Facilitators and inhibitors of transition for older people who have relocated to a long‐term care facility: A systematic review

Abstract

Moving into a long‐term care facility to live permanently is a significant life event for older people. Care facilities need to support older people to make a healthy transition following relocation. To help achieve this, we need to understand what facilitates and inhibits the transition process from the perspective of older people, their families, and care facility staff. Our review generated new knowledge to inform this understanding. We addressed the question: what factors facilitate and inhibit transition for older people who have relocated to a long‐term care facility? Five electronic databases, PsychINFO, British Nursing Index, CINAHL, MEDLINE and Web of Science were searched for the period January 1990 to October 2017. Grey literature searches were conducted using Google Scholar, and Social Science Research Network. Data were extracted for individual studies and a narrative synthesis was conducted informed by Meleis's Theory of Transition. Thirty‐four studies (25 qualitative, 7 quantitative and 2 mixed methods) met the inclusion criteria. Data synthesis identified that transition following relocation was examined using a variety of terms, timelines and study designs. Potential personal and community focused facilitators and inhibitors mapped to four themes: resilience of the older person, interpersonal connections and relationships, this is my new home, and the care facility as an organisation. These findings can inform the development of interventions for these target areas. They highlight also that further research is warranted to understand the organisational culture of long‐term care facilities, how this influences transition, and how it might be shaped to create and sustain a caring culture for older people.

Relocation experiences of the elderly to a long-term care facility in Taiwan: a qualitative study

“…While the fear of losing autonomy was a perceived barrier for successful adaptation as mentioned before, the provision of tailored care in accordance with individual needs was an aspect that was highlighted in our study as valuable to facilitate adaptation to the facility. This is in concurrence with conclusions of studies from Taiwan and other countries that approaches to care that did not consider individual preferences and the uniqueness of residents could be potential barriers to successful transition [12,34,54]. LTC facilities should provide tailored care to assist residents in integrating [35,55].…”

“…Lee (2010) reported the link between greater perceived emotional support from staff and better adjustment to relocation [26]. Other studies have pointed out the role of interpersonal relationships between the elderly residents and the LTC staff as a potential barrier or facilitator for successful relocation to the LTC facility [12,27,57]. Alongside the provision of professional health care, aspects such as cordial greetings, proactive enquiries about physical comfort were all perceived as valuable in alleviating the fears and anxieties of the elderly and to help them feel relaxed and safe in LTC facilities [55,56,58].…”

“…They choose LTC facilities nearer to their family home to keep this connection and to increase the frequency of family members' visits. Continued relationships with family members and signi cant others is a key factor reported in studies internationally in facilitating transition to LTC facilities [12,34,[43][44][45]. Intimate interaction and communication with close relatives or friends diminished the feelings of isolation and loneliness experienced by the elderly when they moved into the facility [35,46].…”

Adjusting to life in a residential aged care facility: Perspectives of people with dementia, family members and facility care staff

“…Crawford, Digby, Bloomer, Tan, & Williams, ; Schultz, Belle, & Czaja, ). There are also multiple studies determining how older adults in general settle in or adjust to their new environment during the early months (for reviews, see Brownie, Horstmanshof, & Garbutt, ; Fitzpatrick & Tzouvaka, ). Unfortunately, most previous studies excluded residents with dementia and we continue to lack clear information about which factors are most relevant to the adjustment of this specific group.…”

“…Crawford, Digby, Bloomer, Tan, & Williams, 2015;Schultz, Belle, & Czaja, 2004). There are also multiple studies determining how older adults in general settle in or adjust to their new environment during the early months (for reviews, see Brownie, Horstmanshof, & Garbutt, 2014;Fitzpatrick & Tzouvaka, 2018).…”