Transfer Trauma and Relocation Stress Syndrome
As we see our loved ones near the end of their lives and begin to need more care, difficult decisions come up with regards to relocating them to a new facility or living situation. While new living options may offer a different type or amount of care, moving a senior who is close to the end of life comes with serious risks. The negative effects of transfer trauma and relocation stress syndrome can include serious depression, anxiety, illness, and even increased risk of death.
Unfortunately, we have experienced firsthand the dangers of relocating the elderly. We have seen people pass away much sooner than expected, sometimes within days or even hours after the move. However, in decisions to return home after a hospitalization, we have seen people live months longer than doctors expected them to. We have seen the incredibly powerful effects of living in a stable, familiar environment.
Moving is a stressful experience even for younger, healthy people who make the decision on their own. For elderly people, especially those who are very frail, sick, or suffering from dementia, or those who not part of the decision to relocate, moving house can be extremely traumatic. Research began as early as the 1960s regarding what are now called “transfer trauma” and “relocation stress syndrome.” Studies have indicated that during the first three months after a transfer, aside from other negative effects such as depression, anger, anxiety, and illness, the death rate for seniors is more than three times higher than the usual rate (*1). In another study of hospital patients, one quarter of those transferred died within 24 hours (*2). In 1992, relocation stress syndrome was recognized as an official nursing diagnosis. It is defined as “the physiologic and psychosocial disturbances that result from transfer from one environment to another.” Similarly, the term transfer trauma refers to “ [the results] of sudden and unexpected relocation [and] is associated with depression, increased irritability, serious illness, and elevated mortality risk for the frail elderly” (*2).
At Helping Hands Group, our first priority is always the well-being of our clients. We are deeply saddened by the losses we have seen following client transfers and we urge our clients and their families to carefully consider whether such moves are in the client’s best interest. Factors such as the client’s ability to participate in the decision-making process, level of cognizance and mental function, physical condition, and emotional stability should be taken into account before attempting a move. Additionally, providing clients with as much support as possible leading up to, during, and after the move is critical.
If it is determined that a move is in your loved one’s best interest, having familiar people and caregivers around is an excellent way to make the transition as smooth as possible. Moving to a new environment with unfamiliar people with whom a person has no connection can be extremely risky and traumatic. If at all possible, keeping the same primary caregiver so that your loved one sees a familiar face each day is incredibly beneficial.
We thank you for taking the time to read about this important issue and we encourage dialogue about the risks associated with moving a senior. Please contact the Helping Hands office if you have any questions or concerns.
(*1) Terri D. Keville, “Studies of Transfer Trauma in Nursing Home Patients: How the Legal System has Failed to See the Whole Picture.” Health Matrix: The Journal of Law-Medicine, 1993.
(*2) Victoria Robinson, MSc., “A Brief Literature Review of the Effects
of Relocation on the Elderly.” Prepared for The Hospital Employees’ Union of British Columbia, 2002.
(*3) Wisconsin Department of Health Services, “Identification of Relocation Stress Syndrome and Transfer Trauma.” 2010. Link: https://www.dhs.wisconsin.gov/regulations/assisted-living/identify-relocation-stress.pdf