"Aging in place" is the preference of most people because they want to maintain the comfort of their home, and stay in their community.(1) But the decision to age in place or to move is not so simple. A systematic review looked at the factors influencing the housing decision-making of frail older adults over the age of 65 (and without cognitive impairment).(2) This review identified 88 factors influencing decision-making, ranging from considerations related to health and access to care, finances, the built environment, but also psychological and psychosocial considerations.
The idea of aging in place can take on a whole new meaning for people who have experienced trauma such as neglect, oppression, sexual abuse, violence, complicated grief, or any other extremely difficult life event. Indeed, the living environment can amplify or reactivate these harrowing experiences.
For example, nearly one-third of Canadians have experienced sexual or physical abuse, and sometimes both, by an adult, before the age of 15.(3) That's not counting traumas experienced in adulthood… These people keep sequelae that can limit their ability to adapt throughout their lives, increase health risks (anxiety, depression, post-traumatic stress syndrome, heart disease and more) and lead to risky behaviours related to physical or sexual violence, mental illness, substance abuse, unemployment and even homelessness.
Do people who have suffered trauma in childhood or adulthood have the resilience to age in place or adapt to an environment that could offer them a better quality of life?
What the research tells us
A recent systematic review of 32 studies looked at the link between older adults with a history of trauma and what it means to age in place.(4) Although the analysis did not find clear links, it nevertheless highlighted some important findings:
- Aging in place does not necessarily mean living in the same house all your life, but rather reflects the possibility of obtaining the care required in the environment of your choice.
- The uncertainty and insecurities associated with aging can be exacerbated by past traumatic experiences.
- Living in inadequate and unsafe housing due to a lack of options does not promote independence and quality of life.
- Stress and hypersensitivity to housing-related sensory stimuli (for example, garish colors, unsanitary conditions, disturbing ambient sounds, foul odors, bright or dim lighting, etc.) can result from past traumatic events and cause re-traumatization leading to mental health issues.
- Housing insecurity or homelessness is a traumatic experience associated with great vulnerability, exacerbating the effects of aging and higher mortality.
- Supportive housing is an important resource for people in crisis.
- Accommodations are required and community support is essential to meet the needs of adults who want to age in place (or in the environment of their choice).
Whether or not you have experienced trauma, it is possible to create a healthier aging experience. Affordable housing solutions exist and adaptations are possible to allow you to feel safe at home.
If you need support after experiencing trauma and if you are going through a crisis, it is important to seek help. Local resources are there to help you: click here to find a resource near you.