Navigating Hardships in Old Age: Exploring the Relationship Between Spirituality and Resilience in Later Life

Abstract

Research suggests that spirituality is important to a large percentage of the older adult population and serves as a promoter of healthy aging. In this qualitative research I conducted and analyzed multiple interviews with 6 women aged 80 and older. Using multiple in-depth interviews I explored the interplay between spirituality and resilience over the life course. A grounded theory analysis of the 30 interviews was performed. The major finding is that participants used their spirituality as a tool to promote and maintain resilience in later life. I present the results as an interpretation of the participants’ perceptions of their spirituality, and indicate their reliance on spirituality to overcome hardship over the life course. In addition, I discuss the connections between spirituality and resilience. The roles these two constructs play in the lives of older adults are considered.

Understanding resilience offers the possibility of generating new insight into human potential. This insight allows us to better understand how individuals recover from adversity, sustain healthy growth and function, and further develop during experiences of hardship (Reich, Zautra, & Hall, 2010; Zraly & Nyirazinyoye, 2010). Examining resilience enables one to consider how people recover from distressing events, persist through extreme adversities, and negotiate everyday aspirations and challenges in life (Maluccio, 2002; Zraly & Nyirazinyoye). These everyday aspirations and challenges, which are revealed and exposed in aging, are rich with complexity. Although growing older affords many opportunities for growth and advancement, growing older also presents inherent challenges. It is the resilient individuals who can effectively and efficiently navigate adversity. Movement across the lifecourse assures that a human will encounter a multitude of life events, and for some individuals these life events will be sources of hardship, stress, or trauma.

What circumstances increase the likelihood of having resilience? How is the capacity to maneuver through adversity in a manner that protects health and well-being and overcomes adversity and hardship achieved? Resilience should not be reduced to merely coping with such adversity; it is also about learning, growing, and being positively transformed by adversity (Pargament & Cummings, 2010; Zautra, Hall, & Murray, 2010). Additionally, individuals accumulate adversity over the lifecourse. For example, Seery (2011) found that a lifetime history of cumulative adversity led to better mental health and well-being outcomes. The research I present in this article furthers our knowledge about the ways older adults are resilient, how individuals develop and sustain resilience over the life course, and the connections between spirituality and resilience.

The concept of resilience is multifaceted and multidimensional (Clark, Burbank, Greene, Owens, & Riebe, 2010). Across research and practice, however, there has been considerable debate regarding the definition and measurement of this concept. There has not been “consensus among researchers regarding a singular definition of resilience” (Arrington & Wilson, 2000, p. 224). In the broadest terms, resilience has been described as a “fluid, dynamic, and not fully understood process” (Greene, 2002, p. 4). Reich et al. (2010) have developed a useful resilience framework. In their research they conceptualized resilience as a process resulting from successful adaption to adversity. More specifically, they conceptualized resilience as a process of recovery (how well individuals are able to bounce back from adversity), sustainability (the capacity to continue to move forward in the face of adversity), and growth (the ability to further develop as a response to adversity).

The study of resilience as both process and trait has been largely concentrated at the earlier stages of the life course, and has primarily used quantitative approaches that measure resilience by identifying positive outcomes despite exposure to adversity (Hildon, Smith, Netuveli, & Blane, 2008; Masten, 2001; Seery, 2011). Consequently, fewer researchers have focused on resilience in later life and have neglected to explore the personal perspectives of resilience in older adult populations. Although existing work is important because it provides a crucial foundation for needed longitudinal studies of resilience in late life stages, it is time for the study of resilience to include the realities of later life (Zautra et al., 2010).

Scant literature exists reporting the investigation of the ways older women are resilient. A growing network of researchers suggests that older women have access to resources that ameliorate hardships in later life, such as social support, spiritual connections, and environmental mastery (Blieszner & Ramsey, 2003; Kinsel, 2005; Ramsey & Blieszner, 1999). My intention with this research was to add to existing knowledge regarding the factors that contribute to resilience for women in later life.

Older adults are increasing in number and living longer into advanced age. The nature of how older adults are living in advanced age and the extent to which they are resilient is considerably complex and heterogeneous. It is important that gerontologists explore the process of resilience and how it both shapes and is shaped by aging. Additionally, it is crucial for us to understand how resilience intersects with spirituality in later life.

Although remaining sensitive to the consequences of problematizing aging and reifying old age as pathology, it remains inevitable that older adults experience aspects of decline and loss over the life course, some more severely than others. In other words, adversity is inescapable at certain points across the life course, especially as we age. These adversities provide opportunity for resilience, making it central to aging (Resnick, Gwyther, & Roberto, 2010). With the inevitability of challenges comes diversity in responses. The work I present in this article explores the connections between spirituality and resilience and the impact these connections have on subjective well-being for women in later life.

Moberg (2005) asserted that all humans have a spiritual dimension by nature of being human; each person therefore has the capacity for spirituality. In essence, spirituality in later life consists of finding core meaning in life, responding to meaning, and being in relationship with God/Other. Aging invites contemplative activities. As many people grow older, these contemplations are translated into the search for life meaning (MacKinlay, 2006). This search is central to quality of life and a sense of overall well-being. This search for life meaning influences spiritual experiences and expressions, particularly as one ages and confronts various realities associated with the end of life. This progression changes the nature of meaning making from provisional, everyday meaning to larger life meaning (MacKinlay). Understanding the spiritual experiences of the oldest-old is important to better ground what we know as gerontologists regarding aging over the life course. In turn, this will help us better understand the implications of everyday life meaning for older adults.

Focusing on older adults’ spiritual experiences is part of this larger understanding. As McFadden pointed out, “For many, but certainly not all older people, faith communities, spiritual and religious experiences and beliefs concerning the sacred will contribute to life quality and meaning” (2005, p. 172). Spirituality provides a framework that guides individuals through painful and joyful events, often facilitating positive discoveries amid negative experiences (Ardelt, Ai, & Eichenberger, 2008). Consequently, spirituality is a powerful resource in later life, providing older adults with the ability to adapt to changing individual needs. Pargament and Cummings (2010) described this as an aspect of resilience. Spirituality has the potential to be a major resource for older adults as they age and as they expand their consciousness. For the purpose of this study, I conceptualized spirituality as a “realm of human experience encapsulating an intense awareness of the present; transcendence of the personal self; and/or a feeling of connection with all of life, the Universe or a Supreme Being” (Atchley, 2009, p. 2).

Spirituality often provides a personal framework that guides individuals through painful events, facilitating the discovery of the positive from the negative (Ardelt et al., 2008). Spirituality is also a powerful coping mechanism providing older adults with the ability to adapt to changing individual needs. This, in turn, is an important and unique feature of resilience (Faigin & Pargament, 2010). A multitude of work exists demonstrating the protective nature that religion and spirituality have for people regarding how they cope with the adversarial nature of life (George, Ellison, & Larson, 2002; Koenig, 2002).

Researchers have indicated that religion and spirituality provide people with a source of hope, comfort, and resilience in the face of adversity (Faigin & Pargament, 2010; Koenig, 2002; Schwarz & Cottrell, 2007). It is essential that we explore these pathways to resilience and identify the mechanisms that shape the process of resilience for individuals as they age and experience later life. We must also understand how these pathways relate to religion and spirituality. In this article, I explore these critical resources and their relevance for older women. I examined the spiritual lives of women in later life and investigated factors that promote resilience. In this investigation of spirituality, I was specifically interested in how they managed adversity over the life course. What emerged from the narratives about spiritualty and adversity were accounts of resilience rooted firmly in spirituality. Findings related to this key theme and their implications are presented and discussed in the remaining sections.

Methods

Design and Sample

In this qualitative analysis I used grounded theory to understand the relationship between spirituality and resilience, using 30 interviews with 6 participants (Glaser & Strauss, 1967). Each participant was interviewed five times to capture the essence of her spiritual experiences and how those experiences spirituality impacted her overall experiences in life. The fifth interview was reserved for joint analysis and member checking to establish contextual validity (Lincoln & Guba, 1985). The participants confirmed that my analysis and interpretation of their experiences resonated with them.

What emerged from the multiple interviews were thick, rich narratives about spirituality being linked to resilience over the life course. I used a theoretical sampling approach (Corbin & Strauss, 1990; Lincoln & Guba, 1985). Participants were not randomly selected or predetermined during the initial planning stages of the project. Women were selected to participate based on their first-hand experience with the phenomenon of interest: spirituality in advanced age. Women age 80 and older were sought based on a variety of settings and living arrangements. The women resided in the Midwestern region of the United States and were mostly community dwelling (none were institutionalized; 1 lived in an assisted-living facility and 5 lived in their own homes).

Initially, I intended to interview nonagenarians and sampled accordingly. After receiving approval from the Institutional Review Board for Human Subjects at my university, I began participant recruitment. I attended a photography exhibit of nonagenarians on display at a local art gallery, which prompted me to contact the artist and request that she connect me with the women from her photography project. The artist agreed, and after receiving permission from the women she photographed for her project, she provided me with names and mailing addresses of 15 women older than the age of 90. I sent a letter explaining my study to these women, and two responded by telephone to express their interest in being interviewed for the project. I scheduled interviews with these 2 women and began data collection. The additional 4 participants came via snowball sampling. A total of 6 women ranging in age from 82 to 94 years were each interviewed five times, for a total of 30 interviews. All interviews were audiotaped and transcribed verbatim. No data analysis software was used in the analysis.

Individual, in-depth interviews were used to gather narrative data that explored each woman's experience of spirituality. The interviews took place in the homes of the women and concentrated on spiritual experiences, beliefs, and practices throughout the life course. Additionally, I asked about the impact of those experiences on stressful and adverse events in their lives. Initial interviews lasted from 1 to 4 hours. Following collection of basic demographic data, I opened the interview with, “I'm interested in finding out about your spiritual experiences and how you have come to hold them. In addition, how is your spirituality relevant to your aging? Also, please describe hardships you have experienced in life. How does your spirituality inform how you handle adversity?” The interviews reflected a degree of interpretation in the moment, by the women and myself, regarding spirituality as a phenomenon and resilience as a subsequent effect. I ceased data collection once I reached data saturation (i.e., when I was no longer hearing new information concerning spirituality and its connection to resilience; Corbin & Strauss, 1990; Lincoln & Guba, 1985).

Data Analysis

I employed a grounded theory approach to analyze the narrative data from interviews. I examined the contents of the data for common themes and patterns that evolved from the narratives (Denzin & Lincoln, 2005; Lincoln & Guba, 1985). Strauss and Corbin (1997) explained that grounded theory is an approach in which the researcher uses a systematic set of procedures to develop an inductively derived emergent theory about a phenomenon, or to refine concepts to construct theory. I arrived at an emergent theory as I reached a saturation point in the data.

I incorporated in my analysis how the women in this study experienced and lived their spirituality. I analyzed the data in a manner that allowed me to arrive at an emergent theory regarding the interplay between spirituality and resilience. Using the tenets of emergent theory, I found that spirituality was a pathway to resilience, ultimately leading to subjective well-being for the women. After coding and categorizing, exemplar themes were connected based on emergent themes and experiences the women expressed during interviews. I then compared the exemplar themes across narratives to arrive at an emergent theory (Denzin & Lincoln, 2005; Lincoln & Guba, 1985). My findings are presented in the following section.

Results

When asked about their spirituality, the women's narratives demonstrated resilience about life, meaning, and spirituality. The women, in their 80s and 90s, were explicit about how their spirituality served as a mechanism for dealing with adversity and hardship. In addition, they accredited their spirituality with helping them reach advanced age. Specifically, the women discussed how spirituality and their connection with God served as tools to help them make sense of advanced age and how they managed to live so long. Spirituality apparently served as a protective factor for these women in later life.

I understood through the interviews how, as these women continued to age, they were responding to both later-life challenges and opportunities. Spirituality served as a framework that enabled the women to cope with painful events and facilitated the discovery of positive growth. Spirituality also served as a powerful mechanism that provided the women with the ability to adapt to changing individual needs, and was an important and unique feature of what I understood as their resilience (Faigin & Pargament, 2010). A key aspect of understanding resilience and how people respond to challenge and adversity is articulating and identifying the underlying components of our abilities to overcome the greatest odds (Faigin & Pargament; Pargament & Cummings, 2010).

The participants exhibited resilience and attributed their spirituality as a key aspect of how they negotiated hardship and how they bounced back in the face of adversity. Essentially, spirituality for these women served as a protective factor. Furthermore, the utility of spirituality was evidenced in their narratives. For some of the women, spirituality was an essential tool, enabling them to accept life's challenges and the opportunities they experienced. The women also described how their spirituality enabled them to have a strong spiritual center. This spiritual center empowered them to cope, to have and maintain an optimistic perspective, and to exhibit a strong sense of well-being as older women. I theorized that for them, spirituality served as a pathway to their resilience. In other words, spirituality was a vital component to how these women experienced, sustained, and recovered from adversity over the life course.

Spirituality as a Pathway to Resilience

Living into advanced age means that individuals will experience adversity, loss, stress, and trauma. Although there are many wonderful experiences associated with growing older—for example, deeper connections with people, a greater sense of self, and increased ability to engage in abstract thinking—the harsh reality is that life presents great challenges and adversities associated with aging (Resnick et al., 2010). The women were explicit in detailing and describing life's challenges. These descriptions encapsulate moments in time, both in the far past and the (then) present, when they were presented with remarkable adversity. These adversities included the death of children (newborn and adult); surviving “terminal” illness; dealing with the loss of physical function; the deaths of parents, partners, and friends; and dealing with social and cultural hardship.

All of the women, despite their experiences with extreme adversity, managed over their lives to exhibit resilience, or the ability to bounce back in the face of adversity. They were able to recover from the traumatic nature of the events they described, as well as sustain the process of regrouping and dealing with their various traumas and hardships. The women in this study experienced the functional aspect of their spirituality as resilience. In other words, resilience was a process with an outcome of being successful in adaptation to adversity. More specifically, spirituality was a pathway to resilience, which led to subjective well-being. This involved a process of recovery and sustainability, allowing the women to further develop spiritually while experiencing a deepening of spirituality over the life course.

One participant explained how her spirituality was paramount in her ability to not only cope with her son's death, but also to perceive it is a transformative experience. She reflected on what it was like to lose her mother earlier in life and compared the two experiences. In particular, she described how a deepening of spirituality served as a protective buffer, enabling her to bounce back from adversity:

When my mother died I didn't think anything else could affect me like that until my son died. And, if I hadn't had my faith I would have gone crazy. God helped me overcome the pain and loss of my son. His death brought me closer to God. I thought losing my mom was the worst thing that could happen. Then five years ago, I lost my second son and that was even harder. It's all in God's hands.

Another participant discussed how her spirituality and her church served as lifelines when her husband was dying and then throughout the years of widowhood she had experienced:

During the process of losing my husband I relied on my spirituality and religious beliefs. I didn't believe in going to heaven, but I believe in a form of God. I relied on prayer in church, no doubt. I can remember him in church because we were always there together. Sometimes I mention him in the prayers for the dead, most often. I depended on the church to teach me how to get through the first few days without him. It was hard, and sometimes still is.

In addition to the women describing instances of resilience, they also described how their resilience had accumulated over time. One woman framed the process in these words: “This, too, in time shall pass.” One participant explained her trust in God and her ability to accumulate resilience:

It's like this: You're more confident in whatever happens. I know I'll get through it. I always have. I don't know what it will be, and I'll be okay. I have confidence in what I call God. So, whatever happens, there is a plan. It all makes sense to me. I trust in the process and I trust in God to help me overcome whatever I need to. I have made it this far, and no matter what happens next, it will be okay. It has to. It always has. I've had many chances to practice overcoming hardship, and I get better at it each time.

This overarching life philosophy reflects resilience as a developmental process over the life course, or what I theorized to be accumulated resilience. The women openly discussed how being older gave them perspective that they did not have earlier in life. They also articulated how enduring various traumas and stresses over time, followed by wonderful and great experiences in conjunction with their reliance on spirituality, enabled them to know and be assured that they would be able to cope with future adversities in life. They not only coped, but also bounced back in ways that resulted in their being stronger and better prepared to manage challenges in later years. The accumulation of resilience was expressed in the way one participant reflected on her blindness:

My parents let a blind man board with us when I was a child. I read to him and took him downtown to visit a brother who was in a home for the blind. He talked to me about his blindness, and I didn't have any idea then that someday I would be blind. But, in retrospect, the Lord was preparing me for what was ahead. I feel that as we grow older, we have all kinds of things happen, and things go wrong. For me, blindness is both a blessing and a hardship. I learned early how to cope and have had many more hardships throughout my life. What I learned then helps me now. I learned how to trust God and myself.

Another participant considered herself to be strong and a survivor. She survived several “terminal” illnesses and accumulated skills and strategies as part of her resilience process:

I have had several things wrong with me physically. But I'm a survivor. Yes, I had cancer twice. I also had bowel cancer. I relied on my faith to make it through those times, especially with heart surgery. I knew everything would be fine. My faith helped me survive because I believe God is real. I rely on that belief to get me through. Each time I deal with a major blow I get better and better on relying on that belief, where I just know it's going to be okay.

When asked about how they survived life's challenges, the women articulated that their spirituality served as a critical resource for the ability to bounce back from adversity while continuing to grow in strength and deepen in their faith. They used traumatic events as opportunities to “achieve highly-valued outcomes, both secular and spiritual” (Pargament & Cummings, 2010, p. 207).

Spirituality and Resilience Lead to Subjective Well-Being

Spirituality served as a protective factor for these women, and was also an integral part of their resilience, which led to their subjective well-being. I argue that spirituality was essential to their accumulation of resilience. During the interviews, the women described what having a sense of well-being meant to them. For example, one participant described the power of faith and how central it was to her well-being: “I have well-being when I'm content and satisfied. My spirituality and religion, my faith, are very central to what I understand as my well-being. I'm happy, and overall I'd say I'm pretty darn healthy.” Another participant discussed her idea and experience of well-being:

It means having no worries and feeling good. At this point the only thing that I actually have a concern for is my health. I'm okay now, but I'm not sure what the future holds for me. The older you get, you're going to have problems. But all in all I don't have that many worries. My spirituality, my belief in God, is a big part of that well-being and how I deal with the less than ideal. I know the Lord will take care of me.

Part of their subjective well-being was a sense of peace. These women discussed how they were able to transcend the anxiety of everyday life and live in a manner that I characterize as peaceful and contented. They had arrived at a place of ultimate peace. It is questionable to what extent we can attribute this to chronological age, but during the course of the interview process these women expressed contentment with life and grounded it in their spirituality. Furthermore, I theorize that this sense of peace was an outcome of their cumulative process of resilience.

An essential theme running throughout the narratives is that these women regarded their spirituality as a way to attain and sustain their subjective well-being. Furthermore, spirituality was an essential component to being able to experience, survive, and thrive in the face of adversity. Spirituality for each woman was different, as was the experience of subjective well-being; the experiences were relative. All of the women discussed having and maintaining well-being, and how they attributed their well-being in later life to having a belief in something greater than themselves. The relationship between spirituality and resilience is complex and dynamic, but despite this complexity I argue that spirituality provided these participants with necessary components of resilience, as well as support, coping, and purpose. Resilience is a dynamic process with a multitude of variables potentially impacting the cumulative process over the life course. The interviewed women demonstrated that spirituality is one pathway to resilience; however, it is not the only path for every older adult.

Discussion

Although remaining sensitive to the consequences of problematizing aging and reifying older age as pathology, it remains inevitable that older adults will experience aspects of decline and loss over the life course, some more severely than others. These adversities provide the opportunity for developing resilience, making it central to aging (Resnick et al., 2010). In this study I found that spirituality was instrumentally linked to the process of resilience for the participating women; in other words, spirituality served as a pathway to resilience. With the inevitability of challenges comes diversity in responses. These responses suggest that for many older adults spirituality has utility and serves as a unique resource not only to make sense of their identity, but to promote and enhance their health and well-being (Faigin & Pargament, 2010; Idler, 1987; McFadden, 2005; Pargament & Cummings, 2010; Wotherspoon, 2000). This claim is applicable to and held validity for the women in this study.

The positive connections between spirituality and subjective well-being are well documented in the literature (Ferraro & Albrecht-Jensen, 1991; George et al., 2002; Idler, 1987; Koenig, 2002). For example, McFadden (2005) found that existential living is rooted in spirituality and religion, and according to the participants in her qualitative study, spirituality and existential roots were the essence of well-being. Additionally, Koenig (2002), in a single-case study with an 83-year-old woman, found that the spirituality/religion–health connection was responsible for how the woman conceptualized her resilience and responded to coping with the adversities associated with older age and chronic illness.

Although Koenig's (2002) research represents only a sliver of the existing work on the connections between spirituality and health/well-being, it does provide us with examples of how spirituality and well-being are positively connected. These positive connections are also supported in my findings, presented here and evidenced in the narratives of the six interviewed women. It is important to note that spirituality is not necessarily relevant to all older adults, but for those whom spirituality is important, a link exists between their spirituality and well-being: spirituality serves as a pathway to resilience, yielding subjective well-being. This process results in an overall positive experience of aging. For these women, this process involved a reframing from the negative to the positive.

This examination of women and their spirituality also suggests that developing resilience is a process. Clark et al. (2010) used the metaphor of a “resilience repertoire” to explain the skills and resources older adults use to moderate the negative experiences in life, and as a result reduce the impact of those negative events. I argue that resilience is more than a repertoire, and that it accumulates over the life course in a fluid and dynamic manner. Seery (2011) suggested that a lifetime of adversity might have positive and protective outcomes, and that this might contribute to an individual's development of propensity for resilience. The findings I present in this article are complementary to the conceptual framework of the resilience repertoire and the cumulative adversity argument. I stress, in a complimentary fashion, the complex but important role spirituality plays in the cumulative process of resilience over the life course.

My findings also support the possibility of spiritual transformation (Pargament & Cummings, 2010). In other words, these adversities and challenges might serve as points at which individuals become spiritually stronger and develop a deeper sense of faith and spiritual connection. The participating women attributed considerable meaning making to their spirituality and resilience. This finding supports existing research. For example, meaning in later life has been identified as an important dimension of resilience in later life. Greene (2002) found meaning making to be essential to resilience for Nazi Holocaust survivors, and Kinsel (2005) found that resilience and women's ability to thrive in later life were attributed to meaningful connections and social relationships.

Conclusion

Resilience for the women represented here was learned and practiced in the context of their spirituality over the life course. To say that spirituality was their only pathway to resilience would be erroneous. Their lives had been complex and rich, and were filled with relationships and meaningful connections. These connections provided buffers and supportive networks as they aged. Enduring hardship, challenge, and adversity while using their spirituality as a framework for making meaning and processing allowed them not only to cope with challenge, but also to bounce back in a manner that resulted in positive development, growth, and positive transformation. This process ultimately led to their perceived well-being. In addition to having a strong sense of subjective well-being, the women had life satisfaction, as well as meaning and purpose. Simply put: The women drew on their spirituality to build their resilience (Resnick et al., 2010), and their spirituality and resilience were essential to their subjective well-being.

I suggest that it is the responsibility of researchers to discover and explore the realities of older adults. This will subsequently provide insights into ways people can optimize their resilience. Supporting spirituality as a pathway to resilience in the lives of older adults is one such way to assist in this optimization. The linkages between spirituality and resilience and the roles they play in the lives of older adults are ripe for further investigation. The growing number of older adults will require us to examine critical resources and features of resilience, for example spirituality and religion. In addition, research must be applied in a manner that aids in the development of resources that promote and enhance strength and resilience in later life.

Biography

Lydia K. Manning, MGS, PhD, is a postdoctoral scholar at the Duke Center for the Study of Aging and Human Development, Duke University, in Durham, North Carolina, USA.