Relocation Stress Syndrome - Easing the Trauma of Moving the Elderly
By Don Drake, Connelly Law Offices, Ltd.
"Relocation Stress Syndrome, commonly referred to as 'transfer trauma,' is a condition that encompasses a wide range of symptoms that an individual may experience when they are forced to move from their familiar environment to a new one," said professional fiduciary and certified elder law Attorney RJ Connelly III. "These symptoms can manifest in several ways, affecting our mood, physical health, and psychological well-being. It's important to note that anyone, regardless of age, can be afflicted with this syndrome; however, it's especially concerning among older adults, as it can significantly impact their quality of life and lead to premature death. Because of this, we must take the necessary measures to mitigate the effects of Relocation Stress Syndrome, especially among our seniors."
"When it comes to older adults, this is an issue I see regularly when a property must be sold due to tax reasons, the death of a spouse, or a senior is moving into a nursing facility," continued Attorney Connelly. "Nothing is more disturbing than seeing a person's life reduced to cardboard boxes, plastic bags, and a dumpster full of property no one wants anymore. It's a sad reality that none of us who work with seniors like to witness, but it needs to be done in many cases as there are few options available."
Change is an inevitable part of life that can be challenging to navigate. Whether it's a significant life event like a divorce, a move to a new city, or starting a new job, changes can be difficult to adjust to, even when it's a choice within our control. However, the stress of change, especially when forced, can be particularly overwhelming for seniors.
With age, the body's health may begin to deteriorate, and loved ones and friends pass on, leaving seniors feeling vulnerable and alone. Then comes the harsh realization they can no longer live independently and require long-term care. The cumulative effect of these changes can be a significant source of stress and anxiety for them, making it even more essential to provide the support and assistance they need to maintain their well-being.
"I have had the unfortunate opportunity to participate in various situations like this throughout my personal and professional life," stated Attorney Connelly. "In many of these interventions, I was tasked with informing seniors of their inability to remain in their homes due to medical or cognitive issues. Witnessing the seniors packing their belongings and leaving the home for the final time was a particularly poignant experience for me. Many were unsure of what to take and left frantically searching for little trinkets that may not seem significant to others but represented wonderful memories to that individual. Although I knew that moving into long-term care was the only viable option, I couldn't help but feel sorrowful at the sight of seniors leaving their homes for the last time."
Rose's Story
Angela came to the office following her father's death and needed assistance with a decedent estate and a power of attorney. Her mother, Rose, and her father were already struggling to maintain their home since both had declining health and trouble meeting the increased taxes, utility bills, and escalating healthcare costs. With her father gone, moving her mother to a long-term care facility had to occur quickly before the winter came.
"Mom was always so calm and understanding; even when Dad suffered the stroke, she did what she could to help everyone despite her limitations," Angela told us. "But after he died, and we moved her into an assisted living program, she seemed happy and started to make friends with others, but that quickly changed. The CNAs would tell me that she started complaining about everything and anything, eventually refusing to come out of her room to join in with activities she initially appeared to enjoy."
"The nurse thought she was depressed over losing dad and felt that it would be best to keep an eye on things and offer her support throughout the day," Angela said. "But things got worse, to the point that mom was not only verbally abusive but became physically aggressive, which was never in her nature. She began to call 911 and tell the police she was being held hostage and wanted to go home."
"The doctor at the facility felt that her symptoms indicated the beginning of dementia as she was having trouble sleeping, roaming around all hours of the night, and refusing to eat," said Angela. "She was also found sitting in the hallway crying and telling the night staff she was looking for my dad in the kitchen, stating she could smell the grilled cheese he was making, something he always did when he was hungry during the night."
"I began to think that I was losing my mom too, but after meeting with my mom and the social worker, she began to open up about what was bothering her, missing her home and the things in it," stated Angela. "Mom didn't even get a chance to grieve the loss of dad before moving from familiar surroundings while also being forced to grieve the loss of her home, her way of life, and her freedom. The social worker discussed relocation stress syndrome with us, and things began to make sense. She also suggested that we include Mom in all decisions affecting her as we moved forward to give her a sense of control over her new life."
"Now, Mom is still having issues but has made progress towards accepting where she is and that she will not be going home again," said Angela. "She is eating better, and her verbal and physical acting out has stopped. She is still tearful at times, which is to be expected, but her mood has certainly improved."
Relocation Stress Syndrome
It is common for seniors to experience relocation stress syndrome when they move to a new location. This syndrome can manifest itself in numerous ways, and its symptoms may not be immediately apparent. Some seniors may exhibit subtle changes, while others may display more noticeable symptoms such as personality, health, or disposition changes.
It is vital for family members and those assisting with senior relocations to be aware of the signs of relocation stress syndrome. These signs may include feelings of anger, anxiety, apprehension, confusion, dependency, depression, insecurity, loneliness, and withdrawal. For some seniors, the feelings of confusion and anxiety can lead to an increased risk of falls, self-care deficits, and weight loss. It is essential to monitor seniors for these symptoms and provide appropriate support and care to help them adjust to their new surroundings.
"During my decades of working with seniors, I have seen that relocation stress syndrome can occur before, during, or after an environmental change," said Attorney Connelly. "And much like PTSD, it can arise months after the event. In the case of Rose, she exhibited verbal and physical aggression, but most cases I have seen involved withdrawal, depression, refusing medications, and poor personal hygiene."
It can also include physiological symptoms, including those that mimic dementia. Even more distressing, some may use alcohol or drugs to cope with their out-of-control emotions, leading to an entirely separate set of problems.
When a Move is Necessary
Attorney Connelly suggests keeping elders in their homes may seem like the ideal choice, but not always. The pandemic lockdown has shown that living alone can also have negative consequences, such as an increase in depression and substance abuse among this population. So, in cases where a move is necessary, he recommends considering these specific actions that could be helpful:
Involve Them in the Process
When it comes to finding a long-term care facility for a senior family member, it is recommended to involve them in the search process if possible. This approach gives them a say in their future living arrangements and has resulted in more positive outcomes. By participating in the decision-making process, seniors are more likely to feel empowered and in control, leading to a smoother transition and a better overall experience. Therefore, if time allows, it is advisable to include the senior in the search for a suitable long-term care facility.
Keep the Experience Positive
When searching for information or completing a task with someone who experiences cognitive difficulties, it can be difficult to keep them engaged in the process. In such situations, identify and concentrate on their strengths to create a positive experience. When they have trouble understanding something, offer encouragement and help them ask questions. Provide clear and direct answers to their queries and be supportive throughout the task. This approach can help build trust and establish a sense of comfort, making a challenging time less daunting for everyone concerned.
Meet With the Staff
When considering a new location for your loved one, scheduling a meeting with the staff at the new destination is essential. During this meeting, you can discuss your loved one's unique strengths and challenges, which will help the staff better plan for the move and find ways to address relocation stress. By taking the time to have these discussions, you can ensure that your loved one's coping levels are considered during the transition to their new home.
Have a Family Meeting
If possible, involve other family members and friends in decision-making when considering a move. This can allow the senior to share their thoughts and feelings with others who may offer a new perspective on the issue at hand. However, it's vital to ensure these individuals support the move. Otherwise, you could end up in a situation where you're facing an unnecessary battle that benefits no one and leads to unnecessary stress.
Make it Familiar
To create a comforting and familiar atmosphere in your loved one's new living space, it's recommended to incorporate as many personal belongings as possible. This can include old pictures, cherished figurines, and any other items that hold sentimental value. As they settle in and adjust to the new surroundings, you may find it helpful to gradually replace some of these old items with newer ones. This can be a collaborative process with the help of other family members, allowing them to gradually transition to a new collection of cherished possessions in their new home.
Seek Support
If your loved one is required to move due to sudden and unforeseeable medical trauma or personal loss, it is highly recommended that family members seek the guidance of a social worker or therapist. They can provide valuable advice on managing and alleviating any relocation stress that may arise from the situation. It is important to prepare your loved one mentally and emotionally for the move; seeking professional help can make the process smoother and more manageable.
"Leaving behind a home that holds countless memories can be an incredibly emotional experience, even if you have the best planning and support from family and friends," said Attorney Connelly. "To make the process a little easier, spend quality time with your loved one as they pack their belongings. Take the opportunity to reminisce about the good times and allow yourself to laugh and cry with them. It's also important to let your loved one decide who will receive some of their precious mementos and what items they would like to donate to those less fortunate. This can provide a sense of closure, accomplishment, and comfort during a difficult time."
"I also strongly emphasize the significance of pre-planning and having a well-crafted estate plan in place," Attorney Connelly continued. "While relocating can be an emotionally overwhelming experience, a comprehensive estate plan can help alleviate some of its stress areas. To be clear, an estate plan cannot fill the emotional void caused by relocation but can provide a sense of security and some peace of mind during the transitional period."
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