Key Messages

  • Resilience is influenced by life experience of adversity and ability to cope. [1,2]
  • Ability to problem-solve, strong social networks and spirituality might predispose an older adult to greater resilience. [1-3]
  • Access to specialist medical care, resources and health professional support may also impact a person’s resilience. [2,3]
  • Resilience is a dynamic process but may be influenced by positive ‘protectors’ or negative ‘stressors’. [1-3]
  • Health professionals may be able to offer strategies to promote resilience. [3]
  • Models for resilience in people with dementia and their carers include social and psychological dimensions of caring. [4,5]


Resilience in older adults can be defined as the ability to ‘bounce back’ and recover physical and/or psychological health in the face of adversity. [1,2] Resilience is important for maintaining function, subjective wellbeing, sense of adjustment, motivation for activity, and life engagement. [1] It is described as a dynamic process that changes over time in response to life events and challenges. [1,2]

Health professionals can reflect on their interactions and services to enhance the social support of older adults to build and maintain resilience in older adults.

Evidence Summary

There are many conceptualisations of resilience in the literature [1,2], many of which have been derived from studies of children and adults, and up until the last few years, very few addressing older adults. [1,2] The concept of resilience had originally been referred to in literature as a personality trait, however increasingly it has been recognised as a dynamic process [3] influenced by life experiences and challenges. [1] In designing interventions for older people that support their resilience it is important to be sensitive to this concept.

Psychological resilience generally refers to how people ‘bounce back’ from adversity, whereas individual resilience can be categorised into health, psychological, emotional, dispositional and psychological elements. [2] Resilience is thought to be dynamic and for each individual based on their life experiences and personal characteristics, and how much these experiences develop resilience in the individual. However the literature also recognises that environmental determinants such as access to resources or care, or actions of health professionals may also impact on a person’s ability to be resilient. [2]

Health professionals often have significant interaction with older adults in times of adversity, especially in a palliative care context, and are in a position to influence a person’s resilience. Enhancing social support systems and focussing upon feelings of self-worth and identity can assist in developing improved coping strategies for the individual and therefore increase their sense of resilience. [3] Supporting resilience in health professionals who work in palliative care can help them to manage stress related to exposure to death, dying and loss. [6,7]

Two models have been developed for resilience in people with dementia and their carers. Both include social and cultural characteristics, and psychological dimensions of caring. [4,5] In addition the model proposed by Teahan et al. [5] incorporates context of caring,  and Parkinson et al. [4] includes maintaining physical health status, safeguarding quality of life and ensuring timely availability of key external resources.

Quality Statement

Overall the quality of the evidence is low to acceptable, with poor reporting on methodology and quality of the studies being reviewed. In addition, the published research is not specific to a palliative and aged care context and suggests significant opportunity for future research.

Page updated 08 July 2021

  • References

  • About PubMed Search

  1. Wermelinger Avila MP, Lucchetti AL, Lucchetti G. Association between depression and resilience in older adults: a systematic review and meta-analysis. Int J Geriatr Psychiatry. 2017 Mar;32(3):237-46.
  2. van Kessel G. The ability of older people to overcome adversity: a review of the resilience concept. Geriatr Nurs. 2013 Mar-Apr;34(2):122-7.
  3. Hicks MM, Conner NE. Resilient ageing: a concept analysis. J Adv Nurs. 2014 Apr;70(4):744-55.
  4. Parkinson M, Carr SM, Rushmer R, Abley C. Investigating what works to support family carers of people with dementia: a rapid realist review. J Public Health (Oxf). 2017 Dec 1;39(4):e290-e301. doi: 10.1093/pubmed/fdw100.
  5. Teahan Á, Lafferty A, McAuliffe E, Phelan A, O'Sullivan L, O'Shea D, Fealy G. Resilience in family caregiving for people with dementia: A systematic review. Int J Geriatr Psychiatry. 2018 Dec;33(12):1582-1595. doi: 10.1002/gps.4972. Epub 2018 Sep 19.
  6. Powell MJ, Froggatt K, Giga S. Resilience in inpatient palliative care nursing: a qualitative systematic review. BMJ Support Palliat Care. 2020 Mar;10(1):79-90. doi: 10.1136/bmjspcare-2018-001693. Epub 2019 Feb 26.
  7. Zanatta F, Maffoni M, Giardini A. Resilience in palliative healthcare professionals: a systematic review. Support Care Cancer. 2020 Mar;28(3):971-978. doi: 10.1007/s00520-019-05194-1. Epub 2019 Dec 6.



Resilience, Psychological:

The human ability to adapt in the face of tragedy, trauma, adversity, hardship, and ongoing significant life stressors. (MESH)

Search String

("Resilience, Psychological"[Mesh] OR Resilienc*[tiab] OR resilient[tiab] OR hardiness[tiab])