Individuals take an active role in realizing well-being and aim to enhance their life situation by optimizing the universal goals of physical and social well-being [
52‐
56]. Frail older people often experience a decline in reserves and resources in multiple domains, e.g. health status, loss of mobility, cognitive functioning, and social activities. This implies that well-being of older people in particular is more likely to be negatively affected by decaying reserve-capacities that otherwise may compensate sufficiently for these losses in resources. Their cognitions and behaviors may foster (or hamper) productive patient-professional interactions and allow them to regulate their resources and cope with or avoid losses in order to protect their well-being [
57]. Moreover, the degree to which chronic conditions are controlled and outcomes are achieved depends partly on the effectiveness of frail older people’s behavioral and cognitive self-management abilities. It is therefore considered essential to involve patients in their own care process [
58]. Empowered patients that are effective self-managers are better equipped to control chronic conditions and to positively influence outcomes [
59]. Key cognitive and behavioral abilities for managing resources for well-being identified earlier are (i) taking initiatives, (ii) investing in resources for benefits in the longer-term, (iii) maintaining a variety in resources, (iv) warranting multifunctionality of resources, (v) self-efficaciously managing resources, and (vi) keeping a positive frame of mind [
57,
60]. These identified key self-management abilities include relevant cognitions, i.e. self-efficacy beliefs and a positive frame of mind, which advance the ability to take action. These cognitive processes are essential for both coping with losses and (pro)actively managing resources. A positive frame of mind refers to the ability to maintain positive expectations for the future, even in adversity. Self-efficacy beliefs, i.e. the belief in one’s own ability to successfully interact with the environment and pursue goals, are important for the performance of many behaviors [
57]. For example, low self-efficacy can lead people to believe they lack the ability to effectively perform a certain behavior that brings desired outcomes, which in turn may result in not engaging in that behavior [
61]. At later stages of life, self-efficacy beliefs may be declined by, for example, physical disabilities and experiences of loss [
57]. These cognitions are relevant but not sufficient. Although a person may have a strong sense of efficacy, he or she needs to perform the particular behavior to achieve desired outcomes. Therefore, Steverink and colleagues [
57] underline the importance of active-motivational processes with respect to managing resources, i.e. taking initiative and investment behavior [
57]. As a result of a decline in reserves and resources, there may be a loss of autonomy and an increase in dependency in old age [
62]. It is suggested that taking the initiative regarding relevant resources in contrast to being passive or dependent is important to attain or maintain well-being. Moreover, investment behavior is assumed to be important in realizing or maintaining well-being as investing in key resources is considered relevant for stability in resources. In addition to cognitions and active-motivational processes, resource-combining processes are presumed relevant, which include realizing multifunctionality of resources and a variety in resources [
57]. Important for realizing well-being are resources that meet various dimensions of well-being at the same time in a mutually reinforcing way, for example, activities serving both social and physical well-being [
63,
64]. In addition, a variety in resources is assumed to be of importance and refers to having multiple resources to realize a particular aspect of well-being. Resource-combining processes can create buffers against a loss of well-being [
64]. Thus, these key cognitive and behavioral abilities are considered most essential in managing losses adequately and managing resources effectively to realize, maintain or improve well-being [
57]. In addition to this, strengthening cognitive and behavioral abilities among frail older people is expected to lead to more productive patient-professional interaction, which in turn is expected to improve the well-being of frail older people [
46,
51]. For productive patient-professional interaction to occur, patients need to be informed (equipped with adequate information in order to become proactive partners and effective decision makers in the care process) and activated (understanding the significance of sharing information and the importance of their own role in the care process) [
51].