Mortality at older ages and moves in residential and sheltered housing: evidence from the UK

Abstract

BackgroundThe study examines the relationship between transitions to residential and sheltered housing and mortality. Past research has focused on housing moves over extended time periods and subsequent mortality. In this paper, annual housing transitions allow the identification of the patterning of housing moves, the duration of stay in each sector and the assessment of the relationship of preceding moves to a heightened risk of dying.MethodsThe study uses longitudinal data constructed from pooled observations from the British Household Panel Survey (waves 1993–2008). Records were pooled for all cases where the survey member is 65 years or over and living in private housing at baseline and observed at three consecutive time points, including baseline (N=23 727). Binary logistic regression (death as outcome three waves after baseline) explored the relative strength of different housing transitions, controlling for sociodemographic predictors.Results(1) Transition to residential housing within the previous 12 months was associated with the highest mortality risk. (2) Results support existing findings showing an interaction between marital status and mortality, whereby unmarried persons were more likely to die. (3) Higher male mortality was observed across all housing transitions.ConclusionsAn older person's move to residential housing is associated with a higher risk of mortality within 12 months of the move. Survivors living in residential housing for more than a year, show a similar probability of dying to those living in sheltered housing. Results highlight that it is the type of accommodation that affects an older person's mortality risk, and the length of time they spend there.

Changes in living arrangements and mortality among older people in China

“…Older people who moved from living with family to an institution show a higher mortality risk than those continuing to live with family. This finding is consistent with a study in the UK indicating a higher risk of mortality among elderly people who moved to residential housing from their private homes ( Robards et al, 2014 ). Such change may be due to the loss of families’ ability to care for elderly relatives, which may be linked to the deterioration of the older person's health ( Gu et al, 2007a ).…”

“…A third limitation is the lack of information about the timing of the transition in one's living arrangements; indeed, the variation in the duration of one's new living arrangements could contribute to different risks of mortality (i.e. Robards et al ., 2014 ). The fourth limitation relates to the respondents who are lost to follow up, who amount to 23 percent of the sample post-2005.…”

“…Living arrangements, especially the change from a familiar environment to an unfamiliar one can have an impact on the risk of mortality in later life. For instance, Robards et al (2014) found that a move into residential housing in the UK was associated with a higher risk of mortality within 1–2 years of the move, even after controlling for health status at the time of the move. The mortality risk also depends on the relationship between the carer and the older person, as older people who were cared for by a spouse, children or other relatives had a lower risk, compared to those with unrelated caregivers ( Wang et al, 2009 ).…”

Cumulative incidence of admission to permanent residential aged care for Australian women – A competing risk analysis

“…According to our study, transition into RAC towards the end of life is highly likely, a result which is consistent with previous studies reporting increased use of RAC services with advancing age 1,8,10 . Other studies have found that people who enter residential care have a high mortality risk with moves most often observed in the last year of life 12,26 . During the last month of life, people over 70 years of age are most likely to reside in residential care, particularly those with dementia 3 .…”

Is migration in later life good for wellbeing? A longitudinal study of ageing and selectivity of internal migration

“…Particularly notable in this regard is work on health encompassing both physical and mental health, including wellbeing. It is in the health arena that the ageing literature has most directly grappled with internal migration, with particular attention given to migration experiences of frail older adults in relation to care, both international (Hardill et al., ) and internal (Robards et al., ). Indeed, ageing literature has tended to address these questions from the perspective of living arrangements, encompassing moves to care institutions (see Feng et al., ; for example).…”