Tuesday, May 19, 2020

Relocation Needs of Frail Older Adults


Every relocation situation is unique for older adults, according to Canadian researchers Roy, Dube, Depres, Freitas, and Legare (2018).  Frail older adults face unique challenges as they lose independence and the ability to safely live in their own homes. They are often unable to make an informed decision without the help of social workers, case managers, family, friends, and relocation experts. Frailty is not inevitable in old age. However, frail older adults are at risk of losing autonomy and independence due to catastrophic health declines and repeated falls. Frailty indicators include diminished strength, exhaustion, weakness, weight loss, slow walking speed, and low levels of physical activity (Xue, 2011).  

While health care and social work professionals have a wide array of expertise and experience on relocating seniors in frail health, what are their prioritized needs? Instead of recruiting participants to ask them their relocation preferences, Roy and her team of researchers carefully examined and critically analyzed 86 previous scholarly studies related to relocation. [The study did not include studies related to “aging in place,” which is a limitation. Most older adults wish to remain in their own homes. Nonetheless, every scholarly endeavor has identified limitations and that challenges further studies on the topic with an expanded scope.] Known as a “systematic literature review,” this qualitative methodology was appropriate for determining the relocation needs and preferences from a databank of global English-language published journals from several disciplines (Roy et al., 2018).

Six categories of housing decisions were prioritized using a wheel to identify factors from most important to least important.  The most important identified elements influencing housing decisions among frail older adults included
Social Dimensions: Proximity of services, opinion of health professionals, social network, social activities, the proximity of siblings, and relationship to the neighborhood.
Psychological and Psychosocial Dimension: Independence, comfort, control, and personal identity.
Built and Natural Environment: Proximity of services, potential adaptability, adapted dwelling, and convenient dwelling.
Time and Space-Time Dimension: Familiarity, routine, maintenance, domestic activities, and triggering event.
Economic Dimension: Housing market, investment, tenure status [renter or owner].
Socioeconomic and Health Dimension: No elements in this category fell within the most important category” (Roy et al., 2018, p. 22).

It is compelling that most planners and experts assume the most important elements in frail older adults making relocation decisions are related to health status and socioeconomic factors.  However, this study suggests that is not so. It is a multidisciplinary and multidimensional decision with comprehensive relevant factors. Because frail older adults risk losing their autonomy, we are challenged with adapting buildings and communities to accommodate them using a holistic approach. They have indicated their preferences.  Let's put their preferences into action. 

References:
Roy, N., Dube, R., Depres, C., Freitas, A., & Legare, F. (2018) Choosing between staying at home or moving: A systematic review of factors influencing housing decisions among frail older adults. PLoS ONE 13(1): e0189266. 

Xue Q. L. (2011). The frailty syndrome: definition and natural history. Clinics in geriatric medicine, 27(1), 1–15. https://doi.org/10.1016/j.cger.2010.08.009




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