Recognizing the Signs of and Coping with Relocation Stress Syndrome
As elders transition into new homes and living situations they often feel displaced, disoriented, or even depressed. Caregivers and other senior care professionals have an increasing responsibility to learn how to support older adults as they face moving into assisted living and other community settings.
On a Scale of 1 to 10
Moving later in life produces a great deal of stress and negatively impacts older adults’ decision-making ability and general health. Most of us have moved at least once and understand the complexities of organizing, downsizing, packing, and moving. For older adults, moving is not only complicated, it is one of the most stressful events in their lives.
According to the widely accepted Holmes-Rahe Social Readjustment Rating Scale, (Stress Scale), moving or relocation is not even listed among the top 40 of life’s most stressful events. But when the Stress Scale is adjusted for senior adults, a move to nursing/retirement home appears third on the list, preceded only by death of a spouse and divorce. The anxiety associated with moving is greater than the death of a friend or a family member, greater than the loss of social identity, and more traumatic than the loss of financial stability.
Relocation Stress Syndrome
Symptoms of stress associated with changes in environment are specific enough that in 1992 the North American Nursing Diagnosis Association (NANDA) added Relocation Stress Syndrome (RSS) as an official diagnosis.
The cluster of diagnoses that characterize RSS include loneliness, depression, apprehension, anxiety, anger, and in older adults, increased confusion. The greatest incidences of RSS occur just before and during a three-month period following relocation. To determine if a patient is “at risk for RSS” medical professionals evaluate the following as the transition occurs: changes in eating habits and sleeping patterns, demonstration of dependency, changes in cognition, insecurity or lack of trust, decline in self-care, and change in relationship with family members. Risk of RSS increases if there is (1) little or no time to prepare for a move; (2) a lack of predictability about the new environment; and (3) little or no time between notification to move and the move itself.
Caregivers Mitigating Stress Symptoms
Be aware of the symptoms above and take steps to address high stress levels. Stress can be reduced when people feel some control over the situation. It is important to give older adults advance notice and plenty of opportunities to express their opinions and participate in the process of impending changes in their lifestyle.
As with any major relocation, individuals are better able to navigate and adjust to late life transitions when they receive three phases of support in a major life transition. The Caring Transitions network was established to provide these three levels of support – before, during, and after the transition.
What Can Families Expect from Transition Service Providers?
- Help with downsizing, organizing, and developing a floor plan to ensure chosen items will fit into the new home.
- Support and resources to help with relocation.
- Project management, move management, and oversight skills to make sure the relocation runs smoothly.
- Unpack and settle clients comfortably into their new home, aiding in the last important steps of a successful transition.
- Quick and efficient liquidation of personal property or furnishings left behind through an estate sale or online auction.
- Services provided directly by vetted, insured, industry certified owners and employees.
The Future
Scientists continue to debate whether RSS is an actual syndrome or simply a combination of observable symptoms. 
Even as they conduct additional research, we must recognize that a change in the home environment does have a significant impact on older adults and their sense of place in the world.
So often, a late-life relocation is complicated by other factors including personal loss, health issues, financial and family matters; making it even more important for caregivers, families, and housing professionals to try and reduce stress and lend a sense of support, control and dignity to the home transition process.
Chris Seman is the President of Caring Transitions®, America’s complete source of trusted information, support, and services for older adults and their families during downsizing, rightsizing, and relocation. 
He can be reached at cseman@caringtransitions.net.
Nan Hayes is the Director of Business Development and can be reached at nhayes@caringtransitions.net.
