A Turning Point in Functional Assessment: From a Medical View to a Social View of Difficulty with Daily Activities

By Alex W. Costley.

Published by The International Journal of Aging and Society

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Article: Print $US10.00
Article: Electronic $US5.00

With a variety of methods now being used to assess functional ability in longitudinal aging studies, many experts now argue that we lack a standardized set of tools to accurately estimate population-based disability rates in older adults. More importantly, a medical view of disability which sees physical limitations as inherent in the individual is being increasingly challenged by a social view of disability which sees these limitations as the products of relationships between individuals and the expectations of their environments. Thus, new methods are needed to explore these relationships. This ethnographic study of functional ability among 64 community dwelling older adults, ages 66 to 91, explores the social context of their daily activities and the ways they manage these tasks. Structured surveys and descriptive statistics were used to measure differences in rates of self-reported ADL and IADL limitations. Open-ended questions, discourse analysis, and grounded theory were used to allow individuals to discuss the subjective meanings of these functional limitations and to identify environmental and social factors affecting the performance of these tasks. These data are used to discuss the theoretical and practical implications of shifting from a medical to a social view of functional assessment among older adults.

Keywords: Daily, Activities, Functional, Assessment, Community, Dwelling

The International Journal of Aging and Society, Volume 2, Issue 2, pp.83-91. Article: Print (Spiral Bound). Article: Electronic (PDF File; 363.972KB).

Dr. Alex W. Costley

Assistant Professor, Health and Physical Education and Gerontology, School of Health and Behavioral Sciences, York College, City University of New York, New York, USA

Dr. Costley is an assistant professor of gerontology and health education at York College-City University of New York. He is a member of AARPs coalition for Livable Communities for All Ages and the Environments and Aging section of the American Public Health Association. Prior to joining the faculty at York College, he served as the educational director of the Division of Geriatric Medicine at New York Presbyterian Hospital. With training in medical anthropology, public policy and program evaluation, his research interests include the sociology of aging in place, public policies for age friendly urban planning, the impact of social networks and neighborhoods on functional ability, and the integration of gerontology in medical education.