By Lacy Doremus, LMSW
 
IT’S TIME TO MOVE.

It may be you, or an elderly parent, but it's your responsibility.

Mention the word “moving” to almost anyone and the look on his or her face becomes one of sheer horror.  It’s the same look one has when visiting the dentist or being audited by the IRS. In the Holmes-Rahe Life Stress Inventory, moving ranks 32nd out of 43 traumatic life events.  The physical logistics of planning, packing, and paying for a move are significant.  Add the emotional component and it leads to a condition known as Relocation Stress Syndrome or RSS ( Mallick and Whipple, 2000).  RSS can affect anyone regardless of age or situation.  However, the older adult is most vulnerable due to their physical health, cognitive, emotional status, and often lack of coping skills.

THE BOOMER

For the “young” elder or baby boomer, moving can be a freeing experience.  The move is often by choice.  Hopefully, they have had the opportunity to plan a roadmap of their future. They feel a sense of control over their own destiny. Although the accommodations may be smaller, such as living on a boat or in an RV, it is the “right size at the right time”. They are not residing in an empty nest but, rather, residing in the right nest to fit their physical, emotional and/or cognitive needs.  They remain in the driver’s seat as relates to health, work, leisure, finances, housing and relationships.  Moving presents a new adventure and chapter in life. 

THE FRAIL ELDERLY

Then there is the case of the frail elder (perhaps your elderly parent) who must downsize. Aging in place is not an option for a number of reasons.  A frail elder is defined as physically or cognitively impaired or both.  Much has been written about adjusting to the new accommodation, but less about the actual process of moving.  How does one actually downsize a household where one has resided for decades? How does one assist the disorganized clutterer or hoarder? Here the process can be anguish for everyone involved. 

The frail elder may be unable to cope with the process and the adult child is at a double loss – convincing the frail elder that the move is necessary and assisting with the move itself. For the frail elder the move is often to smaller accommodations.  It is usually to an assisted living facility, nursing home, smaller house, or apartment. It can even be into the adult child’s residence.  Often the move is not by choice.  Factors for relocation include the following:  decline in health; loss or impending loss of a spouse or partner; continued medication errors; inability to keep up with interior and exterior house maintenance; the inability to complete IADL’s or ADL’s; the risk of being taken advantage of; frequent hospitalizations; history of falls; self-neglect; lack of finances; and finally, the need to be closer to adult children regardless of the state of the relationship.

The frail elderly may (realistically) consider this their final move before death. Not only is there grieving for what was but also the artifacts of an unused life – what could have been but wasn’t.  Although there may be significant positives in rightsizing such as care, safety, activities, and support there is often the focus on loss.  There is the loss of independence and control. There is the fear of the unknown as one loses the routine and predictability of one’s life. There is the loss of roles, identity, and connectedness.  Finally, it is a reminder of one’s death and dying.

THE BOOMER AS HELPER

For the adult child/boomer who may be assisting with the move, it is less about loss and more about change.  It is a time of increased responsibility as one accepts new roles. There is often a change of family dynamics and realignments. Adult children are forced to confront the ambivalence they might have regarding the relationship they have with their parents.  It is a reminder of one’s own mortality and vulnerability.  All this adds to the stress of the move but it’s got to be done.

THE LAST MOVE

In this case, the frail (or not so frail) elder dies, leaving an entire household for the adult child to deal with. Here, it is about loss. But after the funeral and the paperwork, there is still a move to be made. There may be help (other siblings) or hindrance (other siblings). Often the non-titled property has little or no financial value, but has sentimental, historical and/or emotional value both for the giver and receiver. Personal belongings usually have different meanings to each family member. Frequently, decisions regarding these possessions come at a time of crisis.  This time can be an opportunity for family members to reminisce, share memories and work through the grieving process. Unfortunately, this is the ideal rather than the norm.  In these situations it is important to determine what are the goals in the distribution of property and what is the meaning of “fair” among family members. Fair does not always mean equal. Determine what are family members’ perceptions of these highly charged words to avoid misunderstandings. It is helpful to also determine the players – for instance, no spouses. Two books, which are very helpful to assist in this process, are THE SETTLEMENT GAME, by Angie Morris and WHO GETS GRANDMA’S YELLOW PIE PLATE, by Marlene Strum and Marsha Goetting. Disputes in settling estates are often a major reason for adult siblings to break off relationships with one another for decades or even longer.