Introduction

Disability is often understood within models that define it, shape selfidentities and determine which professions engage (Smart, 2009). With a view to clarifying concepts at the outset, I discuss in this chapter how disability is understood. The chapter expands on one of the paradoxes identified in Chapter 1: how separate models are used to understand what disability is generally and to understand what it is in older age.

First, I consider understandings within approaches to disability generally – involving two key models: social and biopsychosocial – and then definitions that dominate approaches to ageing, which are largely biomedical. Next, I discuss sociological understandings of disability in older age (principally, the ‘fourth age’), and one alternative approach to disability from the field of environmental gerontology. This chapter is meant as a bridge to the next, which considers theoretical approaches to disability and to ageing. The two chapters interconnect since definitions are fundamental to theorising and scholarship.

General approaches to defining disability

It is possible to think of what disability is in terms of three main models. The first are medical models, which attribute disability to the person and tend to approach it at the level of the individual. The second are social models, which are associated with disability studies and activism. They attribute disability to the environment and view disability as socially created and, increasingly, as culturally created. The third are biopsychosocial models, which attempt to bridge the social and the medical, and draw on medical sociology. In these models, disability is understood as relational or interactional – linked to the person– environment relationship.

The UK social model and beyond

Until the 1990s, disability was conceived of in terms of medicine, rehabilitation, psychology, special educational needs and social work (Goodley, 2011). The UK social model goes back to a statement from the 1970s on physical disability, which was subsequently broadened to include all impairments (Barnes, 1998): ‘it is society which disables physically impaired people. Disability is something imposed on top of our impairment by the way we are unnecessarily isolated and excluded from full participation in society. Disabled people are therefore an oppressed group in society’ (UPIAS and The Disability Alliance, 1976: 14). This definition made a crucial distinction between impairment and disability – the latter being a socially constructed experience – and it made a link to oppression. Oliver (1996: 31–2) characterised the medical model as, ‘the personal tragedy theory of disability’.