Abstract
The global population of individuals aged 60 years or older has doubled since 1980 and is projected to reach two billion by 2050 (World Health Organization [WHO], 2024). Aging with vitality is possible for older adults, including international migrants, defined as “any person who changes his or her country of usual residence,” and refugees, described as individuals who, “owing to a well-founded fear of persecution for reasons of race, religion, nationality, membership of a particular social group or political opinion, have been forced to seek protection outside their home country” (International Organization for Migration [IOM], 2024). While age-related conditions may be unavoidable, age-friendly policies and interventions can enable vibrant living and peaceful aging for both groups (United Nations High Commissioner for Refugees [UNHCR], 2024). Older migrants and refugees face unique challenges, as they must adapt to aging in a new environment with limited resources and under social conditions distinct from those in their home countries (Hartt et al., 2021; Ho et al., 2022). Unlike locals, who have time to prepare, older migrants and refugees must adapt quickly, often without extended family support, as their families may be dealing with integration challenges themselves (Jetten et al., 2018). Additionally, older refugees may be hesitant to use host countries’ mainstream institutional and homecare services because of fear, distrust, or cultural differences (Hartt et al., 2021; Ho et al., 2022). Our ongoing research into Ukrainian, Syrian, and Afghan refugees’ healthcare practices in Canada reveals a strong reluctance to use conventional eldercare facilities, driven by cross-cultural dissonance and differences in health beliefs or medical practices (Yasin et al., 2024). Older migrants and refugees often encounter barriers in accessing services, partly due to bureaucratic definitions of age that fail to consider the complex needs of this population, as well as the limited availability of resources (Seibel, 2016). Social networks also play a vital role in helping older migrants overcome isolation, fostering social inclusion, and enabling them to access essential resources (Hussein, 2018).
The integration of older migrants and refugees is critical, as they contribute significantly to family stability during resettlement, and they often act as anchors within families, providing emotional and practical support that aids the overall adjustment process (Hartt et al., 2021; Ho et al., 2022). Ensuring their successful integration requires tailored interventions that cater to their specific needs, promoting both dignity and social inclusion (Ciobanu et al., 2017). While resourceful aging emphasizes the strengths and resilience of older refugees and migrants, addressing systemic barriers that limit their full participation in society is equally important. For example, limited access to age-specific services and the loss of familiar social networks can exacerbate feelings of cultural dislocation and marginalization (Ciobanu et al., 2017). Resourceful aging among refugees and migrants also emphasizes the importance of understanding the distinct vulnerabilities faced by older individuals and the strategies they use to manage these challenges (Hachem et al., 2022). By recognizing and addressing these challenges, resourceful aging can be fostered through comprehensive support systems that not only enhance social integration but also empower older migrants to maintain their cultural identity and dignity as they age.
Rooted in the philosophical principles of humanism and holism (Erickson, 2007; Jasemi et al., 2017), holistic nursing emphasizes environments that support physical, mental, and social well-being (Dossey et al., 2015; Frisch & Rabinowitsch, 2019). It advocates a comprehensive approach to healing that considers the whole person physically, emotionally and socially rather than focusing solely on symptoms or diseases (Dossey et al., 2015; Frisch & Rabinowitsch, 2019). This aligns well with the principles of resourceful aging among older migrants and refugees, as both emphasize empathy, cultural sensitivity, and a nuanced understanding of human needs (Al-Hamad et al., 2024; Jasemi et al., 2017). Older migrants and refugees often face significant trauma, health disparities, and a disrupted sense of community and identity (Im & Neff, 2021). Holistic nursing emphasizes cultural competence among healthcare providers, ensuring that they are sensitive to the unique backgrounds and needs of older migrants (Hartt et al., 2021; Ho et al., 2022; Jetten et al., 2018). The principles of holistic nursing resonate with the goals of resourceful aging, promoting a whole-person approach to aging that supports both adaptation and the preservation of cultural identity, which are crucial for maintaining dignity and self-worth (Dossey et al., 2015). Understanding resourceful aging as a holistic process is particularly important for nurses working with culturally diverse populations, as it helps them develop effective strategies to reduce the stressors related to cultural adaptation and integration (Dossey et al., 2015).
Since the mid-20th century, a wide variety of efforts have been made to label, define, conceptualize, and measure the aging process throughout the lifespan (Michel & Sadana, 2017). Even when focusing primarily on literature from Western and higher-income countries, the concepts and definitions of aging-related concepts vary, reflecting diverse perspectives, norms, and values, along with differences in measurement and interpretation approaches (Michel & Sadana, 2017). Exploring resourceful aging through a holistic nursing lens offers insights that can enhance nursing practices by tailoring interventions to address the unique challenges faced by older migrants and refugees as they navigate new cultural norms and healthcare systems. Given the growing elderly population and the prominence of the aging concept, establishing a cohesive definition of resourceful aging among migrants and refugees can reduce ambiguity among researchers and support the development and advancement of strategies to promote their aging process (Michel & Sadana, 2017). Additionally, given the limited in-depth literature on resourceful aging, further conceptual analysis is needed to refine the model and integrate it more effectively into holistic nursing and healthcare approaches. This study aims to (1) analyze the concept of resourceful aging among migrants and refugees and (2) develop a conceptual definition and model for resourceful aging that can be effectively integrated into holistic nursing and healthcare practices.
Method
We utilized the Walker and Avant (2019) method for concept analyses, which involves a structured eight-step approach: (1) selecting the concept, (2) determining the goals of the analysis, (3) identifying all instances of the concept's use, (4) pinpointing its defining attributes, (5) creating exemplar model cases, (6) identifying borderline and contrary cases, (7) identifying antecedents and consequences, and (8) defining empirical referents. An analysis approach that was recommended by Gunawan et al. (2023) was used. The model, in contrast, and borderline cases were developed on the basis of findings from our ongoing work with Ukrainian, Syrian, and Afghan older refugees’ healthcare practices in Canada (Yasin et al., 2024).
Identifying the Concept and Search Strategy
A search for the term “resourceful aging” in the Merriam-Webster Dictionary, the American Heritage Dictionary, and the Oxford Dictionary returned no results. While similar definitions were found for the word “resourceful” across all three sources, the Oxford Dictionary provided the most detailed definition, describing it as “skilled in devising expedients or in meeting difficulties, full of practical ingenuity”(Oxford English Dictionary, n.d.-a). A similar approach was used to define “aging,” with all three dictionaries consulted. The Oxford Dictionary again provided the most comprehensive definition, describing aging as “the process of growing old, showing signs or giving the appearance of advancing age” (Oxford English Dictionary, n.d.-b). A database search was conducted for the terms “resourceful” and “aging” in the academic literature. The search strategy was developed in collaboration with a research librarian, with initial searches performed across multiple databases. The approach included relevant keywords and index terms, forming a comprehensive search strategy that was then adapted for other databases via specific truncations, Boolean operators, and wildcards. To enhance accuracy, the strategy underwent peer review by another librarian following the PRESS peer review strategy (McGowan et al., 2016). Additional searches were carried out via Google Scholar, and reference lists of selected articles were reviewed to include gray literature such as conference proceedings and opinion papers. This approach aimed to ensure a thorough and comprehensive collection of relevant data, aligning with the concept analysis objectives. The search strategy for the review involved querying multiple databases, resulting in the identification of 238 records. The databases included CINAHL (n = 8), Medline (n = 14), Humanities Source Ultimate (n = 149), SCOPUS (n = 34), Social Sciences Full Text (n = 12), and Google Scholar (n = 21). We included records published after 2000 to capture the evolving perspectives and policies regarding aging, migration, and resourcefulness in a modern context. This time frame is justified because it reflects the global shifts in migration patterns, increased attention to aging populations, and the development of resources and support structures in host countries over the past two decades. Following the removal of 32 records due to duplication, retractions, and incomplete information via reference management software, 206 records were screened by title and abstract.
Two independent reviewers, RR and VH, assessed the citations for relevance, with the full texts of selected records reviewed by the same individuals. The inclusion criteria focused on records published in English from 2000 to 2024, which specifically targeted older adult migrants and refugees. The reasons for exclusion at the full-text review stage were recorded. Any disagreements were resolved through discussion or with input from a third reviewer, AA. The search results and inclusion process are presented in a PRISMA flow diagram (see Figure 1). Reviewers carried out screening and data retrieval, addressing disputes in the same manner. In cases of unclear or missing data, the team reached out to the authors for further clarification. Of these, 122 records were excluded on the basis of relevance, leaving 84 reports for retrieval. All 84 reports were retrieved, and a detailed assessment of eligibility was conducted, leading to the exclusion of 38 reports. Ultimately, 46 records were included in the review, offering a comprehensive analysis of the concept. The reference lists of these records were examined, but no further records were identified. See Figure 1 for the PRISMA chart.
PRISMA flow diagram.
Results
Relevant Concepts
The records reviewed employ various terms that are interchangeably used to describe the same phenomenon. To gain a comprehensive understanding of the concept of resourceful aging among migrants and refugees, we explored three of the most common concepts that describe situations in which older migrants and refugees aged in their new countries: aging well, resilient aging, and successful aging. While these terms are interconnected, each carries distinct connotations. They represent the historical evolution of the concept of the aging of migrants and refugees, particularly across the 20th and 21st centuries. The following discussion explores each concept in detail.
Aging Well
Aging well requires a shift from avoiding aging to embracing it as a natural part of life (Corwin, 2021). Bethell (2020) encouraged the overcoming of denial about aging, advocating a realistic, nonprescriptive approach to support older adults’ health and well-being globally. Galiana and Haseltine (2019) illustrate diverse solutions for aging well, crafted by healthcare providers, public and private organizations, and nonprofits, addressing key challenges such as person-centered long-term care, palliative care access, aging-in-place, and integrating health with social care. These strategies emphasize sustainable models that improve older adults’ well-being by providing accessible care, combating aging stigma, and fostering inclusive communities.
Corwin (2021) offers a contrasting perspective by examining American Catholic nuns, who model a culture of acceptance around aging. Unlike mainstream society's tendency to view aging as a problem, nuns consider it a natural phase of life, approached with grace and dignity. This communal culture encourages longevity, autonomy, and well-being, showcasing how an accepting attitude can positively influence aging trajectories. Together, these approaches emphasize that aging well is not only about care access but also about cultural acceptance, inclusivity, and holistic support (Bethell, 2020; Corwin, 2021; Galiana & Haseltine, 2019).
Healthy Aging
The concept of “healthy aging,” introduced by the WHO (2015) in its World Report on Aging and Health, represents a shift toward a more realistic, person-centered approach to aging. Unlike traditional definitions that focus solely on the absence of disease, the WHO defines healthy aging as “the process of developing and maintaining the functional ability that enables well-being in older age” (WHO, 2015). This definition emphasizes how individuals’ intrinsic capacity, including an aggregate of physical and mental attributes shaped by genetics, health conditions, and life experiences, interact with environmental factors such as political, economic, and social resources to influence overall well-being (Rudnicka et al., 2020). The definition also recognizes that variations in aging rates and well-being are often due to these diverse factors, which also contribute to disparities in health and wellness (Michel & Sadana, 2017; Rudnicka et al., 2020). Promoting healthy aging benefits society by reducing dependency and healthcare costs, enabling older adults to contribute meaningfully to their communities (Aronson, 2020). This focus on lifelong health trajectories aligns aging policies with broader public health goals, aiming for well-being that continues throughout life.
Successful Aging
Successful aging is not defined by universal standards but is shaped by how older adults adapt to changes, losses, and limitations while utilizing available resources and opportunities (Estebsari et al., 2020). Key principles include acknowledging personal circumstances, maintaining resilience, and purposefully engaging in meaningful activities (Cosco et al., 2014). Factors such as physical activity, social interactions, and positive attitudes are critical, whereas genetics plays a lesser role (Rowe & Kahn, 2015). Life events, both positive and negative, influence adaptation, underscoring the importance of self-care, education, and community support (Barišić et al., 2024). Successful aging has become central to development strategies aimed at improving older adults’ quality of life by encouraging healthy behaviors to prevent age-related issues and reduce healthcare costs (Barišić et al., 2024; Cosco et al., 2014; Estebsari et al., 2020). Health professionals and community services must design holistic plans that empower older adults with information and support, promoting an active lifestyle (Moody & Sasser, 2020). By addressing physical, mental, and social needs, successful aging can foster resilience and well-being, integrating individual efforts with broader community roles (Estebsari et al., 2020; Rowe & Kahn, 2015).
Defining Attributes
In Walker and Avant (2019), attributes are core characteristics that define a particular concept and are essential in identifying the concept's presence to distinguish it from similar concepts. Our review of the literature identified four key attributes for resourceful aging among migrants and refugees: adaptability, social connectedness, resilience, and resource navigation.
Adaptability
Adaptability is a vital attribute for older migrants and refugees as they transition into new environments, cultures, and living conditions (Torres, 2006). This ability to adjust involves learning new skills, adopting different routines, and navigating unfamiliar social, healthcare, and governmental systems (Torres, 2006). Adaptability is fundamental for maintaining emotional and psychological well-being, especially when older adults have access to language and digital literacy programs (Georgeou et al., 2023; Zauszniewski et al., 2006). The process of adapting is facilitated by external support such as community services that provide guidance on accessing healthcare (Low et al., 2023) or practical support that facilitates the use of digital technologies (Baldassar & Wilding, 2020). For many older migrants, adaptability is closely tied to their previous experiences of overcoming challenges, such as displacement or socioeconomic upheavals, which can enhance their resilience in adjusting to new surroundings (Owino, 2021). Programs that help bridge cultural and language barriers further support adaptability, enabling older migrants and refugees to manage the stressors of migration more effectively (Cramm & Nieboer, 2018; Kim, 2021). The literature emphasizes that adaptability is not solely an individual trait but is deeply influenced by the structural support and services available to help older migrants and refugees navigate the complexities of their new environments (Owino, 2021; Zauszniewski et al., 2006).
Social Connectedness
Social connectedness is essential for the emotional and psychological well-being of older migrants and refugees (Low et al., 2023). Social networks, including family, community groups, and organizations, provide critical access to resources that help maintain physical, social, and mental health (Low et al., 2023). These connections help mitigate feelings of isolation, which are common among older migrants, and foster a sense of belonging that significantly enhances their overall well-being (Hawkins & Haapio-Kirk, 2023). Family support is particularly important in helping older adults navigate complex systems (Ambriz et al., 2023) such as healthcare, social services, and legal procedures (Kim, 2021). Family members can act as intermediaries, assisting with translation, healthcare navigation, and day-to-day tasks. Beyond family, community organizations such as religious institutions and cultural associations play crucial roles in helping older migrants and refugees maintain connections with their cultural heritage and faith, thereby reinforcing their sense of identity and continuity (Reid, 2018). These social structures not only provide practical assistance but also offer emotional reassurance, which is key to successful aging (Reid, 2018).
Resilience
Resilience is the capacity to cope with and respond to various challenges associated with migration and aging (Ambriz et al., 2023), such as language barriers, socioeconomic changes, and limited access to healthcare. Resilience is not only a personal attribute but also shaped by external factors, such as the availability of culturally competent services and social support systems (Georgeou et al., 2023; Hawkins & Haapio-Kirk, 2023). Engaging with culturally familiar practices, such as religious observances or traditional customs, helps older migrants and refugees maintain a sense of stability and emotional well-being, which strengthens their resilience (Ambriz et al., 2023). Social networks and community support systems are critical in fostering resilience among older migrants. These networks help older adults manage the uncertainties of migration by providing emotional and practical support, including assistance with accessing healthcare and social services (Low et al., 2023). Furthermore, healthcare services that are culturally and linguistically appropriate enable older migrants to better cope with the challenges they face, enhancing their capacity for resilience (Barbiano di Belgiojoso et al., 2022). Resilience is thus a dynamic process that evolves in response to both personal strengths and the external resources available to individuals (Ambriz et al., 2023).
Resource Navigation
Resource navigation is the ability of older migrants to identify and effectively employ the resources available to them, such as healthcare services, housing, and financial support (Hawkins & Haapio-Kirk, 2023). This ability is critical for maintaining independence and well-being in environments where systemic barriers, such as language differences and unfamiliar processes, may impede access to necessary services (Barbiano di Belgiojoso et al., 2022; Chowdhury et al., 2023; Ciobanu et al., 2017; Conkova & Lindenberg, 2020). Effective resource navigation requires not only personal agency but also support from family and community networks (Barbiano di Belgiojoso et al., 2022). Social networks, including family and community organizations, play an essential role in helping older migrants navigate these systems (Hu et al., 2024). These networks often provide practical assistance, such as accompanying older adults to medical appointments or helping them complete paperwork. Additionally, culturally competent services with a proper understanding of the specific needs of older migrants are crucial for ensuring that older adults can access the care and support they require (Cramm & Nieboer, 2018). The ability to successfully navigate resources reflects both individual capability and the accessibility of support systems in the host country (Owino, 2021).
Model Case
A model case is designed to represent the concept effectively in real-world scenarios, incorporating all the identified attributes from the analysis (Walker & Avant, 2019). The following section provides a typical example involving resourceful aging among older migrants and refugees. Mohammad, a 68-year-old Syrian refugee, came to Canada hoping to age peacefully and independently. Despite challenges such as learning a new language, navigating healthcare, and adapting to a different culture, he was determined to make Canada home. With his son's support, he secured a small apartment and enrolled in language courses at a community center. Mohammad built strong connections within the local Arab community and mosque, providing both emotional support and practical help in accessing services. Culturally appropriate resources, such as translation services and halal food, eased his transition. Over time, he relied less on formal services, attending medical appointments with interpreters and utilizing programs for older adults. He developed friendships with both refugees and Canadian neighbors, serving as a role model by guiding others through the challenges of aging in a new country. Balancing cultural preservation with integration, Mohammad felt empowered and fulfilled, maintaining his independence while fostering community bonds. His story demonstrates how older migrants, with the right resources and support, can thrive in a new environment.
Mohammad's case exemplifies resourceful aging among older refugees, as it demonstrates how adaptability, resilience, and social connectedness can empower individuals to thrive in a new country despite initial challenges. His proactive efforts to learn the language, maintain cultural connections, and explore healthcare independently reflect an effective balance between integration and cultural preservation. Through the support of his community, culturally sensitive services, and his own determination, Mohammad managed to maintain his independence and sense of identity. His ability to adapt not only helped him age with dignity but also positioned him as a role model for others, fostering stronger community bonds and intergenerational connections.
Contrary Case
A contrary case is presented to highlight an example that opposes the model case (Walker & Avant, 2019). This case offers an alternative perspective on the concept of resourceful aging within the host country and does not present any of the concept's attributes. Bohdan, a 70-year-old immigrant from Ukraine, came to Canada hoping to find stability in her later years but faced significant challenges. Settling in Toronto with his daughter's family, he struggled to adjust. Bohdan chose not to attend language classes, which limited his ability to navigate daily life and access essential services independently. His inability to communicate in English became a major barrier, affecting both his healthcare access and social connections. Bohdan's social interactions were confined to his immediate family, as he was reluctant to engage with the broader community or make new friendships. He avoided participating in community activities, finding it difficult to trust people outside his family. While he clung to familiar Ukrainian customs, he resisted adopting aspects of Canadian culture that could have supported his adaptation. This resistance deepened his dependence on his daughter for basic needs, such as healthcare appointments and managing everyday tasks. Bohdan's refusal to use available resources and his growing isolation contributed to declining emotional well-being and a sense of helplessness. His lack of effort to integrate or connect left him feeling culturally displaced. With minimal community support and limited adaptability, Bohdan's experience of aging in Canada became defined by isolation, dependence, and missed opportunities for self-reliance.
This contrary case illustrates how a lack of adaptability, social engagement, and resourcefulness can hinder the aging process among migrants. Bohdan's experience highlights the potential pitfalls when an older immigrant fails to embrace new cultural norms, build social networks, or access available resources. Unlike resourceful aging, which encourages integration and self-reliance, Bohdan's case reveals how resistance to change and reliance on family alone can lead to isolation, dependence, and deterioration of mental health. His inability to adapt and connect with his environment undermines his sense of identity, resilience and personal agency, reinforcing the importance of proactive engagement and community support in fostering successful aging for migrants.
Borderline Case
A borderline case demonstrates a scenario where only certain attributes of the concept are evident (Walker & Avant, 2019). The following example pertains to resourceful aging within the context of a host country. Fatemah, a 65-year-old refugee from Afghanistan, arrived in Canada through the government-assisted refugee program and settled in Vancouver, hoping to age peacefully in her new home. Upon arrival, she showed some adaptability by enrolling in basic English classes. However, her progress was slow, and she often felt discouraged. While she managed to learn enough English for simple tasks such as shopping and asking for directions, she struggled with more complex interactions, such as understanding medical advice or government paperwork. Fatemah's social network was limited and was confined mainly to the local mosque and a few fellow Afghan refugees. She rarely participated in broader community activities, as her limited language skills and familiarity with Canadian culture left her feeling uncertain. While her children assisted her significantly, arranging medical appointments, interpreting at doctor visits, and helping with official documents, this support also reinforced her dependence and hindered the development of full self-sufficiency. Despite her desire for independence, Fatemah found it challenging to adapt fully and often retreated into familiar Afghan routines at home. However, she demonstrated resilience in navigating essential resources, such as housing, financial aid, and healthcare, with help from family and community organizations. Access to culturally competent services, including interpreters and halal food options, provided some comfort, but she did not actively pursue opportunities for broader integration. As a result, Fatemah's engagement with Canadian society has remained limited, with minimal social integration beyond his Afghan community. His overall quality of life was stable but not optimal, as she struggled to achieve full empowerment and independence while aging in a new country.
Fatemah's case demonstrates only a partial realization of resourceful aging. She showed some adaptability, learning basic English and managing simple tasks, but she remained largely dependent on her family for complex needs such as healthcare and paperwork. Her social connections were mostly limited to the Afghan community, contributing to isolation and minimal integration into Canadian society. Although she accessed essential resources with help, her reliance on others limited her independence and resilience. While her basic needs were met, Fatemah's quality of life could have increased with more active engagement and self-sufficiency. This borderline case highlights limited adaptation and integration.
Antecedents
Antecedents are the conditions that must occur for a concept to be fully realized, forming the foundation for attributes (Walker & Avant, 2019). For resourceful aging to occur among older migrants and refugees, certain antecedents must be present: access to basic needs and services, social and community support, cultural familiarity, legal stability, culturally competent services and intergenerational and community connectedness.
Access to Basic Needs and Services
Access to basic needs and services, such as healthcare, housing, food, and social support, is fundamental to resourceful aging among older migrants and refugees. Without access to these essential resources, older migrants and refugees are at greater risk of social isolation, poor health outcomes, and reduced quality of life (Cramm & Nieboer, 2018; Dzando et al., 2024). Healthcare access is critical for managing chronic health conditions, which are common among older adults and require ongoing medical intervention (Georgeou et al., 2023). Housing stability is equally essential, providing older migrants with a secure foundation from which to build social networks and access other resources (Owino, 2021). Programs that offer housing assistance, healthcare services, and financial support are vital for ensuring that older migrants can age successfully in their new environments (Kim, 2021). Access to preventive healthcare and mental health services is also crucial for maintaining both physical and emotional well-being, enabling older migrants to lead independent, fulfilling lives (Georgeou et al., 2023; Lachman & Agrigoroaei, 2010).
Social and Community Support
Social and community support systems are crucial antecedents of resourceful aging, providing older migrants with both emotional and practical resources to navigate their new environments. Social networks, which include family members, friends, and community organizations, are vital in helping older migrants access healthcare, housing, and social services (Chowdhury et al., 2023). These networks offer not only emotional support but also practical assistance (Baldassar & Wilding, 2020). Community organizations play a central role in providing culturally competent services that are tailored to the specific needs of older migrants and foster a sense of belonging (Georgeou et al., 2023). These organizations help reduce feelings of isolation by offering opportunities for social engagement and connection (Georgeou et al., 2023). Social and community support also enhances resilience, enabling older migrants to cope more effectively with the stresses of migration and aging (Owino, 2021). Ultimately, strong social and community support systems are key to ensuring that older migrants can successfully access the resources they need for healthy, resourceful aging (Lachman & Agrigoroaei, 2010).
Cultural Familiarity and Integration
Cultural familiarity and opportunities for integration are essential for fostering resourceful aging. Older migrants must have the opportunity to maintain a connection to their cultural identity while also engaging in the social and cultural life of their host country (Owino, 2021; Zauszniewski et al., 2006). Programs that provide language assistance, cultural activities, and support for social integration help older migrants feel secure and connected, which in turn promotes their well-being (Georgeou et al., 2023; Low et al., 2023). Maintaining cultural ties is critical for emotional stability, as familiar practices and traditions offer a sense of continuity and comfort in unfamiliar settings (Hawkins & Haapio-Kirk, 2023). Integration programs and efforts that balance cultural preservation with opportunities for social engagement promote both emotional well-being and social inclusion (Baldassar & Wilding, 2020; Khvorostianov et al., 2012; Papadimitriou et al., 2021). These programs help older migrants maintain their cultural identity while also adapting to new societal norms and expectations, fostering a sense of belonging and empowerment in the aging process (Papadimitriou et al., 2021).
Legal and Immigration Status Stability
A stable immigration status, such as permanent residency or citizenship, is a critical antecedent for older migrants and refugees to access healthcare, social services, and other essential resources (Owino & Fuller, 2023). Legal stability ensures that older adults can fully engage with their new communities without the fear of deportation or legal complications, allowing them to access necessary services and healthcare without restrictions (Hawkins & Haapio-Kirk, 2023; Owino, 2021). Programs that assist older migrants in obtaining permanent residency or citizenship play a vital role in securing access to essential services, as well as providing emotional and psychological security (Hawkins & Haapio-Kirk, 2023; Khvorostianov & Remennick, 2015; Lee & Hwang, 2014; Owino, 2021). Such programs address challenges faced by older migrants, including social and cultural isolation, language barriers, and limited access to health services, thereby increasing their quality of life and well-being (Baldassar & Wilding, 2020; Gangopadhyay, 2021). The stress of uncertain legal status can significantly impact the mental and physical health of older migrants, as many fear losing access to necessary services or being separated from their families (Owino, 2021). Stable immigration status provides a foundation for health, well-being, and social integration, allowing older migrants to focus on aging healthily rather than being preoccupied with legal concerns (Owino, 2021). Legal stability not only grants access to resources but also fosters a sense of belonging and social inclusion, which are critical for the mental and emotional well-being of older migrants and refugees as they age (Kim, 2021).
Culturally Competent Services
Culturally competent services are indispensable for fostering resourceful aging, as they bridge the gap between older migrants and refugees and the often complex healthcare and social service systems of their host countries (Georgeou et al., 2023). These services go beyond mere translation or interpretation; they involve a deep understanding of the cultural contexts, traditions, and values that shape older migrants’ experiences of aging. By integrating cultural awareness into service delivery, healthcare providers can better address the specific needs of older adults, ensuring that care is not only accessible but also respectful and responsive to cultural nuances (Chowdhury et al., 2023; Georgeou et al., 2023). This cultural competence extends to social services as well, where an appreciation for cultural practices and family dynamics can significantly enhance the efficacy of support provided to older migrants (Low et al., 2023). Without culturally competent services, older migrants may experience feelings of alienation or misunderstanding, leading to reluctance in seeking care or support, which ultimately exacerbates issues of social isolation and unmet healthcare needs (Pereira & Stagnitti, 2008). The provision of culturally appropriate services, such as healthcare systems that respect traditional healing practices or social services that accommodate cultural norms around family caregiving, fosters trust and engagement (Chowdhury et al., 2023). This trust is critical for encouraging older migrants to participate actively in their own healthcare and social integration, thereby promoting overall well-being (Cramm & Nieboer, 2018). By aligning services with the cultural identities of older migrants and refugees, host countries can ensure that these older migrants not only survive but also thrive as they age in unfamiliar environments.
Consequences
Consequences are the events or situations that can emerge after a concept becomes evident, often inspiring new insights or prompting further research associated with that concept (Walker & Avant, 2019). The following discussion explores the consequences for resourceful aging for older migrants and refugees: enhanced well-being and quality of life; promotion of social integration; reduced dependence on social services; intergenerational and community connectedness; empowerment and personal agency; and cultural identity and dignity in aging.
Enhanced Well-Being and Quality of Life
Enhanced well-being and quality of life are crucial outcomes for older migrants and refugees that can emerge from resourceful aging. Kim et al. (2016) highlighted how leisure-time physical activity plays an important role in the physical, mental, and emotional aspects of health and can instill feelings of optimism and positive emotions for older adults. Additionally, engagement in leisure-time physical activity enhances overall well-being and life satisfaction, which can help mitigate the stress of acculturation that is associated with navigating new environments (Kim et al., 2016). Similarly, Tan et al. (2010) highlighted the importance of older adults taking an active approach to managing their physical and mental health, which can lead to improved quality of life. Furthermore, by assuming personal responsibility for one's health, older adults can gain a sense of control, which can ultimately lead to independence and support well-being (Tan et al., 2010). Torres (2006) explored how access to knowledge and healthcare practices transformed older migrants’ perspectives on aging from passive acceptance to proactive health management, leading to overall improved health.
Promoting Social Integration
Promoting social integration is a key outcome of resourceful aging for older migrants and refugees and is achieved through engagement with local networks, services, and cultural exchanges (Hawkins & Haapio-Kirk, 2023). This fosters stronger relationships, reduces isolation, and enhances a sense of belonging within the host society (Owino, 2021). Phelan et al. (2004) reported that older adults perceive successful aging as a holistic experience in which social health and meaningful connections are essential. Wright (2000) emphasized that online platforms, such as SeniorNet, help older adults maintain social ties despite mobility limitations, enhancing life satisfaction through companionship networks. Active participation in social networks serves as a protective factor against isolation and depression (Hawkins & Haapio-Kirk, 2023). Engagement with community networks also fosters belonging among older adults from diverse backgrounds (Georgeou et al., 2023). Additionally, learning the host society's language enables older adults to participate in community activities and build supportive networks, reducing isolation (Hawkins et al., 2022). Pereira and Stagnitti (2008) noted that culturally relevant leisure and community-based activities help foster belonging and continuity in a new society.
Reduced Dependence on Social Services
As older migrants and refugees learn to navigate systems, they become more self-sufficient, accessing community-based support and managing their needs independently. This enhances their well-being, reduces the strain on public resources, and supports successful aging (Jang et al., 2020). Khvorostianov et al. (2012) reported that older immigrants who used the internet were able to access essential information and resources that supported their integration, aiding their adaptation within the community and fostering independence. Owino and Fuller (2023) highlighted that refugees utilize family ties and community support, which provide a foundation of care, ultimately reducing their need for formal social services. Furthermore, Owino and Fuller (2023) emphasize the role of cultural and spiritual practices for refugees, which act as alternate sources of support, thereby lowering their reliance on formal social services. Similarly, Litwin (2017) examined how various cultural groups rely on informal, community-based support systems, which can reduce the need for formal services and contribute to successful aging among older adults. Such informal support included attending social clubs, which offer older adults a broader support network beyond family and encourage independence (Litwin, 2017). Ambriz et al. (2023) underscored how working at an older age supports self-reliance and financial stability, reducing dependence on public or family resources. Finally, Lin et al. (2020) highlighted the importance of physical activity, as it can play a key role in maintaining independence in older populations.
Intergenerational and Community Connectedness
The capacity to build community relationships and act as a bridge between generations is a crucial component of resourceful aging for older migrants and refugees (Hawkins & Haapio-Kirk, 2023). In their communities and families, they serve as role models, as they adjust to new surroundings while maintaining their cultural heritage (Jetten et al., 2018). Reich et al. (2020) examined themes of social engagement and family importance in various multiethnic groups, highlighting how older adults actively work to maintain connections and provide support within their communities. Owino and Fuller (2023) highlighted that aging refugee men perceived successful aging as the ability to provide guidance or share wisdom, reflecting traditional cultural values, particularly within Burundian communities. As a result, this highlights the role that older adult refugee men play in providing guidance and helping younger generations navigate challenges in foreign environments (Owino & Fuller, 2023).
Empowerment and Personal Agency
Among older migrants and refugees, the development of greater personal resilience and empowerment are important outcomes of resourceful aging (Jetten et al., 2018). As older adults adapt to new environments and overcome challenges, they often become confident in their ability to navigate their environment independently (Jang et al., 2020). Chan and Pang (2007) highlighted how older adults acknowledge the importance of not relying solely on their children for support but rather advocated for a balanced approach from multiple support systems, fostering greater personal resilience. Nelson-Becker (2016) reported that despite some of the challenges that older adults faced, such as financial hardship or economic challenges, they were able to preserve themselves through their situation and demonstrate resilience and empowerment. Tan et al. (2010) revealed how older adult immigrants take charge of maintaining their health by being proactive in seeking medical attention, fostering empowerment and self-reliance. Finally, Nelson-Becker (2016) emphasized that for certain populations of older adults, relying on religious faith provides a source of support, demonstrating how faith-based coping fosters empowerment and personal resilience.
Cultural Identity and Dignity in Aging
The ability to preserve cultural values and traditions while navigating new environments is an important aspect of identity for older migrants and refugees (Reich et al., 2020). Zhu and Elfving-Hwang (2024) reported that, in some cultures, maintaining health and appearance through diet, exercise, and beauty practices fosters self-discipline and cultural pride, promoting successful aging. Additionally, older migrants can uphold their cultural beauty standards while adapting to their host's values, enabling balanced integration (Zhu & Elfving-Hwang, 2024). Chan and Pang (2007) conclude that some cultures value aging at home. However, older migrants and refugees who move into residential care due to necessity can still adapt and build new friendships, achieving successful integration (Chan & Pang, 2007). Baldassar and Wilding (2020) describe “digital kinning,” where older migrants use digital technologies to maintain family ties and social connections across distances. This process also supports cultural preservation by providing access to familiar media, helping migrants maintain their heritage while adapting to new environments (Baldassar & Wilding, 2020). Furthermore, digital kinning can help maintain social connections that might otherwise be threatened in the aging process due to the loss of social networks and language barriers (Baldassar & Wilding, 2020). Such social connections can enable older adults to stay engaged with family members, preserve cultural ties, and foster a sense of belonging and dignity despite long distances, thus leading to successful aging (Hartt et al., 2021). See Table 1 for an overview of the antecedents, attributes, and consequences.
Overview of Antecedents, Attributes, and Consequences
Empirical Referents
The final step in a concept analysis is identifying empirical referents, which are measurable occurrences that help quantify the concept (Walker & Avant, 2019). This step is essential for evaluating tools and frameworks that incorporate the concept. Although there are no validated scales specifically designed to measure resourceful aging among older migrants and refugees, tools exist that explore certain aspects of aging. For example, the 21-item Aging Perceptions Questionnaire–Short version (APQ-S) by Cramm and Nieboer (2018) assesses perceptions of aging, whereas theories such as acculturation theory (Ma & Xia, 2021), social cognitive theory (Winett et al., 2009), and successful aging theory (Friend, 1991) have been used to explore aging dynamics. Kim (2021) used measures such as self-rated successful aging and the Geriatric Depression Scale, whereas Ghaedi et al. (2023) employed the Successful Aging Instrument to examine physical activity, mental well-being, and life satisfaction among older women. Rainville and Mehegan (2019) utilized the Warwick-Edinburgh Mental Well-Being Scale and the Social Engagement Survey to assess a sense of purpose, mental well-being, and social engagement among older adults. The selection, optimization, and compensation model, introduced by Baltes and Baltes (1990), is another well-known framework for understanding how older adults adapt to the aging process. This model defines successful aging as an individualized process that involves three key components: selection, optimization, and compensation. While these tools are well established, they do not fully capture the complexities of resourceful aging among migrants and refugees, especially across diverse settings. This gap indicates a need for developing more nuanced instruments and frameworks that can accommodate the varied cultural, social, and individual dimensions of aging within this population. Further research is recommended to create comprehensive and adaptable measurement tools that allow for more accurate and context-sensitive evaluations.
Discussion
The concept of successful aging has evolved to encompass a multidimensional perspective, emphasizing the importance of integrating various determinants and indicators that contribute to achieving optimal health outcomes for older migrants and refugees (Rodrigues et al., 2023). We employed the Rodrigues et al. (2023) approach, as it considers the combined effects of physical and mental health, along with social well-being, emphasizing the complex interplay of demographic, biological, behavioral, psychological, and social factors in our analysis. This comprehensive multidimensional perspective informed our conceptual model of resourceful aging among migrants and refugees and its link to holistic nursing. The multidimensional framework for assessing successful aging offers valuable insights into the interconnected factors that promote well-being in older adults. Our analysis revealed that resourceful aging cannot be fully understood without considering a broad spectrum of factors, ranging from physical conditions such as mobility and chronic disease management to biochemical factors such as nutrition and overall health maintenance. Additionally, social determinants of health, including community support, cultural integration, and emotional well-being, play crucial roles in shaping aging outcomes. This comprehensive approach aligns with holistic nursing, which emphasizes treating the whole person rather than focusing solely on physical symptoms or conditions (Jasemi et al., 2017). This multidimensional approach not only informs our understanding of resourceful aging but also emphasizes its applicability within the framework of holistic nursing. By addressing the full range of physical, mental, and social needs, holistic nursing supports older migrants and refugees in achieving resourceful aging outcomes. Our conceptual definition of resourceful aging among migrants and refugees integrates these insights, promoting a more comprehensive model of care that aligns with holistic principles and encourages culturally sensitive interventions aimed at enhancing well-being across diverse populations.
Conceptual Definition
Resourceful aging among migrants and refugees is conceptually defined as “The process through which older migrants and refugees adapt to aging in a new country involves embracing changing life circumstances and utilizing available resources and support systems. This enables them to maintain well-being, personal agency, and resilience, preserving cultural heritage while adapting to new environments. By engaging with social norms, shared ideas, and practical ingenuity, they navigate aging with dignity, balancing adaptation with the preservation of identity and traditions.”
Conceptual Model Development: Resourceful Aging and Holistic Nursing Care
Linking resourceful aging with holistic nursing offers a powerful approach to supporting older migrants and refugees, as they navigate the complexities of aging in a new country. Both concepts emphasize the importance of addressing the whole person (Sassen, 2023), recognizing that well-being is interconnected across physical, emotional, social, cultural, spiritual, and self-care dimensions. The link between resourceful aging and holistic nursing lies in their shared commitment to treating the individual as a whole (Sassen, 2023), with attention to the physical, emotional, social, cultural, spiritual, and empowerment and self-care needs of older migrants and refugees.
Holistic nursing inherently aligns with the goals of resourceful aging, as it seeks to treat individuals not only on the basis of their physical health but also in terms of their broader life context, supporting their adaptability and resilience in new environments (Dossey et al., 2015; Talebi, 2023). For older migrants and refugees, aging in a foreign country can be a daunting experience filled with challenges such as adapting to unfamiliar cultural norms, managing language barriers, and maintaining a sense of identity in the face of new environments. Holistic nursing addresses these complexities by taking a whole-person approach (Sassen, 2023), ensuring that care is tailored not only to physical health needs but also to the emotional and social dimensions of aging. By focusing on the whole person, holistic nurses help older migrants build resilience, enabling them to adapt to their new circumstances while maintaining emotional stability and social connections. This comprehensive approach is particularly important for older migrants, who often face significant emotional and social challenges alongside physical health concerns.
A critical element of resourceful aging is culturally competent care, which is vital to both holistic nursing and resourceful aging. For older migrants and refugees, preserving their cultural identity is crucial to their well-being (Hussein, 2018; Jetten et al., 2018). For example, Slewa-Younan et al. (2016) concluded that training programs designed for aged care workers have proven effective in enhancing their capacity to support older refugees, equipping them with the skills to provide culturally sensitive and individualized care. When nurses provide culturally sensitive care, they acknowledge and respect the values, traditions, and beliefs that are important to their patients (Soriano et al., 2019). This not only fosters trust but also supports individuals in maintaining their cultural roots while navigating the challenges of living in a new society (Hachem et al., 2022). By understanding and incorporating elements such as religious practices, dietary preferences, and family structures into care, holistic nurses play a key role in helping older migrants maintain their dignity and identity throughout the aging process.
Equally important is the empowerment that comes from supporting self-care. Holistic nursing promotes the idea that individuals should play an active role in managing their own health (Dobarrio-Sanz et al., 2024), a concept that aligns perfectly with resourceful aging. For older migrants and refugees, this can involve navigating healthcare systems, understanding available resources, and taking steps to maintain their well-being (Jetten et al., 2018). By encouraging self-care, holistic nurses help individuals develop the confidence and knowledge necessary to manage their own health, enable patients to take an active role in managing their health, and foster resilience and adaptability (Dobarrio-Sanz et al., 2024). This empowerment is crucial for older migrants, who often face barriers to accessing care and understanding the healthcare system in their host countries (Hussein, 2018). Moreover, emotional and spiritual support are essential components of both holistic nursing and resourceful aging. Older migrants and refugees often experience trauma, dislocation, and cultural loss, which can strongly affect their emotional and spiritual well-being (Im & Neff, 2021). Holistic nursing recognizes the importance of addressing these needs, creating a compassionate environment where older migrants and refugees can express their fears, emotions, and spiritual concerns (Romem et al., 2024). This support helps strengthen emotional resilience, enabling these individuals to cope with the stresses of aging in a new country and fostering a sense of belonging and stability (Hachem et al., 2022). In summary, this integrated approach is vital in helping older migrants and refugees navigate the challenges of aging in a new environment while also preserving their identity, building resilience, and fostering empowerment. Through culturally competent, emotionally supportive, and empowering care, holistic nursing offers a pathway for older migrants and refugees to age with dignity and autonomy in their new homes. See Figure 2 for the developed model.
Resourceful aging and holistic nursing care.
Implications
The concept of resourceful aging among older migrants and refugees has significant implications for healthcare providers, holistic nursing practices, policymakers, and future research. Healthcare providers, particularly those engaged in holistic nursing, emphasize the need to adopt a whole-person approach that integrates cultural sensitivity, emotional support, and social connection into care delivery. Holistic nursing, grounded in principles of humanism and person-centered care, aligns well with resourceful aging, as it seeks to address not only physical needs but also the emotional, social, and spiritual aspects of well-being (Jasemi et al., 2017; Talebi, 2023). By recognizing the complex realities of aging in a foreign environment, nurses and other healthcare professionals can play a vital role in facilitating resilience, adaptability, and cultural preservation among older migrants and refugees (Frisch & Rabinowitsch, 2019). This could include offering culturally tailored interventions, ensuring language assistance, and collaborating with community organizations to provide comprehensive, accessible care (Dossey et al., 2015).
For policymakers, the concept of resourceful aging highlights the urgent need to develop policies that are inclusive and responsive to the diverse needs of older migrants and refugees. Policies should prioritize access to culturally competent healthcare, social services, and community programs that support resource navigation, social integration, and personal empowerment. This requires a focus on structural changes, such as increasing funding for culturally appropriate home healthcare services, expanding language access services, and training healthcare providers in culturally sensitive practices (Hartt et al., 2021). Additionally, addressing barriers to legal and immigration status stability is crucial, as it enables older adults to more easily access essential services and support systems (Hussein, 2018). By fostering environments where older migrants can maintain cultural connections while adapting to new societal norms, policymakers can promote well-being and reduce dependence on formal services.
Future research should continue to explore resourceful aging among diverse migrant and refugee groups, focusing on the effectiveness of specific interventions that promote social connectedness, resilience, and resource navigation (Ciobanu et al., 2017). Longitudinal studies that examine the evolving needs and strategies of older migrants over time could offer valuable insights into how resilience and adaptability can be sustained. Research should also investigate the role of community-based programs and holistic nursing interventions in enhancing the well-being and quality of life of older migrants, considering variations in cultural, socioeconomic, and individual contexts (Slewa-Younan et al., 2016). Further exploration of resourceful aging can inform the design of programs and policies that effectively support older migrants and refugees, ensuring that they have the tools and resources needed to age with dignity and autonomy in their new environments.
Limitations
We acknowledge that the concept of resourceful aging among migrants and refugees is multifaceted and influenced by the socioeconomic and cultural context of the host country, as well as the characteristics and readiness of the support systems available. Our aim was to explore the usage and various interpretations of resourceful aging rather than assess the quality of existing research. Given the evolving nature of this field and its interdisciplinary scope, our analysis may not encompass all dimensions of the concept, presenting opportunities for future research to further examine the contextual factors affecting resourceful aging among migrants and refugees.
Conclusion
Our work explored the complexities of the concept of resourceful aging among older migrants and refugees, using Walker and Avant's (2019) framework to identify its attributes, antecedents, and consequences and to develop a conceptual model that aligns with the core principles of holistic nursing. This analysis not only provides insights into how older migrants and refugees adapt to new environments, maintain resilience, and utilize resources but also demonstrates how holistic nursing can serve as a promising model of care for this population. By linking resourceful aging to holistic nursing, we emphasized the importance of a comprehensive, culturally sensitive approach that addresses the physical, emotional, social, and spiritual needs of older adults within host communities. Our findings revealed the nuanced dynamics of resourceful aging, highlighting how adaptability, social connectedness, and resource navigation play critical roles in supporting well-being and cultural preservation among older migrants. However, our analysis also underscores the evolving nature of this concept, particularly considering the diverse experiences and challenges faced by older adults in migration and resettlement contexts. To better support resourceful aging, further research focusing on targeted policies, culturally tailored interventions, and practice changes that can enhance quality of life and foster integration is needed. By advancing our understanding of this concept, we can better inform policy, practice, and future care models that aim to empower older migrants and refugees to age with dignity, resilience, and a sustained sense of cultural identity.
Footnotes
Author Contributions
All authors contributed to the paper’s conception, design, and manuscript development. AA led the conceptual framework, data analysis and writing the initial draft of the paper. YY assisted with data search, analysis and contributed to manuscript review and revisions. KM reviewed the paper and assisted in revising the manuscript. RR and VH assisted in data collection and analysis. All authors reviewed, provided feedback, and approved the final manuscript.
