Stress and strain of moving

Researchers Cynthia Wyld, Patricia Duff, Sara
Arber and Kate Davidson report on their study examining the
reactions of residents, relatives and staff to changes caused by
temporary relocation when residential homes have to be rebuilt or

Moving home at any age can be a stressful and
sometimes traumatic experience, and older people who have already
moved from their individual homes into a residential home usually
hope not to have to move again. How should those responsible for
residential homes manage a necessary refurbishment programme in a
way that causes the least stress and distress to elderly

research1 considers issues resulting from temporary
relocation of residents in most of the 17 homes that Anchor Homes
took over from Surrey Council in 1998. It finds that staffing,
communication and timescale were the three main issues connected
with relocations.

staff were guaranteed daily transport to and from their new place
of work and encouraged to remain in employment. This was an
important issue for all homes in ensuring continuity of care. Some
staff were unhappy about moving to work in a new home, often five
to 10 miles from their previous place of work, while others took
the change as an opportunity to retire or change jobs. Senior staff
were more accepting and perceived the benefits of the

Communication with residents,
staff and relatives was undertaken during the 12-month preparation
period at each home, in accordance with plans agreed by Anchor
Homes. Information packs, meetings, and bulletins were used.
Residents were also consulted on the decor and furnishings of their
new room. Staff played a crucial role through their daily contact
with residents.

decision about when and how to communicate information to residents
raises important issues relating to choice, autonomy and rights.
Interviews with staff, residents and relatives suggest that these
have to be balanced with a concern for avoiding stress and ensuring
a continuity of familiar patterns. It was suggested by residents,
relatives and staff that the consultation process was too long.
Despite planning, consultation and reassurances, and in some cases
because of it, some residents became anxious about their future in
relation to friends, social life, familiarity of surroundings,
staffing and continuity of visits.

residents and relatives said they were content with the existing
surroundings and were unable to comprehend the long-term benefits
of change. Staff also expressed the view that residents would have
been better prepared by one-to-one sessions when they would be more
likely to express their anxieties.

were delays of at least a couple of months to the planned date of
the move at each home. Such delays were a common cause of anxiety
for all and constant updates were necessary.

were also a number of specific issues. The study found that there
were four models of relocation: two homes moved into one empty
refurbished building (model 1); one home split between two homes
with existing residents (model 2); one home moving to a newly built
home (model 3); and staying put during the refurbishment of their
home (model 4).

– In
the case of two homes into one previously refurbished home there
were two separate sets of staff and residents, each with their own
established practices and cultures, moved to co-reside in one
refurbished home. The timing for the move was critical and
collaboration between each of the home’s managers helped avoid
conflict of interests during the move.

home had a much higher number of mentally frail residents than the
other. Each home was relocated in different wings of the building;
the two homes retained separate care practices and staff and
residents did not mix.

Where one home was moved into two existing operational homes
residents were relocated into two homes that were geographically
close and could accommodate the “incomers” alongside their existing

residents needed relocating than was originally anticipated; no new
admissions had been made leading up to the move and there were a
higher number of deaths than predicted.

at each of the two homes had different views on staff integration.
At one home the two sets of staff reported that there had been no
difficulties working together – the staff mixed well and shared
information. The other home appeared to have many more
difficulties; existing staff reported that their jobs were more
demanding and tiring. The incoming residents had much higher levels
of dementia than the existing residents at both receiving homes.
The existing residents at one home complained that “temporary”
residents caused disruption within the home, particularly in the
lounge area. There were different cultures in each of the homes
brought together that meant that staff and residents had to adjust
to a number of issues. For example, there were different charges
and prizes for bingo at two homes that caused dissension among

– In
model 3 residents in one home were moved temporarily into a newly
built residential home. The new location was seen positively by
some residents because they had pleasant memories of the site,
where there had once been an army barracks. The new home was
spacious with a different layout from the original home. Staff
found it difficult to transfer their skills and procedures easily
into the new setting and took time to establish new patterns of
social activity. Staff observed that residents with mental health
difficulties fared better following the move than the residents
whose health problems were physically related. This contrasts with
the finding at one of the receiving homes in the 1 to 2

– The
main advantages of model 4 are that residents are able to stay on
in the same location and thus maintain familiarity, and established
patterns of visiting. The refurbishment was planned in five stages
with a number of rooms being refurbished in each stage. Residents
were moved around within the residential home in order to
facilitate the necessary works. Perhaps surprisingly, the constant
presence of builders and noise appear not to have been too

number of core issues can be identified across all four models of
relocation: the timing involved in preparation for the move,
communication methods, the need to preserve residents’ autonomy and
rights, emphasis on providing continuity of care and the
preservation of a social life. The retention of existing staff was
rated as highly desirable across all homes. The mixing of residents
with different levels of mental and physical frailty can create
discontent, anxiety and resentment, particularly among those who
have to accept incomers potentially disrupting their established
lifestyles. Established cultures exist within homes and changes in
location, staffing and social contacts may remove much that has
provided security and comfort.

this study, the two relocation models 1 and 2, which involved the
temporary mixing of staff and residents, were more problematic than
model 3, which allowed single home relocation to an empty
residential home. The least problematic was model 4, refurbished on
site that permitted the residents to stay in the home, albeit
changing rooms within it. Nevertheless, lessons can be learned from
each of these experiences of temporary moving.

Cynthia Wyld is research fellow,
Patricia Duff is research assistant, Sara Arber is professor of
sociology, and Kate Davidson joint director, all at the Centre for
Research on Ageing and Gender, University of Surrey. The authors
would like to thank Anchor Homes for funding the research. The
article represents the views of the authors and not those of Anchor


1 Cynthia Wyld,
Patricia Duff, Sara Arber, Kate Davidson, Managing Change
During The Rebuilding and Refurbishment of Residential Homes,
University of Surrey
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