With aging and the occurrence of later-in-life disabilities, numerous employment and other important life domain issues emerge that can require significant life adjustments. Psychosocial adaptation to disability involves complex interactions between personal, social, and environmental factors for each person (Keany & Glueckauf, 1999). Livneh (2001) recommends viewing adaptation ecologically, and that practitioners use an eclectic approach to teach adaptive coping skills, help client work through perceptions of loss, and assist in modification or removal of environmental barriers. Adjustment to disability for persons with late-onset occurrence can be challenging because of their pre-disability lifestyle and level of functioning. Because of their age and life experiences, such persons have acquired certain stability and predictability factors related to their personal, family, and work life. The occurrence of a disability can potentially disrupt many of the previously manageable aspects of their life such as employment, relationships, and economic independence and lead to feelings of frustration and despair. Their values tend to be more stable and entrenched and can present challenges to adapting to new changes. Successful adjustment requires a level of value examination, a reshaping of values and goals, and implementation of coping strategies (Keany & Glueckauf, 1999). Persons with late-onset disabilities face the dual challenge of adjusting to both their disability and aspects of growing older with the accompanying physical and role changes.

There are certain implications for persons with late-onset disability entering rehabilitation settings. For older persons, independence, effort, accepting pain, and maximizing functional ability are valued often at the expense of comfort and nurturance (Hartke, 1991).

In rehabilitation, goals are often defined by values that constitute quality of life, such as suitable income, independent living arrangement, driving privileges, and job satisfaction. Being able to develop or maintain a positive or high quality of life after a disability is one of the key outcomes in rehabilitation (Kemp, 2000).

Employment

From an employment standpoint, older persons with late-onset disabilities have followed a more traditional career development evolution as described by Super and other theorists (Szymanski, Hershenson, Enright & Ettinger, 1996). In general, their work lives have had elements of choice and some degree of opportunity to move among various employment situations. Many have had stable careers in semi-skilled, skilled, and professional occupations and are actively planning for retirement. In fact, 33% of the workforce over the age of 55 is employed in managerial and professional occupations (U.S. Bureau of the Census, 2000). With the occurrence of a disability after the age of 55, questions regarding ability or lack of ability to remain in employment become important considerations. Financial matters also become significant as adjustment to a reduced level of income is frequently required. The individual may need to explore benefits, such as short and long term disability and Social Security Disability Insurance (SSDI). Future vocational planning with realistic job goals can become a major task for those who desire to continue working. Even consideration of a career change may be a challenge for persons who have remained in one career throughout their employment history, not to mention issues around physical stamina, sensory acuity, and cognitive functioning brought on by the disability or simply the function of age. Some older adults have decided not to pursue competitive employment due to their age and disability and are using vocational programs inappropriately to remain active. Many older persons are not pursuing competitive employment goals, but rather are using vocational programs as a social outlet (Drebing, Losardo,Van Ormer, Krebs, Penk, Nasser, et al, 2002). Alternative programming should be sought for such persons