Nurturing Resilience: Is There an Age Limit?Robert Brooks, Ph.D.

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Nurturing Resilience  Several years ago I gave a presentation during which I shared thoughts about ways in which to enrich family relationships.  Since interactions with family impact on us throughout our lives, I was not surprised to see the wide range of ages in the audience.  At the conclusion of my talk, I asked for questions or comments.  Many hands went up.

A number of questions pertained to parenting, some about younger children or adolescents and some about adult children.  Grandparents offered thoughts about their role in the lives of their grandchildren with one woman noting that given family circumstances she and her husband were the primary caregivers for their grandkids—a situation that seems to have become much more commonplace.   

Not unexpectedly, there were questions about marital relationships.  One woman who I would estimate was in her mid-70s (to be honest, I’ve never been a good judge of a person’s age based on appearance) asked about the capacity of older family members to make changes in their lives.  I believe her question was prompted, in part, by my discussion of “negative scripts,” that is, counterproductive behaviors in which a person continues to engage without any attempt to make changes.  Often an individual who adheres to these scripts abrogates responsibility for improving a situation, instead waiting for others to change their behaviors first. 

This woman introduced the topic by asking, “Is it ever too late?”

I wondered, “Too late for what?”

She replied, “For people to change.  Can they make changes in their lives at any age?”

I noted that I thought that people possessed a greater capacity than they might realize to make modifications in their lives, well into their senior years.  This is a position that my colleague Sam Goldstein and I advanced in our book The Power of Resilience: Achieving Balance, Confidence, and Strength in Your Life.

The woman said, “So you really think change is possible even when we’re older.”

I said, “Yes, but I don’t want to minimize how difficult some obstacles for making changes can be at any age, especially when there are declines in our physical and mental well-being.”    

As I attempted to answer this woman’s questions I wondered what was the trigger for her asking.  I didn’t have to wait long for an answer.

As I concluded my response, she said, “I knew my husband should have been here tonight to hear you.” 

I smiled and many in the audience laughed at this unexpected remark.  The woman also smiled, but I wasn’t certain if she had intended to infuse humor into the conversation.  At that moment I recalled the saying, “Many a true thing is said in jest.”  I should note that I decided not to delve further into how this woman wanted her husband to change or how open she thought he was to making changes.

Doubts about Growth in Our Senior Years

I share this vignette to emphasize that I continue to receive questions about the ability of people to find ways to enrich their relationships and lifestyle beyond a certain age.  Doubts about our capacity for growth beyond a certain age are challenged by an expanding body of research that has found such growth is not a limited commodity,  capped in middle age.  There is no mandatory age barrier that prevents us from modifying our thoughts and behaviors at any point in our lives in order to become increasingly resilient and lead a healthier, more meaningful existence.

A more hopeful position about aging was captured in a blog “Positive Aging: The New Mindset” by Kathleen Doheny posted in the Los Angeles Jewish Home’s Blog.  Doheny wrote, “The concept of positive aging has been around for decades according to Dr. Edward Schneider, dean emeritus and professor of gerontology at the University of Southern California.  What’s new is its widespread acceptance and application.”  Doheny added that this application resulted “in reduced illness and disease, improved longevity and wellness, and increasing social involvement in our current generation of seniors.”

Donehy cited the observations of Molly Forrest, CEO-President of the Jewish Home, who asserted,  “Our greatest achievement as human beings is our ability to adapt to a changing environment.  Taking a positive outlook towards challenges like aging allows us to adjust to what life requires.  Positive aging means having a mindset to accept getting older as yet another step in life rather than the end of the journey.”

In her blog Donehy quoted Dr. Sherwin Nuland, author of The Art of Aging: A Doctor’s Prescription for Well-Being, who proposed that as we age we must be alert to new opportunities to improve our physical and emotional health.  In order to maintain this alertness it is necessary to reject the stereotypes associated with aging and “strive for the best condition that your body and mind is capable of.  We shouldn’t think that just because we have an ailment that all is lost.”

Nuland’s outlook was echoed by an 88-year-old resident at the Jewish Home who reported that he made a concerted effort to remain cheerful, explaining that a good attitude is an essential ingredient for positive aging.  “You can be physically compromised and still have a great outlook on life.”

Accepting Reality and Finding Alternatives  

In reflecting upon his words, I was reminded of an article I wrote almost 13 years ago about aging.  I referred to studies reported in The Positive Aging Newsletter by psychologists Ken and Mary Gergen that found that constructive shifts in mindsets and behaviors were commonplace well beyond our middle age years.  These findings were also relevant for young adults who harbor the unfortunate belief that they cannot make changes in their lives and that their situation cannot improve.

As one example of the Gergens’ more positive outlook about aging, they cite research by Yael Benyamini and Jacob Lomranz in Tel Aviv.  These researchers conducted a study with 423 older adults who were forced to give up various activities such as soccer, volleyball, and back-packing because of deterioration in their physical conditions. The Gergens noted, “As might be anticipated, the research indicated a strong association between the loss of activity and expressions of depression. However, for a large sub-sample of the group this correlation did not hold.”

The explanation why some people did not experience depression in the face of a loss of certain physical capacities while others did may seem apparent but is still important to spotlight.  The people who did not become depressed by the emergence of seemingly negative circumstances in their lives “had located alternative activities to replace those that had been lost. Some who loved to play ball on the beach learned to enjoy jogging or growing vegetables. For this group the feelings of well-being were essentially the same as for people in full health.”

In essence, those seniors who thrived were able to choose alternative behaviors because they could envision these behaviors. They were not hindered by a negative mindset or a belief that one cannot adapt to changing circumstances.

Engaging in Therapeutic Lifestyle Changes

Since I first wrote about the positive aging perspective advanced by the Gergens, I have authored a number of other articles that detail activities in which seniors (as well as younger people) can engage to promote resilience and meaning in their lives.  Some psychologists have categorized these activities under the concept of “therapeutic lifestyle changes” or TLCs, emphasizing that they are within our control to initiate.  Such TLCs include but are not limited to: exercising, meditating, eating a well-balanced, healthy diet, developing and maintaining a support network, jotting down on a regular basis those things for which we are grateful, and contributing to the well-being of others.  

Involvement in these TLCs nurtures resilience and provides a sense of connectedness and purpose.  Given the negative stereotypes that are often associated with aging (ageism certainly exists in our society), it is especially important to recognize that our mindsets about aging play a significant role in how each of us has responded or will respond to the aging of others as well as to our own aging.

Recognition of the capacity of seniors to find continued enrichment and meaning in their lives was highlighted in a Boston Globe Magazine article by Melissa Bailey, a correspondent for Kaiser Health News.  Bailey described the Vitalize 360 wellness coaching program introduced eight years ago at the Orchard Cove retirement community in Canton, Massachusetts in collaboration with the Kendal nonprofit senior living organization in Pennsylvania.  The program is now in 35 communities in 12 states.

When seniors join Vitalize 360, they are assigned a coach who evaluates their emotional and physical health during an hour-long individual session; among other variables, problems such as loneliness, distress, and pain are assessed.  “The coach also inquires about families, friendships, and spiritual life.  Then the seniors meet with their coach every year before their physical checkup with a doctor, to talk about what matters most to them.”

Who are these coaches?  Bailey wrote, “They come from a variety of backgrounds, including fitness, social work, and chaplaincy and help participants set goals—which could be physical, social, intellectual, or spiritual—for the coming year.  These goals become the focus for the senior’s medical team, and the seniors follow up with their coaches every three months to stay on track.”

A Shift from Crisis to Wellness

Aline Russotto, the executive director of Orchard Cove, commented in Bailey’s article about how wellness coaching reflects a shift in the way senior living communities view aging.  “We used to be at our very best when somebody was in crisis, but Orchard Cove staff also want residents to have healthier and happier lives by emphasizing living your best day every single day until the end.”

Bailey included the observations of Dr. Atul Gawande, author of the bestselling book Being Mortal, and an expert about the topic of end-of-life care.  I found Being Mortal to be an incredibly poignant, thoughtful, and relevant book, perhaps even more so since I read it while I was in the process of co-editing with Glenn Wilkerson our recently published book Reflections on Mortality: Insights into Meaningful Living.     

Atul termed the Vitalize 360 program “transformative,” noting that “even as you may have health issues and frailty and the difficulties that can come from aging . . . people have lives worth living.  And in fact, have a lot more life worth living.”  Atul introduced in his discussion about Vitalize 360 an activity I have long advocated for achieving a more meaningful life, namely, contributing to the well-being of others.  He noted that when young people become disabled, we often provide opportunities for them to contribute to the world, but the same is less true for seniors. 

Atul continued, “I see it as the kind of thing you’d like to see go population-wide.  You’d like to make it routine.” 

The impact of Vitalize 360 at Orchard Cove, where the average age of the resident is almost 90, serves as testimony for its effectiveness.  For example, “fitness participation—the proportion of residents who exercise at least three times a week—has more than doubled, from 30 to 77 percent, and one study found participants felt significantly less depressed than a control group, with a notable jump in the number who said they felt ‘delighted with life.’”

The focus on physical fitness is but one aspect of Vitalize 360.  In addition, there is an emphasis on residents continuing to find meaning and purpose through their various activities.  As one illustration, Bailey described Esther Adler, a 93-year-old woman who moved to Orchard Cove in 2012, a few years after the death of her husband.   Adler, a poet, writer, and former Hebrew School teacher “set a goal to ‘be a productive person’ but didn’t know exactly how.  After learning about her background in an extensive intake interview, staff invited her to start teaching Hebrew to patients on the skilled nursing floor.”

Adler learned that the memories of the patients were too brief for her language lessons and shifted her focus to teaching “Bible lessons and prayers instead—a practice she has continued for three years.”  It was also noted that Adler finds purpose in writing poetry and helping neighbors through hospice, which has contributed to her own resilience.

A Few Final Thoughts

I appreciate the reality that declines in our health will impact on how meaningful and purposeful a life we can lead in our senior years.  However, I also believe as the 88-year-old resident of the Jewish Home asserted, “You can be physically compromised and still have a great outlook on life.”  And, I might add, in some instances that great outlook will lessen the decline in our physical health. 

As George Bernard Shaw wrote, “You don’t stop laughing when you grow old, you grow old when you stop laughing.”  Our mindset and attitude certainly play an important role in the process of aging.

In ending, I want to wish all of you a happy and peaceful holiday season and a 2018 filled with laughter, good health, and purpose.

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