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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.



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