Meaning-making processes among older adults with life-limiting conditions: an integrative review

OBJECTIVES: Examine how older adults with life-limiting conditions engage in meaning-making for coping and growth, and how individual needs and attributes shape these processes. METHOD: An integrative review across health and psychosocial disciplines was conducted, incorporating qualitative, quantitative, mixed-method, and theoretical literature. Fifty-eight peer-reviewed records were analysed using reflexive thematic analysis. RESULTS: Four interrelated themes were identified: (1) adjusting global meaning (e.g. core beliefs and purpose) helped buffer distress by aligning it with situational meaning. (2) Disrupted life trajectories compressed time for meaning-making; distress, rumination, and cognitive rigidity impeded integration, while social comparison and reminiscence supported adaptation. (3) Reminiscence, motivated by awareness of life's finitude, supported identity continuity and psychological conflict resolution, though unresolved regrets could evoke existential distress. (4) Meaning-making was temporally integrative, connecting past experiences, present awareness, and anticipated futures; strategies such as positive reframing, acceptance, and legacy-making fostered coherence and hope. CONCLUSION: Meaning-making in older adults with life-limiting conditions is a dynamic, temporally integrative process shaped by cognitive flexibility and adaptive strategies. Significant gaps remain, including limited research on cognitive decline, theoretical inconsistency, and poorly understood intervention mechanisms, which must be addressed to support quality of life, meaning-in-life, and dignity in later life.