There has been quite a lot written recently about the capacity of older people to weather major disasters and disruptions in their lives – earthquakes, floods, and pandemics. Very often the word “resilience” crops up, sometimes praising older people for their resilience or citing the aim of restoring resilience as the objective of post-disaster activities. But what does resilience really mean?
I have recently read the Australian Association of Gerontology’s Position Paper: Promoting Older People’s Resilience and Post-Traumatic Growth following Disasters, Trauma and Adversity (AAG), 2022. This document defines resilience as “the capacity to withstand and recover from significant adversities, and the ability to adapt to severe life situations and cope with stress and preserve functioning.” Protective factors for resilience among older people are quoted as life experience, physical activity, social support, flexibility, spirituality, self-esteem, social cohesion, and access to social resources. These are areas of potential development and enhancement and are widely seen as necessary for the wellbeing of older people. But the authors suggest that addressing the impact of disasters, trauma and adversity are more complex and multi-dimensional than simply building up or maintaining resilience levels.
One of the consequences related to surviving life-threatening disasters and trauma is Post-Traumatic Stress Disorder (PTSD), along with chronic PTSD (symptoms continuing beyond three months) and Delayed Onset PTSD, which may remain hidden for a long period and then emerge suddenly due to an event, trigger, or reminder of the original trauma.
There is also cumulative trauma – generated over a lifetime of experience. Lifetime adversity will certainly have a detrimental effect on physical and mental health and reduced quality of life.
However, there is evidence that some people who are exposed to disasters or trauma, are able to grow from these experiences. This has led to the term Post Traumatic Growth (PTG)to describe the process of experiencing trauma and growing from this experience.
Also contributing to growth in later life, according to the literature, is gerotranscendence, which describes how growth can occur through the natural process of ageing as” a progression towards maturation and wisdom brought about by a life-course trajectory and re-examination of our priorities in life.“
These are all difficult concepts to express simply, but the position paper goes on to analyse them in detail.
It has been suggested that resilience and its protective factors could be learnable behaviours and that interventions including education and training could assist older people to bolster their overall resilience. But other research has focused on how people can acquire resilience. This emphasises the central role that environmental factors can play in developing coping resources, hence resilience. These factors include social supports and social connectedness. Such measures to improve wellbeing in later life are being brought the fore through Age Concern action and in government statements.
Post-Traumatic Stress Disorder
PTSD is less likely to result from surviving a natural disaster than from human action or violence. It can lead to a loss of trust and a sense of betrayal, with associated serious symptoms such as avoidance behaviour, intrusive memories, or self-destructive behaviour. An individual may be constantly alert and hypervigilant, may feel helpless, vulnerable, and frightened. Although PTSD may not figure as such in elder abuse literature, it is clear that serious cases may lead older people to suffer in this way, which needs to be acknowledged.
Post Traumatic Growth
As they age, older people may be beset by multiple challenges in quick succession such as serious illness, loss of partners, loneliness, isolation, and upheaval through relocation. Thus resilience and coping mechanisms become more challenged and stretched.
This is where PTG can come in. Some people grow from traumatic or life-threatening experiences, rising above their trauma and using their experiences to move forward. By rebuilding and redefining their beliefs and goal and accepting their own mortality some people can” find more meaningful and fulfilling ways of leading their lives and understanding who they are”. This may require different types of support and intervention compared with rebuilding resilience. The paper suggests that resilience is more about ‘bouncing back’ to a prior equilibrium, whereas PTG is about ‘bouncing forward’ in response to adversity.
I have been moving through more regularly used and probably easier to understand concepts to the more intangible. Hence arriving at gerotranscendence, which has been defined as a natural process and re-prioritisation as we age. It involves “a shift from a materialistic and pragmatic view of the world to a more cosmic and transcendent one”. We are challenged to reassess our assumptions about existence and our primary values, looking for deeper meaning and purpose. How (and if) this happens will differ according to cultural setting, religion, and spirituality. Is gerotranscendence part of the experience of normal ageing? This calls for some serious discussion.
The AAG paper concludes that being resilient to disasters, trauma and adversity is desirable, but recovering from disasters and potentially growing from these experiences is equally important. It calls not only for efforts to enhance or strengthen resilience in older people, but also support an approach to working with older people which recognises the individual’s narrative and experiences and one which will acknowledge ” the complexity that is human experience”.