Disease Diagnosis and Decline: Anticipatory Relocations of Older Americans
Physical and cognitive changes in older adulthood can occur in acute instances like a stroke, or advance over time. Within these contexts of change, housing concerns often come to the forefront. When older adults receive diagnosis of a debilitating and/or progressive disease, e.g. Multiple Sclerosis, older adults may assess the suitability of their housing and choose to relocate (Song-Lee and Chen, 2009). Some may choose to relocate because family support is not longer sufficient for present and future health care needs (Litwak and Longino, 1987). Others move because they perceived community-based services to be unable to address their needs (Tang and Pickard, 2008). Gardner (1994) argues that personal rather than structural factors--like education, occupation or income level--predict transitions. For many older Americans, current health needs and the ambiguity of disease progression are major factors in the timing of their moves.
Interviews, participant observation and document review were conducted with over 75 older adults, their kin and retirement community professionals from the mid-western United States, Michigan, at different stages of moving between 2009-2012. The three stages were pre-move planning, move in-process, and post-move adjustment. Older persons were recruited if they were moving through snowball sampling techniques from community contacts. Each primary participant was asked to identify his/her kin who are most involved in the move. Many of the kin were adult children of the older adult who is moving, as adult children are more likely than other kin to provide assistance to older adults (Wolff and Kasper, 2006).
This paper will present case studies of “anticipatory” relocations of older adults. Research findings show 1) older adults move as a reaction to their own disease progression and projected mortality and 2) older adults move as a result of their partner’s disease progression and/or expected death. The findings show the deliberate strategies they undertake to plan ahead. Findings also demonstrate challenges that older adults with progressive diseases moving to senior housing communities encounter.
Conclusion and Implications:
This research contributes to the relocation literature, particularly as relocation intersects the health and well-being of older adults. Rather than relocation contributing to declining health, as suggested in other studies, such as Golant 1998, this study finds declining health prompting relocation for some study participants. Older adults voluntarily move as a strategic approach to to optimize their lives (Baltes and Baltes, 1990). This ethnographic study offers an unprecedented glimpse into the experience of older adults facing such illnesses. First, social workers, working with older adult clients on relocation decisions, need to understand how acute and chronic and/or progressive health concerns apply to the selection of housing, and timing of relocations. Second, social workers working in long-term care need to understand ways disease diagnoses affect the post-move experiences of residents. Third, social workers need to develop more effective interventions to facilitate interactions and acceptance of persons with varying diagnoses.