Resilience in Aging
The concept of resilience in aging was born out of the “paradox of old age.” The paradox is that in spite of losses and physical declines experienced in later life, older adults report feeling content, and they have lower rates of psychopathology than the general population. Researchers have argued that this is due to resilience, and that an understanding of resilience can lead to new health promotion strategies that yield healthier, happier people and communities.
TIPS ABOUT RESILIENCE IN OLDER ADULTS
What is Resilience?
Resilience is the result of successful adaptation to adversity. It is revealed by an individual’s ability to cope and recover from crises, sustain a sense of purpose and vitality, and emerge stronger from stressful experiences. Resilience is a dynamic characteristic that may shift according to the circumstance.
Indeed, it can be manifest in many forms: as an outcome of physical or mental recovery from a traumatic event; as a trait that describes an individual’s enduring ability to cope; or as a process of recovering from a stressful event and moving forward. No matter how resilience is viewed, the resources that lead to resilience can result in positive outcomes. (Table 1).
|Table 1. Examples of Resilience Resources and Hypothesized Outcomes|
|Resilience Resource||Hypothesized Outcome|
|Coping capacity||Prevention of disability following injury|
|Emotional awareness and clarity||High levels of emotional differentiation and complexity|
|Sense of purpose||Sustained elevations in positive emotion and hope|
|Social connection/affiliation||Social meaning and value sustained under stress|
|Supportive social network||Less depression and anxiety following loss|
|Cardiac health||Recovery following stress|
|Immune competence||Rapid immune response to acute illness/injury|
Hallmarks of Resilience in Aging
Although resilience is seldom associated with older adults because they experience loss and decline, older adults actually have a higher level of subjective well-being than individuals in any other age group. “Resilience thinking” in older adults gives them the ability to recover from adversity, thrive with a sustained purpose, and grow in a world of turmoil, change, and chronic illness. It is a regenerative capacity that maintains health and function in the face of loss, disability, or disease. The three hallmarks of resilience are shown in Table 2.
|Table 2. Three Hallmarks of Resilience|
Resilience thinking allows older adults to accept the wear and tear of aging, while also dealing with problems and crises – like losing a loved one, spousal caregiving, or acquiring a disability – in ways that leave them feeling stronger than they would have been if they had not encountered those crises. In resilience thinking, failure leads to growth.
Assessing Resilience in Aging
By assessing older adults using a resilience perspective, strengths of an individual can be highlighted. The goal of such an assessment is to determine if an individual has the characteristics that predict positive outcomes when dealing with stressors and calamity, and to suggest the need to encourage resilience if those characteristics are absent. Several of these characteristics are shown in Table 3. Specific questions that can be asked to help assess an individual’s resilience are shown in Table 4.
| Table 3. Characteristics and Behaviors that Lead to Resilience|
How can we Promote Resilience in Aging?
Those who live the longest have been found to be resilient. Since most older adults are interested in a long and happy life, clinicians can share information with and teach older adults about the resilience process. For example, the evidence from neuropsychology disproves the myth that “you cannot teach an old dog new tricks.” Rather, older adults should be encouraged to engage in new activities and make new friendships. Clinicians caring for older adults should discuss with them, write them prescriptions, or outline plans for activities that build resilience, such as joining a social group, developing a family communication plan, starting a stress management program, exercising, and/or beginning a volunteer position, job, or new hobby.
|Table 4. Sample Questions for Assessing Resilience in Aging|
The resilience process builds individual strengths and competencies. Through personal connections, older adults learn about their potentials and gifts from others, which increases their self-efficacy and perseverance in the face of adversity. The meaningful relationships they have with friends and family provide them resources to adapt to adversity, and their engagement in meaningful activities gives them purpose and the motivation to persevere, and continue to learn. As a result, resilient older adults have a positive attitude and forward-looking outlook that we should promote across all populations.
References and Resources
- Fry PS, Keyes C. New frontiers in resilient aging: Life strengths and well-being in late life. New York: Cambridge University Press. 2010.
- Guthreil IA, Congress E. Resiliency in older people: A paradigm for practice. In E. Norman (Ed.). Resiliency enhancement: Putting the strengths perspective into social work practice. New York: Cambridge University Press. 2000; 40-52.
- Hall J, Zautra A, Borns K, et al. Unlocking resilience: The key to healthy aging in Arizona. 2010.
- Hengudomsub P. Resilience in later life. Thai Pharm Health Sci. 2007; 2:115-23.
- Reich JW, Zautra AJ, Hall JS. Handbook of adult resilience. New York: Guilford Press. 2010.
- Resilience Solutions Group.
National Editorial Board: Theodore M Johnson II, MD, MPH, Emory University; Jenny Jordan, PT, DPT, Sacred Heart Hospital, Spokane, WA; Jane Marks, RN, MS, FNGNA, Johns Hopkins University; Josette Rivera, MD, University of California San Francisco; Jean Yudin, CRNP, University of Pennsylvania
Interprofessional Associate Editors: Carleigh High, PT, DPT; David Coon, PhD; Marilyn Gilbert, MS, CHES; Jeannie Lee, PharmD, BCPS; Marisa Menchola, PhD; Francisco Moreno, MD; Linnea Nagel, PA-C, MPAS; Lisa O’Neill, DBH, MPH; Floribella Redondo; Laura Vitkus, MPH, CHES