The experience of older people permanently relocating from their home in the community to a long term care facility: a systematic review.

Abstract

Objective: To systematically review the qualitative research relating to the experiences of older adults permanently relocating from their home to a long term care facility (LTCF). Methods: A systematic review of qualitative research using the methodology developed by the Joanna Briggs Institute. Inclusion criteria for studies included publication in peer reviewed journals, English language papers and permanent relocation to a long term care facility within one year of the study. Results: Following the search and appraisal phase of the systematic review a total of 14 studies (presented in a total of 15 peer reviewed journal articles) were identified for inclusion in the review. The studies covered a period of 25 years and were from 6 different countries. Study methodologies include grounded theory(5), phenomenological studies(5), case study(1), life history(1), content analysis(1) and descriptive study(1). From the studies a total of 62 findings were extracted which were categorized into 11 groups based on common themes. From the 11 categories 5 synthesized findings were identified. These related to the decision making process for relocation, aspects of deep loss and dislocation experienced by many people, the importance of maintaining control and autonomy in relation to life in the facility, the challenges of making a new life with a new sense of purpose and the complex, unique and ongoing nature of the responses to relocation. Conclusion: The systematic review indicates that there is a significant gap in the support services for older people relocating to a LTCF. While the clinical and personal care aspects of the services in LTCFs appear satisfactory there is a failure to recognise the significant psychological and emotional issues faced by older people as they relocate and struggle to adapt to new environments, develop new relationships, learn a new set of rules to survive, create a sense of place, establish new identities and create new meaning for their lives. The review indicates there is little in the way of support for these life transition processes and many people fail to make a successful transition.