Abstract
Demographic trajectories point to a population that is aging and increasingly, the field of social work is turning its eye toward the issues and intersection of aging and disability. As social work instructors and practitioners, we appreciate when an author seeks to empower the reader through multifaceted examples that present the complexity of a given problem. The two books we review in this essay—Disability and Aging and Happiness is a Choice You Make—inspire a shift in mindset that goes far to demystify the aging process and highlight the kinds of supports people need (and value) as they age.
When we were asked to review two books that addressed the twin issues of aging and disability, we found ourselves evaluating the books from the perspective of social work educators but also from our field experiences. As clinical faculty members, we began our teaching careers following many years of practice as clinical social workers. Carol Wilson-Smith worked extensively with individuals and families with disabilities as a caseworker for older adults and, later, as a school social worker in a public school. Carol Weissmann-Mauck began her career in child welfare and, later, established a consulting business that focused on long-term care facilities throughout Illinois. In addition, she founded a successful adult day center where she served as president and owner for 17 years. Christine Escobar-Sawicki spent most of her career in children’s advocacy centers. She currently serves as social work faculty for Illinois Leadership Education in Neurodevelopmental and Related Disabilities, which aims to prepare students as leaders dedicated to improving the quality of life for children and families with disabilities.
Although we come from different backgrounds and areas of practice, we share an interest in books that can inform social workers and other professionals who aspire to help older adults and those with disabilities live full and meaningful lives. As our perspectives are shaped by long tenures in the fields of disabilities and aging, we decided to form a monthly group to read and discuss the books with the aim to share our views with a wider audience through this review. This review reflects what we see—from our differing vantage points—as the important contributions each book makes. We situate our discussion in the context of a long-standing dialogue we have engaged in regarding what constitutes sound practice principles across the fields of aging and disabilities.
Disability and aging
The book by Jeffrey Kahana and Eva Kahana begins with chapters focusing on the historical perspectives of aging and disability research, as well as the connection between aging and disability. There are connections, particularly if you use the biological model framework. However, as social work practitioners, we subscribe to the belief that everyone really does age differently. The authors, a mother and son team, share several chapters of their personal long-term experiences with aging, disability, and caring for a relative both at home and in a nursing facility. Looking at the new approaches to aging today, you will not find many older adults who feel aging is a disability.
The book details a rich history of Eva Kahana’s research and her journey in applying gerontological conceptual frameworks to the field of disability. Chapter 3 of the book provides a glimpse into Kahana’s academic journey, her experiences as a PhD student, and a summarization of the history of what was then, in the 60s and 70s, the new field of gerontology. In sharing experiences of caring for her own aging mother, Kahana discusses lessons that taught her to appreciate the challenges, which ultimately informed her research and her conceptualizations of disability and aging.
The discussion of everyday activities, such as personal care and social activities, in Disability and Aging helps readers to see the impact of disability that each of us may experience one day. For example, chapter 6 focuses on the physical environment for older adults navigating their daily care, such as assistive devices and environmental adaptions. And chapter 4, “A Life Course Perspective,” provides a great deal of information and research to help readers understand social views and theories surrounding aging with disability versus aging and acquiring disability. These chapters provide excellent information to help any reader gain foundational knowledge of the societal views of growing older, as well as the individual experience. They focus on the impact of declining mobility and the experience of maintaining engagement in life events. Kahana and Kahana maintain the point of the book is to make the case that disability in old age need not define a person, but rather can be a source of empowerment. This leads readers to believe that this book will focus on empowerment and working to change the stigma and fear surrounding the experience of aging.
We feel Kahana and Kahana spend much of the book focusing on hardships, stressors, declining abilities, and the sad experiences that may accompany growing older. For example, chapter 5, “Adventurous Aging through International Travel,” focuses on Eve Kahana’s travel with her spouse and the value of engaging in enjoyable leisure activities. The chapter highlights hardships and problems the couple experienced throughout the trip, which makes it appear rather unpleasant. Unfortunately, this chapter seems to highlight what much of our society believes—that aging is something to fear. The remaining chapters of the book provide insight into the challenges of nursing care, end of life, and importance of policy change—all crucial topics when discussing growing older.
Happiness is a choice you make
To offset Disability and Aging and consider another perspective, we also read and discussed Happiness is a Choice You Make: Lessons from a year among the oldest old. John Leland has divided his book, based on interviews he conducted, into the life stories of six very interesting and articulate older adults, taking you through their challenges and triumphs chapter by chapter.
The author works to share the personal stories of each subject in his book in a way that communicates how differently older adults approach their days, depending on their lens of aging and disability. Through interviews, the challenges of aging—physical, emotional, and financial—are shared, as is a more holistic and forward-thinking approach to growing older.
The reader begins to see how challenging it can be for older adults to age in place on their own, as well as with family and outside supports. In addition, the stories demonstrate to the reader the determination and reasoning that older adults apply to their decision to remain in their own home, as opposed to life in a facility. Each story in the book highlights different ways in which the subjects overcome issues and roadblocks, such as access to a grocery store or living in a building without an elevator. One example is Leland’s own mother, Dorothy, and her painful mobility challenges and the impact on her daily functioning. He discusses her difficulty engaging in social activities due to pain and immobility until she gains access to an electronic wheelchair. This accommodation, or assistive device, allows Dorothy the opportunity to reengage with life, eliminating social isolation. Readers will find themselves caught up in the emotional and physical struggles the “oldest of the old” must go through to maintain their autonomy.
Leland discovers while conducting his interviews that older adults, when offered a choice between more time or better health, choose time. Often literature portrays aging as a series of losses, but the individuals interviewed help explain to readers what it really feels like to age and how attitudes matter at all ages. The book relates these very personal journeys in a delightful, yet intuitive way that includes, at various points, support by current aging research. A key lesson learned through the interviews is that even as we age, we can still have control and influence over our quality of life, and that our perspective often has more of an impact on that quality than we realize.
In sum, both books provide important insight into aging and disability. Each book speaks from personal experience and also provides information gained from other resources, individual interviews, and research, showing multiple perspectives and experiences with the aging process while discussing the role of disability that occurs over time. From Kahana and Kahana, a reader can expect to gain insight into societal views on aging. Through their expounding on their own experiences, a reader comes to understand the historical contexts that have informed our perspectives on aging and disability. Readers of Leland’s book are able to learn about aging through the eyes of six different people, all experiencing aging and disability differently. This approach helps to present aging as a normal part of life that can be embraced, just like any other phase.