Paper
Saturday, July 16, 2005
The Effects of Involuntary Interinstitutional Relocation on the Physical, Social, and Cognitive Functioning of Older Individuals
Ann Marie Laughlin, RN, BSN, MS, School of Nursing, Creighton University, Omaha, NE, USA and Tina Miller, BSN, MSN, Creighton University School of Nursing, Omaha, NE, USA.
Learning Objective #1: Identify the effects involuntary interinstitutional relocation has on the older individual |
Learning Objective #2: Discuss strategies health care providers can implement to minimize any deleterious effects associated with involuntary relocation |
Relocation can be disruptive to any individual, but for the elderly person, this can often be a traumatic event, one that can alter the quantity and quality of life. The investigation of this study occurred when a home closed suddenly, forcing the relocation of residents. The purpose of this study was to determine if the process of involuntary relocation had an effect on those relocated. A mixed methods design was utilized and consisted of four parts: mortality statistics; instrumentation; chart reviews; and case studies. Mortality rates, investigated for one year after relocation, were significantly higher when compared to a control group. Nine individuals completed the Dementia Quality of Life Tool, Geriatric Depression Scale, Lubben Social Support Network Scale, and UCLA Loneliness Scale. Mean scores on the sub scales for quality of life all decreased after relocation, however, scores on the geriatric depression scale improved after relocation. Chart reviews (25) consisted of obtaining data from the Minimum Data Set upon initial admission and 3, 6, 9, and 12 months after relocation. Data obtained related to cognitive abilities, mood, and physical functioning. Mean scores were lower at every point in time when compared to the scores pre-relocation, indicating an improvement in these areas of functioning. Case studies were completed on family members and residents who had experienced relocation. A taped interview was conducted and key questions were used to initiate discussion. Four themes were identified: perceptions of care, powerlessness, sense of loss, and anger. Findings from this study suggest that health care providers need to allow individuals as many choices as possible, thereby providing them with a sense of control in the event of relocation. In addition, assessing an individual's attitude toward the move, their strengths, and concerns is vital in order to facilitate adjustment to the new environment.