Smoothing the Transition
When older adults make the decision to move from a home where families were raised, gardens were tended, and dear friends visited to celebrate life’s milestones, there is natural period of adjustment to the new life experience of living in a Life Plan Community (also known as a Continuing Care Retirement Community or CCRC).
Just how well do new CCRC residents adjust to their new environment? What impact do CCRCs have on quality of life issues? What are the factors that enhance optimal aging? And, what is the value of the continuum? Are people happier and healthier in CCRCs vs. remaining at home? The answers to these questions come from two studies funded in part by LCS. The research explored aspects of non-residents’ decision not to move to a CCRC and their overall satisfaction with life. The research also considered the effects of time, including when new CCRC residents begin to master their physical and social setting, if and when respondents had found a sense of contentment and purpose in life going forward, and whether they developed positive social relationships.
Older adults have much at stake when moving into a CCRC including changes in interactions with family and friends and the challenges of adjusting to new physical and social environments. Research identifying factors associated with older adults’ decision-making characteristics and subsequent satisfaction with where they live has very important implications. By learning more, we can help prospective residents make good decisions with which they will be satisfied, and ensure that our communities foster rich social opportunities to new and newer residents that speed a newfound sense of control, integration, belonging, and the warmth of being at home.
© LCS 2014
White Paper: Success and Satisfaction: The Transition to CCRC Living
Two Research Studies
This white paper originally published in 2014.
LCS was one senior living company that helped fund empirical research about the transition experience that older adults have when they prepare to move to a CCRC, actually move in, and then live in the community.
Two related studies were funded via a grant through the Institute for Optimal Aging to professors in the Department of Aging and Mental Health Disparities at the University of South Florida (USF). The USF researchers investigated the factors that influenced decision-making and satisfaction among new CCRC residents and non-residents.
The Decision to Move
The first study entitled “How Do Older Adults Decide to Move to a CCRC and What Contributes to Satisfaction With the Decision?” included 52 new CCRC residents and 49 non-residents who had inquired about but decided not to move to a CCRC.
When the interviews were initiated, residents and non-residents had similar characteristics and both were relatively satisfied with their current living situation and personal well-being.Questions regarding financial status, health status, social support, civic participation, attitudes about CCRCs, and sources of information about CCRCs were factors thought to predict the decision to move. The findings showed:
The largest differences between CCRC residents and non- residents involved the positive perception that CCRCs offer a variety of health services, are a good fit personally and offer a variety of social activities.
CCRC residents see value in the continuum of care. Services that had the greatest effect on the decision to move to a CCRC included on-site skilled nursing center, on-site nurse, housekeeping and help with bathing/dressing/eating.
Residents more often received their first source of information about CCRCs from spouses and children; non-residents more often received that information from friends, direct mail and newspaper advertising.
Participants with greater self-perceived health and social needs, those with positive attitudes about CCRCs, and those who received information about CCRCs from their spouse, friend or child were more likely move to a CCRC.
Overall, the survey outcomes were more encouraging for CCRC residents. CCRC residents had higher satisfaction with their home and well- being than non-residents did at the final interview.
While all participants were more satisfied with their current living situation after 12-months if they reported satisfaction when the survey started, CCRC residents were more satisfied with their living situation and had better well-being than non-residents had, on average. Significant factors associated with well-being included younger age, better cognitive functioning at move-in, and perceived control over social relations.
The second study, entitled “Social Networking During The First Months After Moving To A Continuing Care Retirement Community” built on the foundation of the first study, with increased focus on the personal and social qualities that are associated with a successful transition from home to CCRC.
The majority of the interview questions focused on the individual’s social network as it existed since the move to the CCRC and their current emotional well-being.
Improved Well Being
Answers to questions about emotional well-being indicated that new residents felt their circumstances were about the same as usual or better. The highest report of improved emotional well-being regarded residents’ feeling of “happiness.”
While happiness is comprised of a combination of different things, having a strong sense of personal control in one’s life is a dependable predictor of positive feelings of well-being.
As shown in the table below, the first few months of CCRC living boosted feelings of improved control in enjoyment of daily activities, decision-making, and concentration. Conversely, feelings of strain, worry, unhappiness, lack of confidence and poor self-esteem declined.
Source: Chiriboga., D., Ph.D.
According to the research, a key factor to consider in adapting to CCRC living is how long the resident has lived at the community. To illustrate the role of time, the data was compared by compartmentalizing the length of time in the resident’s new home into shorter (under three months) and longer time intervals (under three months or three months or more). While most residents were well on their way to feeling integrated within their community, both groups of new and newer residents naturally took some time to acclimate in various ways. For instance, about a third of the newest arrivals reported they felt more distant from other people. As time passed, however, nearly all reported the opposite.
Other indications that the perception of well-being improves in residents who had lived in the community for at least 3 months included fewer reports of lack of companionship, fewer reports of feeling left out or isolated, fewer reports of not meeting new friends or rarely interacting with neighbors, and fewer reports of not feeling like they belonged in their new community.
Some residents continued to adapt to CCRC living up to six months after moving in. This data suggests senior living management can do more to foster a sense of belonging in the early months of residency to speed successful transition and foster greater, ongoing resident satisfaction.
Having health, emotional, and social needs met over the course of the first year is a strong predictor of satisfaction with the decision to move. Cumulatively, both sets of research suggest that the vast majority of new residents adjust well to CCRC living, and the findings imply that by 6 months most will feel like they are part of their community. Therefore, commitment to nurturing activity and involvement for 3 to 6 months after moving in may be optimal for some residents.
LCS’ own market research regarding the move-in process suggests that current residents and staff play a major role in a new resident’s adjustment. In many communities, new resident orientations are held to help the resident become acquainted with his or her new home, combining staff and existing resident experiences to provide valuable information to the new resident. Although information is important in the transition to a new living environment, ongoing support to help a new resident to feel at home may be the best way to ensure a successful adjustment.
One year after moving into a CCRC the residents who participated in the research were happier and healthier than those who had remained at home. These findings help validate the conviction that people who choose to live in senior living communities can experience greater well-being—and greater levels of happiness. As CCRC operators, we should continue to advance better and smoother transitions for new residents into our senior living communities, and support new and newer residents who may need more time to adapt to different patterns of social activity.
Involve the prospective resident’s circle of influence.
Seniors with a higher likelihood of moving to a CCRC react to information received by sources they consider credible – most often family and friends they see frequently. Unlike CCRC residents, notably fewer non-residents indicated their first source of information about CCRCs came from a spouse or adult child. Staff can increase sales by influencing how new and prospective residents, and their families and friends, learn about CCRCs and by engaging key influencers in meaningful ways that encourage their recommendation.
Highlight the value of health care services.
Address individuals’ current and future health care needs. CCRC residents regarded on-site health care and support of activities of daily living as the primary reasons for their positive attitudes about a CCRC, making them a lot more likely to move.
Leverage the data.
Non-residents tend to be less satisfied with their lives than CCRC residents are. Consider marketing and public outreach programs that educate the greater community about opportunities for seniors with regard to social interaction, friendships and the ability to remain independent. Inform adult children and consider offering programs and services to friends and family living outside of the community.
Schedule a new resident follow-up visit around 3 to 6 months post move-in.
New and newer residents should already be engaging in activities and enjoying the community’s amenities within 3 months of moving in. A follow-up visit 6 months later can help connect unmet needs with solutions to ensure all new residents feel at home.
Gum, Amber, Ph.D., How do older adults decide to move to a CCRC and contributes to satisfaction with the decision? April 2010 – April 2013, Final Progress Report, April 8, 2013, University of South Florida College of Behavioral and Community Sciences.
Chiriboga, David, Ph.D., Social Networking During The First Months After Moving To A Continuing Care Retirement Community. Fall and Winter of 2011 and 2012. CCRC Report, January 25, 2013. University of South Florida College of Behavioral and Community Sciences.
The following communities managed by Life Care Services during the study participated in the research:
Casa de las Campanas, San Diego, CA
Croasdaile Village, Durham, NC
Cypress Glen, Greenville, NC
Friendship Village Sunset Hills, Sunset Hills, MO
Friendship Village Tempe, Tempe, AZ
The Marshes of Skidaway Island, Savannah, GA
Park Springs, Stone Mountain, GA
Plantation Village, Wilmington, NC
Vantage House, Columbia, MD
Wyndemere, Wheaton, IL
To learn more about how your senior living community can benefit from Life Care Services management, call 515-875-4755 or visit us at https://www.senior-living-management.com/. Where experience is everything.