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The Realities of Relocation Stress

 May 2014

Nan Hayes for Caring Transitions®

As seniors remodel their family home to age-in-place or downsize to an independent living, assisted living, or other community setting, they often feel displaced, disoriented, or even depressed. Senior care professionals have an increasing responsibility to learn how to support older adults as they face these transitions, so seniors may experience changes to environment with less stress, more respect and meaningful rites of life passage.

On a scale of 1 to 10

Moving in late life is associated with a great deal of stress. These stress factors may have a negative impact on the decision-making ability and the general health of older adults. Most of us have moved at least once and can understand the complexities of organizing, downsizing, packing, and moving. Yet, for older adults, moving is not only complicated, it is one of the most stressful events in their lives.

According to the widely accepted Holmes-Rahe Social Readjustment Rating Scale, or the “Stress Scale” as it is more commonly known, “moving,” or “relocation,” is not even listed among the top 40 most stressful life events. But when the Stress Scale is adjusted for senior adults, “Move to nursing/retirement home” is not only in the top 40, but it is in the top 5. This type of move falls third on the list, preceded only by “Death of a spouse” and “Divorce. For older adults this would indicate that anxiety associated with moving is greater even than the death of a friend or a family member, greater than the loss of social identity, and more traumatic than the loss of financial stability.

Relocation Stress Syndrome

Symptoms of stress associated with changes in environment are specific enough that in 1992 the North American Nursing Diagnosis Association (NANDA) added Relocation Stress Syndrome (RSS) as an official diagnosis.

The “cluster” of diagnoses that characterize RSS include loneliness, depression, apprehension, anxiety, anger, and in older adults, increased confusion. The greatest incidences of RSS occur just before and during a three-month period following relocation. In addition, to determine if a patient is “at risk for RSS” medical professionals evaluate the following as the transition occurs: changes in eating habits and sleeping patterns, demonstration of dependency, changes in cognition, insecurity or lack of trust, decline in self-care, and change in relationship with family members. Risk of RSS increases if there is (1) little or no time to prepare for an impending move; (2) a lack of predictability about the new environment; and (3) little or no time between notification to move and the move itself.

So what can be done?

Mitigating the Symptoms of Stress

Family members can be aware of the symptoms above and take steps to help address their loved ones’ stress level. It is most commonly acknowledged that stress may be reduced when a subject is allowed to gain sense of control over the stressful situation, so it is important to provide older adults the ability to make decisions about their own changing lifestyle. They should be encouraged to state their opinion and participate in the process and given advance notification of pending changes.

As with any major relocation, individuals are better able to navigate and adjust to late life transitions when they receive 3 phases of adequate support before, during and after the big event. The professional Caring Transitions® network was established solely to provide these three levels of support to consumers.

On the front end, Caring Transitions helps families and individuals downsize/organize and develop a to-scale floor plan to ensure what will fit into the new home. Then they provide all the necessary support and resources to help move a relocation forward. During the move process, Caring Transitions contributes project management, move management and oversight skills to make sure the relocation runs smoothly; once again reducing the amount of stress families would experience without such support. And finally, Caring Transitions unpacks and settles clients comfortably into their new home, aiding in the last important steps of a successful transition. Any personal property or furnishings that are left behind are quickly and efficiently liquidated through a professional Caring Transitions Estate Sale or Online Auction. All services are provided directly by vetted, insured, industry certified owners and employees.

The Future

Through newer studies scientists continue to debate whether or not RSS is an actual syndrome or simply a combination of observable symptoms. But even as their additional research is conducted, we must recognize that a change in home environment does have a significant impact on older adults and their sense of place in the world. So often, a late life relocation is complicated by other factors including personal loss, health issues, financial and family matters; making it even more important for families, housing professionals and caregivers to try and reduce stress and lend a sense of support, control and dignity to the home transition process.

©2014 Caring Transitions. All rights reserved. (The above contains excerpt from the Society of Certified Senior Advisors Journal #51, originally authored by Nan Hayes.