Residential mobility according to health status in South Korea's largest metropolitan city during the COVID-19 pandemic using generalized estimating equations for longitudinal data

This study examines whether residential mobility differed according to health status in Seoul, the largest metropolitan city in South Korea, during the COVID-19 pandemic. Before the COVID-19 pandemic, people who moved had better health status in the baseline year than those who did not. However, during the pandemic, the residential mobility of people with poor health status increased, particularly in 2019-2020. This pattern appeared to be driven by the 55-74 age group. The effect of health status on residential mobility was not attenuated, even after adjusting for covariates at multiple levels.

Aging in climate change: Unpacking residential mobility and changes of social determinants of health in southern United States

The southern coastal states of the United States are susceptible to extreme weather and climate events. With growing move-in and -out older populations in the region, health implications of their residential mobility lack sufficient knowledge. Using 126,352 person-level records from 2012 to 2021, we examined geospatial and temporal patterns of older populations' residential mobility, considering the changing social determinants of health and disparities. We found the moves of older populations with socioeconomic or health disadvantages were related to increased exposure to environmental hazards and reduced access to health resources. The findings inform targeted strategies for climate adaptation that address the needs of vulnerable aging populations.

Do Health and Housing Attributes Motivate Residential Moves Among Older Chinese Adults? Evidence From an 8‑Year Follow‑up Study

Background and Objectives

Despite the widespread belief in aging-in-place as the preferred housing arrangement for older adults, they are increasingly embracing moving. The person-environment fit theory explains that environmental changes due to residential moves can pose health risks, discouraging older people from moving. However, it also suggests that moves may be suitable when living conditions no longer meet their physical needs. The correlation between older people's health, housing, and their subsequent moving or staying actions in China remains underexplored.

Research Design and Methods

Using alternative operating variables of key concepts and the China Family Panel Studies 2012-2018 data sets, this study examines the effects of health and housing status on older people's residential moves in China. The study outlines changes in health indicators and housing characteristics during multiple moves, as well as examines the relationship between the health and housing status of older adults and moving over a relatively long period of time using both regression models with lagged explanatory variables and fixed effects binary choice models.

Results

The results reveal that: (1) higher rates of subsequent moves were observed among older adults with better self-rated health, positive self-rated health changes, and no ADL impairment, but no significant associations were found between most health variables and moving; and (2) the correlation between older persons' house ownership/type and their residential moves was significant and consistent over time, steady and lasting.

Discussion and Implications

Potential mechanisms explaining the association between specific housing types and ownership statuses on moving are discussed. The findings encourage a focus on the positive benefits of moving in later life and how to provide additional housing options for older individuals.

Ageing in place or stuck in place: Preferred care setting for community-dwelling older persons in a low-resource country in Sub Saharan Africa

BACKGROUND

Ageing in Place is the emerging social policy drive for long-term care coordination of older persons globally. This decision may be the only viable option in many low- and middle-income countries like Nigeria. Nevertheless, the risk of older persons being 'stuck in place' is high if their preferences are not considered or other alternatives are neither acceptable nor available. This study determined factors associated with the preferred care setting among community-dwelling older persons and explored their views about their choices.

METHODS

The study utilised a mixed-methods approach. Participants were older persons (≥ 60 years) in a selected rural and urban community in Oyo State, south-western Nigeria. Quantitative data were collected using an interviewer-administered, semi-structured questionnaire and analysed using Stata version 14 at p<0.05. Qualitative data collection involved 22 Focus Group Discussions (FGD). The discussions were audiotaped, transcribed verbatim and analysed thematically using ATLAS.ti version 8. Selected quotations were used to illustrate themes.

RESULTS

1,180 participants (588 rural vs 592 urban) were interviewed with a mean age of 73.2 ±9.3 years. More rural participants preferred to AIP (61.6%) compared to urban participants (39.2%), p = 0.001. Factors associated with the decision for rural participants were older age [OR:2.07 (95%CI:1.37-3.14)], being male [OR:2.41(95%CI:1.53-3.81)] and having assistance at home [OR:1.79 (95%CI:1.15-2.79)]. In comparison, significant factors for urban participants were older age (≥70years) [OR:1.54(95%CI:1.03-2.31)] and home-ownership [OR:5.83 (95%CI:3.82-8.91)]. The FGD revealed that the traditional expectation of reciprocity of care mostly influenced the desire to AIP. Advantages include improved social connectedness, quality of care, community participation and reduced isolation. Interestingly, participants were not opposed to the option of institutional care.

CONCLUSION

Ageing in place is preferred and influenced by advanced age and home ownership in our setting. Information provided could guide age-friendly housing policies and community-based programmes for the care of older persons.

Loneliness and Off-Topic Verbosity Among Young Adults and Older Adults

OBJECTIVES

Off-topic verbosity (OTV) refers to prolonged speech that derails from the initial conversational topic by including more loosely associated speech and becoming increasingly more unfocused and distant from the initial topic. Previous research has suggested that, among older adults, loneliness may be associated with greater OTV. The purpose of this study was to investigate the nature of the relationship between loneliness and OTV among young adults (n = 62) and older adults (n = 80).

METHODS

Participants completed a measure of loneliness and provided speech samples, which were transcribed and rated for OTV.

RESULTS

Results indicated some relationship between loneliness and tangentiality of speech, particularly among older adults.

DISCUSSION

Overall, loneliness may be associated with greater OTV in older adults, which could further explain the connection between increased loneliness and worse health outcomes in older adulthood.

Characteristics of movers and predictors of residential mobility in the Atherosclerosis Risk in Communities (ARIC) cohort

Current efforts to characterize movers and identify predictors of moving have been limited. We used the ARIC cohort to characterize non-movers, short-distance movers, and long-distance movers, and employed best subset algorithms to identify important predictors of moving, including interactions between characteristics. Short- and long-distance movers were notably different from non-movers, and important predictors of moving differed based on the distance of the residential move. Importantly, systematic inclusion of interaction terms enhanced model fit and was substantively meaningful. This work has important implications for epidemiologic studies of contextual exposures and those treating residential mobility as an exposure.

Understanding Aging in Place: Home and Community Features, Perceived Age-Friendliness of Community, and Intention Toward Aging in Place

BACKGROUND AND OBJECTIVES

Promoting age-friendliness of communities and supporting aging in place (AIP) are of great importance. Based on processes of belonging and agency, which suggest that person-environment interactions influence residents' evaluations and behaviors related to the environment, this study aims to examine the interrelationship between the availability of age-friendly features, perceived age-friendliness of community, and intention toward AIP.

RESEARCH DESIGN AND METHODS

This study used the 2015 AARP Age-Friendly Community Survey, which includes 66 home and neighborhood features under the eight domains specified by the WHO's Age-Friendly Cities Guidelines. A series of regression and mediational analyses were conducted to test hypotheses.

RESULTS

Overall, a greater availability of age-friendly features was positively associated with perceived age-friendliness of community and AIP intention. The relationship between age-friendly features and AIP intention was mediated by perceived age-friendliness of community (50.3% to 96% of the total effects). When perceived age-friendliness of community was introduced to models, the direct effects of housing, outdoor spaces and buildings, and transportation domains remained significant.

DISCUSSION AND IMPLICATIONS

Findings suggest that a greater availability of age-friendly features influences older adults' perception on their community, leading to the development of a desire to age-in-place, supporting processes of belonging and agency. Domains of housing, outdoor spaces and buildings, and transportation may be the most important features in promoting age-friendliness of community and the key determinants of aging in place. Policy makers and practitioners may need to prioritize promoting age-friendly built environment before social environment in building age-friendly communities.

Older People’s Preferences for Housing and Environment Characteristics

Population ageing presents significant challenges for many countries, one of which is the provision of adequate housing. Developing understanding of the needs and preferences of ageing societies will be crucial in order to assist in the provision of suitable housing and communities that are sustainable in the long term. While a preference to ‘age in place’ is clear in the literature, comparatively less academic research is available on older people’s preferences for more specific housing and environment attributes. The aim of this study is to identify the main housing and environment characteristics that are linked to the health and wellbeing of the elderly and determine the preferences for such characteristics via a survey with UK residents aged 55+. The results indicate a strong preference for independent living and an increasing desire for bungalows in later life. Housing conditions, energy efficiency, thermal comfort, and home adaptions to facilitate ageing in place are particularly important housing characteristics to older people. The location and environment are also key drivers of housing preferences; a safe neighbourhood, accessibility to amenities, public transport, and a clean and walkable environment are particularly important. Preferences varied with age, but gender has a less significant impact on the preferences expressed. The findings of this study will be valuable for stakeholders engaged in housing policy and provision for older people.

Mobility-based disadvantage in older age: insecure housing and the risks of moving house

This paper develops knowledge of the logistics of moving house amongst older people living in insecure housing. These people typically do not move once and settle into a new house, but face ongoing moves driven by factors including housing affordability, tenure conditions and eviction. The paper identifies four domains of experience faced by people undergoing cumulative, involuntary residential moves: the material (process of relocating oneself and possessions), economic (costs of moving house), embodied (physical experience) and affective (how relocation is experienced and felt). The logistics of relocation are examined through the experiences of single older women living in insecure housing in the greater Sydney region of Australia. The accounts of these women foreground the costs and challenges of insecure housing that are a consequence of relocation. Conceptually this work contributes to understandings of mobility-based disadvantage in older age through drawing out the ways that the logistics of moving house – of relocating oneself and possessions – contribute in distinct ways to mobility-based disadvantage through risks to identity and senses of home. Empirically it addresses gaps in gerontological and housing scholarship through developing knowledge of the logistics and experiences of ongoing, involuntary residential moves.

Residential Reasoning and the Tug of the Fourth Age

Purpose of the Study

Where to grow older occupies the minds of many aging adults. This study examines how anticipation of the fourth age influences third-age residential reasoning. It also investigates the role of social relationships in choosing housing for later life.

Design and Methods

Analyses were based on semi-structured interviews with 30 community-dwelling retirees aged 67-97 who were asked about preparations for the future, including housing.

Results

Replies about future housing fell into two categories: preemptive and contingent. In preemptive reasoning, participants anticipated that their current homes would be suitable over the long term and explained why, while those engaged in contingent reasoning could imagine a possible future move to more supportive housing and even had destination places in mind. Both types of responses reflect residential reasoning that is ongoing and driven in large part by anticipation of fourth-age vulnerabilities. Peers influenced participants' thinking about whether, when, and where to move. Relationships with spouses and offspring were also factors commonly mentioned in residential reasoning, both in terms of sources of support and perceived obligations.

Implications

The fourth age is generally conceived as an experience of loss, but it also functions as a social imaginary. Our study suggests that the fourth age, both as a potential personal destiny and a social construct, influences housing decisions among those firmly in the third age. More attention in housing research to prudential anticipation of the fourth age as well as the relational aspects of residential reasoning would enhance understanding of late-life housing choices.

Patterns of changing residential preferences during late adulthood

Earlier research on residential mobility has demonstrated a tendency for the young old of the 55+ population to prefer peripheral locations, whereas older age groups choose central locations. Here, we present survey results indicating that such late-adulthood differences in preferences are supported by age-related shifts corresponding to differences in housing preferences expressed by individuals in peripheral as well as central locations in Sweden. A sample of 2,400 individuals aged 55 years and over was asked to select the seven most important characteristics of a dwelling from a list of 21 alternatives (Survey of Housing Intentions among the ELDerly in Sweden (SHIELD), 2013). The preferences expressed were used as dependent variables in logistic regressions to determine to what extent the housing preferences of older people are linked to age, gender, socio-economic status and type of geographical area. The results demonstrated a close link between neighbourhood characteristics and housing preferences. Owning the dwelling, having a garden and access to nature were stressed as important by individuals living in non-metropolitan middle-class areas and in suburban elite areas. The youngest cohort expressed similar preferences. Older age groups instead stressed the importance of an elevator, single-storey housing and a good design for independent living; preferences that have similarities to those expressed by individuals living in large cities and smaller urban centres where such housing is more readily available.

A market-oriented model for the independent-living retirement village industry

Purpose

As the “baby boomer” generation continues to enter their senior post-retirement years, the provision of affordable retirement housing has become increasingly important for the community, practitioners and policymakers. However, relatively little attention has to date been placed on identifying an effective market mechanism for the industry of the independent-living retirement villages to meet this increased and unprecedented demand. This study aims to develop an innovative and affordable retirement village development model which meets the needs of all stakeholders including seniors, retirement village residents, the retirement village industry and government.

Design/methodology/approach

The attributes of this study are as follows: structure of individual living units, retirement village characteristics, retirement village facilities and services and support mechanisms. The analysis was undertaken based on data relating to independent-living retirement villages in five Australian states. A hedonic pricing model was used where the price distributions relating to these four aspects were estimated.

Findings

The results confirmed the structures of the independent living units and the retirement village characteristics were closely related to pricing, followed by services and supports with a lesser relationship, although the facilities were not significantly related to pricing.

Research limitations/implications

This research is not able to address the entire retirement village market in Australia because the available market data are limited.

Practical implications

This research uses an innovative supply-side approach to assess retirement village attributes and values, which provides stakeholders with up-to-date market information to assist in guiding the performance of the retirement village industry.

Social implications

The market evaluations imply that seniors are reluctant to pay for village attributes that are not regarded as highly sought-after. A cost-effective strategy of new retirement village developments and upgrades can be further induced, which in turn can enhance the market efficiency and affordability of the retirement villages.

Originality/value

This pricing model for retirement village units extends previous studies into retirement villages and presents stakeholders with an innovative and reliable market-oriented model.

Choosing between staying at home or moving: A systematic review of factors influencing housing decisions among frail older adults

Background

Most older adults wish to stay at home during their late life years, but physical disabilities and cognitive impairment may force them to face a housing decision. However, they lack relevant information to make informed value-based housing decisions. Consequently, we sought to identify the sets of factors influencing the housing decision-making of older adults.

Methods

We performed a systematic literature search for studies evaluating any factors influencing the housing decisions among older adults over 65 years old without cognitive disabilities. Primary research from any study design reported after 1990 in a peer-reviewed journal, a book chapter or an evaluated doctoral thesis and written in English, French or Spanish were eligible. We extracted the main study characteristics, the participant characteristics and any factors reported as associated with the housing decision. We conducted a qualitative thematic analysis from the perspective of the meaning and experience of home.

Results

The search resulted in 660 titles (after duplicate removal) from which 86 studies were kept for analysis. One study out of five reported exclusively on frail older adults (n = 17) and two on adults over 75 years old. Overall, a total of 88 factors were identified, of which 71 seem to have an influence on the housing decision-making of older adults, although the influence of 19 of them remains uncertain due to discrepancies between research methodologies. No conclusion was made regarding 12 additional factors due to lack of evidence.

Conclusion

A wealth of factors were found to influence housing decisions among older adults. However, very few of them have been studied extensively. Our results highlight the importance of interdisciplinary teamwork to study the influence of a broader range of factors as a whole. These results will help older adults make the best possible housing decision based on their unique situation and values.

Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs as well as facilitate aging-in-place.

Transitions in Living Arrangements Among Older Mexican Americans

This study examines the transition from independent living to a coresidential living arrangement across the late life course among older unmarried (i.e., widowed, divorced/separated, and single) Mexican Americans. Using 18 years' worth of panel data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly, event history analyses revealed that age at migration, physical disability, and cognitive impairment were strong predictors of the transition to a coresidential living arrangement. Importantly, a decline in physical and cognitive abilities heightened the risk of transition to a coresidential living arrangement, net of time-variant measures of disability and impairment. These findings provide evidence for incorporating a dynamic approach to examining living arrangements across the late life course for Mexican-origin Hispanics living in the United States, with implications for policy and service providers.

Management of Relocation in Cognitively Intact Older Adults

Relocation, a major life transition that can affect health positively and negatively, is moving from one permanent home to another. Many older adults will relocate at some time during their life. Relocation is also a complex process that requires careful consideration and planning before the move (i.e., pre-location) and adjustment to the new home after the move (i.e., post-relocation). The current article is a summary of content based on a comprehensive evidence-based practice guideline focused on management of relocation in cognitively intact older adults. The guideline was designed to be used across diverse settings by nurses and other providers. Pre-relocation guidelines include assessment for the need for relocation, interventions prior to moving, and outcomes for evaluation of the pre-relocation process. For post-relocation, content focuses on assessment of risks for not adjusting after the move as well as intervention guidelines to promote adjustment and outcomes for evaluation. Implications include advocacy for older adults by using the guideline, disseminating it, and conducting future research. [Journal of Gerontological Nursing, 42(11), 14-23.].

How does difficulty communicating affect the social relationships of older adults? An exploration using data from a national survey

Healthy social relationships are important for maintaining mental and physical health in later life. Less social support, smaller social networks, and more negative social interactions have been linked to depression, poorer immune functioning, lower self-rated health, increased incidence of disease, and higher mortality. Overwhelming evidence suggests that communication disorders adversely affect social relationships. Much less is known about whether some or all aspects of social relationships are negatively affected by a communication disorder. The relative impact of a communication disorder on social relationships, as compared to other kinds of disability, is also poorly understood. Data were analyzed from a representative national sample of community-dwelling adults aged 65 and older living in the continental United States (n=742). Results from multiple regressions indicated that difficulty communicating was significantly associated with several parameters of social relationships even after controlling for age, gender, partnership status, health, functional limitations, and visual impairment. Communication difficulty was a significant predictor of smaller social network size, fewer positive social exchanges, less frequent participation in social activities, and higher levels of loneliness, but was not a significant predictor of negative social exchanges. These findings suggest that communication disorders may place older adults at increased risk for mental and physical health problems because of social isolation, reduced social participation, and higher rates of loneliness. In addition, it appears that communication disorders may have a greater impact on positive, rather than negative, aspects of social relationships.

LEARNING OUTCOMES

As a result of this activity, the following learning outcomes will be realized: Readers will be able to (1) describe changes in the social relationships of older adults that occur as part of normal aging, (2) identify the aspects of social relationships that were significantly impacted by a communication difficulty, and (3) discuss possible reasons for these findings including potential clinical implications.

Development of an integrated staircase lift for home access

PURPOSE

Stairways into buildings present a significant environmental barrier for those with mobility impairments, including older adults. A number of home access solutions that allow users to safely enter and exit the home exist, however these all have some limitations. The purpose of this work was to develop a novel, inclusive home access solution that integrates a staircase and a lift into one device.

METHOD

The development of an integrated staircase lift followed a structured protocol with stakeholders providing feedback at various stages in the design process, consistent with rehabilitation engineering design methods.

RESULTS

A novel home access device was developed. The integrated staircase-lift has the following features: inclusivity, by a universal design that provides an option for either use of stairs or a lift; constant availability, with a lift platform always ready for use on either level; and potential aesthetic advantages when integrating the device into an existing home. The potential also exists for emergency descent during a power outage, and self-powered versions.

CONCLUSIONS

By engaging stakeholders in a user centred design process, insight on the limitations of existing home access solutions and specific feedback on our design guided development of a novel home access device.

[Reflections on the topic of good housing conditions and growing old: Not everybody has a choice]

BACKGROUND

The variety of options with regard to housing for elderly people has increased. This study was carried out to understand how individuals reflect on their own options within this growing market.

MATERIAL AND METHODS

In a qualitative study design 26 single person households (65+ years) were interviewed. The aim of the study was to understand what influences the individual ideas about moving residence or staying put.

RESULTS

A great majority of the elderly seem to reflect on their own living situation. There are not just spatial and constructional reasons that make people consider moving residence but also the financial situation, the possibility to spend the day with meaningful activities and the existence of a social network. The individual need for security and autonomy for the present and the future influences the interpretation of a given situation.

CONCLUSION

The reflection on ones own housing situation is interlinked with the person's ability and capacity. One can only find solutions if one can think of them and one can only act if one has the potential.

User perceptions of existing home access solutions and a novel home access device

PURPOSE

This study aimed to evaluate end user perspectives of four existing home access solutions (HAS) and a newly designed experimental device (the ARISE).

METHOD

A cross-sectional design was used to evaluate the ARISE prototype against other HAS. Specifically, participants trialed stairs, a ramp, a platform lift (PL), a stair glide and the ARISE, after which they completed questionnaires aimed at soliciting their perspectives of these solutions. The time taken by participants to use each HAS was also collected.

RESULTS

Five HAS design features were deemed as important by 90% of participants: ease of use, ability to use independently, reliability, safety and security. Time taken to use each HAS from fastest to slowest was: stairs, the ARISE, ramp, PL and stair glide. The ARISE prototype was rated as the first or second most preferred device by the most number of participants, followed by the PL, then the ramp.

CONCLUSIONS

Results from this study provide greater understanding of user perspectives of HAS. End user feedback on a novel prototype device has provided valuable insight into its usability and function, which should not only guide future development of this device, but also provide direction for other innovations around home access. Implications for Rehabilitation It is anticipated that gaining a better understanding of strengths and weaknesses of home access solutions will: assist clinicians and end users in finding solutions that meet the individuals' needs. lead to the development of new or improved solutions that more closely address user needs. encourage further innovation in the area.

Moving as a gift: relocation in older adulthood

While discussions of accessibility, mobility and activities of daily living frame relocation studies, in older adulthood, the paper explores the emotional motivation of gift giving as a rationale for moving. This ethnographic study investigates the processes of household disbandment and decision-making of older adults in the Midwestern United States relocating in post-Global Financial Crisis contexts. In this study, relationships are created and sustained through the process of moving, linking older adults (n=81), their kin (n=49), and professionals (n=46) in the Midwestern United States. Using Marcel Mauss' The Gift (1925/1990) as a theoretical lens, relocation in older adulthood is conceptualized as a gift in two ways: to one's partner, and one's kin. Partners may consider gift-giving in terms of the act of moving to appease and honor their partner. Kin who were not moving themselves were also recipients of the gift of moving. These gifts enchain others in relationships of reciprocity. However these gifts, like all gifts, are not without costs or danger, so this paper examines some of the challenges that emerge along with gift-giving.

Residential normalcy and environmental experiences of very old people: changes in residential reasoning over time

The decision to relocate in old age is intricately linked to thoughts and desires to stay put. However, most research focuses either on strategies that allow people to age in place or on their reasons for relocation. There is a need for more knowledge on very old peoples' residential reasoning, including thoughts about aging in place and thoughts about relocation as one intertwined process evolving in everyday life. The aim of this study was to explore what we refer to as the process of residential reasoning and how it changes over time among very old people, and to contribute to the theoretical development regarding aging in place and relocation. Taking a longitudinal perspective, data stem from the ENABLE-AGE In-depth Study, with interviews conducted in 2003 followed up in interviews in 2011. The 16 participants of the present study were 80-89years at the time of the first interview. During analysis the Theoretical Model of Residential Normalcy by Golant and the Life Course Model of Environmental Experience by Rowles & Watkins were used as sensitizing concepts. The findings revealed changes in the process of residential reasoning that related to a wide variety of issues. Such issues included the way very old people use their environmental experience, their striving to build upon or dismiss attachment to place, and their attempts to maintain or regain residential normalcy during years of declining health and loss of independence. In addition, the changes in reasoning were related to end-of-life issues. The findings contribute to the theoretical discussion on aging in place, relocation as a coping strategy, and reattachment after moving in very old age.

Influence of Late Life Stressors on the Decisions of Older Women to Relocate into Congregate Senior Housing

Late-life stressors often require individuals to make substantial alterations in behavior and lifestyle and can affect their overall health and well-being Relocation is a significant life stress regardless of age. The primary aim of this study is to elucidate the push-pull factors associated with moving into congregate senior housing. The secondary aim is to investigate the decision-making processes and stresses associated with moving into a congregate living environment. Interviews were conducted with 26 women who were new residents in congregate senior housing. Relocation, as expected, was considered to be stressful although individual differences were found among perceptions of relocation stresses. Women who had made the decision to relocate on their own showed evidence of better psychosocial well-being at the time of the move. One-quarter of the sample chose to move in order to provide care to another person. As the options for senior housing continue to evolve and the numbers of adults reaching advanced age continue to increase, it is important to understand the factors that contribute to successful adaptation. This knowledge will enable facility administrators to implement programs and procedures to assist incoming residents with acclimating to their new homes.

Moving beyond ‘ageing in place’: older people's dislikes about their home and neighbourhood environments as a motive for wishing to move

Ageing in place has been promoted by policy makers as the optimal residential solution for later life, premised on older people's reluctance to contemplate relocation, their declining residential mobility and high levels of residential satisfaction. This paper takes a critical perspective to the notion of ageing in place by examining older people's dislikes about, rather than levels of satisfaction with their home and neighbourhood environments, and establishing whether such dislikes influence a desire to move. Analysis of the 2004 Living in Wales Survey shows that despite high levels of residential satisfaction, a significant proportion of older people do wish to move. Logistic regression results indicate this desire is strongly associated with dislikes about their immediate home environment, more than neighbourhood factors. Contemplating a move in later life may be shaped more by a desire to ‘attach’ to people, than to remain in situ to preserve an attachment to place.

I Want to Move, But Cannot

Objectives: The purpose of this study was to investigate characteristics of seniors in the Canadian population who are involuntary stayers and to assess associations with health. Method: Data come from the 1994 Canadian National Population Health Survey, with the sample restricted to those 65 and older ( N = 2,551). Results: Nearly 1 in 10 seniors identified as an involuntary stayer. Seniors with few socioeconomic resources, poor health, greater need for assistance, and low social involvement were more likely to identify as an involuntary stayer. Furthermore, seniors who were involuntary stayers report significantly more distress and greater odds of low self-rated health than other seniors. Discussion: This study brings into visibility an understudied segment of the elderly population: seniors who are unable to move from their present location despite their desire to do so. Further research and policy responses assisting seniors to age in a setting of their own choosing are needed.

Deciding to move into extra care housing: residents’ views

Extra care housing aims to meet the housing, care and support needs of older people, while helping them to maintain their independence in their own private accommodation. In 2003, the Department of Health announced capital funding to support the development of extra care housing, and made the receipt of funding conditional on participating in an evaluative study. Drawing on information collected directly from residents in 19 schemes, this paper presents findings on the factors motivating older people to move to extra care housing, their expectations of living in this new environment, and whether these differ for residents moving to the smaller schemes or larger retirement villages. In total, 949 people responded, 456 who had moved into the smaller schemes and 493 into the villages. Of the residents who moved into the villages most (75%) had not received a care assessment prior to moving in, and had no identified care need. There was evidence that residents with care needs were influenced as much by some of the attractions of their new living environment as those without care needs who moved to the retirement villages. The most important attractions of extra care housing for the vast majority of residents were: tenancy rights, flexible onsite care and support, security offered by the scheme and accessible living arrangements. The results suggest that, overall, residents with care needs seem to move proactively when independent living was proving difficult rather than when staying put is no longer an option. A resident's level of dependency did not necessarily influence the importance attached to various push and/or pull factors. This is a more positive portrayal of residents’ reasons for moving to smaller schemes than in previous UK literature, although moves did also relate to residents’ increasing health and mobility problems. In comparison, type of tenure and availability of social/leisure facilities were more often identified as important by those without care needs in the villages. Therefore, as in other literature, the moves of village residents without care needs seemed to be planned ones mostly towards facilities and in anticipation of the need for care services in the future.

The urban elderly in the United States: health status and the environment

A large number of elderly persons live in United States metropolitan areas and center cities. Although the urban environment can be supportive of health, the urban elderly face issues of decrease in organ function and reserves; impaired chemical clearance and detoxification; vulnerability to medication-environment adverse interactions (heat/psychotropic drugs); legacy of past occupational and environmental cumulative exposures to persistent agents; overall poorer health status; decreased ability to respond to disasters, emergencies, and extreme conditions; decreased ability to access good and services outside their homes; and increased sensitivity to environmental conditions. Planning for these challenges can create a supportive environment and improve the health of the urban elderly.