Geriatric Nursing
Volume 29, Issue 2 , Pages 85-86, March 2008

Resilience in Aging: The Real Experts

Article Outline

 

I know I say it all the time but for the last month I have lived it—I am truly thankful that I have had the opportunity to work with older adults throughout my entire teenage and adult life. Although I have had to endure a variety of health challenges, as we all do over the years, I was recently hit with something that is near and dear to my heart—physical function! Somehow, I had inadvertently fractured a bone. I was told, by a rather young orthopedist, those infamous words of “my dear, at your age new bone is not likely to grow!” I felt old, disabled, and the core of my definition of quality of life was destroyed by an inability to walk, let alone run. Then, I thought about the many older adults I have provided care for over the years and how they would respond. One simple word came to mind: resilience.

Resilience has been described as a personal characteristic that likely develops over time.1 More recently, resilience has been viewed as a dynamic process that influences the ability to deal with, survive, overcome, learn from, and recover from inevitable adverse experiences of life by incorporating internal traits such as hardiness, high self-efficacy, and external factors, such as social support, that promote coping.2, 3, 4, 5 Who better than older adults, therefore, to be our role models of resilience? The following are some of the techniques and demonstrations of resilience I have noted and learned from over the years.

1.The ability to make connections. All those older adults who develop new friends in an assisted living facility or nursing home whether these are fellow residents or staff.

2.Not seeing crises as insurmountable problems. The older woman who was planning to spend the day one way, maybe visiting a friend or having lunch with a grandchild, and then slips in the shower and sustains a hip fracture or skin tear so significant sutures are required. She smiles up at the ambulance attendant and begs him or her not to bother her daughter at work while she gets this all fixed! She continues to roll with the changes in function and persist in therapy or through treatments until she is back to, and even better than, her baseline function.

3.Accepting changes as a part of living. The older man who has macular degeneration and gives up driving and his car, taking some joy in gifting this to a grandchild and then uses the money saved in insurance to buy a reading machine.

4.Moving toward new goals. The 90-year-old woman who has a stroke with a hemiparesis and persists in therapy with a head-down determination to get back to living on her own, accepting help in the areas in which it is needed.

5.Taking decisive actions. The women and men who stand strong and say no more medical interventions for a spouse of 60 years, help that spouse optimize his or her final days, and then continue to engage in a new life after 90.

6.Continuing to look for opportunities for self-discovery. The woman who says, when you ask her to participate in a new intervention or activity, I have never tried that but am willing to give it a go!

7.Maintaining a positive view of yourself. The 90-plus-year-old woman who asks you to clasp her pearls for the New Year’s Eve party, checks out the mirror and says, I look pretty damn good for my age!

8.Keeping things in perspective and maintaining a hopeful outlook. All of the older men and women who move into long-term care facilities, giving up sometimes lifelong homes, with enthusiasm and optimism.

9.Continuing to take care of yourself. The older caregiver who tells you, “I will bring my husband down for you to check his urine and postvoid residual after I go for my swim this morning.”

I thank these role models as I head into aging full force—changing eyesight, deceased hearing, and broken bones. These many women and men who roll with the waves of life and keep swimming have taught me well. Resilience is not simply acceptance and defeat. Rather, resilience provides us with the resources and skills to accept change and use it to persist with those things that are important to each of us. It is the avoidance of self-pity, anger, and depression and allows us to put effort into recovery and adaptation. We must adapt and adjust. For example, we move farther from or closer to the paper we are reading, get new glasses, buy hearing aides, or learn new patterns of exercise to accommodate broken bones, and we survive. Again, I extend my thanks and deep appreciate to all those older individuals I have encountered who have taught me resilience and hope you will take a moment today to do the same.

Although we see this resilience in people all of the time, we actually know little about how to develop resilience and what factors influence it. The theme for the Gerontological Society of American (GSA) conference (November 21–25, 2008) is focused specifically on resilience and is titled, “Resilience in an Aging Society: Risks and Opportunities.” We have much information to share and to learn on this topic from a nursing perspective; examples are: What pathways predict resilience despite multiple risks? How do new vulnerabilities or strengths emerge over the life course? What interventions effectively strengthen resilience? How might we translate research findings into evidence-based health interventions? Please consider attending the 2008 GSA 61st Annual Scientific Meeting at the Gaylord National Resort and Convention Center in National Harbor, Maryland, a new international destination on the Potomac, just across from our nation’s capital. In so doing, we can all add to what we know about resilience in older adults and acknowledge those we have learned resilience from and help all of us who are aging to become or remain resilient as we meet the challenges that may lay ahead.

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References 

  1. Glantz M, Johnson J. Resilience and development positive life adaptations. New York: Kluwer Academic; 1999;
  2. Hardy S, Concato J, Gill TM. Resilience of community-dwelling older persons. J Am Geriatr Soc. 2004;52:257–262
  3. Hardy SE, Concato J, Gill TM. Stressful life events among community-living older persons. J Gen Intern Med. 2002;17:832–838
  4. Wagnild G. Resilience and successful aging (Comparison among low and high income older adults). J Gerontol Nurs. 2003;29:42–49
  5. Wilcox S, Bopp M, Oberrecht L, et al. Psychosocial and perceived environmental correlates of physical activity in rural and older African American and White women. J Gerontol B Psychol Sci Soc Sci. 2003;58:P329–P337

PII: S0197-4572(08)00029-3

doi:10.1016/j.gerinurse.2008.01.003

Geriatric Nursing
Volume 29, Issue 2 , Pages 85-86, March 2008

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