Mapping Uncharted Territory in Later Life Disablement Trajectories: A Closer Look at Progressive Disease.

Abstract

Aging research has conceptualized disablement via two primary frameworks. Paradigms of successful aging frame substantial disablement in aging as universally abnormal. These models have often been challenged as narrow and ableist, leaving out common experiences among people with chronic conditions. By contrast, steady decline paradigms frame substantial disablement in aging as universally normal. These models have invited challenges due to ageism inherent in automatically conflating older age and disability. Both frameworks juxtapose monolithic and rigid ideas of normalcy-and thus limit our understanding of dynamic possibilities in later life health and functioning. Given that people with progressive conditions often experience wide variability in daily status and inconsistency in long-term outcomes, current later-life disablement models may overlook such experiences. We thus propose additional nuance in later-life disablement modeling that brings innovative stochastic frameworks of daily health and functioning to longitudinal trajectory concepts. Using an "aging with progressive disease perspective," we outline gaps and opportunities in the current landscape of later-life disablement modeling. We then engage our standpoints from lived experience with progressive conditions to recommend new directions in conceptualizing relationships between aging and disability. Including such conditions in later-life disablement models can improve health care and supportive services for affected individuals.