joseph’s–MayoHealthSystem,Mankato,MN
SocialWorkServicesDirector(July2005toOctober2010)
 Develop,maintainandevaluatepatientcareprocessesthatpromote
desiredoutcomes.
 Evaluatethequalityandeffectivenessofpatientcarepracticeandpatient
careservicesadministration.
 Acquireandallocatehuman,materialandfinancialresourcesforthe
effectiveprovisionofpatientcare.
 Develop,maintainandevaluateorganizationalsystemstofacilitatethe
deliveryofpatientcare.
 Provideleadershipforassigneddivisional,departmentandinstitutional
initiativestoenhancepatientcareoutcomes.
 Develop,maintainandevaluateanenvironmentthatdevelopsand
supportsprofessionalpractice.
 Facilitateandsupportresearchandintegrateitintothedeliveryof
patientcareand/ortheadvancementofprofessionalpracticeandother
disciplines.
 Provideleadershiptothedesignandoperationofthesystemstoensure
continuouscomplianceofregulatorystandards,qualityimprovements
andinnovationinpatientcare.
MinnesotaStateUniversity,Mankato,MN
AdjunctInstructor(October2004topresent)
 TaughtSOWK663: SocialWorkGroups,MinnesotaStateUniversitySchool
ofSocialWork,fall2012.
 TaughtSOWK425/525: SocialWorkinHealthCareSettings,Minnesota
StateUniversitySchoolofSocialWork,fall2005,fall2006,fall2007,fall
2008,fall2009,fall2010&fall2011.
 TaughtSOWK412/512:SocialWelfareIssuesandPolicy,MinnesotaState
UniversitySchoolofSocialWork,spring2008,fall2009,spring2010&
spring2011.
 TaughtSOWK190: IntroductiontoSocialWelfareServices,Minnesota
StateUniversitySchoolofSocialWork,spring2005.
IndianaUniversitySchoolofSocialWork,Indianapolis,IN
AdjunctInstructor(May2003toJune2004)
 FacultyFieldLiaisonforMSWstudentsparticipatinginpracticum
placement,fallsemester2003andspringsemester2004.
 TaughtS503:HumanBehaviorintheSocialEnvironment,(MSWcourse),
IndianaUniversitySchoolofSocialWork,fall2003.
 TaughtS530:SocialPolicyandServiceDeliveryI,(MSWcourse),Indiana
UniversitySchoolofSocialWork,summer2003.
CommunityHospitalsandTheIndianaHeartHospital,Indianapolis,IN
ClinicalSocialWorker(October2001toJune2004)
 Performedcomprehensiveassessmentofpatient/familygoalsaswellas
assessmentofbiophysical,psychosocial,environmental,financialand
dischargeplanningneeds.
 Implementeddischargeplansforpatients,includingreferralstohome
healthagencies,placementsinextendedcarefacilitiesaswellasprovided
safeandappropriatetransitiontothenextlevelofcare.
 Procuredservicesandservedasanadvocateonbehalfofpatientsand
families.
DomesticRelationsCounselingBureau,Indianapolis,IN
ClinicalSocialWorker(February2000toJanuary2003)
 Conductedcustodyandparentingtimeevaluationsincasesofdivorce
andnever‐marriedparents;maderecommendationsfortreatmentand
services;conductedcustodyandparentingtimemediationtoassist
clientsinresolvingdisputes.
 Researchedandpreparedrecommendations,referrals,andevaluations
forassignedcasesincludingrecommendingtreatments,services,and
actionspertainingtofamilymembersandeffectedparties;submitted
reportstothecourt;testifiedincourtasanexpertwitness.
 Elicitedpertinentinformationfromotherprofessionalsinvolvedin
servingthefamily;actedasanagencyrepresentative,informedothersof
agencyservices;discussedalternativesandrecommendationsforthe
family.
 Developedtrainingcurriculumandeducationmaterialsforclientsand
staff.
 Facilitatedtrainingtocommunityagencies.
MidtownCommunityMentalHealthCenter,Indianapolis,IN
PsychiatricSocialWorker(August1999toFebruary2000)
 Providedpsychotherapyservicestoindividualswithmentalillness.
 Providedconsultationandeducationservicestoagenciesandthe
community.
HealthEastHospitalsandHospice,St.Paul,MN
MedicalSocialWorker(March1998toJuly1999)
 Performedcomprehensiveassessmentofpatient/familygoalsaswellas
assessmentofbiophysical,financial,psychosocial,environmental,and
dischargeplanningneeds.
 Implementeddischargeplansforpatients,includingreferralstohome
healthagencies,placementsinextendedcarefacilitiesaswellasprovided
safeandappropriatetransitiontothenextlevelofcare.
 Procuredservicesandservedasanadvocateonbehalfofpatientsand
families.
MinnesotaCitizensCouncilonCrimeandJustice,Minneapolis,MN
CrimeVictimLiaison/Specialist(June1996toDecember1997)
 Assistedcrimevictimsandadvocatedontheirbehalfduringtheir
involvementwiththecriminaljusticesystem.
 Recommendedcourseofactiontoprosecutorsconsistentwithboththe
Victim’sRightsStatuteandthedesiresofthevictim.
 Providedemergencyassistanceandcrisisinterventiontocrimevictimsin
conjunctionwithlawenforcement.
WomenofNationsEagle’sNestShelter,St.Paul,MN
Advocate(June1996toSeptember1997)
 Providedsupport,individualandgroupcounseling,advocacy,crisis
interventionandaccesstoresourcesforbatteredwomenandtheir
children.
 Workedavarietyofshiftsinallareasoftheshelterincluding
administration,facilitiesandthewomenandyouthprograms.
EDUCATION
IndianaUniversity,Indianapolis,IN
PhDinSocialWorkreceivedOctober2015
 ExternalMinorisGerontology.
AugsburgCollege,Minneapolis,MN
MasterofSocialWorkreceivedJune1999
 CompletedMaster’scourseworkwithemphasisonfamilypractice.
 CompletedMaster’sthesisonfamilyviolence.
UniversityofSouthDakota,Vermillion,SD
BachelorofSciencereceivedMay1996
 CompleteddualmajorinCriminalJusticeandSociology.
NorthernArizonaUniversity,Flagstaff,AZ
NationalStudentExchangeParticipant,1995‐1996
 CompletedsenioryearofundergraduatestudyasaNationalStudent
Exchangeparticipant.
LICENSURE/CERTIFICATIONS








MinnesotaLicensedIndependentClinicalSocialWorker
IndianaLicensedClinicalSocialWorker
CertifiedHospiceAdministrator
CertifiedBasicLifeSupportInstructor
CertifiedCrucialConversationsTrainer
CertifiedCriticalIncidentStressManagementFacilitator
CertifiedPsychologicalFirstAid
IndianaCertifiedFamilyandCivilMediator
AWARDS/FELLOWSHIPS
Recipient,GraduateMinorinAgingFellowship,IndianaUniversity
SchoolofMedicine(March2004)
Recipient,UniversityTravelFellowship,IndianaUniversity
GraduateSchool(April2004)
PROFESSIONALORGANIZATIONMEMBERSHIPS
 Member,MinnesotaBoardofSocialWorkAdvisoryCommittee
 Member,MinnesotaStateUniversityMasterofSocialWorkAdvisory
Board
 Member,SocietyforSocialWorkLeadersinHealthcare
 President 2008
 Member,NationalAssociationofSocialWorkers
 Member,MinnesotaSocialServiceAssociation
 Member,GerontologicalSocietyofAmerica
 Member,AssociationforGerontologyinHigherEducation
 Member,AGESocialWork
RESEARCHEXPERIENCE
 ResearchAssistant,GeriatricEnrichmentinSocialWorkEducation:
DevelopingAging‐SavvySocialWorkersThroughaTeachingandLearning
Clearinghouse,IndianaUniversity(August2003toJune2004)
 ResearchIntern,ConnectingAdolescentandParents:ParentsTalkingto
TheirTeenwithCancer,IndianaUniversity(July2003toJune2004)
 ResearchAssistant,EvaluatingtheDivisionofFamilyandChildren’s
CustomerServices,IndianaUniversity(January2003toJune2003)
 ResearchAssistant,OfficeofResearchServices,IndianaUniversity
SchoolofSocialWork(December2002toJune2003)
RESEARCHPRESENTATIONS
 AgingWell:AModelofPractice,”presentedtoPro‐SeminaronClient
Systemsclass(2003)
 EffectivenessofaSupportGroupforHospiceCaregivers,”presentedto
QuantitativeMethodsclass(2003)
 DomesticViolence:ACriticalFeministPerspective,”presentedto
PhilosophyofScienceandSocialWorkclass(2003)
 TheMaleandFemaleResponsetoMiscarriage:DoesCounselingHelp?”
presentedtoInteractiveSeminarScholarshipSkillsclass(2002)
PROFESSIONALWORKSHOPSPRESENTED
 ProfessionalBoundarieswhendeliveringHomecareandHospice
Services”WillPresenttoAreaHomecareandHospiceProviders
(February15,2007)
 “EthicsofAging”PresentedatElementsofEthicsConference(January
2006)
 “SuccessfulAging”PresentedtoSeniorNetworkProviders(September
2005)
 “SuccessfulAging: DoSeniorCentersMakeaDifference?”presentedat
CSWE/NGSSW,NewYork,NY(March2005).
 “PromotingSuccessfulAgingAmongOlderAdults,”57th AnnualScientific
MeetingoftheGerontologicalSocietyofAmerica,Washington,DC
(November2004)
 “PromotingSuccessfulAgingAmongOlderAdults,”IndianaUniversity
SpringSymposium,Indianapolis,IN(April2004)
 “Sex,DatingandIntimacyinLateLife:ImplicationsforEducationand
Practice,”oneandone‐halfhourworkshoppresentationat
CSWE/NGSSW,Anaheim,CA(February2004)
 “EffectivenessofaSupportGroupforHospiceCaregivers,”Indiana
UniversitySpringSymposium,Indianapolis,IN(April2003)
 “MediatingParentingTimeandChildCustody,”MarionCounty
Prosecutor’sOfficeAnnualConference,Indianapolis,IN(February2001)
 “MediatingParentingTimeandChildCustody,”FathersandFamilies
AnnualConference,Indianapolis,IN(December2000)
PUBLICATION
 TheoryDiscussioninSocialWorkJournals:APreliminaryStudy,
AdvancesinSocialWork,Spring2006,Vol.7,No.1.
SPECIALTRAINING
 BuildingaFoundationofManagementSkills,MayoClinic(Fall2005)
 PreparingFutureFaculty,OfficeforProfessionalDevelopment,Indiana
University,Indianapolis,IN(2002–2004)
 MemberandProgramParticipant,(April2003toJune2004)
 HennepinCountyChildProtection,Minneapolis,MN
 M.S.W.Intern(August1998toApril1999)
 HealthEastHospice,St.Paul,MN
M.S.W.Intern(December1997toMarch1998)
 Children’sInnWomenandChildren’sShelter,SiouxFalls,SD
B.S.Intern(May1995toAugust1995)
COMMUNITYSERVICE
 BoardMember,March2008toOctober2013)
CADA,MankatoMN
 HarryMeyeringCenter,Mankato,MN
BoardMember,(July2007toOctober2011)
 VINE,Mankato,MN
AdvisoryBoardMember,(July2007toJuly2008)
 MankatoAreaDomesticViolenceTaskForce
Member,(January2006toJune2011)
 MankatoAreaSexualAssaultResponseTeam
Member,(July2005toJune2011)
 FaithInAction,SleepyEye,MN
Volunteer(September2004toOctober2007)
 Ph.D.Committee,IndianaUniversitySchoolofSocialWork,Indianapolis,
INStudentRepresentative(August2003toJune2004)
 St.VincentHospiceandPediatricHospice,Indianapolis,IN
Volunteer(February2000toJune2004)
 BigSistersofCentralIndiana,Indianapolis,IN
Volunteer(March2000toJune2004)
 SexualOffenseServices,St.Paul,MN
VolunteerAdvocate(September1996toJuly1999)