Contextualising Resilience: How do Meaning and Experience Inform Adaptation within the Contexts of Advanced Age and Culture?

Abstract

Background Resilience is a process that mobilises existing resources to achieve positive outcomes under challenging circumstances. Despite being conceptually quite easy to envisage, resilience denotes a complex relationship between adversity, protective and risk influences and a positive behavioural response. Given the health and social compromises that are regularly faced by ageing adults, resilience to adversity is especially important in very late life. This thesis adds to very scant data investigating resilience in the oldest-old (advanced age), using a populationbased sample from Aoteoroa/New Zealand. As well as focusing on the socio-historical context, a sociocultural contextualisation is employed to investigate resilience in Māori (Tangata Whenua; indigenous population of New Zealand). Different life attitudes and challenges associated with ageing are likely to require different resource patterns. The aims for the current work were to assess groups of factors that hang together and collaboratively predict positive health outcomes; investigate the relationship between resilience and positive health outcomes, and compare resilience scores with psychosocial profiles. Method Data were obtained from interviews conducted with 641 older adults (250 Māori aged 80-90 years and 391 non-Māori aged 85 years; 284 male, 357 female) and included psychological, attitudinal, social, spiritual and cultural measures. Māori data included cultural knowledge and engagement. Two hierarchical cluster analyses using 20 age-relevant psychosocial and seven cultural resource indicators were conducted to determine how resources were grouped and analyses also investigated how these profiles were related to physical and mental health. Regression analyses were conducted to investigate how resilience (functional status relative to health impairment) was related to mental health outcomes. Comparison of cluster profiles and resilience was undertaken. Results Resource profiles and resilience were related most closely to social connections and spirituality. More advantageous profiles and higher resilience were associated with good mental and physical health outcomes. Conclusions Māori and non-Māori of advanced age are heterogeneous when it comes to access to and utilisation of potential resilience resources. However, health was associated with high levels of participation in society in multiple domains. Knowledge of which resources contribute to resilience and the patterns of that contribution has implications for maximising ageing well. Data on resilience for the oldest Māori is novel, unique, and will be of importance to Māori communities and wider society.