Relocating to another home is difficult for anyone, but it is more taxing for the elderly. While for most adults who move houses, it’s just a matter of time before they can adjust to their new residence and neighborhood. For seniors, however, transferring from one place to another can take a toll on their mental, emotional, and physical well-being. And, the effects of the relocation can linger on for many years.
While aging in place is certainly possible, it is not always a viable option for all elderly adults. So, moving from their house to a retirement home or from one assisted living facility to another nursing home becomes necessary.
But because of their aging bodies, complicated medical conditions, and desire to remain in the house they’ve lived in for many years, relocating becomes really distressing for them. Many old adults share this experience known by many names, including transfer trauma, moving anxiety, and relocation stress syndrome.
What is Relocation Stress Syndrome?
First called “transfer trauma” in the 1960s, relocation stress syndrome (RSS) was a more clinical term that became an official diagnosis of the North American Nursing Diagnosis Association (now NANDA International) in 1992.
Today, relocation stress syndrome is defined by the organization as “a state in which an individual experiences confusion and difficulty in adjusting to a new environment as a result of relocation.”
The condition is associated with a range of symptoms, and can affect anyone who is transferring houses. However, it affects people differently, depending on many factors, and hits older adults more particularly.
The following individuals are more prone to experiencing relocation stress syndrome than others:
- Women,
- Widows,
- Individuals with cognitive impairments, such as dementia and Alzheimer’s disease,
- Individuals with limitations getting around independently,
- Individuals living alone, struggling with routine home maintenance, or feeling unsafe in the home environment,
- Residents in long-term care facilities, especially those who need to relocation for one reason or another, and
- Individuals with little or no family support system.
Mental Health Effects of Relocation Stress Syndrome
Relocation stress syndrome can affect seniors in many different ways, i.e., there is a broad spectrum of symptoms that come with the condition. This can include cognitive decline, psychological distress, withdrawal from social activities, increased depression, and even pre-mature death.
Symptoms will depend on an older adult’s health status, experiences, coping skills, and how they interpret the transfer. Their response to the move will largely depend on whether they view it as a loss, harm, threat, or challenge.
Among the mental health effects of relocation stress syndrome include the following:
Confusion
Being in a new environment, older adults might have a hard time understanding the situation or adjusting to their new home.
Stress and anxiety
It doesn’t matter if a senior has cognitive impairment or not. When it comes to relocating from one home to another, the elderly population perceive the experience as stressful. A senior’s stress level increases when they have an emotional attachment to their home or if they value their independence.
Sleep disturbances
It’s common to have trouble sleeping, especially when you just moved to a new place. In older adults, this further worsens their feelings of distress.
Depression
Research suggests that seniors become prone to depression when they transfer from one residence to another, especially within the first year after their move.
“Residents also go through a grieving process of missing their more familiar home, and such grief can worsen mental symptoms,” Dr. Gary Small, chair of psychiatry at Hackensack University Medical Center in New Jersey, told U.S. News & World Report.
These transitions frequently come with mood changes, tearfulness, and withdrawal from social activities, among other symptoms of depression.
Changes in appetite
Another depression-like symptom that comes with moving is a change in appetite.
Lucille (Lucy) Trent was a resident at Mountain View Regional Hospital in Norton, Virginia, where she lived “exceptionally well” for around four years. During her stay in the facility, she would often sit by the communal TV and drink bottles of Coca-Cola. She only had to call out “Hello?” and a staff member at the nursing home would get her another Coke. “It was her thing,” her daughter Kim Meade told AARP (formerly the American Association of Retired Persons).
However, after relocating to another facility, Lucy’s appetite plummeted. It became increasingly difficult for staff to get her to eat or drink anything—not even her favorite Coke. Bottles of the soft drink remained full after a month of her transfer.
“It got to a point where she wouldn’t eat anything at all,” Meade says. “She just started to look through me.”
About three months later, the 94-year-old died. Officially, her death was attributed to chronic obstructive pulmonary disease, but her daughter knew that the relocation played a key part to her mother’s premature death.
Shorter life expectancy
Unexpected and involuntary relocation can cause severe symptoms that increase morbidity and the risk of premature death. A sad but true example of this scenario is what happened to the residents of Mountain View.
In July 2022, the 44-bed nursing home told its 20 long-term residents of its impending closure for “excess capacity.” They had until April 2023 to relocate to their new homes, but all residents were out by mid-September 2022.
A resident named Betty Artrip was transferred to a 97-bed facility, but the relocation caused her to become anxious, confused, and fearful. “It was almost like a depression came over her,” her son Jerry told AARP. After just around five weeks, the 93-year-old died.
Seven other Mountain View residents died less than three months after their moves, and three more died less than six months after their transfers. Of the 18 residents who were relocated (two died before their move), only seven survived as of December 2023.
“If we had one or two [residents] pass away a year, that was a lot to us,” Misty Mullins, who worked as a certified nursing assistant at Mountain View for almost a decade, told AARP. “The move was killing people.”