Attention, finally, for overlooked subset of elderly

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Attention, finally, for overlooked subset of elderly

Research focuses on wellness of those with chronic disabilities
Brian Donohue

American society has lavished attention for decades on the expansive “boomer” population – its dreams, careers, families, habits, midlife crises and now its retirement. Many millions of research dollars have been spent divining strategies for the vast group’s “healthy aging.”

​Nearly all the scrutiny and benefits, however, have overlooked one boomer subset: those with a long-term physical disability.


AgingDisabled-Ivan
"It’s often not the disability itself but rather secondary conditions that create great difficulty," researcher Ivan Molton said.
picture of Ivan Molton

“Almost always, researchers’ definition of aging successfully involves avoiding disability. So all these people who have lived with disability are not only left out of that conversation, they have already quote-unquote failed at aging successfully,” said Ivan Molton, a University of Washington clinical psychologist and assistant professor of rehabilitation medicine.

Molton recently received a five-year grant to promote healthy aging among people with long-term disabilities, specifically multiple sclerosis, muscular dystrophy, spinal cord injury and post-polio syndrome.

Advances in medicine have enabled this population, collectively upward of 1 million people in the United States and historically consigned to a shortened life, to reach retirement age. Nevertheless, they are often excluded from research about how to improve seniors’ wellness, Molton said, because of the mistaken presumption that they could not benefit, given their poor mobility. 


AgingDisabled-Richins
Paige Denison
Scot Richins leads exercises at a senior center in Ballard, Wash., as part of King County's "EnhanceFitness" program – the exercise arm of the "EnhanceWellness" approach UW is testing.
Scot Richins leads exercises at a senior center in Ballard, Wash.

One study under Molton’s grant incorporates “EnhanceWellness,” a community-based program that has shown effectiveness among typically-abled seniors. Case managers work one-on-one with individuals to help them set goals for maintaining health in the face of functional decline.

He described the program’s approach.

“Rather than me telling you [the patient] what you need to do, I ask what your goals are and what barriers exist, and then we work together via phone and in-person counseling to come up with a list of ways to overcome those barriers. It has to be your goal, but I’m going to hold you to it. I check in regularly to see how you’re doing.”

The program is manpower-intensive, Molton said, but practical because many social workers have been trained to deliver it in existing programs for seniors; it just needs to be modified a bit for seniors with long-term disabilities.

In the new study, Senior Services of King County staff will facilitate the program, working with UW’s rehab medicine team. One strength of the program is that it can happen at home, in a coffee shop, a library, a senior center – much handier than requiring someone to get to a clinic. 


AgingDisabled-Burien
Paige Denison
Aging participants help one another at a Samoan group class on empowerment in Burien, Wash. Aging participants help one another at a Samoan group class on empowerment in Burien, Wash.
Aging participants help one another at a Samoan group class on empowerment in Burien, Wash. Aging participants help one another at a Samoan group class on empowerment in Burien, Wash.

Three other studies supported by the grant hone in on different aspects of aging with disability: barriers to healthcare access, developing psychological resilience, and the impact of managed-care programs and the Affordable Care Act on this population.

People who have lived for decades with multiple sclerosis or spinal cord injury, for example, may feel like they’ve learned to manage the condition rather than surrender to it. Often they have built successful careers and raised families, overcoming their hardship in some respects. But the challenges of aging can amplify disabilities’ symptoms and make “golden years” sound like a cruel misnomer.

“If you look at the people in our study, it’s often not the disability itself but rather secondary conditions that create great difficulty. MS causes difficulty in walking and fine motor control, but people told us that the fatigue and pain and insomnia that come with aging are more problematic than the walking difficulty,” Molton said.

“We hope to learn the most effective ways to promote successful aging for those people.”

Molton's team is actively recruiting participants. Interested people should check the team’s website or call for information. 866.928.2114.