The Gift of Time: Aging and Lifelong Disabilities

Presented at New Perspectives on Aging, University of New Hampshire, 6 October 11

Edward F. Ansello, Ph.D.Virginia Center on Aging, and

Virginia Geriatric Education CenterVirginia Commonwealth University

Richmond, VA 23298-0229(804) 828-1525

eansello@vcu.eduwww.vcu.edu/vcoa

Things are seldom as easy as you’ve been told

Nor as difficult as you’d feared

The Chronicles of Ed

Topic Outline1. The democratization of aging2. The geriatric imperative3. Aging being enveloped by disability, because

of difficulty with "aging"4. The unknown aging dividend5. Lagging public policy and the role of coalitions

as de facto policy6. Assisted autonomy as a modus operandi7. Keys to effective coalitions

The Democratization of Aging

• The province of the wealthy• Medians in 1900 & 2000• Retirement in perspective• Aging is a construct, experienced amid and

influenced by the norms, limitations, expectations, and horizons around us.

The Geriatric Imperative

• Post-reproductive nonconformity• Within-group variance• Individuation• 1 to the 100th power

Aging and Lifelong Disabilities

• Aging being enveloped by disability, because of difficulty with "aging"

• Similarities between systems: marginal/undervalued; underfunded; reliance on caregivers, etc.

• Differences between systems: chronological vs. functional; person-centered vs. program-driven; large

numbers of unidentified clients; non-affiliations

The Unknown Aging Dividend

• Tim Obrien (The Things They Carried): story truth vs. happening truth

• We've been "problem" driven, e.g. ,warnings about the “Silver Tsunami”

• Facts-knowledge-wisdom; conflict resolution; focused exploration of potential benefits (vs. costs)

Public Policy on Aging with Lifelong Disabilities

• Lagging public policy and the role of coalitions as de facto policy

• Newness of aging with lifelong disabilities; historical non-intersection and different priorities of the systems

• Differences between currently older and younger with lifelong disabilities

Assisted Autonomy

• History of “autonomy” and laissez faire indifference

• Illusion of "independence“• Assisted autonomy as a modus operandi• Getting assistance that the person needs

and can direct

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Keys to Intersystem Coalition Building: (1) Starting

Neutral broker non-threatening matchmaker

Spark a champion or zealotSpecific problem issue(s) to be addressedIncentive perceived benefitsFocus clear cause or purpose

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Keys to Intersystem Coalition Building:(2) Proceeding/Succeeding

Objectives achievable through specific tasks and activities

Approvals top-down and bottom-up sanctions in writing

Ownership members must see the coalition as “theirs” and attend

Fit compatibility with other like- minded individuals and groups

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Keys to Intersystem Coalition Building: (3) Continuing

Resources modest but adequate funding or pool of in-kind

Real Members must be more than just people appointed because they fit a category

Executive agency heads, directors, managers, advisory councils, as

well as service providers Channeling members convey content back

to their agencies, reinforcing partnership (minutes, e-mail)

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Coalitions in the South

• Maryland and Virginia (three keys)

• Florida (organizational)

• North Carolina (organizational)

• Texas (processes)

• Alabama (results)

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Partners I, II, and III Projects: The Integrated Model of Services

Maryland and Virginia,1986-1997

1) Collaboration2) Outreach3) Capacity Building

(Ansello, Coogle & Wood, 1997)

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Area Planning and Services Committee (APSC) in Metro Richmond

• Established in 2003, evolving from two-year single county MR task force

• Good mix of organizational members, with written commitments; meets monthly all year

• Doctoral student intern, summer 2004, helped with surveys of members/registrants

• Identified priorities democratically at outset: cross-training, public awareness, emerging issues

• Down and dementia; loss and bereavement; spirituality and aging; aging in place, etc

Next Steps

• Community partnerships; advisory board; marketing vs. selling; “shared enterprise”

• Agree on a dream• Identify a neutral broker• Draw in interdisciplinary involvement by

recognizing enlightened self-interest• Accept slow growth