Relocation Stress Syndrome
Over the past decade, medical professionals have increasingly been diagnosing and treating seniors with relocation stress syndrome (RSS), also known as “transfer trauma.” The syndrome is characterized by a combination of symptoms – including anxiety, confusion and loneliness – that often present themselves after a move to a senior living.
Read more about RSS, how to identify seniors at risk and how to prevent the syndrome in your senior loved ones.
Relocation Stress Syndrome
It took a stroke to get my 77-year-old blind and widowed father to finally agree it was time to move from his beloved home out in the Texas countryside to a care home. The assisted living community my brother and I picked seemed the perfect fit – Dad would be going from one cute house out in the country to another, only in this case, he would get 24/7 care and three home-cooked meals a day. His birdhouses would move with him. His bed and recliner, too. Perfect right?
Cue the record scratch.
What Dad really wanted was what 88% of Americans want, according to an AARP study. Dad wanted to “age in place” in the beloved home that he built with my late mother on the land given to our ancestors by the “Father of Texas,” Stephen F. Austin himself.
“I tell people home is a feeling,” says Tracy Greene Mintz, a California-based social worker and a nationally-recognized expert in relocation stress syndrome. “You should be able to achieve the feeling of home anywhere, but when you yank people out of what their concept of home is, it can be very traumatic.”
It’s been a couple months since Dad’s move and while we no longer have to worry about him falling in his home with only a button around his neck to call for help, or forgetting to take his medication, we now worry that he’s depressed or worse, that his mental and physical health are on a rapid decline.
Moving is right up there with death, divorce and getting fired when it comes to life’s most stressful moments. While a move from one house or even state to another can be stressful on anyone, for seniors it can be especially so. It’s one thing to move into a new home because your family’s growing. It’s quite another to downsize from a 2,000-square-foot house that you raised your family in, into a 200-square-foot room you may very well die in.
With such a move comes all sorts of issues to grapple with. There’s the loss of a home built and loved and all the things that filled it, now discarded, divvied out to family or sold off. Possibly the move coincides with the death of a spouse. It might be sudden like in my dad’s case or unwelcome, also like my Dad’s case.
Even if a move is eagerly anticipated, anxiety and depression can hit a senior suddenly, much like postpartum depression can surprise a new mom.
The stress that follows a move is called “relocation stress syndrome” (RSS), a serious enough syndrome that in 1992, the North American Nursing Diagnosis Association added it as an official diagnosis. Now hospitals and insurance companies across the country are taking it seriously as well.
What to Do If You Suspect a Loved One Has RSS
Relocation Stress Syndrome tends to show up in most of those affected right before a sudden move and within the first three months of a move, according to a white paper produced by the company, Moves for Seniors. Symptoms include anxiety, depression and forgetfulness. Physical symptoms can crop us as well.
“The effects of stress on the mind and body are well known,” says Greene Mintz. “This particular stress is a little bit different in that it is so easily misdiagnosed as a problem to do with aging. When people have stress, they tend to get angry or irritable, they can’t focus, they can’t think clearly, they have trouble making decisions. These are all also symptoms of dementia.”
What you don’t want is a misdiagnosis of dementia when what your loved one has is trauma from a move. Signs to look for in a loved one include changes in cognition, changes in eating habits and sleeping patterns, perhaps a new sense of insecurity or lack of trust and a decline in self-care.
So what to do if you suspect a loved one has RSS? You can connect Dad or Mom with a therapist to help them work out the underlying issues with the move. Larger assisted living communities may have groups to welcome new members. Sign your parent up and encourage them to mingle with others.
Perhaps the biggest thing you can do is change the way you address the issue with your loved one. Instead of being a cheerleader and forcing them to embrace the change, acknowledge the normal fears and sadness.
“There are two magic words in all of this and they are ‘you’re right,’” says Greene Mintz.
Ways to Prevent Relocation Stress Syndrome
There are many steps you can take to prevent transfer trauma in a loved one:
- If the senior is being moved from a hospital, the hospital will have an advocate or “navigator” on staff to help with the transition and to ensure it’s a smooth process. Use these resources.
- Involve the senior in the decision-making. If they insist on going home, allow them to try it out. If that’s not feasible and they do indeed need to go to a facility, they need to pick one out and agree to it.
- Make sure the senior knows exactly what’s happening. Keep them in the loop. Never just drop them off at a facility they haven’t vetted. “I don’t believe in infantilizing seniors,” says Greene Mintz. “They are adults and they deserve the dignity of being told honestly what’s going to happen.”
- Acknowledge their fears. If they ask, “What if I don’t like anybody there?” Mintz says not to lie and say, ‘I’m sure there are fine people there.” Instead say, “I’m not sure. We’re going to find out. Try to keep an open mind.”
- Validate their feelings. “Allow them the space to feel whatever they’re going to feel. Maybe they’ll feel excited. Maybe they’ll feel relieved because they were just barely holding it together at home. Maybe they feel nervous and terrified. These are all perfectly valid feelings,” says Greene Mintz.
- Whenever possible, try to recreate their old home in their new home. “We don’t invest enough time in recreating that feeling at the new location,” says Greene Mintz. Take pictures of their bedside set-up and the top of their dresser and recreate it with the same items.
If you can afford it, consider hiring a senior move manager. There are more than 900 move management firms in the U.S. devoted to moving seniors and setting up the perfect space for them. They’ll even help you or the senior clean out the old home.
What Not to Do If Your Loved One Has RSS
Transfer trauma typically will subside within 3-6 months. That’s the typical time it takes a senior to adjust to their new surroundings. What you don’t want to do in the meantime is move them again.
“That is just layering trauma on top of trauma. Moving again is not the anecdote to moving,” says Greene Mintz. “If, after six months, your loved one hasn’t been able to settle in, or is constantly sick or is very depressed or there’s some really big significant change like they used to be independent in toileting and now they’re not, then that’s significant.”
In this case, Greene Mintz recommends seeking out the help of your loved one’s family doctor, the Family Caregiver Alliance or, if your loved one has Alzheimer’s disease or dementia, the Alzheimer’s Association.
Do you know a parent or senior loved one who has had relocation stress syndrome? What was the experience like? We’d like to hear your stories in the comments below.
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