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Rebecca Hoch lay on the floor of her apartment, her left leg twisted beneath her and her right leg broken. She knew it was broken because she could see shards of her femur piercing the skin above her right knee.

“Keep still,” she told herself. “You'll make it worse by moving.”

She was 94 years old, and she had been sitting in her apartment at the Terraces of Baycrest, a Toronto retirement home. When she stood up to go to her afternoon poetry class, her leg gave out. The Terraces gives all residents a “lifeline” alert button to wear in case of such an emergency, but Mrs. Hoch had taken hers off – she didn't like the way it felt around her neck.

She yelled for help until she was hoarse, but no one heard her through the heavy fire door. Finally, two hours later, a neighbour heard her cries.

Now 96 and in a wheelchair, Mrs. Hoch winces when she remembers the fall – not because of the pain, which she says was not too bad, but because the paramedics cut off one of her favourite outfits, a navy skirt with six buttons and a beige blouse with a blue floral pattern that her daughter-in-law bought for her in Israel.

“I loved that blouse,” she sighs.

The fact that Mrs. Hoch is alive to mourn her lost clothing is remarkable. Not many 94-year-olds could survive such a brutal fall. Even fewer would battle through rehab to get out of hospital, then through a nursing home and return to independent living at the Terraces. But Mrs. Hoch has done it, with help from a home health aide and by the grace of her own determination.

What drives some people to fight back against illness and recover from loss, while others simply fade away? Where does someone like Mrs. Hoch, who looks so frail in her wheelchair, find the strength and the resilience to keep going?

“I'll never give up,” she declares in her native Scottish burr. “Hope springs eternal – even if it's just for another hour, you hope to live. It's within you.”

We all know we're going to die some day. Most of us think of that day, if we do at all, as way off in the misty future.

But when you're staring down your 10th decade, death is a daily reality.

At the Terraces, the administration announces deaths on white slips of paper that are distributed to everyone's mailboxes: “It is with sadness that I inform you of the passing of …” Residents open the familiar notes with a combination of curiosity and dread, wondering who it will be this time. Last winter, they got so many of the little slips that some complained of death-notice fatigue.

Lawrence Sandy, a 93-year-old with a resonant voice and a flair for the dramatic, says the notes make him sad, but he moves on quickly.

“It sorta gets you down for a minute or two, but it disappears very fast. Life goes on,” he says. “It happened to them, it'll happen to us, too. You go to bed at night and you're grateful when the morning is another day.”

Mr. Sandy devised a strategy to protect his positive attitude. When he says hello to people he never asks, “How are you?” He doesn't want to get trapped listening to someone moan about their prostate or their indigestion, he says. So instead, he greets everyone with a jaunty, “You're looking great!”

If residents dwelt on every death and illness, the retirement home would be an unbearably gloomy place. But they don't, and it's not. Death stalks the hallways, but less like the grim reaper and more like a pesky, familiar visitor – unwelcome, but not terrifying.

Death is “unbelievable, it's unthinkable,” says Ruth Hanff, 94, a Terraces resident for eight years. “But the older you get, the more acquainted you become with it. The more acquainted you become, the less terrible it seems to be.”

Residents in this retirement home are, by definition, survivors. Whether it's good luck, good genes or good decisions, something has kept them alive and relatively healthy for this long. They didn't perish in car crashes in their teens, succumb to heart attacks in midlife, or die from cancer in their 60s.

But fate isn't the only force keeping them going.

“People with a positive attitude really cope better,” Terraces program director Sheila Smyth says. “That makes a huge difference.”

A 2001 study of 180 U.S. nuns found that positive emotions in their writing samples strongly predicted who would live the longest. Those who expressed the most positive emotions outlived the negative nuns by an average of 6.9 years.

That doesn't mean you have to plaster on a Pollyanna smile or die. A positive attitude can take surprisingly different forms. Steely determination, the will to make the best of whatever hand you're dealt in life, even a touch of cantankerousness – these are traits that predict a long life.

“It helps to be feisty. The person who tends to do well is the squeaky wheel. The little old lady who is very timid and passive … tends to get left in a corner and forgotten about,” says Michael McBryde, medical director for residential care at B.C.'s Fraser Health.

Mrs. Hanff, for one, thinks happiness isn't everything.

“You cannot always be happy, happy, happy,” she says. “I want an even keel, contentment.”

Mrs. Hanff, who is Jewish, fled Nazi Germany and settled in Chile before immigrating to Canada. She suffers from profound hearing loss, is frustrated by her physical slowness and says she sometimes feels alone. But she takes comfort in having a few close friends, enjoys her children and she likes watching the Food Network and CNN on her “idiot box. … “I am not bitter – I'm grateful. Life is a gift from God.”

At first impression, Mrs. Hoch's resilience is nearly obscured by her fierce self-criticism.

She apologizes for the humbleness of her apartment, the slowness of her wheelchair, even the state of her hairdo.

She sheds no tears for herself, but her eyes well up when she mentions her sister, who is 94 and losing her memory.

“It should be me. … She's everything, I'm nothing,” she says firmly. “I'm stupid. If I were clever, I wouldn't be so fat.”

For the record, Mrs. Hoch is not fat – or stupid.

Self-esteem was not a popular concept when Mrs. Hoch was growing up in Glasgow in the 1910s. Back then, pride was a sin, not a virtue, and children were expected to be obedient and hardworking – not the precious, brilliant stars of their parents' universe. Mrs. Hoch excels at finding beauty everywhere, but almost never finds it in herself.

Rather than holding her back, self-criticism seems to spur her forward. That fire inside keeps her going.

“Self-esteem has been highly overrated,” Dr. McBryde says. Someone like Mrs. Hoch may not see herself as special, but her strong attitude has kept her alive through injuries and illnesses that have felled many others.

“She has a great desire to keep living, and that is much more important in this context than self-esteem,” Dr. McBryde says.

Residents of the Terraces must contend with other losses besides death. Mrs. Hoch is grateful for her wheelchair, but she gets impatient, too. Sometimes when she's jockeying back and forth for 10 minutes just so she can reach a book on the shelf, she feels like screaming with frustration. “I could just jump out of my skin sometimes,” she says.

The woman who hitchhiked alone from Glasgow to London in her youth now lives a life governed by a pair of support hose, which keep her circulation going. Once a home health aide takes off the tight knee socks in the early evening, Mrs. Hoch has to keep her feet up, effectively confining her to her room at night.

But her curiosity for life always seems to outweigh, for her, the indignities that accompany living into old age. She reads voraciously and attends poetry class whenever she's able. Her face lights up when she recalls how she recited Address to a Haggis on Robbie Burns Day, last January.

At night, she lies in her twin bed and watches the cars on Highway 401 below; they look like shooting stars to her. Sometimes she tries to remember the names of everyone who has died during her time at the Terraces.

Mrs. Hoch believes in God or some omniscient being, but her thoughts on the afterlife are vague. She doesn't think she'll be reunited with her husband and three best friends, all dead now – heaven is not some sort of celestial meet-and-greet, she says – though she would love to see her father, who died at age 53, once more.

Trapped in her wheelchair, she says she knows one thing for certain: When you die, “your soul soars.”

But for now, she can wait.

***

In their own words

Residents of the Terraces of Baycrest on life, love, and living in a retirement home

“[Growing old] is just like growing up. It happens so gradually, there are no surprises. One day you might have a pain in your knee, the next you don't. It's just a gradual thing. I always thought I'd be very sophisticated at 30 – I'm still waiting.” – Jean Goldstein, 86“I don't want to die, but by the same token if it happens, it happens. If it's game over, I've had one helluva life.”

– Seymour Hersch, 77

“I look around here and I say, gee, I'm maybe going to be like that in a couple years. Looking ahead to having to use a walker and waiting for the bus to come. You have to be fatalistic about these things.” – Bernard Rubin, 81

“You don't really get a chance to say goodbye [to friends who die]. You see them in the dining room and then you don't see them one day. … It's just part of life. You can't do anything about it.”

– Milton Goldstein, 87

“You go to bed at night and you're grateful when the morning is another day. It's a day-to-day existence when you get 93; you never know.”

– Lawrence Sandy, 93

“A big problem here is I'm the only man who shows up at meetings. The men let the women run this place. They're all Hillary Clintons.”

– Mr. Sandy

“My wife and I get along. … You have your arguments, but never go to bed angry. Before you go to bed, always be sure you kiss each other.”

– Mr. Sandy (married 67 years

to Kay)

“I don't have any great desire to get married again unless I meet an 18-year-old with money who owns a liquor store.”

– Mr. Hersch

“My friends, some didn't like to come here [to the Terraces]. It's not a pleasure to see so many people in wheelchairs. Some people don't like to be reminded of their own vulnerability.”

– Ruth Hanff, 94

“Young people think today they will always stay young. Nobody stays young. Women want to stay young forever. One woman who is sitting at my [lunch] table, she looks like a clown painted. Some people can't make peace with it.”

– Mrs. Hanff