Journal of Applied Gerontology

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DOI: 10.1177/07334648093355952009

2010 29: 231 originally published online 3 JuneJournal of Applied GerontologyKimberly J. Stoeckel and Frank Porell

Housing Relocation Expectations and FallsDo Older Adults Anticipate Relocating? : The Relationship Between

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Journal of Applied

Gerontology

Volume 29 Number 2

April 2010 231-250

2010 The Author(s)

10.1177/0733464809335595http://jag.sagepub.com

231

Do Older AdultsAnticipate Relocating?

The Relationship Between Housing

Relocation Expectations and Falls

Kimberly J. Stoeckel

Frank Porell

University of Massachusetts, Boston

The relationship between the occurrence of falls and the expectations older

adults have about making future residential moves is examined in this

research. Data from the 2002 Health and Retirement Study (HRS) are used

to analyze self-reported probabilities of moving among a nationally repre-

sentative sample of noninstitutionalized adults aged 65 and older. The results

show that falls were predictive of anticipation of housing relocation as indi-

cated by more than 50% reported probability of moving within the next 2 years.The results suggest that consideration of housing relocation is greater among

older adults who experience tangible events indicative of a trajectory of

deteriorating health.

Keywords: housing; residential relocation; falls

Housing relocation patterns among older adults, including moves initi-

ated by changes in health and disability, have been the focus of exten-sive research (for a review, see Walters, 2002). Past research suggests that

health status is a major contributor to residential migration in later life

(Choi, 1996; De Jong, Wilmoth, Angel, & Cornwell, 1995; Hansen &

Gottschalk, 2006; Litwak & Longino, 1987; Longino, Jackson, Zimmerman,

& Bradsher, 1991; Speare, Avery, & Lawton, 1991). However, little

research has explored the extent to which older adults consider and plan for

residential moves when facing increasing disability. Due to the unexpected

and sudden nature of many health events in later life, it is challenging to

Article

Manuscript received: August 26, 2008; final revision received: January 27, 2009; accepted:

March 7, 2009.

Authors Note: Please address correspondence to Kimberly J. Stoeckel; email: Kim.

[email protected]

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232 Journal of Applied Gerontology

examine how older adults anticipate and plan for housing relocation trig-

gered by health and disability. The unpredictability of many adverse medi-

cal events in late life may interfere with the ability to accurately anticipatefuture needs. However, certain subgroups of older adults (i.e. high fall risk)

may experience gradual, increased awareness of functional status changes

that may positively influence moving expectations.

The primary interest of this study is the relationship between falls and

expected probability of housing relocation among older adults. Housing

relocation, hereafter referred to as relocation, occurs when individuals

move from one residence to another. Falls, often recurrent, are common

among persons aged more than 65 years and greatly increase the risk ofinstitutionalization and mortality (Donald & Bulpitt, 1999; Nikolaus &

Bach, 2003; Tinetti & Williams, 1997). However, fall risk has been found

to decline if appropriate adjustments are made to daily routines and envi-

ronments (Nikolaus & Bach, 2003; Yuen & Carter, 2006). How older adults

who fall consider making residential moves provides insight into how func-

tionally declining individuals contemplate future housing needs.

Literature Review

Residential Relocation in Later Life

Residential moves are common throughout the life course and are typi-

cally associated with significant and transitional life-course events such as

marriage, career moves or retirement (Lu, 1999; Walters, 2000, 2002).

Although relocation occurs with much less frequency among older adults

than their younger counterparts, late life housing moves are common(Blake & Simic, 2005; Oswald & Rowles, 2006). The late life migration

developmental model, postulated by Litwak and Longino, is commonly

used as a theoretical foundation on which to examine residential patterns

among older adults. This model differentiates late life moves into three

distinct and nonconsecutive categories, each of which is prompted by dif-

fering life course events associated with aging (Litwak & Longino, 1987;

Robison & Moen, 2000).

An array of foreseen and unforeseen events trigger residential moves inlater life, including retirement, moderate or severe disability, or the loss of

a spouse (Choi, 1996; Colsher & Wallace, 1990; Oswald & Rowles, 2006;

Speare et al., 1991; Walters, 2000).Amenity moves, the first type of move,

is driven by motivations to seek leisure activities and pleasant climates

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Stoeckel, Porell / Do Older Adults Anticipate Relocating? 233

(Litwak & Longino, 1987). These migrants tend to be younger, healthier,

and wealthier individuals seeking locations that provide attractive features

and services (Walters, 2002). However, as people age, the decline ofphysical health and functional abilities can elicit different reasons to relo-

cate. Encompassing the second and third moves of Litwak and Longinos

migration model, assistance moves and institutional moves are motivated

by efforts to seek support and assistance within the community or institu-

tional settings in response to worsening health or increasing disability

(Robison & Moen, 2000; Walters, 2000, 2002).

Though health status is just one of many motivators of relocation (De

Jong et al., 1995; Oswald & Rowles, 2006), much attention has been givento the influence of health on relocation in later life. The effects of health are

complex and can influence relocation twofold. Although some research sup-

ports the proposition that declining health may hinder relocation (Robison

& Moen, 2000; Sommers & Rowell, 1992; Walters, 2000), most research

has found a positive relationship between status changes and residential

moves (Choi, 1996; Colsher & Wallace, 1990; De Jong et al., 1995; Findley,

1988; Glaser & Grundy, 1998; Longino et al., 1991; Speare et al., 1991).

Assistance movers represent a segment of the population taking proac-tive decisions to respond to health and functional status changes that might

negatively affect safety and well-being in current dwellings. Home symbol-

izes autonomy for many people (Wiles, 2005), and efforts to maintain

independence in living arrangements can motivate relocation among elders

experiencing functional status changes (Oswald, Schilling, Wahl, & Gang,

2002; Oswald & Wahl, 2004). Physical environments and individual health

and competency are interrelated, which is a foundational premise of the

environmental gerontology research domain (Lawton & Nahemow, 1973;

Oswald & Wahl, 2004). Moving to a different home environment prior to

institutionalization is one of many environmental adaptation options that

can lead to improved health and functional status (Oswald & Wahl, 2004),

helping to achieve the goal of residential autonomy in later life.

Residential Relocation Expectations

How older adults consider moving when facing changes in health and

disability requires closer examination. Do older adults contemplate andconsider residential moves prior to the development of serious health com-

plications or significant increases of dependence? Relocation in later life is

often a result of a long decision process (Oswald & Rowles, 2006) of which

considering the benefits of a range of environmental adaptations is an



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important component. Although assessments of future actions are subjective

and outcomes are susceptible to unknown future events, the measurement of

respondent expectations has been found to be successful in relation to eventualnursing home placement (Holden, McBride, & Perozek, 1997; Taylor,

Osterman, Acuff, & Ostbye, 2005). Despite the subjectivity and tentativeness

surrounding the future, expectation measurements can be useful tools to

produce valid estimates of actual behavior and are representative of respond-

ents contemplation of future, even if uncertain, events (Juster, 1997).

The little research that has explored the expectation about noninstitu-

tional relocation among older adult populations suggests that moving

expectations are linked with actuation of moves but may vary acrossunique situations experienced by older adults (Bradley, Longino, Stoller,

& Haas, 2008; Colsher & Wallace, 1990; Hansen & Gottschalk, 2006;

Robison & Moen, 2000). Multiple studies found that approximately half

of individuals, among those age 65 or older (Bradley et al., 2008; Hansen

& Gottschalk, 2006) or people of all ages (Lu, 1999), who indicate inten-

tions to relocate, had moved by follow-up. The apparent inconsistency in

anticipating residential relocation in late life can be partially explained by

the influence of complicating factors. For older adults, unforeseen and sud-den health events are particularly relevant in triggering residential moves

and place additional complications on accurately foreseeing future moves

(Colsher & Wallace, 1990). It is our contention that analysis of residential

relocation expectations among older adults may be strengthened by focus-

ing attention on subgroups that have experienced certain tangible life

events, such as falls, which can readily be perceived as indicating a trajec-

tory of deteriorating health and/or functional status.

Falls and Residential Relocation

Falls are common among older adults. Approximately one third of

community-dwelling adults aged 65 and older, and one half of adults aged

80 and older fall within a 1-year period (Donald & Bulpitt, 1999; Nikolaus

& Bach, 2003; Tinetti & Williams, 1997). Unintentional falls accounted for

63% of nonfatal injuries for people aged 65 and older, in 2005, and are the

leading cause of injury for this age group (Centers for Disease Control and

Prevention [CDC], 2006). Moreover, falls are the foremost cause of deathresulting from unintentional injury, accounting for 42.5% of this type of

death in 2004 (CDC, 2006). Among those older than 85 years, 80% of

unintentional injuries are caused by falls, and more than half of all deaths

caused by unintentional injury result from falls (CDC, 2006). It is important



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to note that not all falls lead to injury, immediate changes in functional

status, or the need for institutional placement. The CDC statistics only rep-

resent falls that lead to injury requiring medical care, suggesting that theprevalence of falls may be greater than the numbers imply.

Older adults with a history of falls comprise one subgroup for which unpre-

dictable health status changes can be lessened. The psychological effects of

falls are lingering and can lead to decreased confidence and restricted

activities, contributing to increased dependency and compounding the risk

of future falls (Fuller, 2000; Tinetti & Williams, 1997). Older adults who

fall have significantly lower measures of health status and functional status

when compared to nonfallers (Mann, Locher, Justiss, Wu, & Tomita, 2005),indicative of an interrelationship between physical well-being and fall risk.

Falls are a health and safety risk factor, often leading to nursing home or

hospital admissions (Donald & Bulpitt, 1999; Stevens, 2005; Tinetti &

Williams, 1997).

A majority of falls occur within or around the home, accounting for as

many as 75% of all falls among community-dwelling older adults (Yuen &

Carter, 2006). Falls research examining effectiveness of preventative meas-

ures suggests that fall risk can be reduced by 30% if adjustments areapplied to a persons daily routine and/or housing environment (Nikolaus

& Bach, 2003). Though home modification is one approach available to

lessen fall risk, financial cost is prohibitive (Pynoos & Nishita, 2003), and

research suggests low levels of compliance with proposed housing modifi-

cations or alterations to daily routine among older adults (Nikolaus & Bach,

2003; Yuen & Carter, 2006). Moving into a housing environment better

suited to changing needs represents an alternative to home modification for

older adults seeking more supportive home environments (De Jong et al.,

1995; Speare et al., 1991; Tabbarah, Silverstein, & Seeman, 2000).

Notwithstanding the tenacious strength of place attachment that may hinder

willingness to consider housing moves in later life (Hays, 2002), changing

home environments is a key option to attain one-floor living space, elevator

access, or even universally designed housing accessible for persons with

disabilities (Pynoos, Sabata, & Choi, 2005).

Older adults who report falls are an important subgroup to consider

when examining older adults expectations about residential relocation.

Recurrent fallers have been found to be more likely to comply with homeintervention programs (Nikolaus & Bach, 2003) and may, therefore, be

more willing to consider moving as a means to adapt home environments

to be better suited to their physical needs. This particular subgroup may

have greater awareness of declining health and functionality and be more

inclined to explore relocation options.



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Research Objectives

Additional research is needed to build better understanding of how olderadults consider future housing needs in response to health, functional, and

disability status changes. Most residential relocation research has focused

on differentiating characteristics between older adults who do and do not

move but do not measure the degree to which older adults anticipate relo-

cating (Chen & Wilmoth, 2004; Choi, 1996; De Jong et al., 1995; Glaser &

Grundy, 1998; Longino et al., 1991; Sommers & Rowell, 1992; Speare

et al., 1991). The few studies that have examined moving intentions are not

generalizable because they use small and nationally unrepresentative sam-

ples (Colsher & Wallace, 1990; Robison & Moen, 2000), are limited to

specific relocation destinations (Silverstein & Angelelli, 1998), or exclude

the oldest subjects (Hansen & Gottschalk, 2006; Robison & Moen, 2000).

Exclusion of the oldest individuals is particularly noteworthy because this

subpopulation of older adults is most likely to be experiencing health and

functional declines associated with assistance migration relocation.

The research question addressed in this study is whether or not older

adults who report falling in the past 2 years are more likely to anticipate

moving within the following 2 years. This research question embodies animportant link between consideration of residential relocation and concrete

events that negatively affect safety and well-being in the home. Three

important components of this research contribute to further development of

the literature in this field. First, by expanding the sample to include the

oldest of the older adult population, the sample will encompass persons

most likely to be experiencing frailty and increasing limitations in manag-

ing within their home environments. Second, use of a large, nationally

representative data set (Health and Retirement Study [HRS]) will enhancethe generalizability of the results. Lastly, by relating the expectation of

future moves to the recent occurrence of falls, the analysis will be sensi-

tized to respondents experiencing tangible events suggestive of decreasing

functionality and safety within home environments.

Conceptual Model

The behavioral model of late life migration, developed by Wiseman,provides a conceptual foundation for this study. An underlying assumption

of the model is that individuals continuously reevaluate their residential

situation with respect to their needs, desires, resources and perceptions of

potential outcomes (1980, p. 146). Accordingly, this model maintains that



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every person has a potential to make a residential move. Residential reloca-

tion is broken down into two interrelated decisions: the decision about

whether or not to move, and the decision about where to move. The consid-eration of residential moves, the first component of this model, results from

a myriad of factors that interact with individuals external environments

and personal characteristics. The most notable of these influential charac-

teristics are health, economic status, and home ownership status, all of

which can facilitate or impede the ability to engage in the second compo-

nent of the model, actual residential relocation.

Within this behavioral model of late life migration, circumstances that

cause individuals to reassess the appropriateness of housing arrangementsare defined as trigger events. Connected either to push factors or pull fac-

tors, these triggers can encompass a range of events, including retirement,

negative changes in health status, or widowhood. Pull factors positively

facilitate relocation and include the desire for amenities, attractive retire-

ment settings, or social networking. In the alternative, push factors also

prompt the reassessment of residential environment but result from disabil-

ity, changes in health, or increasing awareness of inappropriate fit of hous-

ing or neighborhood environments. Whether push or pull, these triggersresult in individuals reevaluating the adequacy of current housing, inde-

pendent of the actuality of moving.

In this study, we examine the first component of the two-step process of

residential relocation as presented in this theory, the decision to move and

the events that may prompt older adults to contemplate relocation More

specifically, this research will focus on falls, a specific push factor influenc-

ing elders to contemplate relocation due to the clear relationship between

housing environments and fall risk (Nikolaus & Bach, 2003; Pynoos et al.,

2005; Tabbarah et al., 2000; Yuen & Carter, 2006). We hypothesize those

older adults who report falling will be more likely to indicate probability of

relocation within the next 2 years.

Method

Sample

The analysis is based on data from the 2002 wave of the HRS, a nation-

ally representative longitudinal survey about health, employment, eco-

nomic status, and family structure of sample respondents (see Juster &

Suzman, 1995, for detailed review of HRS). The study population is first



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restricted to community-residing HRS self-respondents aged 65 or older, of

White, Black, or Hispanic race/ethnicity. A small number of respondents

with missing data on study variables (n = 672) were excluded from theanalysis sample. More than half of these (n = 389) were dropped because

of missing data for the dependent variable due to structural patterns for

expectations questions in the HRS questionnaire. The final sample is com-

prised of 8,462 respondents.

Measures

Dependent variable.A series of questions about expectations of an arrayof future events are included in the HRS study for which respondents rate

the probability of occurrence on a scale of 1 to 100, with greater scores

indicating higher probability of occurrence. The expectations question ask-

ing respondents to indicate the probability of making a residential move in

the following 2 years was used to construct a dependent variable with three

categories (0%, 1%-50%, 51%-100%). For simplicity in exposition, we

will refer to these outcome categories as no, moderate, and highrelocation

or moving expectations in our discussion of results. Analyses were per-formed to test the sensitivity of the empirical results to alternative specifi-

cations of the dependent variable, including different category compositions.

None of these alternative specifications produced more satisfactory empir-

ical results.

Falls variable. The home environment can be a fall risk factor (Nikolaus

& Bach, 2003; Yuen & Carter, 2006), and older adults can make adjust-

ments to the home environment to reduce this possibility.

The HRS variables related to self-report of falls during the past 2 years are

collapsed into a dummy variable distinguishing respondents who reported

having fallen one or more times during the past 2 years from nonfallers.

Health and well-being independent variables. Health and well-being

characteristics found to affect late life relocation in past research were

specified as variables. Poor self-reported health, operationalized as a

dummy variable in this study, has been found to both encourage and dis-

courage residential relocation expectations (Hansen & Gottschalk, 2006;Silverstein & Angelelli, 1998). Counts of activities of daily living (ADL)

deficits (personal care needs) and functional limitations (mobility and

physical strength) are related to relocation (Choi, 1996; Silverstein &

Angelelli, 1998; Sommers & Rowell, 1992) and were specified sensitive to

HRS skip patterns (see Wallace et al., 2004). In addition, a count of



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depressive symptoms was specified, with reverse coding on 2 of 8 ques-

tions from the CESD-8 (Centre for Epidemiologic Studies Depression

Scale) scale (see Turvey, Wallace, & Herzog, 1999).

Housing characteristics variables.The relationship between home own-

ership status and residential relocation among older adults is well docu-

mented in the literature, with home ownership deterring expectations

(Hansen & Gottschalk, 2006; Silverstein & Angelelli, 1998) and actual

moves (Bradley et al., 2008; Choi, 1996; De Jong et al., 1995; Longino

et al., 1991; Meyer & Speare, 1985; Sommers & Rowell, 1992; Speare

et al., 1991). Home ownership status was coded as a dummy variable dif-ferentiating renters from owners.

Older adults who have resided in their current home environment for

longer durations are less likely to expect to move (Silverstein & Angelelli,

1998) or make a residential move (De Jong et al., 1995; Longino et al., 1991;

Meyer & Speare, 1985; Sommers & Rowell, 1992; Speare et al., 1991).

Duration of residence was computed from data about reported moves

between all HRS waves, beginning with the 2002 HRS. Due to limita-

tions in HRS questions about residency length in the content of questionsacross waves, duration of residence could not be finely measured and resulted

in missing data for a fairly large number of respondents. Categorical dummy

variables were specified to distinguish between three subgroups of respond-

ents, including those with missing information on length of residence.

Living arrangements and proximity to informal caregivers can also

influence expectations about relocation. Living alone is positively related

to both moving expectations (Colsher & Wallace, 1990; Silverstein &

Angelelli, 1998) and actual late life moves (Colsher & Wallace, 1990; De

Jong et al., 1995). Living arrangement was operationalized as a dummy

variable, distinguishing respondents who lived alone from those who core-

sided with any other person. Research also suggests that older adults relo-

cate to be nearer to adult children when experiencing declines in health and

functionality (Rogerson, Burr, & Lin, 1997). The presence of nearby adult

children has been found to reduce relocation expectations or actuation of

relocation (De Jong et al., 1995; Silverstein & Angelelli, 1998). The proxim-

ity to children dummy variable distinguishes respondents who live within 10

miles of at least one of their children from respondents with no children liv-ing nearby. The presence of friends or relatives as neighbors also influences

how attached older adults are to neighborhood and home environments.

Additional dummy variables were created to measure whether respondents

had relatives or good friends living in their neighborhood.



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Marital status variables.The literature suggests that widowhood trig-

gers relocation (Choi, 1996; Meyer & Speare, 1985; Sommers & Rowell,

1992). Marital status was operationalized as categorical dummy variables.

The recent death of a spouse has also been found to influence residential

relocation among older adults (Chevan, 1995; Choi, 1996) and to increase

expectations and actuality of moving (Colsher & Wallace, 1990; Hansen &

Gottschalk, 2006; Robison & Moen, 2000). A dummy variable was speci-

fied to distinguish respondents who reported that their spouse had died inthe past 2 years.

Demographics. An array of sociodemographic variables, including age,

gender, education, race/ethnicity, household income, net worth, and retire-

ment status, were specified as additional control variables. Because net

worth and income were highly skewed, these variables were specified with

categorical dummy variables based on quintiles of their distribution for the

full sample of 2002 HRS respondents. Table 1 contains a summary of vari-

able definitions for these and all other variables specified in the models.

Empirical Results

Descriptive Statistics

Table 1 and 2 contain descriptive statistics of the weighted study sample.

Table 1 outlines the sample distribution according to the three categoriesof the dependent variable. Table 2 contains the sample means and standard

deviations for the independent variables used in the analysis. The majority

of the sample were women (59%), non-Hispanic White (87%), homeown-

ers (81%), and retired (69%), with a mean age of 74.5 years. Married

Table 1

Dependent Variable Category Descriptives Housing

Relocation Expectation Within Two Years

N %

No expectation (0%) 5,428 64.1

Moderate expectation (1%-50%) 2,393 28.3

High expectation (51%-100%) 641 7.6

Total sample 8,462 100.0



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Table 2

Descriptive Statistics and Variable Descriptions

Variable Listing Description M SD

Faller 1 = 1falls in past 2 years, 0.27 0.45

0 =no falls

Health and well-being variables

Fair/poor self-reported health 1 =fair, poor; 0 =excellent, 0.27 0.44

very good, good

Depressiona Count of CESD symptoms (0-8) 1.47 1.87

Functional limitationsb Count of functional 2.34 2.19

limitations (0-9)Activities of daily Count of ADL (0-6) 0.33 0.88

living (ADL) limitationsc

Housing characteristic variables

Renter 1 =renter, 0 =homeowner 0.19 0.39

Duration of residency: 1 =3 years of residency 0.90 0.30

3+ years in current home

Duration of residency: 1 =missing residency data 0.02 0.14

missingd (2 years residency)

Lives alone 1 =lives alone, 0 =lives 0.32 0.47

with spouse or othersProximity to children 1 =lives within 10 miles 0.37 0.48

of child(ren), 0 =other

Relatives in neighborhood 1 =relatives in neighborhood, 0.32 0.46

0 =other

Good friends 1 =good friends in 0.75 0.43

in neighborhood neighborhood, 0 =other

Marital status variables

Divorced/separated 1 =divorced/separated 0.09 0.29

Widowed 1 =widowed 0.32 0.47

Never married 1 =never married/single 0.03 0.18(married)

Recent death of spouse 1 =spouse death in past 0.04 0.20

2 years, 0 =other

Demographic variables

Age Number of years (65) 74.47 6.77

Male 1 =male, 0 =female 0.41 0.49

Education Number of school 12.29 3.08

years completed

Non-Hispanic Black 1 =Non-Hispanic Black 0.08 0.26

Hispanic 1 =Hispanic 0.05 0.21(Non-Hispanic White)

Low incomee 1 =


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respondents accounted for more than half of the sample (56%). One third

of the sample reported being widowed (32%), but only 4% of the sample

indicated a recent death of a spouse. Living with or living near possible infor-

mal support caregivers is predominant. About 67% of the participants did not

live alone, nearly 40% lived near adult child(ren), one third reported living

near relative(s), and two third indicated having good friends in their neigh-

borhood. Approximately half of the sample had mid- to mid-high income(48%), but more than one fourth (27%) were in the highest asset category.

One fourth of the sample (27%) had fallen one or more times in the past

2 years. Likewise, 27% of the sample self-reported being in fair or poor

physical health. However, average counts of ADL and functional limita-

tions were relatively low (0.33 and 2.34 respectively).

Multinomial Logistic Regression

A multinomial logistic regression model on weighted observations was

estimated using the nomregprocedure of the statistical package, SPSS

(Version 16.0). Although our dependent variable is ordinal, we did not find

statistical support for the proportional odds assumption that underlies an

Table 2 (continued)

Variable Listing Description M SD

Middle income 1 = $20,829-$35,190 0.25 0.43

Middle-high income 1 = $35,191-$62,975 0.23 0.42

(High Income: $62,976+)

Low net worth 1 =$20,000 0.13 0.34

Moderate net worth 1 = $20,000-$86,999 0.17 0.37

Middle net worth 1 = $87,000-$191,999 0.20 0.40

Middle-high net worth 1 = $192,000-$436,399 0.23 0.42

(High net worth: $436,400+)

Retired 1 =retired, 0 =other 0.69 0.46

Notes: N = 8,462. Reference categorical dummy variable is provided within double quote

marks.

a. CES-D symptoms: depressed, activities required effort, restless sleep, unhappiness, loneli-

ness, did not enjoy life, sad, unmotivated.

b. Functional limitations: walking, sitting, standing, climbing stairs, stooping, reaching, pull/

push objects, lifting, picking up a dime.

c. ADL: dressing, walking, bathing, eating, getting in/out of bed, toileting.

d. Assigned 1 if missing data for duration of residency variable.

e. Household income and wealth variables delineated based on quintiles of full 2002 HRS

sample.



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Table 3

Multinomial Logistic Regression Model: Self-Reported

Expectation of Future Housing Relocation Within 2 Years

Moderate Relocation High Relocation

Expectations Expectations

1%-50% vs. 0% 51%-100% vs. 0%

Variable Listing OR 95% CI OR 95% CI

Faller 0.96 0.86-1.08 1.32** 1.10-1.60

Health and well-being variables

Fair/poor self-reported health 0.95 0.83-1.08 0.93 0.74-1.16Depression 1.04* 1.01-1.07 1.15*** 1.09-1.20

Functional limitations 1.01 0.98-1.04 1.00 0.95-1.04

Activities of daily living 0.98 0.91-1.05 0.93 0.83-1.05

(ADL) limitations

Housing characteristic variables

Renter 1.56*** 1.31-1.86 2.05*** 1.55-2.70

Duration of residency: 3+ years 1.02 0.85-1.23 0.93 0.70-1.25

Duration of residency: missing 0.78 0.51-1.19 1.33 0.74-2.42

Lives alone 1.18 0.99-1.40 1.20 0.91-1.57

Proximity to children 1.26*** 1.14-1.40 1.57*** 1.32-1.87Relatives in neighborhood 0.74*** 0.66-0.82 0.65*** 0.53-0.79

Good friends in neighborhood 0.92 0.82-1.03 0.79* 0.65-0.95

Marital status variables

Divorced/separated 1.04 0.82-1.30 1.34 0.94-1.93

Widowed 0.96 0.80-1.16 1.08 0.80-1.47

Never married 1.46* 1.07-1.99 1.81* 1.10-2.98

Recent death of spouse 1.18 0.92-1.52 1.49* 1.02-2.19

Demographic variables

Age 0.98*** 0.97-0.99 0.97*** 0.96-0.99

Male 0.94 0.84-1.05 0.76** 0.63-0.93

Education 1.12*** 1.10-1.14 1.07*** 1.04-1.11

Non-Hispanic Black 0.89 0.72-1.10 1.20 0.87-1.66

Hispanic 0.63** 0.46-0.85 0.81 0.51-1.28

Low income 0.72** 0.56-0.92 0.38*** 0.25-0.58

Moderate income 0.78* 0.64-0.95 0.57** 0.40-0.79

Middle income 0.79** 0.66-0.93 0.58*** 0.43-0.78

Middle-high income 0.93 0.79-1.08 0.68** 0.52-0.90

Low net worth 0.80 0.62-1.03 0.94 0.63-1.41

Moderate net worth 0.77** 0.64-0.93 0.81 0.59-1.11

Middle net worth 0.90 0.77-1.06 0.90 0.68-1.20

Middle-high net worth 0.93 0.81-1.07 0.77* 0.59-1.00Retired 1.20** 1.07-1.35 1.22* 1.00-1.47

Notes: Reference Category no relocation expectation (0%).N= 8,462; pseudoR2= .06; OR= odds

ratios; CI = confidence interval.

*p< .05. **p< .01. ***p< .001.



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ordinal logit model specification. This led us to estimate a less restrictive

multinomial logistic model in this analysis. The empirical results are reported

in Table 3. The table contains estimated odds ratio transformations of themultinomial logit model parameters and corresponding 95% confidence

intervals for the two outcome categories of moderate and high expecta-

tions of moving relative to a common reference category of no expecta-

tion of moving.

Results

The hypothesized relationship between falls and greater self-reportedexpectations for relocation was supported in the analysis. Respondents who

reported one or more falls had 32% greater expected odds of reporting a

high expectation of moving in the next 2 years over no expectation of mov-

ing relative to nonfallers. Of the health and well-being variables, the results

suggest that depression is the only factor significantly related with reloca-

tion expectations. The odds of moderate expectation and high expectation

of moving over no expectation increased with each additional depression

symptom by 4% and 15%, respectively.The empirical results suggest that both housing and proximity of social

contacts (family and friends) influence whether or not older adults consider

future residential moves. As hypothesized, moving expectations are greater

among renters than homeowners. The odds of reporting moderate or high

expectations of moving over no expectation of moving are about 56% and

105% greater, respectively, among renters relative to otherwise similar

homeowners. Interpersonal relationships and proximity to family members

and neighbors were also found to be associated with consideration of resi-

dential moves. The odds of moderate and higher moving expectations were

26% and 35% lower, respectively, among respondents who indicated hav-

ing relatives in the neighborhood compared to otherwise similar respond-

ents without relative neighbors. The presence of good friends only lessened

the odds of high moving expectations (21%), compared to otherwise simi-

lar respondents without such sources of neighborhood social contact.

However, the nearby presence of children increased expected odds of

reporting a probability indicative of moderate and high relocation expecta-

tions by 26% and 57%, respectively.Respondents who were widowed in the past 2 years had a 49% greater

odds of reporting high over no expectations of relocating in the near future

relative to their counterparts who were widowed longer than 2 years ago or

not widowed. Never being married was the only marital status variable

found to be associated with both moderate and high moving expectations.



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Respondents who were never married had 46% and 81% greater odds of

reporting moderate or high expectations of moving relative to no expectation,

as compared to otherwise similar respondents who were married.Several sociodemographic characteristics were also found to have a

significant relationship with expectations of future relocation. Increasing

age decreased the odds of reporting moderate and high moving expecta-

tions by 2% and 3% per each additional year. Education increased the

expected odds of reporting moderate and high relocation expectations over

no expectations by 12% and 7%, with each additional year of schooling,

respectively. Retirement status similarly increased the expected odds of

reporting moderate and high moving expectations by 20% and 22%, respec-tively. Lastly, the empirical results suggest that household income influ-

ences individual expectations about relocation. Overall, respondents with

lower income expressed lower expected odds of moving compared to

respondents with the highest level of income.

Discussion and Conclusions

Factors influencing respondents expectations about moving in the next

2 years were examined in this analysis. The relationship between expecta-

tions about moving and the occurrence of falls was emphasized due to the

interaction between fall risk and housing environment (Nikolaus & Bach,

2003; Yuen & Carter, 2006). The analysis revealed a significant relation-

ship between falling and relocation expectations. Older adults who had

fallen one or more times in the past 2 years were significantly more likely

to report a higher probability (>51%) of near future residential relocation.

This relationship was not significant among respondents who indicated

50% or lower nonzero probability of their likelihood of moving in the next

2 years. The finding implies that falling in later life can lead to older adults

contemplating alternative housing as a possible means to alleviate fall risk

and to enhance safety and overall functional performance. However, the

analysis suggests that recent falls is just one of multiple factors that influ-

ence expectations about future moves. It is, therefore, necessary that the

relationship between recent falls and relocation expectations be analyzed in

combination with other significant predictors.The strength and saliency of housing and proximity of social contacts

must also be considered as a possible deterrent for older adults in contem-

plating relocation, even when falls occur. The importance of individual

attachment to home and neighborhood in the consideration of moving is

demonstrated in the analysis outcomes. As hypothesized, older adults who



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rented were significantly more likely to expect to move in the next 2 years

than homeowners. This association may be attributable to decreased place

attachment and a developed lifestyle pattern of residential relocation thatmay accompany a history of living in rental units.

Neighborhood social networks also appear to be significantly related to

how older adults consider future residential moves. Respondents who report

living near relatives were overall less likely to expect to move. Those who

have good friends as neighbors were less likely to indicate a higher probabil-

ity of moving. These results imply that older adults perceive their social

networks to be very important and are less willing to consider moving if it

requires them to leave the support of family and friends. One exceptionappears to be living within close proximity to one or more adult children.

Adult children are a primary source of support and assistance for aging

adults as dependency increases. It would be expected that the nearby pres-

ence of children would lessen the likelihood that older adults would antici-

pate or need to make a residential move. However, respondents who

reported living within 10 miles of an adult child(ren) were overall more

likely to expect to move in the next 2 years. A possible explanation is that

many older adults may plan to move in and coreside with a nearby child. Inthe alternative, the nearby presence of adult children could be suggestive of

greater involvement of children in older adults lives. Closer proximity

allows for adult children to be directly aware of their parents health and

environmental circumstances. These adult children may be more engaged

in discussing and encouraging housing alternatives with parents who are

facing increasing misfit with their home environment.

The empirical findings of this analysis also lend support to the already

well-documented relationship between recent widowhood and relocation

(Chevan, 1995; Choi, 1996; Colsher & Wallace, 1990; Hansen & Gottschalk,

2006; Robison & Moen, 2000). This research validates this relationship by

demonstrating that the recent death of a spouse is only significantly related

with relocation expectations among those respondents reporting greater

than 50% probability of moving. This is suggestive of the strength of the

relationship between recent widowhood and actualization of relocation, a

finding supported by previous research (Chevan, 1995; Choi, 1996; Colsher

& Wallace, 1990; Hansen & Gottschalk, 2006; Robison & Moen, 2000).

Household income was also demonstrated in this research analysis to bea salient and influential factor on residential relocation expectations in later

life. Overall, it appears that older adults in lower-income brackets are less

likely to anticipate moving to a different housing setting in the near future

compared to those with highest income levels. This may be a result of fewer

housing options being available for older adults in the lower-income category



19/22


(Reschovsky, 1990) and the constraints these individuals may experience

when exploring alternative housing. These findings imply that older adults

with lower income are less likely to seriously consider relocation even ifexperiencing falls and highlight the importance of creating affordable hous-

ing options for a broader economic base of older adults.

Overall, the empirical findings of the analysis lends support for the idea

that older adults do anticipate and consider relocation when experiencing

tangible events indicative of a trajectory of deteriorating health and/or

functional status. This result lends additional empirical support for the

environmental gerontology assertion that environmental contexts and health

and functional status are interrelated (Oswald & Wahl, 2004) by suggestingthat older adults do consider relocation, one of multiple environmental

adaptations, to possibly have a preventive role in future health outcomes.

However, the subjective considerations about housing, such as attach-

ment to place and the sense of identity garnered from a familiar home envi-

ronment, are extremely salient among older adults and can serve as barriers

to implementation of environmental changes that might be beneficial for their

physical well-being (Nygren et al., 2007; Oswald & Rowles, 2006; Oswald

& Wahl, 2004). The findings of this study, suggestive of a significant relation-ship between falls and expectations about relocation, indicate that older

adults do consider relocation under certain circumstances. Therefore, the

importance of incorporating information about residential options within

elder service programs is valid and should be encouraged. Not only would

this provide greater access to education for those already considering hous-

ing alternatives, it would create opportunities for older adults resistant to

environmental adaptations to be exposed to the potential benefits of such

actions. More emphasis on the link between a range of housing adaptations

and the maintenance of independence and autonomy would help counteract

the subjective barriers to potentially beneficial environmental adjustments.

Several limitations to this study should be acknowledged. HRS respond-

ents were not asked to report on their motivations for considering residen-

tial moves or into what type of housing environment they intended to move.

Therefore, different types of late life moves, as theorized by Litwak and

Longino (1987), were not controlled for in the analysis. The characteristics

and motivations of amenity movers differ from those who make assistance

moves. By not differentiating between these unique characteristics, the rela-tionship between falls and expected probability of moving may have been

weakened. Home environment characteristics were another dimension not

incorporated in this study. Respondents who reside in senior-friendly

dwellings or choose to make modifications to their homes may be less

inclined to consider moving, even if experiencing falls.



20/22


The findings of this analysis lead to additional research questions that

can be explored in future studies. Although we tested some alternative

model specifications where respondents who had at least one fall requiringmedical treatment were distinguished from other fallers, the results were

not any more informative than those reported here. We speculate that at

some frequency level repeated minor falls may exert a similar influence on

moving expectations as an isolated, more serious fall requiring medical

treatment. Additional research sensitive to differences between fallers

would be beneficial and strengthen understanding of the relationship

between the severity and frequency of falls and residential relocation con-

siderations. In addition, the cross-sectional design of the study is limited inexplaining whether or not older adults expectations about future moves are

predictive of actual relocation. A longitudinal examination of expectations

about housing moves would allow for follow-up analysis of study respond-

ents and broaden the understanding of the relationship between relocation

expectations in later life and the actuality of outcomes.

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Kimberly J. Stoeckel, MS, is a doctoral candidate in the gerontology department at the

University of Massachusetts, Boston. Her research interests include housing, aging in place,

and residential relocation in late life.

Frank Porell, PhD, is a professor in the gerontology department at the University of

Massachusetts, Boston. His research interests include Medicare service utilization patterns,

long-term care, and nursing homes.

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