272 Grief and Loss Across the Lifespan
continuity. Moving from one home to another is nearly always difficult, but
for older adults who have lived in a home for many years, a move to a new
location can be traumatic even when it is to a more comfortable, safer home
(Hooyman & Kiyak, 2008).
A survey by the AARP in 2005, found that 95% of those over age 75
desired to stay in their homes, and even at age 50, about 89% expressed
that preference (Hooyman & Kiyak, 2008). They wanted to stay in their
homes due to familiarity, close neighbors, and a sense of control of the
known (Hooyman & Kiyak, 2008). Family and friends may question older
adults who do not want to leave a large home that is too difficult to navi-
gate or where repairs are numerous. Nevertheless, families and caregivers
need to recognize the home as symbolic of the elder’s identity and sense of
safety (Hooyman & Kiyak, 2008). Despite such losses, possible benefits of
a move for older adults include finding a situation that provides needed
stimulation from others and involvement in daily activities of value to older
adults who had limited outlets for hobbies and other recreational interests.
Consideration of the gains and losses involved in a move should be part of
preparation for relocating.
When older people need to move to an assisted living facility due to
chronic illness or disability, the adjustment is made more difficult by little
time for preparation. When severe or sudden disability requires a move to
a nursing home, older people may feel even more distraught. It is impor-
tant to examine the close relationship between self-identity and home when
elders move to long-term care facilities. This sort of move threatens person-
hood, and communities that provide ways to maintain control and mark-
ers of individuality are likely to offer the easiest adjustment (Rubinstein &
Medeiros, 2005).
Regardless of the nature of the move, many older adults experience
feelings of sadness and loss when giving up a familiar setting and many of
their possessions. This is a maturational loss that can be experienced as dis-
enfranchised by the older adult when family and friends do not understand
their feelings. They must dispose of a lifetime of possessions to which power-
ful memories attach, increasing the feelings of loss associated with a move
(Hooyman & Kyak, 2008). When moving an older adult to a nursing home, it is
wise for family members and/or caregivers to help the adult select a few spe-
cial possessions that can function much like a “transitional object” for a young
child. Older adults can feel soothed by having specific pieces of furniture or
smaller objects that hold special meaning.
The death rate for nursing home residents is estimated to be over
300 times higher than community rates (Djivre, Levin, Schinke, & Porter,
2012). Residents must cope with “living with dying” on a regular basis and
facilities should incorporate palliative principles, such as support for griev-
ers, caregivers, and friends of the deceased (Djivre et al., 2012). Professionals,
researchers, and residents should collaborate to discover ways to human-
ize care and revise traditions, rules, and training for managing the deaths
of residents. Residential staff must compassionately recognize and respect
residents’ grief after other residents’ deaths and must also recognize the
anxiety surviving residents feel due to the reminder of the imminence of
their own demise.