Exploring meanings of successful aging among people with long-term spinal cord injury.

Abstract

Purpose/Objective: The purpose of the present study was to develop an understanding of successful aging (SA) meanings and influences that is informed by the lived experiences of people aging with long-term spinal cord injury (SCI). Method: This study was conducted in partnership with three Canadian provincial SCI organizations using an integrated knowledge translation (IKT) approach. To ensure findings were meaningful and practical to the three SCI organizations, the study was grounded in pragmatic philosophical assumptions. Semistructured interviews were conducted with 22 people aging with long-term SCI (minimum 45 years of age; minimum 10-years postinjury). All interviews were audio-recorded, transcribed verbatim, and subjected to a reflexive thematic analysis. Results: SA was understood as an interconnected and multifaceted concept that prioritizes health, participation, and independence. Participants discussed how SA was influenced negatively by personal (aging-related complications, intrapersonal emotional distress) and environmental (lack of available resources, differing community priorities) barriers. Participants reported that SA was positively influenced when individuals acted as self-advocates, were prepared and aware of aging-related changes, and maintained strong relationships with others. Conclusions/Implications: This study presents an initial, SCI-specific understanding of meanings and influences on SA. Although there were similarities between our findings and previous SA models, pertinent differences were also identified. Findings highlight that supporting quality participation experiences for people aging with long-term SCI may be an important direction SCI organizations can take to support their membership. Impact and ImplicationsThis study extends the aging with spinal cord injury (SCI) literature by presenting an initial, SCI-specific understanding of successful aging that is informed by lived experience. Findings from this study highlight relevant research gaps in the area of aging and SCI that future research studies should address. Findings from this study have the potential to inform the development of programs and resources that SCI community organizations offer to support their aging clients.

Organizations’ Perspectives on Successful Aging with Long-Term Physical Disability

“…Almost half of the organizations described health and well-being as a key component of successful aging. Overall, the way that organizations conceptualized health and wellbeing was consistent with the needs and priorities identified by those aging with physical disability [7,[10][11][12]. While original models of successful aging focused predominantly on physical health [4][5][6], models of successful aging based on the perspectives and priorities of those aging with physical disability emphasize psychological well-being, resilience, and quality of life as core elements of successful aging [7,10,11].…”

“…When asked how they define successful aging, those aging with physical disability tend to describe maintaining autonomy as a key signal of successful aging [7]. Some individuals with physical disability desire to minimize their dependence on others as they age [11][12][13]; however, not everyone sees independence and self-reliance as a goal [7,[10][11][12]. In order to support successful aging for those with physical disability, organizations should not assume that all individuals seek to maximize their independence; rather they should be prepared to support their clients to live as independently as they would like to live.…”

“…Recently, rehabilitation scholars have sought to develop models of successful aging that are meaningful for those aging with disability and that can be used as a guide for organizations serving this population [7,[10][11][12]. To identify these components of successful aging, they have asked individuals with long-term physical disabilities to define what successful aging means to them and what resources they need to age well.…”

“…To identify these components of successful aging, they have asked individuals with long-term physical disabilities to define what successful aging means to them and what resources they need to age well. Key components of successful aging that emerge from these interviews generally include (a) valued activity and social connection [7,[10][11][12]; (b) the maintenance of health and function through the management of symptoms and avoidance of secondary conditions [7,[10][11][12]; (c) preparation, adaptation, and resilience in the face of age-related changes [7,[10][11][12], and (d) autonomy (although attitudes regarding the degree of autonomy vary, with some describing independence and self-reliance, and others describing self-efficacy and decisional autonomy) [7,[10][11][12].…”

“…The framework outlines two strategies for closing these gaps: eliminating environmental barriers (e.g., inaccessible built environments) and providing facilitators (e.g., access to assistive equipment and technology) [13]. This sentiment is also reflected in the perspectives of those aging with physical disability, who describe how their ability to age successfully is dependent on their environment and access to supports and resources [7,[10][11][12]. However, to date no studies have considered how the organizations that support those aging with physical disability define what it means to age successfully for this population.…”