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Resilience in Aging

A few years ago, I was invited to give the annual Lehman Lecture in Medical Ethics at Allegheny College in Meadville, Pennsylvania. Allegheny is a small liberal arts college dedicated to providing its undergraduates with a well-rounded education, one that encourages interdisciplinary study and community service.

It just so happened that the evening before I flew out of San Antonio on my way east, I attended a lecture at Trinity University given by Former President George H. W. Bush.  His talk was titled, “Life After The Presidency,” and one of the key moments of his speech for me was when he made reference to his skydiving avocation, begun in his eighth decade of life. Even older now, he continues to jump out of airplanes. “People ask me why I do it,” he said. “I tell them there are many reasons but one of the more important ones is that I want to demonstrate that old people can still do things!” 

My visit to Allegheny coincided with “Senior Day”-an annual event sponsored by the college for the benefit of the senior citizens of their community. I had been asked to address this gathering as well and what a special privilege this was for me. I had the pleasure to observe firsthand a working model of seniors being valued in their community. 

Here they were: hundreds of folks, the husbands and wives arm and arm for mutual support, the widows and widowers, some with canes or walkers, others in wheelchairs.  In the foyer of the auditorium, bright young students with smiles on their faces served them coffee. I watched as the seniors made their way down the aisles, laughing and talking with each other, the youngsters among them. 

They were being feted for their age and their wisdom. They were being honored not because they are like the celebrities pictured on the glossy cover of the AARP magazine each month. Not because they were “beautiful seniors” all done up and plasticized. They were being celebrated for just who they are –our parents, our grandparents, our mentors. And this day—Senior Day –was a tribute to their ongoing commitment to their families and to their community.

I told them what President Bush said about why he jumps out of airplanes with a parachute strapped to his back now that he is an octogenarian. And I had many more stories to tell about my own patients: the 75-year-old woman who continues to care for foster children; the 88-year-old man who organizes senior education classes in a program now with over 500 enrollees; the 76-year-old grandmother who hasn’t missed her weekly turn at her church’s soup kitchen in 15 years; the woman who at age 81 turned her sun porch into a studio and whose paintings sell all over the South.

I can go on and on: seniors who have gone into politics, who care for their grandchildren full time in the absence of parents, who have written moving memoirs of their life experiences, who attend writing workshops and poetry readings, who give generously of their time and money to community events and non-profit organizations.

The word gerontologists use to describe these folks is “resilient.” In recent years, the study of resilience in aging has come into its own. A recent book (to which I have made a contribution)—”Resilience in Aging: Concepts, Research, Outcomes,” edited by Resnick, B., et al—defines resilience as “a dynamic process of maintaining positive adaptation and effective coping strategies in the face of adversity…or challenge, whether it be physical, psychological, economic, political, environmental, or social.”

Whether or not resilience is process or character trait—or both—is still being studied, but, in the main, resilient individuals are self-confident and know their own strengths and limitations. Five themes arise when interviewing resilient individuals:

–Equanimity: maintaining a balanced perspective on life.

–Perseverance: continuing to strive and cope in spite of adversity.

–Self-Reliance: belief in one’s abilities.

–Existential Aloneness: reveling in one’s own uniqueness and the belief in the continuity of the self across time.

–Spirituality/Meaningfulness: enabling the individual to draw conclusions as to why events occur and embrace the need for change, flexibility and growth.

One application of the scientific literature may be to identify interventions such as life review or reminiscence—or other creative processes such as art and music and dance—that tap into resilience, and thus might stimulate or enhance it in order to facilitate successful aging. What I witnessed on Senior Day at Allegheny College was a wonderful example of this.

At the end of my talk, twenty or more Allegheny College students stood up at the front of the auditorium holding signs. “Come with me if you want to attend a class on Romantic Poetry,” said one. Another read, “Come learn about Molecular Biology.”  Another, “Learn more about Bioethics.” The choices were many, rich, and varied. The folks in attendance were thrilled as they talked excitedly among themselves to decide where to go, whom to follow. I wanted to stay, to learn, to be a part of this vibrant community. But my trip was over.

What a different place America would be if every small town, every city throughout this land had a Senior Day like the one I was privileged to be a part of in Meadville, Pennsylvania. Perhaps this is something all of us—citizens, businessmen, medical professionals, politicians and educators—can strive to facilitate.

 

Written by: Jerald Winakur, MD, F.A.C.P., C.M.D

JERALD WINAKUR, M.D., F.A.C.P., C.M.D. practiced internal and geriatric medicine for 36 years  and is a Clinical Professor of Medicine and an Associate Faculty member at the Center for Medical Humanities and Ethics at the University of Texas Health Science Center at San Antonio. He speaks and lectures on ethical caregiving in aging America. His book, “Memory Lessons: A Doctor’s Story,” is about the trials and joys of caring for his father with Alzheimer’s disease.

 

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