Surprisingly, recent surveys reveal that older adults are coping well during the pandemic despite increased vulnerability to the virus’s consequences.
In one study conducted by Age Wave and Edward Jones, 39% of the Silent Generation (ages 75+) and 33% of Boomers (56-74) reported “very well.” In contrast, 24% of the Millenials (ages 24-39) and Gen Zers (18-23) responded “not well,” compared to 15% of Gen X (40-55),12% of Boomers, and only 5% of the Silent Generation. In another study involving older adults with pre-existing major depressive disorder, researchers found no increase in depression and anxiety during the pandemic. Most of the respondents were more concerned about the risk of contracting the virus than social isolation. The older adults with depression reported that struggling with depression taught them to be more resilient.
What is Resilience?
Resilience is the process of adapting well in the face of adversity, trauma, loss, threats or significant sources of stress, family and relationship conflicts, severe health conditions, workplace and financial stressors, and pandemics. Resilience is not the absence of adversity or distress. Cultivating resilience involves experiencing pain and difficulty. Research suggests that an accumulation of misfortunes throughout life offers the opportunity to develop resiliency and build self-efficacy for improving outcomes later in life. The ability to “bounce back” from life’s problems is the resiliency hallmark. Resiliency is the capacity to view hardships as challenges to be mastered rather than threats to be endured. Often, people who overcome difficulties achieve profound personal growth and thrive despite adversity.
Resilience as a Protective Factor
The hypothalamic-pituitary (HPA) axis is the primary stress system sensitive to chronic and acute stress. In response to threats or challenges, the HPA system produces hormones such as cortisol. This hormone varies according to an individual’s wake-sleep cycles, exposure to light and dark cycles, and the circadian rhythm. The HPA axis shares a close relation to the body’s immune, nervous, and other endocrine systems.
As aging occurs, hormone secretion changes with increased cortisol output and impaired sensitivity of the HPA axis. Despite greater vulnerability to HPA dysregulation, many older adults demonstrate extraordinary resilience. Emotional regulation, or well-developed coping skills, and the social environment greatly influence older adults’
HPA axis function, including cortisol and may be protective factors for enhanced wellbeing.
Recent studies on the disablement process indicate that resilience is protective against activities of daily living (ADL) and instrumental activities of daily living (IADL) limitations, which modify the association between the onset of new chronic conditions and subsequent disability. Among people who experience the beginning of a recent chronic illness, those with higher resilience levels experience lower future disability levels.
In a study on the association of resilience and social networks with pain outcomes among older adults, the researchers found that among 4161 survey respondents with back pain, osteoarthritis, and rheumatoid arthritis, high resilience reduced moderate and severe pain symptoms by 50-60%, followed by diverse social networks. Social support is associated with improved physical quality of life and functional abilities, while resilience is associated with reduced depression.
Types of Resilience
Resilience involves psychological, social, and physical aspects that help overcome age-related adversities. Psychological resilience is a process of using positive adaptive behaviors when dealing with challenges, such as loss of functional independence or depression. Physical resilience is the
ability to maintain good health, persevere, and recover function in the face of adversity, such as a hip fracture. Social resilience is the ability to develop, engage in, and maintain positive relationships, in addition to adapting and enduring social isolation.
Key Characteristics of Resilience
Mental, social, and physical factors are the key characteristics of resilience among adults 65 and older. Research indicates that adaptive coping styles, optimism, hopefulness, positive emotions, social support, community involvement, ADL independence, and physical activity engagement are predictive for high resilience. According to studies, neither mental illness nor physical limitations predict low resilience with strong social networks. Social support both before and during adversity appears to increase the likelihood of fostering high resilience in older adults.
Physical characteristics associated with high resilience include ADL and IADL independence, physical activity, better physical health, and fewer chronic conditions. Studies addressing the potential health outcomes later in life suggest that high resilience can help older adults achieve improved quality of life, mental health, and overall successful aging, despite adversities encountered. The combined psychological, social, and physical characteristics of high resiliency increase the potential to influence the process of successful aging positively.
Improved Health and Wellbeing
Resilience produces increased happiness, wellbeing, satisfaction with life, improved resistance to stress, and lower depression levels. ADL independence, increased longevity, lower mortality risk, and faster recovery from cardiovascular events are positive outcomes. Studies indicate that resilience impacts longevity, especially at more advanced ages. Respondents ages 94-98 years with high resilience were 43.1 % more likely to reach 100 years than those with low adaptability.
Studies and observations show that women tend to be more resilient than men. Older women appear to be exceptionally skilled at establishing and maintaining social connections, reaching out to help others, and connecting through volunteering and community participation, resulting in high resilience. On average, women live longer than men and encounter more significant adversity, such as losing a spouse, chronic conditions, and possible social isolation.
Successful aging offers the opportunity for older adults to participate in society actively. The life experience and wisdom of older adults provide numerous contributions to their community. Younger generations can benefit from the experiences and resilience of older adults. Older adults can mitigate the pervasive negative perceptions and stereotypes of aging through their valued contributions. A sense of purpose and engagement by older adults promotes an enhanced quality of life and satisfaction.
The Importance of Self-Efficacy, Morale, and Purpose
Self-efficacy is the optimistic self-belief that one can perform novel or challenging tasks and achieve desired outcomes. The “can-do” sense of control over one’s environment and a belief in controlling unpredictable environmental demands help develop resilience. Self-efficacy is predictive of the ability to recover, bounce back from adversity, and adapt to change. Additionally, social support and physical health predict self-efficacy.
A person’s confidence in their ability to influence life events is associated with increased self-care and rating of healthy aging. Self-efficacy is also an arbitrator for changes in health behaviors and utilization of the healthcare system. For older adults, self-efficacy is related to improved sleep, increased energy, decreased pain, enhanced life satisfaction, and reduced depression.
Morale, a significant psychosocial factor, is defined as “a future-oriented optimism or pessimism regarding challenges closely related to subjective wellbeing.” Depression and perceived loneliness appear to be key risk factors for lower wellbeing among older adults, especially the most senior age groups.
A sense of purpose is positivity related to increased plasticity, wellbeing, and improved cognitive functions. A sense of purpose can protect the brain against the harmful effects of stress. Finally, a sense of meaning results in improved health and longevity. Okinawans in Japan are known for their longevity attributed to a strong sense of purpose. Okinawans pursue okigai or “reason for being” or “waking up in the morning.”
Developing Resilience
Healthy Aging Programs involve successful outcomes for chronic disease management and mind-body interventions to improve older adults’ self-care. Studies found that self-efficacy related to controlling stress levels and coping resulted in improved health behaviors. Other findings include fewer hospitalizations and days hospitalized for patients enrolled in a community-based, self-management program addressing relaxation techniques, emotional regulation, sleep management, nutrition, and health-related decision-making methods. A two-year follow-up evaluation demonstrated maintenance of results and lowered healthcare costs.
Healthy aging programs inspired by mind-body interventions (MBIs) focus on the relaxation response (RR) characterized by decreased heart rate, blood pressure, breathing rate, and muscle tension. Results from the Healthy Aging MBI for participants 65 years and older consisting of 90-minute sessions for nine consecutive weeks found significant increases in self-efficacy and morale for program completers.
Storytelling or narrative work can reduce negative assertions while learning novel coping methods and reframing our lives. A positive correlation exists between the narrative work of storytelling and resilience. Furthermore, storytelling can foster social support by sharing narratives and learning new coping strategies. Storytelling promotes creativity, reflection, self-expression, a sense of meaning, and forms a diversity of aging perspectives.
According to researchers, spirituality contributes to protective factors such as hope, purpose, social connection, and self-confidence. Individual spiritual beliefs establish a sense of hope and change in overcoming adversity. Studies find that spiritual practices result in reduced stress and physiological measures. Spirituality is a tool in promoting and sustaining resiliency later in life.
Healthcare professionals can develop self-efficacy based interventions for social and physical activity. Self-efficacy is addressed by gradating tasks and using the “just right” challenge to achieve mastery for tasks perceived as unattainable. Therapeutic exercise helps maintain physical abilities to perform ADLs and IADLs independently. Furthermore, providing social support interventions and community engagement are critical factors for fostering resilience.
Conclusion
Resilience is multi-faceted involving physical, psychological, and social protective factors. Although specific individuals appear to be instinctively more resilient, many older adults demonstrate exceptional coping skills during turbulent times. Healthcare professionals possess the tools to help older adults cultivate resiliency and receive seniors’ guidance and inspiration on overcoming life’s challenges.
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