Comparison study: the impact of on-site comprehensive service access on self-reported health and functional status of older adults

"Home Is Where My Couch Is": The Role of Possessions in the Process of Moving and Adjusting to Continuing Care Retirement Communities

We examined the role of possessions in the process of moving and adjusting to continuing care retirement communities (CCRCs). Totally, 59 CCRC residents in 12 CCRCs were interviewed. We categorized three main types of residents: "I want it all," "I want it that way," and "I want to break free." Each type experienced differently the role that objects play in (a) the reasons for moving, (b) choosing a CCRC and a specific apartment, (c) organizing one's belongings in preparation for relocation, and (d) adjusting to the new apartment. Most residents were attached to their belongings and reported having great difficulty leaving them behind. Our findings suggest that while older adults should be given every possible opportunity to make their own choices about their belongings, it is also necessary to balance between the desire to maintain continuity with their past, and the limited space of a CCRC apartment.

Should I've stayed or should I've gone? What residents of continuing care retirement communities and former candidates think and feel one year after their decision: a quantitative longitudinal comparison

The aim of this study was to compare satisfaction with residence, wellbeing and physical health of continuing care retirement community (CCRC) residents with people who considered enrolling in the same CCRCs but elected not to move. A total of 101 participants were recruited from 13 CCRCs located in multiple cities in the United States of America. A phone interview was conducted with participants three months or less from enrolment and one year later. Compared with those who chose not to move, CCRC residents reported lower satisfaction at baseline, but higher satisfaction at one year. Wellbeing declined from baseline to follow-up for both groups, but was higher in CCRC residents both at baseline and at one year. CCRCs might consider giving new residents a longer cancellation period in order to allow sufficient time for the adjustment process. This, in turn, might both prevent an early departure and affect the decision of potential CCRC residents to move into the community.

Health and medical services use: a matched case comparison between CCRC residents and national health and retirement study samples

Little is known about the health status of adults living in continuing care retirement communities (CCRC). Using matched-case control, 458 adults from the Health and Retirement Study (HRS) or a CCRC-based sample were compared on total comorbidity, self-rated health, home health services use, and hospitalizations. At year 2, the CCRC sample reported more comorbidities (96%) but significantly better self-rated health (96% good/excellent) than the HRS sample (93% comorbidity, 73% good/excellent; p < .01). There were no significant differences in frequency of home health use or hospitalization. Living in a CCRC appears to be associated with higher self-ratings of health in this sample.

Factors associated with permanent transition from independent living to nursing home in a continuing care retirement community

OBJECTIVE

Identify risk factors for and time to permanent transition from independent living units to nursing home among residents in a continuing care retirement community (CCRC).

METHODS

Prospective cohort study (n=298) among residents at least 75 years of age living independently at baseline. Proportional hazard regression identified risk factors associated with permanent transition from sociodemographic and health status data.

RESULTS

During the 3-year follow-up, 11% of the subjects were permanently transferred. Predictive factors were depression (relative risk [RR] 3.9; 95% CI 1.5-9.8), incontinence (RR 3.8; 95% CI 1.3-11.4), impaired cognition (RR 3.6; 95% CI 1.1-11.3), and dependence on activities of daily living disability (RR 1.5; 95% CI 1.3-1.8). Compared with those with no risk factors, presence of all 4 increased the relative risk to 74-fold and shortened the time to permanent transition by 32 months.

CONCLUSION

Prevention and treatment for depression, incontinence, and programs to improve or maintain cognitive function and ability to perform activities of daily living among CCRC residents may prolong their independent living life.