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Living Arrangements - Relocation Effects

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There has long been concern that relocation to a nursing home may adversely affect physical and mental health due to the disruption of daily routines and connections to family and friends. Recent research has demonstrated higher mortality rates among those who have recently relocated to a nursing home, compared with persons remaining at home. This problem has been labeled relocation stress syndrome, defined as physiological or psychosocial reactions resulting from transfer from one environment to another. Symptoms include anxiety, apprehension, confusion, depression, and loneliness. Acceptance to institutionalization generally begins within six to eight weeks, and adjustment is usually complete within three to six months.

It could be argued that it is not the relocation itself that leads to a greater likelihood of mortality, but the admission of largely high-risk persons who are already near death. However, one study found that those institutionalized for reasons other than poor health also experienced an increase in mortality immediately following admission to a nursing home (Aneshensel et al., 2000), suggesting that there are factors inherent in the relocation itself that elevate the postadmission mortality rate.

There are a range of housing types available to older adults, and the factors that influence moves seem complex. Most research has focused on predictors of relocation to different geographical areas (to be closer to or with family members), or to institutions. Future research needs to explore predictors of relocation into specific housing types, such as assisted living or CCRCs. The rapid growth of the older adult population necessitates an understanding of determinants of living arrangements and its implications for the elderly.

CHRISTY M. NISHITA JON PYROOS

BIBLIOGRAPHY

AARP. Understanding Senior Housing into the Next Century: Survey of Consumer Preferences, Concerns, and Needs. Washington, D.C.: AARP, 1996.

ANESHENSEL, C. S.; PEARLIN, L. I.; LEVY, S. L.; SCHULER, R. H. "Transition from Home to Nursing Home Mortality among Persons with Dementia." Journals of Gerontology Series B 55B, no. 3: S152–S162.

Assisted Living Federation of America. The Assisted Living Industry 1999: An Overview. Fairfax, Va.: ALFA, 1999.

BEAN, F. D.; MYERS, G. C.; ANGEL, J. L.; and GALLE, O. "Geographic Concentration, Migration, and Population Redistribution of the Elderly." In Demography of Aging. Edited by L. G. Martin and S. H. Preston. Washington, D.C.: National Academy Press, 1994.

Joint Center for Housing Studies. Housing America's Seniors. Boston, Mass.: JCHS, Harvard University, 2000.

KANE, R. A., and WILSON, K. B. Assisted Living in the United States: A New Paradigm for Residential Care for Frail Older Persons? Washington, D.C.: AARP, 1993.

KRAMAROW, E. A. "The Elderly Who Live alone in the United States: Historical Perspectives on Household Change." Demography 32 (1995): 335–352.

KRAUSS, N. A., and ALTMAN, B. M. Characteristics of Nursing Home Residents 1996. Rockville, Md.: Agency for Health Care Quality and Research, 1996.

MANION, P. S., and RANTZ, M. J. "Relocation Stress Syndrome: A Comprehensive Plan for Long-term Care Admissions." Geriatric Nursing 16, no. 3 (1995): 108–112.

National Association of Home Care. World Wide Web document, 2001. www.nahc.org.

SCHAFER, R. Determinants of the Living Arrangements of the Elderly. Boston, Mass.: Joint Center for Housing Studies, Harvard University, 1999.

SILVERSTEIN, M., and ZABLOTSKY, D. L. "Health and Social Precursors of Later Life Retirement-Community Migration." Journal of Gerontology: Social Sciences 51B, no. 3 (1996): S150–S156.

SIRROCCO, A. Nursing Homes and Board and Care Homes. Hyattsville, Md.: National Center for Health Statistics, 1994.

WOLINSKI, F. D.; STUMP, T. E.; and CALLAHAN, C. M. "Does Being Placed in a Nursing Home Make You Sicker and More Likely to Die?" In Societal Mechanisms for Maintaining Competence in Old Age. Edited by S. L. Willis, K. W. Schaie, and M. Hayward. New York: Springer, 1997. Pages 94–130.

U.S. Department of Housing and Urban Development, Office of Policy Development and Research. The Challenge of Housing Security: Report to Congress on the Housing Conditions and Needs of Older Americans. Washington, D.C.: HUD, 1999.

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