Abstract

This paper presents a beginning conceptual framework for the science of bridging ageing and disability. The need for bridging is significant for two primary reasons: (1) the growing population of persons aging with long-term chronic conditions and disabilities who have not been part of most traditional long-term care supports and service programs for older adults, and (2) the increasing trends towards both integrated health and social care systems and merged care systems for older and younger adults with disabilities.

Data and methods: The conceptual model is drawn from a growing body of international research on aging and disability, theoretical scholarship, and policy statements that identify the need for and elements of bridging ageing and disability knowledge, practice and policy. An international group of experts in the area of aging with disability engaged in an integrative discussion process to define and develop fundamental points of a framework for bridging ageing and disability fields of research, policy, and practice. Discussions took place over seven telephone conference calls from November, 2011 to March, 2012. The initial call was preceded by three rounds of written review by a subgroup of a background document synthesizing available scholarly literature, policy documents, and conference presentations from a recent conference on aging with disability, the Growing Older with Disability conference, held in June 2011 in Toronto.

Results: The iterative discussion grounded in the summary of findings produced an expert-based consensus statement with global scope and specific plans for action. A definition of bridging was developed identifying its purpose as improving efficiency, equity or care, inclusion and support at all levels from person to society. The expert group found bridging to encompass a range of concepts, tasks, technologies and practices aimed at improving knowledge sharing and collaboration across stakeholders, organizations, and fields of care and support for persons with disabilities, their families, and the aging population. Tasks involved in bridging were determined to be activities dissemination, coordination, assessment, empowerment, service delivery, management, financing and policy. Specific priority areas for bridging related to long-term care were proposed to be support of families and caregivers, training and education of direct support professionals, self-determination, access, availability, and affordability of supports and services, ethnical issues related to non-discrimination in areas such as palliative care and end of life. Recommendations for action include: development of a formal agenda for bridging aging and disability, provision of public and private financial support for research and scholarship that advances the science of bridging, and the incorporation of bridging and knowledge transfers as key strategies in policy planning where all citizens can fully participate.

Policy implications: This conceptual framework creates a scaffolding to aid the development of the science of bridging ageing and disability knowledge, practice, and policy in long-term care supports and services. It translates existing knowledge and policy directives that support the concept of bridging into a working model that facilitates international dialogue about bridging. It also articulates directions for future research, policy, and practice development relevant to long term care supports and services.

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