Abstract:

Topics of aging and disability permeate the gerontological literature. As the size of the elderly population in the United States grows there will be increasing numbers of older adults who will require some form of intervention or services. Aging and disability are regarded as medical phenomena: the individual's experiential component is forgotten or lost. The purpose of this study was to gain an understanding of the lived experience of aging and disability as it is conveyed through the narratives of older women who were participants in a rehabilitation program. Because narrative constructions are socially and culturally derived, many elements combine in the narrative account of persons who are aged and live with a disability, including the bio-medicalization of aging, healthcare policy, and media portrayal of the aged, among others. The primary data for this study were the narratives of ten older women who were participants in a rehabilitation program on a rehabilitation hospital in northeastern New York. The study excluded individuals who were not cognitively intact, or were physically unable to participate in a series of three in-depth unstructured interviews. Each of the interviews was audio-taped and verbatim transcripts were generated. Each transcript was analyzed according to the general steps of Giorgi's (1985) descriptive phenomenological method. Meaning units were identified and characterized as to one of the four existential lifeworlds: spatiality, corporeality, temporality, and communality. In addition, narrative structure was described and metaphoric content was analyzed. The experience of aging and disability can be described through the four existential lifeworlds. Themes emerged that explicate the experience. Spatial themes include: lived space defined and circumscribed by the body, adapting lived space, and loss of space. Themes of corporeality include: alteration of the body, capacity of the body, prior lived corporeal experience, and how does the body know? Temporal themes are: limited time, time passing, time heals, future time and duration. Themes of communality are: disruption of natural order, guilt, outliving your life, and exchange and reciprocity. The women in this inquiry also revealed themes of perception of age identity, and spirituality. For these women the lived experience of aging and disability can be characterized by the metaphor: "the whole is greater than the sum of the parts." The understanding of the essential nature of this lived experience that emerged from this study has implications for health education, health policy and health practice. The study suggests that the practice of rehabilitation medicine, based solely on precepts of medical science, may be inadequate to facilitate optimal outcomes for older rehabilitation patients. The participants in this study derived benefit from many aspects of the rehabilitation experience. The study suggests that individuals who work in rehabilitation need a broad conceptualization of what constitutes legitimate knowledge for practice.