In this article, the author reviews 78 studies addressing the relocation of the elderly. He begins by defining the four major forms of relocation and describing the trends in the current health care marketplace precipitating relocation events. Next, he reviews the major findings of studies assessing the potential negative and positive outcomes of relocation. These outcomes include changes in mortality rates, morbidity, and psychological or social changes. In addition, factors associated with successful relocation are presented. Finally, the primary contribution of this article is that the author assesses the strengths and limitations of this prior literature and combines the research he reviews in an analytic model. This model helps show some opportunities for future research in the relocation of the elderly.
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References
1.
Aldrich, C. , and E. Mendkoff. 1963. Relocation of the aged and disabled: A mortality study. Journal of the American Geriatrics Society11:185-194.
2.
Aleksandrowicz, D.1961. Fire and its aftermath on a geriatric ward. Bulletin of the Menninger Clinic25:23-32.
3.
Amenta, M. , A. Weiner, and D. Amenta. 1984. Successful relocation. Geriatric Nursing (November/December): 356-360.
4.
American Association of Homes and Services for the Aging . 1996. Closed nursing homes. Washington, DC: American Association of Homes and Services for the Aging.
5.
Beaver, M. L.1979. The decision-making process and its relationship to relocation adjustment in old people. The Gerontologist19:567-574.
6.
Blackmun, J.1980. Concurring opinion on O’Bannon vs. Town Court. United States Supreme Court ruling delivered June 23, 1980. United States Law Week48:101-105.
7.
Borup, J.1982. The effects of varying degrees of inter-institutional environmental change on long-term care patients. The Gerontologist22:409-417.
8.
Borup, J. . 1983. Relocation mortality research: Assessment, reply, and a need to refocus on the issues. The Gerontologist23:235-242.
9.
Borup, J. , and D. Gallego. 1981. Mortality affected by interinstitutional relocation: Update and assessment. The Gerontologist21:8-16.
10.
Borup, J. , D. Gallego, and P. Heffernan. 1980. Relocation: Its effect on health functioning and mortality. The Gerontologist20:468-479.
11.
Borup, J. H.1979. Relocation and its effect on mortality. The Gerontologist19 (2): 167-172.
12.
Borup, J. H. . 1981. Relocation process: Stress, attitudes, informational network and problems encountered. The Gerontologist21:501-511.
13.
Bourestom, N. , and L. Pastalan. 1981. The effects of relocation on the elderly: A reply to Borup, Gallego, and Heffernan. The Gerontologist21:4-7.
14.
Bourestom, N. , and S. Tars. 1974. Alterations in the patterns following nursing home relocations. The Gerontologist14:506-510.
15.
Brand, F. N. , and R. T. Smith. 1974. Life adjustments and relocation of the elderly. Journal of Gerontology29:336-340.
16.
Brody, E. , M. Kleban, and M. Moss. 1974. Measuring the impact of change. The Gerontologist14:299-305.
17.
Brugler, C. , M. Titus, and J. Nypaver. 1993. Relocation stress syndrome. Journal of Nursing Administration23 (1): 45-50.
18.
Burnette, K.1986. Relocation and the elderly: Changing perspectives. Journal of Gerontological Nursing12:6-11.
19.
Carp, F. M.1974. Short-term and long-term predictors of adjustment to a new environment. Journal of Gerontology29:444-453.
20.
Carsrud, A. L. , K. B. Carsrud, D. P. Henderson, C. J. Alisch, and A. V. Fowler. 1979. Effects of social and environmental change on institutionalized mentally retarded persons: The relocation syndrome considered. American Journal of Mental Deficiency84:266-272.
21.
Castle, N. G.1997. Replaced by fish. Journal of Long-Term Care Administration (December): 10-11, 24-25.
22.
Castle, N. G. , and V. Mor. 1996. Resident transfers from nursing homes to hospitals: A review of the literature 1980-1995. Medical Care Research and Review53 (2): 123-148.
23.
Chanfreau, D. , J. M. Deadman, H. George, and K. E. Taylor. 1990. Transfer of long-stay psychiatric patients: A preliminary report of inter-institutional relocation. British Journal of Clinical Psychology29:59-69.
24.
Chenitz, W. C.1983. Entry into a nursing home as status passage: A theory to guide nursing practice. Geriatric Nursing (March/April): 92-97.
25.
Coffman, T. L.1981. Relocation and survival of institutionalized aged: A reexamination of the evidence. The Gerontologist21:483-500.
26.
Cohen, E. S.1981. Legal issues in “transfer trauma” and their impact. The Gerontologist21:520-522.
27.
Cohen, E. S. . 1986. Legislative and educational alternatives to a judicial remedy for the transfer trauma dilemma. American Journal of Law and Medicine114:405-432.
28.
Cohen, E. S. , and S. W. Poulshock. 1977. Societal response to mass dislocation of the elderly. The Gerontologist17:262-267.
29.
Cohen, H. , J. W. Conroy, D.W.S. Frazer, G. E. Snelbecker, and S. Spreat. 1977. Behavioral effects of interinstitutional relocation of mentally retarded residents. American Journal of Mental Deficiency82:12-18.
30.
Csank, J. , and J. Zweig. 1980. Relative mortality of chronically ill geriatric patients with organic brain damage, before and after relocation. Journal of the American Geriatrics Society28 (2): 76-83.
31.
Danermark, B. , and M. Ekstrom. 1990. Relocation and health effects on the elderly: A commented research review. Journal of Sociology and Social Welfare17:25-49.
32.
Davis, R. E. , J. A. Thorson, and J. H. Copenhaver. 1990. Effects of a forced institutional relocation on the mortality and morbidity of nursing home residents. Psychology Reports671:263-266.
33.
Densen, P. M.1987. The elderly and the health care system: Another perspective. The Milbank Quarterly654:614-638.
34.
Downey, G. W.1974. Must a transfer order be a death sentence for SNF patents?Modern Healthcare3:44-47.
35.
Everard, K. , G. Rowles, and D. High. 1994. Nursing home room changes: Toward a decision-making model. The Gerontologist344:520-527.
36.
Friedman, S. M. , J. D. Williamson, B. H. Lee, M. A. Ankrom, S. D. Ryan, and S. J. Denman. 1995. Increased fall rates in nursing home residents after relocation to a new facility. Journal of the American Geriatric Society43 (11): 1237-1242.
37.
Gass, K. , G. Gaustad, M. Oberst, and S. Hughes. 1992. Relocation appraisal, functional independence, morale, and health of nursing home residents. Issues in Mental Health Nursing13:239-253.
38.
Gillick, M. , and K. Steel. 1983. Referrals from long-term care to acute facilities. Journal of the American Geriatrics Society31: 74-78.
39.
Goldberg, G.1973. Moving a geriatric hospital. Hospitals47 (15): 57-59.
40.
Gordon, W. Z. , R. L. Kane, and R. Rothenberg. 1985. Acute hospitalization in a home for the aged. Journal of the American Geriatrics Society33:519-523.
41.
Grant, P. , R. Skinkle, and G. Lipps. 1992. The impact of interinstitutional relocation on nursing home residents requiring a high level of care. The Gerontologist32 (6): 834-842.
42.
Grant, P. R.1985a. Predictors of the level of care assigned to new nursing home residents. Canadian Journal on Aging4:38-46.
43.
Grant, P. R. . 1985b. Who experiences the move into a nursing home as stressful? Examination of the relocation stress hypothesis using archival, time series data. Canadian Journal on Aging4:87-100.
44.
Grey, C.1978. Moving 137 elderly residents to a new facility. Gerontological Nursing4: 34-38.
45.
Gutman, G. M. , and C. P. Herbert. 1976. Mortality rates among relocated extended-care patients. Journal of Gerontology31:352-357.
46.
Haddad, L.1981. Intra-institutional relocation: Measured impact on geriatric patients. Journal of the American Geriatrics Society29:86-88.
47.
Harrington, C. , and H. Carrillo. 1999. The regulation and enforcement of federal nursing home standards, 1991-1997. Medical Care Research and Review564:471-494.
48.
Hasselkus, R.1978. Relocation stress and the elderly. The American Journal of Occupational Therapy (November/December): 631-636.
49.
Isler, C.1975. Reducing the risk in relocating the elderly, RN38:48-51.
50.
Jasnau, K. F.1967. Individualized versus mass transfer of nonpsychotic geriatric patients from mental hospitals to nursing homes with special reference to the death rate. Journal of the American Geriatrics Society15:280-284.
51.
Kasl, S.1972. Physical and mental health effects of involuntary relocation and institutionalization on the elderly—A review. American Journal of Public Health62:377-383.
52.
Kasl, S. V. , A. M. Ostfeld, G. M. Brody, L. Snell, and C. A. Price. 1980. Effects of “involuntary” relocation on the health and behavior of the elderly. In S. G. Haynes and M. Feinleib (Eds.), Second Conference on the Epidemiology of Aging. US Department of Health and Human Services, NIH Publication No. 80-969.
53.
Killian, E. C.1970. Effect of geriatric transfers on mortality rates. Social Work15:10-26.
54.
King, K. , M. Demond, and K. McCance. 1987. Coping with relocation. Geriatric Nursing8:258-260.
55.
Knepper, K.1996. Involuntary transfers and discharges of nursing home residents under federal and state laws. The Journal of Legal Medicine17:215-275.
56.
Kowalski, N.1981. Institutional relocation: Current programs and applied approaches. The Gerontologist21:512-519.
57.
Kowalski, N. C.1978. Fire at a home for the aged: A study of short-term mortality following dislocation of elderly residents. Journal of Gerontology33:601-602.
58.
Lawton, M. P. , and J. Cohen. 1974. The generality of housing impact on the well-being of older people. Journal of Gerontology29:194-204.
59.
Lawton, M. P. , and S. Yaffe. 1970. Mortality, morbidity, and voluntary change in residence by older people. Journal of the American Geriatric Society18:823-831.
60.
Lentz, R. , and G. Paul. 1971. “Routine” vs. “therapeutic” transfer to chronic mental patients. Archives of General Psychiatry25:187-191.
61.
Lieberman, M. A.1961. Relationship of mortality rates to entrance to a home for the aged. Geriatrics16:515-519.
62.
Locker, R. , and A. Rubin. 1974. Clinical aspects of facilitating relocation. The Gerontologist14:295-299.
63.
Markson, E. W. , and J. H. Cumming. 1974. A strategy of necessary mass transfer and its impact on patient mortality. Journal of Gerontology29: 315-321.
64.
Markson, E. W. , and J. H. Cumming. 1975. The post-transfer fate of relocated mental patients in New York. The Gerontologist15:104-108.
65.
Markus, E. , M. Blenkner, M. Bloom, and T. Downs. 1971. The impact of relocation upon mortality rates of institutionalized aged persons. Journal of Gerontology26:537-541.
66.
Markus, E. , M. Blenkner, M. Bloom, and T. Downs. 1972. Some factors and their association with post-relocation mortality among institutionalized aged persons. Journal of Gerontology27:376-382.
67.
Marlowe, R. A.1973. Paper presented at the Annual Meeting of Gerontological Society, Puerto Rico. Geriatric Focus12 (no. 31).
68.
McConnel, C. E.1984. A note on the lifetime risk of nursing home residency. The Gerontologist24 (2): 193-198.
69.
Mikhail, M.1992. Psychological response to relocation to a nursing home. Journal of Gerontological Nursing18:35-39.
70.
Mor, V. , S. Sherwood, and C. Gutkin. 1986. A national study of residential care for the aged. The Gerontologist26:405-417.
71.
Morris, J. N.1975. Changes in morale experienced by elderly institutional applicants along the institutional path. The Gerontologist15:345-349.
72.
Mullen, E.1978. Relocation of the elderly: Implications for nursing. Journal of Gerontological Nursing34:13-16.
73.
Nirenberg, T.1983. Relocation of institutional elderly. Journal of Consulting and Clinical Psychology51:693-701.
74.
Nypaver, J. , M. Titus, and C. Brugler, C.1996. Patient transfer to rehabilitation: Just another move?Rehabilitation Nursing212:94-97.
75.
Ogren, E. H. , and M. W. Linn. 1971. Male nursing home patients: Relocation and mortality. Journal of the American Geriatric Society19:229-239.
76.
On-line Survey Certification of Automated Records. 1996. Arlington, VA: Health Care Financing Administration.
77.
Pablo, R.1977. Intra-institutional relocation: Its impact on long-term care patients. The Gerontologist17:426-435.
78.
Patnaik, B. , M. P. Lawton, M. M. Kleban, and R. Maxwell. 1974. Behavioral adaptation to the change in institutional residence. The Gerontologist14:305-307.
79.
Percy, C. H.1974. The need for redefinition of long-term care facilities. The Congressional Record, 30 July: 25693-25705.
80.
Petrou, M. , and J. Obenchain. 1987. Reducing incidents of illness postransfer. Geriatric Nursing18:35-39.
81.
Pino, C. , L. Rosica, and T. Carter. 1978. The differential effects of relocation on nursing home patients. The Gerontologist18:167-172.
82.
Potter, R. , and M. Berger. 1974. Moving long-term patients. Social Work19:359.
83.
Pruncho, R. , and N. Resch. 1988. Institutional relocation: Mortality effects. The Gerontologist28:311-317.
84.
Pruncho, R. , and N. Resch. 1989. The context of change: Disorientation following intra-institutional relocation. Journal of Applied Gerontology8:465-480.
85.
Raasoch, J. , R. Willmuth, L. Thomson, and R. Hyde. 1977. Intra-hospital transfer: Effects on chronically ill psychogeriatric patients. Journal of the American Geriatric Society25:281-284.
86.
Rantz, M. , and K. Egan. 1987. Reducing death from translocation syndrome. American Journal of Nursing87:1351-1352.
87.
Rogers, J. C. , M. R. Stuart, P. Sheffield, D. E. Swee, and P. Formica. 1990. Functional health status of relocated nursing home residents. Journal of American Board of Family Practice33:157-162.
88.
Roslaniec, A. , and J. J. Fitzpatrick. 1979. Changes in mental status in older adults with four days of hospitalization. Research in Nursing and Health2:177-187.
89.
Rosswurm, M.1983. Relocation and the elderly. Journal of Gerontological Nursing9:632-637.
90.
Rowland, K.1977. Environmental events predicting death for the elderly. Psychological Bulletin84:349-372.
91.
Schulz, R. , and G. Brenner. 1977. Relocation of the aged: A review and theoretical analysis. Journal of Gerontology32 (3): 323-333.
92.
Shamian, J. , A. M. Clarfield, and J. Maclean. 1984. A randomized trial of intra-hospital relocation of geriatric patients in a tertiary-care teaching hospital. Journal of the American Geriatrics Society32:794-800.
93.
Shaughnessy, P. W. , and A. M. Kramer. 1990. The increased needs of patients in nursing homes and patients receiving home health care. New England Journal of Medicine322:21-27.
94.
Silverstone, B. M. , and C. Kirschner. 1974. Elderly residents’ reaction to enforced relocation during a hospital strike. The Gerontologist14:71, abstract.
95.
Smith, R. T. , and F. N. Brand. 1975. Effects of enforced relocation on life adjustment in a nursing home. International Journal of Aging and Human Development6:249-259.
96.
Storandt, M. , and I. Wittels. 1975. Maintenance of function in relocation of community-dwelling older adults. Journal of Gerontology30:608-612.
97.
Tickle, E.1993. The relationship of health care experience to satisfactory relocation in long-term care. Nursing Connections6 (4): 13-24.
98.
Watson, C. G. , and H. R. Buerkle. 1976. Involuntary transfer as a cause of medical hospitalization in geriatric neuropsychiatric patients. Journal of the American Geriatrics Society24:278-282.
99.
Weinstock, A. , P. Wulkan, C. J. Colon, J. Coleman, and S. Goncalves. 1979. Stress inoculation and interinstitutional transfer of mentally retarded individuals. American Journal of Mental Deficiency83:385-390.
100.
Weinstock, C. , and R. Bennett. 1971. From “waiting on the list” to becoming a “newcomer” and an “old-timer” in a home for the aged, and its impact upon cognitive functioning. Aging and Human Development2:46-58.
101.
Wells, L. , and G. Macdonald. 1981. Interpersonal networks and post-relocation adjustment of the institutionalized elderly. The Gerontologist21:177-183.
102.
Wittels, I. , and J. Botwinick. 1974. Survival in relocation. Journal of Gerontology29:440-443.
103.
Wolanin, M.1978. Relocation of the elderly. Journal of Gerontological Nursing43:47-50.
104.
Yawney, B. A. , and D. L. Slover. 1973. Relocation of the elderly. Social Work18:86-95.
105.
Zweig, J. , and J. Csank. 1975. Effects of relocation on chronically ill geriatric patients of a medical unit: Mortality rates. Journal of the American Geriatric Society23:132-136.
106.
Zweig, J. , and J. Csank. 1976. Mortality fluctuations among chronically ill medical geriatric patients as an indicator of stress before and after relocation. Journal of the American Geriatric Society26:264-277.
