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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