By Jennifer Crane, MS, CDP
There are many factors that contribute to making the best selection regarding where and how a person will spend his or her last years. Key to the success of this process is the idea of personal readiness (Rossen, 2007). Researchers have identified the component of choice as a key factor of readiness that is crucial to a person’s ability to adapt to his or her new environment and successfully integrate to his or her surroundings and circumstances (Rossen & Knafl, 2007). For the older adult, choice is necessary for effective selection of, and adaptation to, a living environment where he or she can successfully age.
Options and Concerns
Choices can include options to age in place, a transition to more transitory environments, or nursing home care. It can be a stressful thing for an older adult to contemplate necessary adjustments to his or her living situation. Rossen (2007) identifies health concerns, upkeep and maintenance of the home or yard, financial considerations, safety, and even social isolation as a possible impetus for decisions regarding changes to an older person’s lifestyle. Wiles, Leibing, Guberman, Reeve, and Allen (2012), in their research about “Aging in Place,” point out that older people want choices regarding where and how they age, emphasizing issues such as access to friends, church, social clubs, doctors, and familiar services.
Researchers have identified the component of choice as a key factor of readiness that is crucial to a person’s ability to adapt to his or her new environment and successfully integrate to his or her surroundings and circumstances
Long-Term Satisfaction
It is important to allow for choice and a sense of control by the older person, in order to assure long-term satisfaction with life as one ages (Wiles et al., 2012). In a study involving women, Rossen and Knafl (2007) confirmed the notion that choice is key in the success of late-life transitions. The authors specifically note that women who perceive that they have a say in the decision to move, and some level of control over the process, will exhibit a higher level of adjustment and satisfaction than those who do not feel they had a say in the matter (Rosssen & Knafl, 2007). Rossen (2007) emphasizes the importance of an older person feeling like he or she has a choice about, and is involved in, any decision regarding his or her future.
Choice and Inclusion
Rossen (2007) emphasizes that a persons’ perception about the choices and decisions being made, along with his or her feelings of being in control of what is happening, is the key to determining positive or negative outcomes. If a person feels that he or she has a choice, it is tied to feelings of psychological adjustment and overall satisfaction with life (Rossen, 2007). For example, research shows that older adults who have chosen to age in place enjoy the benefits of a retaining a sense of their identity, independence, and autonomy; this is due to the security of familiar environs and connectedness to a community of supportive individuals (Wiles et al., 2012). Rossen (2007) observes that positive outcomes for older people relocating to independent congregate living communities (ILCs) can include: improvements in health; opportunities for socialization; psychological benefits; and, a sense of safety. Conversely, when a person does not feel included in decisions regarding his or her life and future, it is common for that person to experience difficulty in adjusting to his or her circumstances (Rossen, 2007). Rossen (2007) affirms that negative outcomes can include: decline in health; reduced socialization, independence, and quality of life; depression and loneliness; and, even higher morbidity rates.
The opportunity for an older adult to voice his or her own opinions and needs regarding a possible living-environment transition is a key factor in a successful outcome. Rossen (2007) notes that the older adult’s perception that he/she has a choice in the matter results in a positive psychological adaptation, while coercing him/her to relocate can result in numerous declines in health and psychological status. Rossen (2007) recommends fruitful discussion with older people about their feelings and desires regarding: the environment in which they would like to age; their preparedness for a move; the disposition of their belongings (especially, what he/she can bring to where they might move); and their need to maintain the continued support of family and friends. Perhaps, it is the dignity of maintaining long-lasting relationships, treasured possessions and some familiar trappings of life that helps older adults adjust well and be ready for a new living environment. Choice and readiness are important components whether a person is aging normally or whether a person is experiencing some special need requiring more comprehensive care.
Of the many aspects that contribute to an older person’s successful aging process and adaptation to a living environment, perception of choice is the key factor. For a positive outcome, an older person facing this decision must: have a say in where and how he/she spends the last years; be consulted on the disposition of belongings and treasured items; and, be provided with a supportive family and social structure. These factors contribute to the older person’s sense of well-being in the new situations he or she will be facing as aging progresses. Positive adjustment to new experiences depends on feelings of readiness that come from a person having the perception of choice regarding his or her life. It is very difficult for people to make positive adjustments if they do not feel they had a choice in their path. It would be beneficial to investigate the ways in which the construct of choice affects the outcome for people who have cognitive deficits. The literature seems to assume a certain level of cognitive function, and older people with cognitive deficits may be unable to make their own independent decisions without a greater level of support.
References
Rossen, E. K. (2007). Assessing older persons' readiness to move to independent congregate living. Clinical Nurse Specialist, 31(6), 292-296.
Rossen, E. K., & Knafl, K. A. (2007). Women's well-being after relocation to independent living communities. Western Journal of Nursing Research, 29(2), 183-199. doi:10.1177/0193945906292539
Wiles, J. L., Leibing, A., Guberman, N., Reeve, J., & Allen, R. E. (2012). The meaning of "aging in place" to older people. The Gerontologist, 52(3), 357-366. doi:10.1093/geront/gnr098
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