Even when entered into voluntarily, the transition to senior living can pose a number of adjustment challenges to new residents. Although Continuing Care Retirement Communities (CCRCs) are entered into by choice, and although these communities offer a number of amenities to their residents, a number of difficulties are associated with such a major transition in living situations for some older adults. This could be due to the semi-public nature of such communities, concerns over eventually losing one’s autonomy, or many other reasons. A recent study in the Gerontologist attempts to characterize the variety of types of adjustments to the transition to CCRC living, by asking older adults to characterize their experiences in their first year in a CCRC.
This qualitative study focused on the experiences of 59 older adults across 12 CCRCs. Eight of these CCRCs were nonprofit organizations and four were privately owned. Half were chains, and half were not. The completed interviews with CCRC residents were analyzed for themes across study participants, and typologies of their experiences were created from this analysis.
Three major themes emerged about the transition to a CCRC. The first related to whether the transition was characterized as a discontinuity in the resident’s life course. The second theme related to whether the transition to the CCRC was taken with an orientation toward the resident’s past, present, or future. The third theme centered around whether the resident’s activities and interests were centered inside or outside the CCRC. These themes emerged in distinct patterns across the types of CCRC residents identified by this study, suggesting that each of these factors should be evaluated and taken into account as CCRCs attempt to assist with the transitions of new residents. Examining the patterns of these major themes, the researchers identified four types of CCRC residents: (1) “the shades of gray” type, (2) the “finally found it” type, (3) “the disapprover,” and (4) the “still searching after all these years” type.
The “shades of gray” type characterized 27 of the residents interviewed. These residents described their lives as a mix of good, bad, and mediocre experiences, and viewed the transition to a CCRC as a continuation of that pattern, so the transition was not experienced as a major discontinuity. These individuals were also very oriented to future decline, and looked on CCRCs as an outlet in the face of inevitable decline. These individuals’ activities and interests were also centered around the CCRC.
The “finally found it” type characterized 23 of the residents interviewed. These residents emphasized the discontinuity between negative past experiences and present positive ones. For these individuals, the CCRC brought safety, fulfillment, interest, and social engagement. These individuals were also very focused on the present and the activities and opportunities it provided. They were fully present in the CCRC, which met or exceeded their expectations. These residents had a limited desire to explore the outside community or maintain contact with their old community, and described CCRC activities and social relationships as filling up their day.
The “disapprover” type characterized six of the residents interviewed. These individuals viewed their overall past and present experiences negatively and viewed the transition to the CCRC as a continuation of dissatisfying life experiences. There was not a distinguishing time orientation of the disapprovers, but they tended to view the mix of past, present, and future in the same negative light. As for their place attachment, while disapprovers remained physically in the CCRC, mentally they were more present in their past community—despite the fact that their prior community no longer met their needs and that they had entered the CCRC willingly.
Lastly, the “still searching after all these years” type characterized only three of the residents interviewed. These residents described their lives as a “quest for ‘something else’ that has been unreachable, thus far.” However, even though they had not yet reached their intended goals, they also had not yet given up. Their transition to a CCRC represents a continuation of those goals, such as a search for true love. In light of such goals, these individuals remain future-oriented. This orientation also made these individuals feel atypical compared to their peers in the CCRC, and so these individuals did not perceive themselves as fully belonging to the CCRC.
While the proportions of these types may be of interest, it should not be assumed that these proportions are typical, since the interviews were not drawn from a representative sample. Instead, the researchers aimed to draw from as wide a swath of CCRC residents as possible to capture as many different experiences as possible.
By qualitatively drawing on the experiences of CCRC residents, the researchers have pointed to a variety of aspects of the experience of CCRCs that can ideally help administrators and health care professionals consider the experiences of residents in ways that can help identify their needs and dissatisfactions. Ideally, this can further help with the development of initiatives that can best serve the adjustment of the many types of residents moving into senior living.
Ayalon L and Greed O. A typology of new residents’ adjustment to Continuing Care Retirement Communities. The Gerontologist. (2015). gnu121 DOI:10.1093/geront/gnu121