Resilience: thoughts on the value of the concept for critical gerontology

Resilience among older adults with multimorbidity using the Connor-Davidson scale in the Canadian Longitudinal Study on Aging: health behaviour, socio-economic, and social support predictors

OBJECTIVE

Multimorbidity is recognized as a serious health condition faced by a majority of older adults. Research investigating adaptive responses to multimorbidity, termed multimorbidity resilience, has been growing. This paper examines protective and risk factors, with a focus on health behaviours, socio-economic resources, and social support using an established measure of resilience (Connor-Davidson Resilience Scale) among older adults, focusing on older persons with two or more concurrent chronic conditions.

METHODS

Using Baseline (2011-2015), Follow-up One (2015-2018), and Follow-up Two (2018-2021) data from the Comprehensive Cohort of the Canadian Longitudinal Study on Aging, we tested hypotheses using 13,064 participants aged 65 years and older, who completed all waves and reported two or more of 27 chronic conditions, for the full sample of multimorbid individuals and three multimorbidity clusters: Cardiovascular/Metabolic, Musculoskeletal, and Mental Health. Associations between protective and risk factors and resilience were examined using linear regression to model the Connor-Davidson resilience scale, adjusting for illness context and social determinants of health.

RESULTS

Among all multimorbid individuals, the strongest associations with resilience were found for higher self-rated health, greater sleep satisfaction, better appetite, higher household income, more relatives and friends, being overweight (compared to normal weight), fewer housing problems, and fewer skipped meals. Weaker associations were found for non-smokers, less alcohol consumption, less pain, sedentary behaviour, being non-married (compared to married), and among Canadian born (compared to foreign). The analyses for the three multimorbidity clusters were largely replicated for the three multimorbidity clusters, but with some nuances depending on the cluster.

DISCUSSION

This research provides confirmatory evidence for several protective and risk factors affecting the ability to cope and recover from multimorbidity adversity among older adults. There are consistent patterns for the multimorbidity disease clusters, but some distinct relationships arise that are worthy of attention. The implications of the findings for modifiable health behaviours and socio-economic factors are discussed for their public health and clinical relevance.

An 'all-world ageing' perspective and its wider ethics of care: An empirical illustration

Recent commentaries have proposed 'all-world ageing' as a new perspective for social scientific ageing research. It is based on the theoretical observation that the ageing process involves all forms of entities co-ageing relationally with each other, and with their surrounds. Its disciplinary implications hence being that what we categorize as ageing in social scientific ageing research should not be limited to human bodies, and that ageing non-humans should be brought under its purview. To empirically illustrate these theoretical and disciplinary assertions, and explore their implications, the current paper reports a study of how people co-age with non-humans they interact with in their daily lives. Sixteen people aged 66-90 were interviewed, ten of them also being observed at those times. The findings show some intricate and diverse relations that involve their co-ageing with varied biological entities and nature surrounds (such as plants, domestic animals and green spaces) and varied non-biological entities and non-nature surrounds (such as materials, technologies, accommodations, organizations and infrastructures). Meanwhile, important crosscutting themes - including lifespan, function and aesthetics - emerge as objectives of care, valued and exercised in broad terms. This empirical reconnaissance shows the potential for an all-world ageing perspective to engage diverse societal challenges and inform diverse areas of practice as part of a wider ethics of care. From it, a number of important considerations and undertakings arise for future scholarship.

The mediating effects of hope on the relationships of social support and self-esteem with psychological resilience in patients with stroke

PURPOSE

To explore the mediating effect of hope in the relationships between social support and self-esteem with psychological resilience among patients with stroke survivors in early rehabilitation.

METHODS

A cross-sectional study design was adopted. Data from a cross-sectional survey of 210 patients undergoing early stroke rehabilitation were analyzed using structural equation modeling. The variables of interest were measured using the Connor Davidson Resilience Scale, the Social Support Rating Scale, the Herth Hope Index, and the Self-Esteem Scale. This article reports according to the STROBE checklist.

RESULTS

A positive relationship was found between social support and psychological resilience (β1 = 0.548), which was mediated by hope (β2 = 0.114), and social support had significant direct effect on resilience (β3 = 0.434). A positive relationship was also found between self-esteem and psychological resilience (β4 = 0.380), which was mediated by hope (β5 = 0.200), and self-esteem had significant direct effect on resilience (β6 = 0.179).

CONCLUSION

According to the results of this study, some strategies can be incorporated into the rehabilitation process to enhance psychological resilience, such as cultivating individual personality characteristics and improving patients' social relationships. In the future, we need to explore methods for improving psychological resilience among patients with stroke in combination with their risk factors to improve their quality of life and reduce the incidence of post-stroke depression.

Exploring perceptions of frailty, resilience, and self-efficacy in older adults and caregivers in acute care context

This study aimed to explore the experience and perceptions of frailty in hospitalized older adults and caregivers caring for older adults, in relation to resilience and self-efficacy. A qualitative explorative descriptive study design was utilized. Face to face interviews were conducted from September 2020 to July 2021 with 24 older adults who were 65 years and above and hospitalized in the acute care hospital. Ten informal family caregivers were also recruited. Data were analysed using an inductive content analysis approach. Frailty encompassed physical elements as well as manifestations of psychological traits, fear of the unknown, and being in control. Resilience was determined by individual psychological traits and mindset, and the possession of a coping mechanism. Self-efficacy could influence both frailty and resilience through inner motivation and assistance received. Older adults and family caregivers reported that considerable decline in physical health with age and level of perseverance can determine the level of frailty. Resilience and self-efficacy play a pivotal role in the context of frailty. Understanding resilience in this context will assist nurses to facilitate the use of individual and sociocultural resources to improve the way resilience is experienced by older adults. Various coping strategies can enhance self-efficacy and build greater resilience in older adults, including maintaining their active involvement in health management and social life.

Home care and quality of life among community-dwelling dependent older adults in Israel: a multiple mediator model

PURPOSE

To examine the association between home care provision (combined paid formal home care and non-paid family-only home care) versus non-paid family-only home care with quality of life (QoL) of older adults, as well as the mediating effects of loneliness, social isolation and satisfaction with family relationships and support.

METHODS

A convenience sample of 360 Israeli dependent adults aged 65 + responded to questionnaires. Using bootstrapping, we tested the strength and significance of the conditional indirect effects of the four simultaneous mediators.

RESULTS

Using combined home care provision (paid formal home care and non-paid family-only home care) versus non-paid family-only home care for older adults was associated with lower QoL of care-recipients (B = - 4.57, t = - 2.24, p = 0.001, 95% CI - 8.58, - 0.56; R2 = 0.37), and was fully and strongly mediated by feelings of loneliness (B = - 1.92, p = 0.001, 95% CI - 3.66, - 0.79), social isolation (B = - 0.54, p = 0.001, 95% CI - 1.47, - 0.07) and satisfaction with family support (B = - 1.09, p = 0.001, 95% CI - 2.57, - 0.16). However, the indirect effect through satisfaction with family relationships was not significant. The highest proportion of the indirect effect size was (B = 0.42, 95% CI 0.13, 1.97) for loneliness, followed by satisfaction with family support (B = 0.23, 95% CI 0.01, 1.07), and social isolation (B = 0.11, 95% CI 0.01, 0.66), respectively.

CONCLUSIONS

Using combined formal home care might reduce the QoL of care-recipients by increasing their feelings of loneliness, social isolation and reduced perceived family support. Practitioners should encourage family members to continue with family regular support and contact alongside the use of formal home care in order to maintain satisfaction and QoL of older relatives.

Financial freedom, final fantasy, 'formative ageing': A study of ageing single women and retirement in contemporary China

This article aims to continue a conversation sustained in this journal during the last three decades; a conversation that seeks to promote critical thinking on age and ageing through the lens of gender and sexuality. I do so by considering a specific group of Chinese women: single women living in Beijing or Shanghai. I invited 24 of them, born between 1962 and 1990, to share their imaginations about retirement, in the Chinese context, where the mandatory retirement age for women is 55 or 50 (60 for men). My aims are three-fold: to insert this group of single women into retirement and ageing studies; to recuperate and document their retirement imaginations; and ultimately, to draw insights from their subjective accounts, to revisit dominant paradigms of ageing, notably so-called successful ageing. Empirical data show how these single women treasure financial freedom, but usually without taking concrete steps towards its accomplishment. They also embrace a diversity of imaginations about where and with whom they want to spend their retirement life, and what they want to do - both long-held dreams and new careers. Inspired by yanglao, a term they use instead of retirement, I argue the term 'formative ageing' is a more inclusive and less normative way of looking at ageing.

Pandemic Stories: The Voices of Older Adults

To document the reactions and experiences of older persons during the COVID-19 pandemic, we have conducted a qualitative study of 25 older adults (50 years of age and older) throughout the pandemic, using serial interviewing methods. This analysis reports on the data collected from the first two rounds of interviews - one conducted in the summer of 2020 and one conducted in the fall of 2020. Our thematic analysis found eight major themes: thoughts on the dangers of the pandemic, how the virus has changed daily life (including social life), health care during COVID (being a caregiver, losing a loved one, seeking health care), missing spontaneity and dealing with existential dread, the growing frustration, seeking connection through civic participation, adaptation and resilience, and the social ills that the pandemic has revealed. These stories describe both loneliness and connection, hope coupled with disappointment, but overwhelmingly, an insight into what the pandemic has shown us about the social ills that it has revealed.

How do individual, social, environmental, and resilience factors shape self-reported health among community-dwelling older adults: a qualitative case study

BACKGROUND

While older adults are living longer, they often face health challenges, including living with multiple chronic conditions. How older adults respond and adapt to the challenges of multimorbidity to maintain health and wellness is of increasing research interest. Self-reported health, emerging as an important measure of health status, has broad clinical and research applications, and has been described as a predictor of future morbidity and mortality. However, there is limited understanding of how individual, social, and environmental factors, including those related to multimorbidity resilience, influence self-reported health among community-dwelling older adults (≥ 65 years).

METHODS

Informed by the Lifecourse Model of Multimorbidity Resilience, this explanatory case study research explored older adults' perceptions of how these factors influence self-reported health. Data were generated through semi-structured telephone interviews with community-dwelling older adults.

RESULTS

Fifteen older adults participated in this study. Four key themes, specific to how these older adults describe individual, social, environmental, and multimorbidity resilience factors as shaping their self-reported health, were identified: 1) health is a responsibility - "What I have to do"; 2) health is doing what you want to do despite health-related limitations - "I do what I want to do"; 3) the application and activation of personal strengths - "The way you think", and; 4) through comparison and learning from others - "Looking around at other people". These themes, while distinct, were found to be highly interconnected with recurring concepts such as independence, control, and psychological health and well-being, demonstrating the nuance and complexity of self-reported health.

CONCLUSIONS

Findings from this study advance understanding of the factors that influence assessments of health among community-dwelling older adults. Self-reported health remains a highly predictive measure of future morbidity and mortality in this population, however, there is a need for future research to contribute additional understanding in order to shape policy and practice.

Multimorbidity resilience and health behaviors among older adults: A longitudinal study using the Canadian Longitudinal Study on Aging

Objective

There has been a growing interest in examining why some individuals adapt and bounce back from multimorbidity (resilience) better than others. This paper investigates the positive role of protective health behaviors on multimorbidity resilience (MR) among older adults focusing on older persons with two or more concurrent chronic conditions, and separately for three multimorbidity chronic illness clusters.

Methods

Using Baseline and Follow-up One data from the Comprehensive Cohort of the Canadian Longitudinal Study on Aging, we studied 10,628 participants aged 65 years and older who reported two or more of 27 chronic conditions, and three multimorbidity clusters: Cardiovascular/metabolic, Musculoskeletal, and Mental health. Associations between health behaviors and MR were evaluated using Linear Mixed Models, adjusting for socio-demographic, social/environmental, and illness context social determinants of health.

Results

Among older adults with two or more illnesses, smoking, satisfaction with sleep, appetite, and skipping meals were associated with MR in the expected direction. Also, obesity (compared to normal weight) and skipping meals showed longitudinal interaction effects with survey wave. Most of the results were replicated for the physical multimorbidity clusters (Cardiovascular/metabolic and Musculoskeletal) compared to the full 2+ multimorbidity analyses; however, for the Mental health cluster, only satisfaction with sleep was supported as a lifestyle predictor of MR.

Discussion

Several modifiable health behaviors identified in the broader health and aging literature are important in affecting levels of multimorbidity resilience in older age. These factors are important strength-based areas to target. Additionally, several social determinants of health are also supported and parallel research on multimorbidity risk. The effects of lifestyle factors for resilience among older adults is dependent on the type of multimorbidity measured. We conclude that the results have significant public health, program intervention, and clinical implications for healthy aging among persons coping with multimorbidity.

Rural older adults' resilience in the context of COVID-19

Public health and media discourses have often portrayed older adults as a vulnerable group during the COVID-19 pandemic. Yet, some emerging research is showing that older adults are faring better in terms of their mental health when compared to their younger counterparts. Understanding older adults' mental well-being during the pandemic requires in-depth exploration of the different place-based resources and systems around them. In particular, rural older adults face distinct challenges and opportunities related to accessing valued resources to promote their well-being. Drawing together research on aging and multi-systemic resilience, we explored what strategies, resources, and processes rural older adults valued in the initial stages of the COVID-19 pandemic. A series of 51 semi-structured telephone interviews were conducted from May to August 2020 with 26 rural older adults in Manitoba, Canada. Despite adversities, participants drew on and developed resources at the individual, local, community, institutional, and societal level to support their well-being. Specifically, they identified individual strategies (e.g., positivity, acceptance, and gratitude), resources in their immediate environments (e.g., opportunities to keep busy, connect with friends, family and neighbours, and outdoor visits), and community organizations that contributed to their well-being. They also identified broader systems that shaped their resilience processes, such as access to health services, opportunities to volunteer and support others, media stories, reliable information, and public health policies and practices that value older adult lives. Importantly, some resources were less accessible to some participants, highlighting the need to develop strategies that address inequitable resources at different levels. By describing rural older adults’ resilience we seek to advance the growing body of research in relation to social ecological resilience that moves beyond a focus on individual characteristics to include understanding of the role of material, social, and cultural contexts.

A Unified Model of Resilience and Aging: Applications to COVID-19

Drawing on multidisciplinary research focusing on a spectrum ranging from individual experience to structural system-level risk response and resilience, this article develops a rationale for a Unified Model of Resilience and Aging (UMRA). In response to a broad range of adversities associated with aging, it details the ways in which some individuals are able to bounce back better than others, or adapt better than expected, termed resilience. However, resilience and aging theoretical models have developed out of different disciplinary developments, ranging from individual levels to structural level complex systems, including several gerontological theoretical models addressing adaptation to life course and aging processes. The article reviews and synthesizes prior conceptual and theoretical work, and their empirical groundings, in order to develop an integrated resilience model with wide applications to aging-related problems including chronic illness, mental health, widowhood, poverty, caregiving burden, etc. The article focuses specifically on COVID-19 pandemic risk, response and resilience in order to specify applications of the UMRA, and to suggest avenues for future research and testing of theoretical axioms.

Multimorbidity resilience and COVID-19 pandemic self-reported impact and worry among older adults: a study based on the Canadian Longitudinal Study on Aging (CLSA)

Background

The Coronavirus Disease-2019 (COVID-19) pandemic has created a spectrum of adversities that have affected older adults disproportionately. This paper examines older adults with multimorbidity using longitudinal data to ascertain why some of these vulnerable individuals coped with pandemic-induced risk and stressors better than others – termed multimorbidity resilience. We investigate pre-pandemic levels of functional, social and psychological forms of resilience among this sub-population of at-risk individuals on two outcomes – self-reported comprehensive pandemic impact and personal worry.

Methods

This study was conducted using Follow-up 1 data from the Canadian Longitudinal Study on Aging (CLSA), and the Baseline and Exit COVID-19 study, conducted between April and December in 2020. A final sub-group of 9211 older adults with two or more chronic health conditions were selected for analyses. Logistic regression and Generalized Linear Mixed Models were employed to test hypotheses between a multimorbidity resilience index and its three sub-indices measured using pre-pandemic Follow-up 1 data and the outcomes, including covariates.

Results

The multimorbidity resilience index was inversely associated with pandemic comprehensive impact at both COVID-19 Baseline wave (OR = 0.83, p < 0.001, 95% CI: [0.80,0.86]), and Exit wave (OR = 0.84, p < 0.001, 95% CI: [0.81,0.87]); and for personal worry at Exit (OR = 0.89, p < 0.001, 95% CI: [0.86,0.93]), in the final models with all covariates. The full index was also associated with comprehensive impact between the COVID waves (estimate = − 0.19, p < 0.001, 95% CI: [− 0.22, − 0.16]). Only the psychological resilience sub-index was inversely associated with comprehensive impact at both Baseline (OR = 0.89, p < 0.001, 95% CI: [0.87,0.91]) and Exit waves (OR = 0.89, p < 0.001, 95% CI: [0.87,0.91]), in the final model; and between these COVID waves (estimate = − 0.11, p < 0.001, 95% CI: [− 0.13, − 0.10]). The social resilience sub-index exhibited a weak positive association (OR = 1.04, p < 0.05, 95% CI: [1.01,1.07]) with personal worry, and the functional resilience measure was not associated with either outcome.

Conclusions

The findings show that psychological resilience is most pronounced in protecting against pandemic comprehensive impact and personal worry. In addition, several covariates were also associated with the outcomes. The findings are discussed in terms of developing or retrofitting innovative approaches to proactive coping among multimorbid older adults during both pre-pandemic and peri-pandemic periods.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-02769-2.

Count Your Life by Smiles and Tears: An Integrative Review on Resilience and Growing Older

The concept of “resilience” is considered helpful in understanding how people navigate adversities typical to later life. It is also a concept of growing interest internationally in research and in social policy and (social) practice. This article employs an integrative review methodology to explore current trends in theoretical and empirical research on resilience. A total of 25 quantitative and qualitative studies from 2011 to 2020 are included in this review. Findings indicate how the reviewed studies typically define resilience from three perspectives: resource-based, outcome-based, and process-based perspectives of resilience. In the results of the same studies, the resource-based and outcome-based perspectives are elaborated upon while detailed results from a process-based perspective are lacking. Additionally, even though adversity is recognized as a key element in conceptualizing resilience, it is scarcely defined if defined at all in the reviewed studies. Further research is recommended in this article to contribute to a realistic and encouraging narrative on growing older in social policy and (social) practice.

Measurement Invariance of the Brief Resilient Coping Scale (BRCS) in Peruvian and Spanish Older Adults

Although the Brief Resilient Coping Scale (BRCS) has been validated in some European and American countries, there are no studies that evaluate its factorial invariance among different nations. In this sense, the objective of the study is to evaluate the factorial invariance of the BRCS in samples of older adults in Peru and Spain, using multigroup Confirmatory Factor Analysis. 236 older adults from Peru participated (Mean age = 72.8, SD = 6.90) and 133 older adults from Spain (Mean age = 71, SD = 7). In the Peruvian sample 78.4% were women and 21.6% men; while in the Spanish sample the majority were women (69.9%). The BRCS was scalar invariant but not strictly invariant between Spain and Peru. Our results found invariance of the structure, factor loadings and intercepts in both countries. These results support the use of BRCS in studies that compare the resilience between samples of older adults in both countries, and encourage applied research for the development of resilience in older adults in Spain and Peru.

Life challenges and resilience: the role of perceived personality continuity

OBJECTIVES

Self-functioning, one aspect of mental health, is positive in later life. Although experiencing challenges may disrupt mental health, internal resources can foster resilience. This study examines how the frequency of recent challenges relates to current self-functioning. Perceived personality continuity, one's sense of maintaining their trait personality, is investigated as an internal resource.

METHOD

Participants (N = 99 young adults, 88 older adults) reported all challenging events experienced in the last six years. Perceived personality continuity over the same time was assessed. Multi-measurement of current self-functioning included self-concept clarity, self-esteem, and self-acceptance.

RESULTS

Older adults reported higher self-concept clarity and self-esteem; young adults reported higher self-acceptance. Experiencing more challenges related to lower self-concept clarity and self-esteem across age groups, with a stronger negative link to self-esteem for young adults. Perceived personality continuity partially mediated relations between: (i) challenges and self-concept clarity, and (ii) challenges and self-esteem. Perceived personality continuity mediated positive self-functioning for older adults only.

CONCLUSION

A late life strength, older adults report higher self-functioning overall. Challenges negatively relate to self-functioning across age groups, but younger adults' self-esteem is more vulnerable. When having faced challenges, older adults' perceived personality continuity is critical to positive current self-functioning.

Migration and Resilience in Urban Canada: Why Social Resilience, Why Now?

Drawing on an extensive review of recent literature about resilience and integration, this paper evaluates a social resilience approach to the integration of international migrants in Canadian cities. We advocate a social resilience approach that acknowledges how institutions of all types play critical roles in newcomers’ efforts to establish their lives in new places, especially when faced with unanticipated events such as a global pandemic. Centering research around the concept of social resilience goes beyond the neoliberal idea that integration is primarily an individual affair achieved with support from friends, family, and a nebulous community and draws attention to the social diversity of migrants and the complexity of their migration and settlement histories. Inherently relational, a social resilience approach encourages comparative studies of integration across cities that can reveal how different institutions and their programs affect migrants’ trajectories. Detailed examinations of local institutions and their responses to shifting selection and integration policies, especially during a pandemic, also hold the potential to provide crucial information for supporting newcomers effectively.

Assessing Resilience in Older Adulthood: Development and Validation of the Resilience Scale for Older Adults

This study presents on the initial development and validation of the Resilience Scale for Older Adults (RSOA). This new measure is based on a theoretical model of resilience grounded in qualitative research conducted with older adults. The scale consists of four resilience protective factors with 11 underlying facets. The Intrapersonal factor consists of Perseverance and Determination, Self-Efficacy and Independence, Purpose and Meaning, and Positive Perspective. The Interpersonal factor consists of Sense of Community, Family Support, and Friend/Neighbour Support. The Spiritual factor consists of Faith and Prayer, and the Experiential factor consists of Previous Adversity and Proactivity. The findings of three independent studies using older adult samples support the four-factor, 11-facet structure of the RSOA. Results also provide promising initial reliability and validity information, and analysis of gender invariance suggests that the factor structure is comparable across men and women. Implications for the applicability of the RSOA in research and clinical settings are discussed.

The Critical Role of Coping Strategies in Moderating Loneliness and Quality of Life: Parallel and Unique Processes among Transgender and Heterosexual Cisgender People in Pakistan

Groups marginalized and/or isolated by minority status—including transgender individuals—are at significant risk for loneliness and diminished quality of life (QoL), effects that can be mitigated to some extent by coping styles. In this study, we examined the relationships among coping styles, loneliness, and QoL outcomes in a marginalized but understudied gender minority group, namely, 200 transgender individuals living in communities in an emerging/developing non-Western geo-cultural region of South-Central Asia (Pakistan), comparing them against a reference group of 100 heterosexual cisgender individuals. Results indicated strong relationships among coping styles, loneliness, and QoL in both transgender and cisgender groups. Moderating variable analysis revealed that coping skills—whether adaptive or maladaptive—help explain differences in loneliness and QoL not only between trans- and cis-gender individuals, but also within just the transgender group. The implications of these findings for intervention strategies to improve QoL among transgender populations are discussed, with reference to both the specific context within Pakistan and the larger context of transgender marginalization within many developing/emerging countries.

Brief Resilience Scale (BRS) Portuguese Version: validity and metrics for the older adult population

OBJECTIVE

This study aims to analyze the psychometric properties of the new Brazilian-Portuguese version of the Brief Resilience Scale (B-BRS) in older adults.

METHOD

A sample of 1251 participants (54.20% women; M = 68.02 years, SD = 6.52) completed the B-BRS and seven scales on successful aging and mental health. Confirmatory factor analysis was used to study the B-BRS dimensionality. Convergent and divergent validity was analyzed by means of examining the relationships of B-BRS with scales on successful aging and mental health.

RESULTS

The results supported the unidimensionality of the B-BRS after controlling for wording method, as well as satisfactory reliability (ω = .79). B-BRS structure remained invariant across education level and income groups. B-BRS scores positively correlated with successful aging factors and negatively with psychopathology symptoms.

CONCLUSION

To conclude, our findings provide some evidence on the reliability and validity of the B-BRS, as well as its validation for use in the senior population.

What older adults do in online communities when they co-create and co-destruct value

Purpose

This study aims to explain the value co-creation and co-destruction practices of older adults in an online community (OC).

Design/methodology/approach

Adopting practice theory and service-dominant logic as a theoretical perspective, this paper examined an OC of older adults by conducting an inductive thematic analysis of the interactions of the participants in the community.

Findings

The analysis revealed older adults engage with three value co-creation plus one value co-destruction practices in the OC including, communal coping practices, happiness creation practices, social capital generation practices and disparaging practices for older adults.

Research limitations/implications

Illustrated in a conceptual model, this study extends previous work evidencing OCs serve as a platform for value co-creation and value co-destruction activities in the context of older adults. Further, it suggests OCs facilitate resilience of older adults through value co-creation practices. Recognition of value co-destruction in OCs is critical as it is detrimental to the resilience of older adults. This study provides the needed foundation to advance knowledge on the use of OCs by older adults and suggests future research directions.

Practical implications

Identifying co-creation and co-destruction practices of older adults in OCs enables service providers (e.g. caregivers) to engage better in online value co-creation practices. Further, the findings of this study address one of the main priorities of service science to investigate the impact of value co-creation on well-being.

Originality/value

Despite the significant engagement of older adults in OCs, there is a lack of enough knowledge in the literature regarding value co-creation and co-destruction practices of older adults in OCs. This study addressed this gap by explaining how older adults co-create and co-destruct value in online spaces.

Impact of sense of coherence, resilience and loneliness on quality of life amongst older adults in long-term care: A correlational study using the salutogenic model

AIMS

This study aimed to identify the predicting factors of quality of life (QoL) from a set of psychosocial, sociodemographic and clinical variables amongst older adults in a long-term care setting.

DESIGN

A cross-sectional, descriptive correlational study.

METHOD

The study was conducted in a nursing home and a day care centre from July to December 2019. Two hundred older adults were recruited. Guided by the salutogenic model, the sense of coherence (SOC) scale, Connor-Davidson resilience scale, de Jong Gierveld loneliness scale and World Health Organization quality of life instrument-older adults (WHOQOL-OLD) were used. The sociodemographic and clinical profiles of participants were collected. Descriptive statistics, Pearson product-moment correlation coefficient, independent-samples t test, one-way analysis of variance and stepwise regression were utilised in the analysis.

RESULTS

The mean score for WHOQOL-OLD was 94.42 ± 19.55. The highest mean score was observed in the "Death and Dying" facet, while the lowest mean scores were reflected in the "Autonomy" and "Intimacy" facets of QoL. Regardless of resident type, most QoL scores were similar across different variables. Based on the stepwise regression, higher manageability and meaningfulness in SOC, higher resilience, lower social loneliness, lower emotional loneliness and hearing impairments are significantly associated with higher QoL.

CONCLUSION

Manageability, meaningfulness and resilience should be enhanced while ameliorating feelings of loneliness to improve the QoL amongst older adults receiving long-term care. Age, marital status, educational level, care arrangement, body mass index, performance in activities of daily living, comorbidities and hearing and mobility impairments could influence QoL and thus warrant more attention.

IMPACT

Future interventions can be conducted in group sessions to facilitate social interaction and alleviate loneliness. More resources should be allocated to enhance older adults' care arrangements and coping mechanisms to provide them with the support, as they face challenges in daily life due to mobility impairment and other restrictions.

Attitudes towards oldest-old adults (age ≥80 years): A survey and international comparison between Swedish and Austrian nursing students

BACKGROUND AND RATIONALE

Ageism in nursing, particularly regarding oldest-old adults (age ≥80 years), adversely affects patient safety and care quality. Nurse education can reduce ageist attitudes. Swedish and Austrian nursing students' attitudes towards adults age ≥80 years have not been assessed.

AIMS

To analyse attitudes towards adults age ≥80 years among nursing students from universities in Sweden and Austria.

DESIGN

A prospective cross-sectional survey including the four-factor, 26-item validated Ageing Semantic Differential scale and demographic questions.

METHODS

A pen-and-paper survey was administered to nursing students at the Medical University of Graz, Austria (May-June 2019); an online survey was conducted at the University of Gothenburg, Sweden (January-June 2020). Demographic data were analysed descriptively; means and individual item ratings were calculated for each country. Multiple logistic regression was performed for each factor of the instrument: (1) Instrumentality, (2) Autonomy, (3) Acceptability and (4) Integrity. Six independent variables were included in the regression analysis.

RESULTS

In total, 136 Austrian and 222 Swedish students responded (88% women). Compared with Austrian students, Swedish students were older and had more positive attitudes about oldest-old adults. Swedish students' median factor ratings (7-point scale) were 3.62 (Factor 1), 3.50 (Factor 2), 2.71 (Factor 3) and 3.80 (Factor 4). Austrian students' median ratings were 4.25 (Factor 1), 3.83 (Factor 2), 3.28 (Factor 3) and 4.00 (Factor 4). Regression analyses showed that the variables country, older family member/acquaintance, and age were associated with the different factors.

DISCUSSION

Compared with Austrian students, Swedish students' attitudes towards oldest-old adults were more favourable. We discussed the findings at individual, interpersonal/intergroup and societal/cultural levels and present implications for education and research.

CONCLUSIONS

Nurse education should address ageism as a multilevel phenomenon, and include the person-centred care perspective. Further research comparing nursing students' attitudes from different cultures is needed.

Determination of the effects of innovativeness levels of the elderly on their psychological resilience

PURPOSE

This study was conducted to determine the rate at which the individual levels of innovativeness of the elderly explain their psychological resilience.

DESIGN AND METHODS

This study was conducted with 313 elderly people. The data of the study were collected using the Individual Innovativeness Scale and Psychological Resilience Scale for Adults.

FINDINGS

In this study, a significant relationship was found between individual innovativeness and psychological resilience in the elderly. Demographic variables were related to psychological resilience.

PRACTICE IMPLICATIONS

Within the scope of these results, increasing the individual innovativeness levels of older adults will enable them to be psychologically more resilient.

Development of a resilience scale for oldest-old age (RSO)

Background

Globally, the population of oldest-old (those aged ≥80 years) is rapidly growing. This change is likely to have a deep impact on societies. Resilience is a key concept related to facilitating adaptation, and can be applied, to aging-related change and losses, as well as promoting health and well-being in this population. However, no existing scales have been developed to measure resilience among oldest-old people. To address this, we developed a resilience scale for oldest-old age (RSO), and examined its reliability and validity.

Methods

The RSO is a self-administered questionnaire developed via a literature review, interviews with oldest-old individuals, and interviews with experts. The survey included 3000 community-dwelling oldest-old people who were recruited via random sampling in Yokohama city, Japan. Construct validity was determined using confirmatory factor analysis. Internal consistency was calculated using Cronbach’s alpha. The revised Philadelphia Geriatric Center Morale Scale (PGC) and the self-anchoring scale to measure the feeling that life is worth living (SAS-WL) were used to assess the criterion-related validity of the RSO.

Results

We received 1283 valid participant responses. Confirmatory factor analysis identified nine items from one factor of the RSO with a goodness of fit index of 0.979, adjusted goodness of fit index of 0.963, comparative fit index of 0.973, and root mean square error of approximation of 0.049. Cronbach’s alpha was 0.800. The total RSO score was positively correlated with the PGC (r = .492, p < 0.001) and the SAS-WL (r = .559, p < 0.001).

Conclusions

The RSO demonstrated adequate reliability and validity for assessing individual resilience among oldest-old people. Thus, the scale is potentially useful for promoting health and well-being in oldest-old age.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02036-w.

Online health communities, contributions to caregivers and resilience of older adults

The aim of this paper is twofold. Firstly, to investigate the potential benefits of online health communities (OHCs) for informal caregivers by conducting a systematic literature review. Secondly, to identify the relationship between the potential benefits of OHCs and resilience factors of older adults. Performing a thematic analysis, we identified the potential benefits of OHCs for informal caregivers of older adults, including two salient themes: (a) caregivers sharing and receiving social support and (b) self and moral empowerment of caregivers. Then, we uncovered how these potential benefits can support resilience of older adults. Our findings show that sharing and receiving of social support by informal caregivers, and self and moral empowerment of informal caregivers in OHCs, can support four resilience factors among older adults, including self-care, independence, altruism and external connections. This review enables a better understanding of OHCs and Gerontology, and our outcomes also challenge the way healthcare and aged-care service providers view caregivers and older adults. Furthermore, the identified gap and opportunities would provide avenues for further research in OHCs.

Flood risk perceptions and coping capacities among the retired population, with implications for risk communication: A study of residents in a north Wales coastal town, UK

Flood risk communication strategies have been ineffective for older adults as they have failed to accommodate diversity, viewing retired populations as homogenous. There have been calls from academics and NGOs to develop more detailed understandings of older adults' risk experiences to inform disaster risk reduction (DRR) and communication approaches. We conducted in-depth interviews with twelve members of the retired population, of which the majority happened to be members of a local church, in a flood risk area of north Wales, UK, in 2018 to ascertain risk perceptions, coping capacities, and risk communication preferences to inform more age-centred approaches. Results present retired population are a diverse group with varying perceptions and capacities. While personal risk perceptions were low overall, coping capacities varied and were primarily social in nature, which can be sustained despite mobility or other limitations typical of older age. Participants expressed preference for traditional/interpersonal risk communication methods, such as telephone calls or home visits. A key recommendation from this study is that risk communication and DRR practices should adopt people-centric approaches that are co-produced and respect the differentiated vulnerabilities, capacities and needs of at-risk populations. This study and its findings are important is providing a more nuanced picture of the vulnerabilities and capacities of the particularly at-risk population of older adults. We must ensure that future DRR research, policies and practices focus on all experiences of at-risk populations, not only the dominant narratives or extremes of groups, to capture differences within groups' abilities to support more effective community DRR.

Resilience in older persons: A systematic review of the conceptual literature

Although ageing research increasingly incorporates resilience, a common notion on what resilience means is lacking. We aimed to give a comprehensive overview of the conceptual literature on resilience in older persons, identifying areas of consensus and variation/debate. A systematic search of eight databases from different disciplines led to the inclusion of 36 texts. Across the conceptual literature of resilience in older persons, three common features of descriptions of resilience were identified: a stressor, a response and a mechanism. Based on differences in their interpretation of how resilience is expressed we distinguished two perspectives. The first, classical and most widely applied perspective, describes the expression of resilience as a positive response to a high intensity stressor. The second, newer perspective, describes resilience in the context of responses relative to equilibrium, following low intensity stressors. Almost all descriptions across the two perspectives describe the resilience mechanism to be dynamic and emphasize the importance of the context in achieving resilience. This review provides clarity on the current conceptual status of resilience in older persons, an important step towards a higher level of consistency in the future use of resilience in ageing.

The Influence of Life Experiences on the Development of Resilience in Older People With Co-morbid Health Problems

Background: Co-morbidity is a major late-life challenge with poor outcomes, yet many older people are resilient. We consider an ecopsychosocial framework of resilience to investigate this disparity. This theorises that sources of resilience may be personal, social and structural. We explored older people's responses and reactions to significant life experiences, to understand resilience development for managing later life health challenges.

Methods: We applied a two-stage, cross-sectional mixed-methods design to the Cognitive Function and Ageing Studies Wales (CFAS Wales). Participants' defined quantitatively as resilient (high level of well-being despite co-morbidity) were identified in the wave 1 dataset. A sub-sample of the resilient participants aged 65+ were randomly selected for semi-structured interviews (N = 20). Qualitative thematic analyses were both inductive and deductive.

Results: The analyses revealed four primary life experiences reflecting different developmental trajectories. “Early years as formative” and “work and employment as formative” occurred at normative developmental stages in the life-course. In contrast non-normative life events such as loss, bereavement, illness of self, and others underpinned the themes of “adverse events and experiences” and “caring experiences.” Four potential mechanisms for resilience were central to these life experiences, reflecting reactions, actions, and development: “character and self-identity;” “approach to life and insight;” “meaningful relationships and belonging.”

Conclusions: This work contributes further theoretical insights into the ecopsychosocial resilience framework. It highlights the process of interdependence between the individual and the wider environment, suggesting how the availability and accessibility of resources and human agency (protective factors), can influence, and be influenced by, the timing of significant events and experiences. In doing so, it corroborates international healthy ageing policy which recognises resilience as important for a public health response to support older people to adjust to changes and losses experienced in later life. It highlights the importance of current and future policies and services for supporting the management of adverse events earlier in the life-course, and recommends that policies and services take a “long view” on population health and well-being and consider the whole life-course, in addition to specific points in the ageing process.

Mediating effects of psychological resilience on life satisfaction among older adults: A cross-sectional study in China

The mediating effects of psychological resilience on quality of life among older adults were rarely examined empirically. Based on the literature on the relationship between psychological resilience and quality of life and the factors associated with psychological resilience among older adults, a theoretical model was proposed with the hypothesis that psychological resilience would mediate the relationships between both filial support and sense of community and life satisfaction among older adults. The research used a cross-sectional design. Non-probability sampling method was applied to recruit 418 community-dwelling older adults in two adjacent cities in Fujian, China in 2017. A face-to-face structured Chinese questionnaire was adopted to collect data. The structural equation modeling showed that psychological resilience mediated the relationships between both filial support and sense of community and life satisfaction. The findings confirmed the positive impacts of psychological resilience on older adults' life satisfaction and highlighted the importance of family and community contexts to older adults' psychological resilience and life satisfaction. Interventions and programmes that aim to promote filial support towards older adults and enhance their sense of community would contribute to both their psychological resilience and life satisfaction.

New horizons in supporting older people's health and wellbeing: is social prescribing a way forward?

Older people's health and care needs are changing. Increasing numbers live with the combined effects of age-related chronic illness or disability, social isolation and/or poor mental health. Social prescribing has potential to benefit older people by helping those with social, emotional or practical needs to access relevant services and resources within the local community. However, researchers have highlighted limitations with the existing evidence-base, while clinicians express concerns about the quality of onward referral services, liability and upfront investment required. The current article provides a critical review of evidence on social prescribing, drawing on the RE-AIM Framework (Glasgow et al., 1999) to identify questions that will need to be addressed in order to inform both the design and delivery of services and the evolving research agenda around social prescribing. We emphasise the need for researchers and planners to work together to develop a more robust evidence-base, advancing understanding of the impacts of social prescribing (on individuals, services and communities), factors associated with variation in outcomes and strategies needed to implement effective and sustainable programmes. We also call on policymakers to recognise the need for investment in allied initiatives to address barriers to engagement in social prescribing programmes, provide targeted support for carers and improve access to older adult mental health services. We conclude that social prescribing has potential to support older people's health and wellbeing, but this potential will only be realised through strategic alignment of research, local level implementation and national policy and investment.

Developing a model of resilience in older adulthood: a qualitative meta-synthesis

The study of resilience in an older adult population is expanding rapidly. However, most theoretical models of resilience have been developed with children or young to middle-aged adults. The objective of the present study was to review systematically the qualitative literature examining resilience in older adults, and to develop a comprehensive model of resilience in older adulthood. A qualitative meta-synthesis was conducted to review the qualitative literature examining resilience from older adults’ perspectives. An exhaustive search of the literature revealed 1,752 articles. From these articles, 34 studies meeting inclusion criteria were selected for analysis. Across the 34 studies analysed, eight themes were revealed as important for achieving resilience later in life: perseverance and determination, self-efficacy and independence, purpose and meaning, positive perspective, social support, faith and prayer, previous experience and being proactive. These themes can be organised into a four-factor model: (a) Intrapersonal Protective Factors; (b) Interpersonal Protective Factors; (c) Spiritual Protective Factors; and (d) Experiential Protective Factors. This study presents a new model of resilience in older adulthood that is grounded in qualitative literature and is relevant and appropriate for an older adult population. This research may be useful for clinicians, support workers and researchers working with older individuals through improving our understanding of what contributes to resilience later in life.

Effects of protective factors on the depressive status of elderly people in Taiwan

This study was conducted to examine the effect of protective factors on the relationship between crisis episodes and depression in the elderly population in Taiwan.In this study, the Taiwan Longitudinal Study on Aging was used as basis for a cross-sectional secondary data analysis. After eliminating respondents below the age of 65 years and those with missing values, 2426 samples were collected. Predictive variables, such as crisis episodes, personal resources, family ties, social participation, and social support, were investigated, and the dependent variable of "depression status" was measured using the Center for Epidemiologic Studies Depression scale.According to the results of regression analysis, the protective factors of self-assessed health (ß = -0.290, P < .001), instrumental support (ß = -0.153, P < .001), financial satisfaction (ß = -0.126, P < .001), emotional support (ß = -0.101, P < .001), crisis episodes (ß = 0.087, P < .001), support satisfaction (ß = -0.081, P < .001), leisure participation (ß = -0.053, P < .05), family ties (ß = -0.048, P < .05), and community participation (ß = -0.042, P < .05) had a significant effect on depression status. Moreover, leisure participation had a moderating effect on the relationship between crisis episodes and depression (ß = -0.07, P < .01). In addition, according to path analysis results, family ties had a significant negative predictive power on depression (β = -0.225, P < .001), as did social support (β = -0.978, P < .001). The predictive power of crisis episodes on depression through social support was 0.197 (-0.201 × -0.978 = 0.197, P < .001), and it was -0.324 (-0.331 × -0.978 = -0.324, P < .001) through social participation, which indicated that social support plays a mediating role between crisis episodes and depression and between social participation and depression.Strengthening effective protective factors can improve the resilience of elderly people and enable them to cope with dilemmas rapidly and effectively when faced with crisis episodes as well as restore their health status and enjoy a satisfactory life.

Exploring the implementation of the Community for Successful Ageing (ComSA)program in Singapore: lessons learnt on program delivery for improving BioPsychoSocial health

BACKGROUND

The Community for Successful Ageing (ComSA) program has implemented overlapping BioPsychoSocial (BPS) components as part of a Community Development (CD) grassroots and volunteer-led initiative. Implementation of such multi-component programming is influenced by known program characteristics including novelty, complexity and observability as well as related organizational factors. As such, we explored ComSA CD's implementation from the organizational perspective, seeking to inform program improvements.

METHODS

We conducted four focus groups with program staff, partners and trainers (total N = 21 participants). Findings were analysed using an interpretative approach and synthesized into a line of argument informing lessons learnt.

RESULTS

An implementation framework was identified. It is guided by considering the influence of known program characteristics across major themes, representing three core implementation stages. These and supporting sub-themes are elaborated in turn: 1) Creating commitment toward the program was challenged by novelty and at times a lack of shared understanding of ComSA CD, particularly relating to the S component. Overall, cohesion within organizational contexts and having a strong rapport with the community (ability to engage) were needed to persuade volunteers and participants to commit to the program. 2) Coordination and resource allocation were influenced by the complexity of interconnecting BPS components - requiring aligning communication between partners and adapting the BPS sequence, given the separated management structure of program trainers. Efficiency of resource utilization was constrained by the ability to pool and match resources given the limited manpower and community partners who worked-in-silo due to a KPI-centric culture. 3) Collaborative program monitoring and appraisal increased observability of the program's benefits, but depended on partners' prior commitment. Despite appreciating its holistic BPS programming, dropout rate was used as a way to gauge program success, which has limited interpretability. Occasional uncertainty about the program value contributed to concerns about duplicating existing ageing programs, particularly those related to the B component.

CONCLUSION

Lessons learnt for improving BPS programming include (1) eliciting better participants' buy-in and shared program vision, (2) increasing adaptability of BPS sequence and building a culture of shared values for working together (3) and developing comprehensive monitoring systems for program appraisal.

Exploring underexposed stories: the experienced lifecourse of financially excluded older adults

To gain insights into vulnerable lifecourses and give a voice to those often underrepresented in quantitative research, this study examines the life stories (past, present and future) of 19 financially excluded older adults using an adapted version of McAdams’ life-story interview scheme. Although these life stories demonstrate an accumulation of many disadvantages and an uncertain future because of current financial situations, the stories also reflect the generativity, resilience, coping strategies and agency of financially excluded older adults. We demonstrate how the experienced lifecourse is built around both negative and positive turning points and transitions which go beyond the classical education–work–retirement triumvirate, and how socio-cultural life scripts are used as a framework to build one's own life story in order to achieve continuity. The discussion highlights the potential for deploying the life-story method as a qualitative resource for providing individualised care.

Genotype, resilience and function and physical activity post hip fracture

BACKGROUND

Individuals who are resilient are more likely to engage in functional tasks and exercise post hip fracture. There may be a genetic predisposition to being resilient.

OBJECTIVES

This study tested the direct and indirect association of 10 candidate genes, age, cognition, gender, comorbidities, pain and social activity on resilience, function and exercise post hip fracture.

METHOD

This was a descriptive study including 172 community dwelling older adults. Measures included: age, gender, cognition (Modified Mini Mental Status Exam), comorbidities, social activities (self-report), DNA (GRM1, NTRK1, NTRK2, GNB3, NPY, SLC6A15. SLC6A4, BDNF, CR1TR1, FKBP5), pain (areas of pain and Numeric Rating Scale), function (Physical and Instrumental Activities of Daily Living; Lower Extremity Gains Score; Short Physical Performance Battery; Grip Strength) and exercise (Yale Physical Activity Scale).

RESULTS

The majority of participants were Caucasian (93%), 50% were women and the average age was 81.09 (SD = 7.42). There were significant associations between resilience and single nucleotide polymorphisms from GRM1, NTRK1, NTRK2, GNB3, NPY and SLC6A15. Resilience, age, cognition, social activity, pain and genetic variability were directly and/or indirectly associated with exercise and/or function.

DISCUSSION

This study highlights the importance of resilience for engagement in exercise and function after hip fracture and provides preliminary evidence for a genetic role for resilience.

Strengths in older adults: differential effect of savoring, gratitude and optimism on well-being

Objetive: The present study aimed to compare the efficacy of three separate strengths training-based interventions - Gratitude, Savoring, and Optimism - in older adults. Method: The sample comprised 124 older adults, namely, 74 women and 50 men, non-institutionalized individuals who regularly attend day centers in the provinces of Jaén and Córdoba, southern Spain. Their ages ranged between 60 and 89 years. The measures used were Anxiety, Depression, Life Satisfaction, Positive and Negative Affect, Subjective Happiness, and Resilience. Results: Training in Gratitude and Savoring increased scores in Life Satisfaction, Positive Affect, Subjective Happiness and Resilience, and reduced Negative Affect, whereas training in Optimism failed to produce a significant change in these variables. The Savoring and Optimism interventions decreased scores in Depression but, contrary to hypothesis, this was not the case for Gratitude. Conclusion: These results represent an important step in understanding what type of strengths work best when it comes to enhancing well-being in older adults and consequently helping them tackle the challenges of everyday life and recover as quickly as possible from the adverse situations and events that may arise.

Neighborhood Social Cohesion, Resilience, and Psychological Well-Being Among Chinese Older Adults in Hawai’i

Background and Objectives

A growing body of literature indicates that neighborhood social cohesion is generally associated with lower levels of psychological distress and higher levels of life satisfaction (LS). However, very few studies have examined these relationships among Chinese older adults, the fastest growing aging population across all racial/ethnic groups in the U.S. Focusing on this population, the current study aims to examine the associations of neighborhood cohesion with psychological distress and LS as well as the mediating role of resilience and the moderating role of birth place in the associations.

Research Design and Methods

Ordinary least squares regressions were applied to analyze data collected among 430 Chinese older adults aged 55 and older residing in Honolulu, Hawai’i.

Results

Results show that neighborhood social cohesion was positively associated with lower levels of psychological distress and higher levels of LS for the whole sample. The association between social cohesion and psychological distress was moderated by birth place such that the protecting effects of neighborhood cohesion on distress were only salient for the U.S.-born but not for the foreign-born. Moreover, the mediating role of resilience was identified: It contributed to more than 60% of the association between social cohesion and psychological distress, and more than 22% of the association between social cohesion and LS.

Discussion and Implications

Our findings indicate the importance of a cohesive social environment and resilience in shaping psychological well-being and quality of life for older Chinese adults, the U.S.-born in particular, living in Honolulu, Hawai’i.

Enhancing Resilience in Community-Dwelling Older Adults: A Rapid Review of the Evidence and Implications for Public Health Practitioners

Background: Resilience is a valuable platform for strengthening individuals and communities in the face of disaster. This review sought to evaluate the current literature related to individual and community resilience in community-dwelling older adults to understand the status of resilience in this population, identify gaps, and make recommendations about effective interventions that promote improved individual and community level capacity. Recognizing the concept of resilience is contested, the review conceptualized resilience as a collective concept that is multi-level and interdependent across those levels, cumulative, and contingent on context.

Methods: The rapid review located 29 relevant peer review journal articles and industry reports related to research or evaluations of interventions aimed at increasing resilience at either a personal or community level. The results of these papers were thematically analyzed.

Results: This review found personal resilience relates to those personal capacities and resources one has and uses to deal with individual stresses and change. We identified several recurring themes within those studies focused on personal resilience, including: (1) positive reframing and agency; (2) personal meaning and purpose; (3) acceptance and belonging. At a community level, we identified the following themes influence collective capacity and resources: (1) empowerment and shared decision making; (2) collective agency; and (3) collective leadership and engagement.

Conclusions: The review highlighted the need to reframe how communities view older adults and shift the narrative away from focusing on age-related deficits toward acknowledging the economic and social contribution older adults make to the community through activities such as volunteering and the sharing of knowledge of history, culture and skills. Demonstrating the interdependence across levels, these activities illustrate personal-level capacities promoting collective action and participation as important for increasing community resilience. The review argues resilience is developed in everyday circumstances, therefore active involvement within communities needs to be encouraged within community-dwelling older adults. Developing active involvement will not only contribute to both personal and community level resilience but will enable communities to prosper and flourish through adversity.

Defining Successful Aging: Perceptions From Elderly Chinese in Hawai'i

Background: This study aims to examine the lay perceptions of successful aging among elderly Chinese in Hawai‘i, the state has the highest life expectancy in the United States. Method: Principal components factor analysis and logistic regression models were used to analyze survey data collected among 136 respondents who were asked to evaluate the importance of 12 successful aging items developed in Asian societies involving the Chinese population. Results: Results from factor analysis reveal three distinct factors out of the 12 items of successful aging—(a) psychosocial and economic well-being, (b) physical well-being, and (c) social support from adult children. The former two factors were perceived as important dimensions of successful aging by most survey participants, and approximately 35%-41% respondents viewed items composing Factor 3 as important. Discussion: Results suggest that elderly Chinese in Hawai‘i have unique perceptions of successful aging that go beyond the Rowe and Kahn’s biomedical model to include more psychosocial components. In addition, their perceptions are similar to but slightly different from perceptions of elderly Chinese in China and Singapore in levels of familism. Our findings indicate cultural variation of successful aging.

The role of the visual arts in the resilience of people living with dementia in care homes

This study responds to a gap in the literature relating to the resilience of people living with dementia in care homes. We applied an ecopsychosocial framework of resilience, theorising that sources of resilience may be personal, social and structural. Visual arts enrichment activities were examined to see how they might provide opportunities for resilience. The data used for this study were qualitative and originated from people with dementia aged between 70 and 99 years old (N = 48) living in four care homes in North East England, United Kingdom and staff/carers/family members (N = 37). The results showed that visual arts enrichment activities supported the resilience of those with dementia through creative expression, increased communication, improved self-esteem, and influenced relationships with carers and family members. It is concluded that even those with advanced dementia are capable of demonstrating resilience which can be supported by, and explored through, visual arts enrichment activities.

Strategies for improving mental health and wellbeing used by older people living with HIV: a qualitative investigation

Recent research into "successful ageing" and "resilience" in the context of ageing with HIV highlights older people living with HIV's (OPLWH) adaptations and coping strategies hitherto neglected by early research's emphasis on difficulties and challenges. Yet "resilience" and "successful ageing" are limited by their inconsistent definition, conflation of personal traits and coping strategies, normative dimension, and inattention to cultural variation and the distinctive nature of older age. This article thus adopts an interpretivist approach to how OPLWH manage the challenges to their mental health and wellbeing of ageing with HIV. Drawing on interviews with 76 OPLWH (aged 50+) living in the United Kingdom, we document both the strategies these participants use (for example, "accentuating the positive" and accessing external support) and the challenges to these strategies' success posed by the need to manage their HIV's social and clinical dimensions and prevent their HIV from dominating their lives. This points to (a) the complex overlaps between challenges to and strategies for improving or maintaining mental health and wellbeing in the context of ageing with HIV, and (b) the limitations of the "resilience" and "successful ageing" approaches to ageing with HIV.

The relationship between trait emotional intelligence, resiliency, and mental health in older adults: the mediating role of savouring

OBJECTIVES

The present study explores savouring, defined as the process of attending to positive experiences, as a mediator in the relationships between resiliency, trait emotional intelligence (EI), and subjective mental health in older adults. Following Fredrickson's Broaden and Build Theory of positive emotions, the present study aims to extend our understanding of the underlying processes that link resiliency and trait EI with self-reported mental health in older adulthood.

METHOD

A sample of 149 adults aged 65 and over (M = 73.72) were recruited from retirement homes and community groups. Participants completed measures of resiliency, savouring, trait EI, and subjective mental health either online or in a paper format.

RESULTS

Path analysis revealed that savouring fully mediated the relationship between resiliency and mental health. However, trait EI did not significantly predict mental health in this sample.

CONCLUSION

These findings provided partial support for the Broaden and Build Theory of positive emotions. As anticipated, savouring imitated the broadening effect of positive emotions by mediating the relationship between resiliency and mental health. However, savouring failed to reflect the undoing effect of positive emotions and did not mediate the relationship between EI and mental health. These findings have implications for positive psychology exercises and may be a simple, yet effective means of improving the life quality of older adults.

Resilience in American Indian and Alaska Native Public Health: An Underexplored Framework

OBJECTIVE

To conduct a systematic literature review to assess the conceptualization, application, and measurement of resilience in American Indian and Alaska Native (AIAN) health promotion.

DATA SOURCES

We searched 9 literature databases to document how resilience is discussed, fostered, and evaluated in studies of AIAN health promotion in the United States.

STUDY INCLUSION AND EXCLUSION CRITERIA

The article had to (1) be in English; (2) peer reviewed, published from January 1, 1980, to July 31, 2015; (3) identify the target population as predominantly AIANs in the United States; (4) describe a nonclinical intervention or original research that identified resilience as an outcome or resource; and (5) discuss resilience as related to cultural, social, and/or collective strengths.

DATA EXTRACTION

Sixty full texts were retrieved and assessed for inclusion by 3 reviewers. Data were extracted by 2 reviewers and verified for relevance to inclusion criteria by the third reviewer.

DATA SYNTHESIS

Attributes of resilience that appeared repeatedly in the literature were identified. Findings were categorized across the lifespan (age group of participants), divided by attributes, and further defined by specific domains within each attribute.

RESULTS

Nine articles (8 studies) met the criteria. Currently, resilience research in AIAN populations is limited to the identification of attributes and pilot interventions focused on individual resilience. Resilience models are not used to guide health promotion programming; collective resilience is not explored.

CONCLUSION

Attributes of AIAN resilience should be considered in the development of health interventions. Attention to collective resilience is recommended to leverage existing assets in AIAN communities.

Holistic Wellness in Older Adulthood: Group Differences Based on Age and Mental Health

PURPOSE

To understand how demographic variables and depression symptoms relate to the prevalence of wellness, resilience, and age perception within a sample of community-dwelling older adults.

DESIGN

In all, 200 residents across 12 senior housing sites were surveyed. Research questions included the following: (1) Do group differences exist in wellness, resilience, and age perception based on age, sex, race, education, and depression symptoms? (2) Which profile of variables is most strongly associated with self-rated depression among older adults?

METHOD

Multivariate analyses of variance were used to examine group differences. A discriminant analysis demonstrated which variables comprised the profile of individuals who ascribed to depression symptoms.

FINDINGS

Younger respondents (i.e., age 55-70) had significantly lower levels of wellness (η² = .034) and resilience (η² = .052). Respondents suffering from depression symptoms had lower levels of wellness (η² = .155), resilience (η² = .163), and positive age perception (η² = .067) and higher rates of negative age perception (η² = .052). The discriminant analysis correctly categorized 75.3% of the cases related to depression symptoms, and resilience and certain forms of wellness were most relevant.

CONCLUSIONS

The current study sheds light into within-group differences in wellness, resilience, and age perception that depend on variables such as age and depression.