Unveiling the Relocation Journey: A Qualitative Study of Key Factors Influencing Older Adults’ Decisions to Relocate to Senior Living Communities

Abstract

This study aimed to develop a comprehensive understanding of the decision-making process among older adults regarding leaving their homes and relocating to senior living communities (SLCs) in the United States. Specifically, it explored various aspects of the relocation experience, including the reasons behind their decision to relocate, the factors influencing their choice of destination, and the challenges encountered during the decision-making process. The study’s data were collected from 44 older adults residing in SLCs through five in-depth, semi-structured focus group discussions. The study results revealed that older adults’ decisions to relocate to an SLC were influenced by health-related factors, housing- and property-related factors, family dynamics, and socio-psychological factors. Older adults evaluated environmental and locational factors, facility attractions and amenities, and opportunities for socialization when selecting an SLC for relocation. Additionally, the study identified several barriers faced by older adults, including family-related barriers, economic constraints, socio-psychological barriers, and barriers related to knowledge and information about SLCs.

1. Introduction

The global demographic landscape is undergoing a profound transformation as the world’s population ages at an unprecedented rate. Projections suggest that the global population of individuals aged 60 and older will double, reaching 2.1 billion by 2050 [1]. The United States is also experiencing a significant demographic shift, with recent forecasts predicting that more than 22% of the U.S. population will be aged 65 or older by 2040 [2]. While this aging trend presents various opportunities for older adults, families, and society as a whole, enabling many older adults to live longer and continue contributing to the economy, it also introduces a distinct set of challenges. As more Americans reach the age of 65 and live longer, the prevalence of chronic conditions, cognitive impairment, and disabilities among older adults is expected to rise alongside an increasing life expectancy. Recent forecasts suggest that approximately 56% of Americans reaching the age of 65 will require long-term care services due to significant cognitive or physical decline [3]. Consequently, the demand for paid long-term care and support services among older adults is expected to rise substantially in the foreseeable future.

With increasing care needs, older adults often face the complex decision of either relocating to a long-term care facility or aging in place with formal or informal care services. For instance, an exploratory study by Sim et al. [4] explored the experiences and impacts of relocation during a community housing redevelopment for older adults. The findings revealed that psychological and emotional reactions to relocation were complex. Many participants initially experienced reluctance and anxiety at the prospect of moving. These feelings were often linked to the duration of time individuals had lived in their homes. Additionally, the study indicated that the relocation process was perceived to become more difficult as people aged, suggesting that attachment to one’s environment becomes more significant in preserving identity in older age. A key source of anxiety for participants was the perceived threat to their way of life, which was frequently associated with attachment to the natural environment.

The vast majority of older adults prefer to remain in their homes and communities, maintain independence for as long as possible, and avoid relocation to institutional settings [5,6,7,8]. Aging in place enables older adults to maintain valued aspects of their lives, such as privacy, flexibility, autonomy, and convenience, which have been integral to their well-being [9,10]. While some older adults can continue aging in place by modifying their home environments and independently securing support care and services, for many others, relocating to institutionalized settings may become the only viable solution to meet their diverse needs [11,12]. A longitudinal study by Ronkainen et al. [13] examined the self-reported well-being among older adults during their initial year in a senior housing facility. To assess the statistical significance of changes in well-being between two measurement points, a nonparametric homogeneity test was conducted. The findings indicated statistically significant increases in feelings of security, alongside decreases in independence, particularly in terms of the ability to manage daily activities, over the study period. Moreover, the study also revealed a reduction in feelings of loneliness among participants.

In another study based on the classic push and pull framework of Lee [14], Smetcoren et al. [15] investigated whether individual differences among older adults could predict specific push and pull factors, such as housing, health, neighborhoods, and social contact. The findings revealed that respondents with lower household incomes and poor mental health were significantly more likely to have relocated due to stressors that pushed them from their previous residence. In contrast, older adults with higher household incomes or who were homeowners were primarily attracted to move by more appealing environmental factors.

While aging in place is considered an alternative to relocating to structured community environments such as independent living, assisted living, or retirement communities, many older adults who choose to remain in their own homes often lack the necessary amenities to accommodate the cognitive and functional decline associated with aging, including disabilities and dementia. In addition, an unsuitable environment, inadequate housing conditions, and physical structures that are not adapted for an aging population can create various mobility challenges, increasing the risk of accidents and falls [16]. Among individuals aged 65 and older in the United States, unintentional falls are the leading cause of both injuries and fatalities [17]. Unfortunately, as most homes and communities lack the structural features necessary to support healthy aging, aging in place independently within poorly built environments may not be a safe or viable long-term care option for many older adults.

The majority of older adults who choose to age at home depend on informal caregivers for support [18]. The demand for informal care is expected to rise as more baby boomers reach the age of 65. However, contemporary social shifts—such as smaller family sizes, increased female workforce participation, declining birth rates, and the greater geographical mobility of children—are contributing to a decline in the availability of family and social support for older adults [19]. Studies have reported that one in four individuals experiencing a gray divorce (late-life divorce) in 2019 was aged 65 or older, and this trend is expected to increase in the future [20]. Children who experience parental divorce may be less willing or able to provide care for their aging parents [21]. These demographic and societal shifts are expected to reduce the availability of individuals who traditionally have served as informal caregivers, potentially creating a significant care gap and leaving many older adults with unmet care needs. For those who choose formal care services, the high cost of home care, a limited awareness of the available options, difficulties in coordinating care, and insufficient knowledge about home healthcare can make aging in place both an emotional and financial burden. On the other hand, relocating to senior living communities (SLCs) can provide older adults with a safe housing environment and appropriate care.

SLCs are classified into five categories based on the level of care provided: independent living, designed for active older adults seeking an upscale, self-sufficient lifestyle; assisted living, which supports seniors who require assistance with daily activities but do not need round-the-clock care; skilled nursing, providing 24/7 medical care for individuals who can no longer be cared for at home; memory care, specifically tailored for those with Alzheimer’s disease or other memory-related conditions; and continuing care retirement communities (CCRCs), which integrate multiple levels of care, including independent living, assisted living, skilled nursing, and memory care, within a single community [22,23]. Over the past two decades, SLCs have transitioned from primarily providing healthcare services similar to those offered by nursing homes to embracing a person-centered approach that prioritizes the individual needs and preferences of residents [24].

Residents in SLCs experience greater emotional, social, physical, intellectual, and vocational wellness compared to older adults who age at home [25]. These communities promote a residential lifestyle with a less institutionalized atmosphere, integrating various hospitality elements and services to enhance residents’ well-being and overall satisfaction. These services may include diverse dining experiences and recreational and wellness activities (e.g., pools, fitness centers, nutrition programs, and social events), as well as amenities such as housekeeping, laundry, personal conveniences (e.g., hair salons, bank services), and transportation. Additionally, state-of-the-art features traditionally associated with luxury hotels and resorts are becoming increasingly prevalent in SLCs. As a result, affordable purpose-built SLCs may serve as an attractive housing and care option for a growing number of older adults.

Seniors’ relocation has been extensively studied across various disciplines, including demography, marketing, psychology, and gerontology, resulting in the development of several conceptual frameworks that explain the relocation process. Lawton and Nahemow’s person–environment framework suggests that an individual’s well-being is contingent upon the balance between environmental demands and personal abilities [26]. This framework primarily explores how a decline in personal capabilities can create a mismatch with one’s living environment, potentially leading to negative health outcomes and a diminished quality of life. A poor fit, such as difficulty navigating stairs due to declining health, can result in adverse health consequences [27].

Wiseman’s behavioral model posits that relocation decisions are driven by residential satisfaction and shaped by push–pull factors [28]. Push factors include declining health and a loss of support, while pull factors encompass amenities, social networks, and the climate. The model also takes into account internal factors (e.g., health, income, and past experiences) and external factors (e.g., the housing market) in the decision-making process. Litwak and Longino’s developmental framework identifies three stages of relocation following retirement: (1) amenity-based moves, where retirees seek enhanced comfort and lifestyles; (2) assistance moves, where declining health prompts relocation near family or formal care providers for support; and (3) dependency moves, where increased care needs, such as major disabilities, necessitate a move to institutional settings [27,29]. Lee’s theory of migration suggests that relocation is influenced by a combination of attracting factors in the destination that draw individuals there, repelling factors in the area of origin that push individuals away, intervening obstacles that may hinder the move, and personal factors that influence individual choices [14].

These frameworks collectively illustrate how aging, an individual’s health status, and environmental factors shape relocation decisions among older adults. Building on these frameworks, the prior literature on older adults’ relocation has identified several factors influencing the decision to move, including health concerns, the absence of an informal caregiver, the death of a spouse, and issues with their current housing situation [15,27,30,31,32]. While existing studies have enhanced our understanding of why older adults consider relocation, they often adopt a one-sided approach that focuses primarily on the challenges associated with their current living situations. Specifically, limited research has addressed how older adults determine where to relocate, frequently overlooking the various factors related to the new environment that play a crucial role in their relocation decisions. Furthermore, approximately 82% of older adults continue to live in their own homes and communities in the U.S. [33,34]. This substantial proportion of individuals aging in place suggests the existence of a subgroup who remain at home involuntarily, potentially due to concerns that SLCs may not fully accommodate their needs and preferences or because they face constraints such as limited resources and other barriers to relocation [24]. While many older adults consider moving, various challenges ultimately lead them to remain in their current residences [34,35].

This suggests that motivation alone may not be sufficient for older adults to consider relocating, as various factors influence their decision-making process regarding SLCs. However, there is a lack of research specifically addressing the challenges older adults face when making relocation decisions. Such challenges can hinder the relocation process, forcing older adults to age in place even when formal and informal home care services no longer meet their evolving needs. Moreover, the existing body of literature on older adults’ relocation does not provide a systematic understanding of the factors that shape their decision-making process. It is increasingly important to expand this line of research and further investigate this area to gain a deeper understanding of older adults’ reasons for relocation and the challenges they encounter during the relocation process.

Thus, this exploratory study aimed to investigate the factors influencing older adults’ decisions to relocate to SLCs and the challenges they encounter. More specifically, the current study sought to systematically examine the key determinants shaping older adults’ decision-making, the criteria they consider when selecting an SLC, and the barriers that may hinder their transition. To achieve the aforementioned aims, the following research questions were explored:

RQ 1: What factors influence older adults’ decision to relocate to SLCs?

RQ 2: What factors do older adults consider when selecting an SLC?

RQ 3: What challenges do older adults face when making relocation decisions?

This study contributes to the understanding of senior living relocation by offering a holistic picture of the relocation decision-making process of older adults. As the older adult population continues to grow, addressing their increasing housing and care needs will become essential. The findings of this study provide valuable insights for policymakers in understanding the housing needs and preferences of older adults. Equipped with this knowledge, policymakers can assess whether new SLCs and housing developments offer optimal housing and care solutions to better accommodate the evolving needs of older adults. Additionally, well-designed structures can be tailored to provide a supportive physical and social environment, enhancing quality of life and well-being while also reducing relocation barriers for individuals considering a move to these communities.

2. Materials and Methods

2.1. Study Design

Five in-depth, semi-structured focus group discussions were conducted with older adults who were current residents of SLCs. Open-ended questions were utilized to guide and facilitate discussions, following the recommendations of Krueger [36]. A structured focus group discussion guide was developed, consisting of seven primary questions aimed at exploring older adults’ experiences with relocating to SLCs. Specifically, the questions examined the reasons for relocation, the selection process for an SLC, challenges or barriers encountered during relocation decision-making process, and the overall relocation experience. Additional probing questions were incorporated to elicit more detailed and comprehensive responses.

2.2. Study Procedure

A purposive sampling technique was employed to recruit participants from various types of SLCs who had already relocated to these communities. Specifically, maximum variation sampling was utilized to ensure that the participants represented a diverse range of backgrounds, demographics, and tenures, thereby capturing a broad spectrum of perspectives. This approach facilitated the elicitation of a wide array of viewpoints, contributing to the thematic richness of the data. Participants were required to meet specific inclusion criteria: residency in an SLC, a minimum age of 65 years, sufficient cognitive competence, and a baseline level of health that allowed for active participation. To further enhance diversity, focus groups were structured to reflect variations in age, gender, education, marital status, race, and tenure. This methodological approach ensured a comprehensive exploration of the experiences and opinions of older adults residing in different types of SLCs. Prior to the discussions, the researcher verified participants’ eligibility to ensure compliance with these criteria. A total of 44 residents participated in five focus group discussions, recruited from various SLCs located in the southeastern region of the United States.

Participants provided informed consent at the beginning of the focus group sessions. Following the provision of consent, they completed a written survey to collect demographic information and individual characteristics. To guide the discussion, the researcher delivered an opening statement to set the intended direction. Participants were asked to reflect on the time they first considered relocating from their residence to an SLC. They were then guided through a series of questions exploring various aspects of their decision-making process, including their reasons for relocation, factors considered in selecting an SLC, and challenges encountered. This approach allowed for a comprehensive exploration of participants’ experiences, decision-making processes, and the journey that led them to choose an SLC as their new residence.

The moderator primarily facilitated the discussion, ensuring that it remained aligned with the research objectives while intervening only when necessary. Probing questions were employed when participants needed clarification or had difficulty comprehending introductory questions. The questions used in earlier focus groups served as a foundation for subsequent sessions, with minor refinements made based on the researcher’s observations and participants’ feedback. This iterative approach facilitated in-depth and meaningful discussions while maintaining a clear focus on the study’s objectives.

Participants openly shared their opinions and experiences regarding their long-term care choices, with all participants actively contributing to the discussion. To ensure balanced participation, the moderator employed skilled facilitation techniques (i.e., structured turn-taking, prompting quieter participants) to promote equal engagement and prevent dominance by a few participants. Additionally, the moderator actively encouraged all focus group members to share their perspectives and probed for alternative viewpoints to capture a diverse range of insights. Focus group discussions were conducted in private, comfortable meeting rooms within SLCs. Each session lasted approximately 1.5 to 2 h and was moderated by the same researcher conducting the study to ensure consistency in facilitation.

2.3. Data Analysis

The audio recordings of the focus group sessions were transcribed verbatim. The transcripts were then reviewed multiple times alongside observation notes collected at the conclusion of each focus group session to develop a comprehensive understanding of the language and terminology used by participants. The transcription and analysis of focus group recordings commenced immediately after the first discussion and continued iteratively until data saturation was reached, ensuring that no new themes emerged.

The data analysis strategy outlined by Krueger and Casey was employed to examine participants’ responses, with data saturation achieved through iterative review [37]. Krueger and Casey’s method offers a systematic approach to qualitative data analysis, ensuring transparency and consistency throughout the process [37,38]. By focusing on the frequency, extensiveness, specificity, and intensity of responses, the method allows for a nuanced interpretation of participants’ views. The iterative review process and data saturation ensured comprehensive findings, while triangulation across focus groups and expert validation further strengthened the credibility and validity of the results. This approach enhanced the reliability of the themes identified, ensuring they reflected a broad range of perspectives and were well supported by evidence.

The initial coding process involved highlighting key terms, ideas, phrases, concepts, and relevant statements to contextualize participants’ comments and extract underlying meanings. Following Krueger and Casey’s guidelines, the researcher considered the frequency (number of times a topic is mentioned), extensiveness (number of participants who mentioned a topic), specificity (specific responses based on experiences), and intensity (topic with a special intensity of depth of feeling) of statements and illustrative examples provided by participants to prioritize the analytical themes [37,38]. Each focus group transcript was independently coded and categorized to identify emerging first-order themes based on participant responses to discussion questions. These initial themes were then consolidated into higher-order themes based on semantic similarities. Data saturation was reached as no new themes emerged during the final iterations of coding, reinforcing the robustness of the findings. To enhance the credibility of the results, multiple iterations of data review were conducted to identify new codes and refine emerging themes.

The themes and subthemes identified within individual focus groups were systematically compared across all discussions to detect recurring patterns. This process facilitated data triangulation, ensuring that the findings represented a broad spectrum of perspectives rather than being influenced by individual outliers. To further strengthen the methodological rigor, two experts in the field reviewed the identified themes and subthemes for refinement and verification. Necessary revisions were made, and a final consensus was reached in alignment with expert feedback. This approach reinforced the validity of the findings through triangulation and cross-validation, as recommended by Krueger [39] and Denzin [40].

3. Results

3.1. The Demographic Characteristics of the Participants

The focus group participants consisted of 44 older adults aged 65 to 100 years. The majority of participants (84.1%) were female. The age distribution was as follows: 40.9% were between 76 and 85 years old, 29.5% were between 65 and 75 years old, 25% were between 86 and 95 years old, and 6.8% were between 96 and 105 years old. In terms of the racial composition, 72.7% identified as White, 15.9% as Hispanic or Latino, 9.1% as Black or African American, and 9.1% as Asian. Regarding educational attainment, 43.2% had completed high school, 20.4% held a bachelor’s degree, and 13.6% had some college experience. Regarding income, 34.1% reported an annual income of USD 25,000 or less, and 15.9% reported an income between USD 25,000 and USD 50,000, while 27.2% chose not to disclose their income. As for participants’ marital status, 59.1% of participants were widowed, 20.4% were divorced, 11.4% were married, and 9.1% were single. In terms of participants’ health status, 31.8% rated their health as very good, 29.6% as good, 20.4% as fair, and 9.1% as excellent, while the remaining 9.1% did not disclose their health status. The full demographic information of the participants is provided in

Table 1. Demographic characteristics of the participants.

Demographic Characteristics	N	%
Gender
Male	7	15.9
Female	37	84.1
Total	44	100
Age
65–75	13	29.5
76–85	18	40.9
86–95	11	25
96–105	2	4.6
Total	44	100
Education
High school or below	19	43.2
Associate degree	4	9.1
Some college	6	13.6
Bachelor’s degree	9	20.4
Master’s degree	5	11.4
Doctorate degree	1	2.3
Total	44	100
Income
USD 25,000 or less	15	34.1
USD 25,001–USD 50,000	7	15.9
USD 50,001–USD 75,000	3	6.8
USD 75,001–USD 100,000	3	6.8
USD 100,001–USD 150,000	2	4.6
USD 150,001–USD 200,000	0	0
USD 200,001 or more	2	4.6
Missing	12	27.2
Total	44	100
Marital Status
Single	4	9.1
Married	5	11.4
Divorced	9	20.4
Widowed	26	59.1
Total	44	100
Race
White	32	72.7
Black or African American	4	9.1
Hispanic or Latino	7	15.9
Asian	1	2.3
Total	44	100

and Figure 1.

3.2. Reasons for Relocation

The thematic analysis of older adults’ experiences identified four key themes related to the reasons for relocation: (1) health-related factors, (2) housing- and property-related factors, (3) family dynamics, and (4) socio-psychological factors (Figure 2). Each of these themes are discussed below.

Theme 1: Health-Related Factors

Health emerged as a predominant theme in the focus group discussions. Inadequate health or concerns about future health deterioration were identified as significant drivers influencing older adults’ decisions to relocate to SLCs. All participants acknowledged the likelihood of requiring some form of assistance as they aged and cited illness, declining health, or frequent hospitalizations as primary reasons for their move. These decisions were largely reactive, made in response to sudden health crises. Conversely, some participants expressed proactive concerns about their future well-being and their ability to maintain self-care as they aged. Some participants stated the following:

“I am primarily here in the facility because of my health issues. I would stand up and talking to someone and I would fall out with no forewarning or anything like that. So, I had to find another place to live from where I am at.”

“I knew that I needed some kind of help because I had some health issues.”

Another participant shared her experience of searching for a facility while she was hospitalized. She stated the following:

“When my husband died, I was left alone but I didn’t want to go with any of my children… But then I had a stroke, and I couldn’t live alone anymore. Right after that effect, while I was in the hospital, my son-in-law was looking in a computer to find a place because I couldn’t live alone anymore…and he came across this place.”

Several other participants reported that they made a deliberate choice to move to an SLC while still in good health, aiming to proactively prepare for potential future challenges. One participant elaborated on the repercussions of aging and the difficulties associated with maintaining self-care at home, stating the following:

“A lot of us here are physically not able to take care of ourselves and they [facility] help you out here… not only physically but mentally… and some of us are slowing down and we have got dementia settling in and this [facility] is the perfect place to be.”

Theme 2: Housing- and Property-Related Factors

The majority of participants reported increasing difficulties in managing their homes and properties. Many cited challenges related to home designs that were not conducive to aging and did not adequately support their evolving needs, which could contribute to an increased risk of falls and injuries. One participant exemplified this concern with the following statement:

“For me, I knew I had to get out of the home because it was a two-story home. Children were concerned about me falling… so I made the move and I am very happy that I did.”

Furthermore, a considerable number of participants expressed concerns about managing their large homes, gardens, and yards following the loss of a spouse. One of the most frequently cited motivations for relocating to an SLC was the desire to alleviate the burdens associated with homeownership and household maintenance. The following narratives illustrate their experiences.

“My house is just too big. I couldn’t take care of the yard… I have a yard for a size of baseball field…so I sold it, and I found this place.”

“I couldn’t keep up the house…I couldn’t keep up with everything that we have. I said I’m wearing out. I said times have changed. So, I signed up.”

Theme 3: Family Dynamics

The analysis of the focus group data revealed that familial factors, such as a spouse’s declining health, the loss of a spouse, and family members’ concerns for the well-being of older adults living at home, played a significant role in influencing the decision to relocate to an SLC. Several participants indicated that their decision to move was driven by their spouse’s deteriorating health, as they were unable to provide the necessary care and support. One female participant expressed this sentiment, stating the following:

“My husband started losing his hearing…and he had other health issues like diabetes and other stuff. I could not help him in there. All I could do was talk to him and hold his hand.”

On the other hand, the loss of a spouse resulted in various challenges, including difficulties with home maintenance, increased feelings of depression, and heightened experiences of loneliness among older adults. Several female participants highlighted that the passing of their spouses was a significant factor influencing their decision to transition to an SLC. The following participant comment exemplifies this experience:

“The first word that comes to my mind is widowhood…that we’re all widows or widowers. You are left alone. And I think that’s common to all the married people here is widowhood.”

Another participant emphasized the significance of family support and stated the following:

“I think it’s important…our family’s enthusiasm about us moving in here…You need your family’s support and they [family members] were enthusiastic and that helped us.”

Theme 4: Socio-Psychological Factors

The majority of focus group participants identified socio-psychological factors as the primary drivers of their decision to relocate. These factors included the desire for autonomy and independence, experiences of loneliness and depression, the need for social engagement, and a strong determination not to burden their families. While most participants expressed deep appreciation for their children’s willingness to accommodate them, they remained resolute in their decision to avoid placing caregiving responsibilities on their families, a sentiment that was consistently echoed among nearly all participants. Interestingly, several participants disclosed that while they had relocated closer to their children and families, they still preferred to maintain a certain degree of independence. One male participant encapsulated this perspective by stating the following:

“We also wanted a child nearby… but not too close. An hour away is good, right? … the right distance for both of the children as well as for us.”

Another participant recounted her experience when her daughter invited her to move in with her. She stated the following:

“I said… I will think a little more because I did not want to live with my daughter or my grandchildren because I feel like maybe they need their own privacy, and I wanted my independence.”

Older adults who were living alone in their homes chose to relocate due to feelings of loneliness and depression associated with aging in place. Their decision to move to a senior living community (SLC) was primarily driven by the desire to alleviate these emotional challenges and mitigate social isolation. One participant expressed this sentiment, stating the following:

“When I was in Seattle, I was by myself for five years… and I was very alone…I was alone so much that I …. I didn’t want to be around anybody anymore. I was just really depressed. The main reason I came here [move to a facility] is that I wanted to be around people… to try to see if I could do that… and see if I could get out of that depression.”

3.3. Factors Influencing Older Adults’ Decisions in Selecting an SLC for Relocation

The analysis of the focus group data identified three major themes influencing older adults’ decisions on where to relocate. These themes included (1) environmental and locational factors, (2) facility attractions and amenities, and (3) opportunities for socialization (Figure 3).

Theme 1: Environmental and Locational Factors

One of the most frequently cited factors that strongly influenced participants’ decision-making was the geographical location of the SLC. A significant majority of participants emphasized that residing in close proximity to their children was of paramount importance. Many older adults expressed that as they age, they increasingly rely on their children for support and assistance.

Beyond proximity to family, the location of SLCs was also considered important for other reasons. Several participants indicated a preference for communities situated near shopping centers, healthcare facilities, and other essential public amenities, as accessibility to these services was a key consideration. Additionally, familiarity with the location and the presence of a warm climate were also factors mentioned by some participants as influencing their decision.

“I’m near my daughter, which is so important. I think it’s important for all of us to be near family.”

“This location is perfect for me because I live relatively close to here…and I was familiar with everything going on; so, it seemed to be the right answer for me.”

“I did not like the Michigan weather up there when I moved. So, I moved here because I like the warm weather.”

Theme 2: Facility Attractions and Amenities

Participants emphasized that their decision to relocate to an SLC was primarily influenced by the extensive range of activities and amenities available within these facilities. Many specifically highlighted key factors such as diverse activity programs, dining options, educational and recreational opportunities, room layouts and configurations, the ability to choose between one-, two-, or three-bedroom apartments, architectural design, and the overall contemporary ambiance of the facility as significant motivators in their selection process.

When asked about their criteria for choosing a facility, a substantial number of participants cited multiple reasons that influenced their decision. The majority of older adults underscored the importance of recreational activities, noting that these opportunities played a crucial role in fostering daily engagement and enthusiasm. Additionally, the availability of 24/7 care, emergency communication systems, and guaranteed lifelong care with the option to transition to higher levels of care were identified as critical considerations. One resident of a continuing care retirement community (CCRC) shared her reasons for moving into the facility, stating the following:

“You’re guaranteed that you will get assisted living and skilled nursing… that you’ll get.”

Residents also expressed a preference for facilities that offered both rental and buy-in options. One participant stated the following:

“We did not buy any of them… That’s because… then you’re here permanently…and this is going to be the place that you’re going to be for the rest of your life basically, well, when you buy in. So, I would not want to do that.”

The availability of a diverse range of food options was highly important to both male and female participants.

“Food was very important for me…food that is prepared well and quite a variety of food… It was a big attraction for me.”

Space was a significant concern for participants, particularly regarding living areas, the kitchen size, and the number of rooms. One female participant emphasized the importance of having her own kitchen and the ability to prepare her own meals, stating the following:

“For me, kitchen was very important. I love to cook, and I have the option if I don’t feel like going down for dinner. And I feel like preparing for things like entrees that my husband would prefer, and I would prefer. I can do it and I have done it.”

Another female participant added the following:

“Space was very important for me. I could not move from a big home into a very small space, because it was so difficult to give up things that were part of my history…and because I have a spacious apartment, that made it much easier for me to be here.”

Theme 3: Opportunities for Socialization

The majority of participants highlighted that relocating to a senior SLC provided an ideal opportunity to engage in social interactions with other older adults. Many individuals who had previously lived alone expressed experiencing feelings of loneliness in their former homes. Additionally, some participants emphasized the lack of socialization opportunities within their previous residential communities. One participant articulated this sentiment, stating the following:

“I thought that I will have friends just like me who have been misplaced or needed friendships and that it will be an easy task.”

A participant from another focus group noted the following:

“Socialization in a group like this (focus group) was very important for me.”

Another participant expressed that socialization at an older age was harder. He stated the following:

“I’m new in town and in order to meet people at my age, it’s very difficult. When you’re younger, you meet people through your kids being in school, and their parents and so forth, things like that…but when you are at my age, it’s hard to make new friends… and so I thought moving to a facility was a good way to meet people.”

Another participant shared that she and her husband felt isolated at home and started searching for a community. She said the following:

“As time goes on, I found this isolation… even going out just once a day to lunch was not enough to have us see people…and our neighborhood was very nice. But everybody was gone all the time. When they came home in the evening, they have their own families to take care of. So, I began thinking about finding a place [community] to move.”

3.4. Barriers Related to Relocation

The focus group discussion results revealed four major themes related to barriers: (1) family-related barriers, (2) economic constraints, (3) socio-psychological barriers, and (4) barriers related to knowledge and information about SLCs (Figure 4).

Theme 1: Family-Related Barriers

While family recommendations served as a significant motivator for relocation, family resistance also emerged as a major barrier to older adults’ decisions to move. Many children preferred their aging parents to reside with them and were unsupportive of the idea of relocating to an SLC. Overall, older adults emphasized the crucial role of family support in facilitating their transition to an SLC. One participant stated the following:

“My son would say… there is no way mamma that you are going into those facilities.”

Another participant shared the following:

“I like my independence, but my daughter wants me to stay with her.”

Another participant shared their children’s reaction upon being informed of their decision to relocate to an SLC. He stated the following:

“Our kids had a problem with the idea [of relocating to senior living] because they never understood…it was the lack of knowledge… They had little or no experience in this area and their general reaction was…” “You’re going to do… what?”

Serving as the primary caregiver for family members, such as adult children with disabilities or a disabled spouse, also hindered some older adults from relocating to SLCs. One participant stated the following:

“I had him [husband] in bed, I had taken care of him… disabled in bed …for five years. So, I came down here [facility] after he died as I didn’t need to take care of him.”

Theme 2: Economic Constraints

Another significant barrier identified by participants was economic constraints. Several participants emphasized that their limited financial resources restricted their options and choices in selecting an SLC. Additionally, residents highlighted the high cost of senior living as a major obstacle in their relocation decision-making process.

Some participants stated the following:

“Cost was a barrier for me… it was more about affordability.”

“For my children was the price. Money.”

“Does it make sense financially. I mean, that was a question I struggled with. Is this a good investment? Is this a good use of our money? You know, does it make sense financially?”

“I sold my condo to have the money to buy in this facility, otherwise I wouldn’t be here.”

“For me, the financial issue left me sort of feeling insecure about making such a commitment.”

Many participants consistently identified the cost as a significant barrier preventing them from relocating to their preferred SLC. One participant expressed this concern, stating the following:

“I wanted to move into the facility that was actually closer, but it was way too expensive.”

Several focus group participants expressed concerns about the potential depletion of their deposits within a few years, with no possibility of a refund. Many residents emphasized their desire to leave an inheritance for their children, which influenced their decision to opt for a rental arrangement rather than the buy-in option that required a substantial deposit. Additionally, some participants later realized that they needed to sell their homes to cover the entry fees, despite initially intending to pass their properties on to their children. One participant articulated this concern, stating the following:

“We went to [….] and you have to give them your house, which you could have willed to your kids… plus it was terribly expensive.”

Theme 3: Socio-Psychosocial Barriers

Being separated from family and friends emerged as a significant challenge for many participants, as they expressed concerns about losing connections with their previous living environment. Several participants described the emotional difficulty of leaving behind a familiar setting they had built over time and the challenges associated with starting anew. Although many older adults preferred to select an SLC close to their loved ones, this was not always a feasible option.

Another major barrier identified was the fear of the unknown. In particular, older adults with no prior experience in SLCs reported apprehension about living among unfamiliar individuals in a new environment. Participants remarked the following:

“I didn’t have anybody that had ever lived here… I didn’t know what I was going into. That’s putting it really like it was …I didn’t realize what it was going to be like… to actually live in a community with all these people that you don’t know. You’re out of your comfort zone of people… and you’re in a group of people that you’ve never seen before.”

“I think there are a lot of people that don’t want to move because initially, inertia primarily. And I think it’s the fear of the unknown. And they don’t want to make any changes.”

“They don’t want to be one of those old folks. They don’t think they’re old.”

Individuals with friends or family members already residing in SLCs did not express the same level of apprehension, as their familiarity with the establishment provided them with a clear understanding of what to expect. In contrast, a minority of participants reported that their children had conducted extensive research, visited the facility, and ultimately made the decision on their behalf, resulting in their transition to the community without prior exposure or a guided tour.

Several residents expressed concerns about living in close proximity to older adults with severe physical and cognitive impairments, as well as those experiencing depression. One resident reflected on her past happiness at home and remarked the following:

“Living where I was living, and I was near everything… I could get in my car or I could walk to anything. I liked that. I had friends too that I socialized with and I was very involved with my children. And so, I really liked that life that I had.”

Additionally, some participants shared that relocating to an SLC required them to leave behind their previous lives and possessions, which contributed to feelings of loss and adjustment challenges.

“I moved with trepidation and wasn’t sure it was the right move for me.”

“It is difficult to give up things that were part of my history.”

“A big obstacle is admitting that you are displacing your life and accepting that this is what you need to do. That’s hard. It’s hard to face it.”

“I guess the uncertainty of it. Am I making the right decision? Is this a good choice? What’s it going to be like?”

Older adults who had prior exposure to nursing home facilities through their parents, siblings, friends, or spouses generally held negative perceptions of such environments. Concerns frequently cited by participants included fears of negligence, inadequate care, restricted autonomy, and potential abuse within these facilities. One participant reflected on their personal experience with their mother and sister in a nursing home and stated the following:

“The nursing home where my mother was, there was abuse of older adults…so you need to find some place where they don’t abuse you. You got to make sure of that.”

Another participant shared the following:

“There is a lot of neglect there [nursing home]. Older adults are being neglected.”

A resident who was adamant about aging at home and finally moved to a facility after gaining more information in his late nineties stated the following:

“I had specified in my living will that I wanted to die at home. I didn’t want to die in an institution because my wife in her final years, spent a lot of time in a nursing home…and I did not want to die in a nursing home…it was like being in a warehouse.”

Theme 4: Barriers Related to Knowledge and Information about SLCs

The analysis of the focus group data revealed that older adults faced several barriers related to knowledge and information. Participant responses indicated a lack of awareness regarding the diverse range of long-term care options available to them. The majority of participants reported having limited knowledge about SLCs prior to their relocation and were largely unfamiliar with the different types and levels of SLCs, as well as the range of services these facilities provide. One participant stated the following:

“It’s the lack of knowledge. I think it becomes a problem when you don’t understand.”

Additionally, participants who had transitioned to an SLC expressed a lack of awareness regarding the various types of facilities available beyond traditional nursing homes. A male resident, who initially chose to age in place but later decided to relocate to a retirement community, shared the following insight:

“A friend who lived in the same complex…. She decided she was going to move to a place like this continuing care… I had no knowledge of continuing care facility like this. I didn’t understand it.”

All participants unanimously recommended that individuals conduct a comprehensive tour of the facility and, if feasible, experience various services offered before making a decision to relocate to an SLC.

4. Discussion

The purpose of this study was to explore the factors influencing older adults’ decisions to relocate to SLCs, as well as the challenges they encountered in the relocation process. Five focus groups were conducted with current residents of SLCs to gain insight into their relocation experiences. The study identified several key findings regarding the factors that impact older adults’ relocation decisions.

Health-related factors were identified as one of the primary reasons for relocation, encompassing a range of concerns such as deteriorating health, acute medical crises, or the need for hospitalization. Although previous research has produced varied findings on the role of health in relocation decisions, the present study emphasizes the significant impact that both current and anticipated health issues have on the decision to move. Participants, even those in relatively good health, expressed a heightened awareness of the potential health complications and disabilities that often accompany aging. Consequently, many of them opted to relocate to SLCs as a proactive step, seeking to prepare for potential health challenges in the future. This foresight highlights how individuals are increasingly considering their long-term health needs when making housing decisions, reflecting a broader trend toward anticipatory planning for aging-related issues. Additionally, the study suggests that older adults may prioritize environments that offer healthcare support, accessibility, and a safety net for future health-related uncertainties.

Furthermore, the current study found that housing- and property-related factors were significant drivers of relocation. The findings indicated that an inadequate housing size and poorly designed living spaces can lead to unsafe living conditions for older adults, significantly raising the likelihood of falls and other injuries. Furthermore, the upkeep of large properties, particularly those with expansive yards or pools, poses a considerable physical and financial burden for older individuals. These responsibilities may become increasingly difficult to manage as their physical abilities decline with age. As a result, many older adults may feel compelled to move to more manageable living environments, such as smaller homes or senior housing facilities, to reduce these risks and improve their overall well-being. Additionally, the stress associated with maintaining these properties can negatively impact their mental health, further influencing their decision to relocate.

According to a report published by the U.S. Census Bureau, the existing housing stock in the United States is largely ill-suited to meet the needs of older adults who wish to age in place, with only about 10% of housing units classified as “aging ready” [41]. This lack of suitable housing poses challenges to daily living, potentially compromising older adults’ health and limiting their ability to live safely and comfortably at home [41,42,43]. The situation is even more critical for older adults with disabilities or health conditions, as less than 4% of U.S. residential units are accessible for individuals with disabilities, and only about 1% are wheelchair accessible [44]. These findings align with a recent AARP study, which reported that approximately 50% of older adults acknowledged the need to modify their living arrangements to remain safely at home [45].

The focus group discussions also highlighted the important influence of family dynamics on the decision to relocate. Support from family members, along with their advice and guidance, played a crucial role in reinforcing older adults’ perception that their living environment was no longer suitable for their needs. This support often made it easier for individuals to consider and act on the decision to move to senior living communities (SLCs). Furthermore, family members’ involvement in the relocation process not only provided practical assistance but also helped alleviate emotional concerns, such as feelings of isolation or a fear of change. The emotional and logistical backing of family members often created a sense of reassurance, encouraging older adults to embrace the transition. In many cases, the desire to live closer to spouse or to ensure that their care needs were met in a supportive environment was a key motivator for relocation. This finding aligns with prior studies that described relocation as a process of negotiation and compromise among spouses and children, with the decision to move often being a collective family decision [46,47]. While a spouse’s declining health may prompt a joint relocation for couples, the loss of a spouse or widowhood represents another significant family-related factor influencing widows and widowers to transition to SLCs.

Socio-psychological factors also played a key role in influencing older adults’ decisions to relocate, including feelings of loneliness, social isolation, depression, and a desire for increased social interaction. The study’s findings further indicated that, although many participants had the option to move in with their children or grandchildren, their preference for maintaining autonomy and independence, coupled with a reluctance to place caregiving responsibilities on their family members, was a recurring motivation for choosing to relocate to a senior living community. This aligns with previous research, which has suggested that a primary reason older adults opt to move to retirement communities is to prevent disrupting the lives of their family members [47,48,49,50,51].

In relation to the decision-making process regarding the selection of an SLF, three key themes emerged from the analysis of the focus group data: environmental and locational factors, facility attractions and amenities, and opportunities for socialization. The location emerged as a crucial factor, primarily because older adults preferred to live near their children. However, previous research has suggested that older adults who have children and choose to move to retirement communities do not place significant importance on being geographically close to their children, family members, or long-standing friends [52,53].

An interesting finding from this study was that while older adults did not necessarily prefer moving in with their children, there was a strong consensus that they valued living in close proximity to their children or friends. Participants acknowledged that as they aged and their health declined, they would require increasing support from their children. While they expressed a desire to minimize the burden on their families, maintaining close connections with them remained a top priority. Furthermore, participants placed considerable emphasis on the familiarity of the location and neighborhood. In addition to practical considerations such as access to transportation, the proximity to shopping centers, restaurants, and healthcare facilities, and favorable weather conditions, their decisions were largely influenced by their familiarity with the area or the presence of familiar social networks. The involvement of family members and friends in selecting an SLC was particularly noteworthy, as many older adults lacked prior experience with such facilities. This reliance on the insights and experiences of their social circle highlights the significant role of external influences in the relocation decision-making process.

This study also found that the attractions and amenities of SLCs played a crucial role in the selection process. The attractions of a facility and its amenities are important considerations for relocation among older adults [27,54,55]. Older adults placed significant emphasis on hotel-like designs, warm and welcoming environments, upscale amenities, and high-quality, hospitable services. Many participants cited multiple factors that influenced their choice of an SLC, highlighting the growing demand for diverse living spaces and lifestyle options among today’s older adults. The most attractive features included recreational and educational opportunities, which provided a sense of purpose and engagement, offering residents something to look forward to each day. More specifically, the most frequently mentioned preferences included a variety of dining options, hotel-style room designs and layouts, comfortable living spaces, a luxurious yet home-like atmosphere, and friendly, welcoming, and supportive staff.

The results of the focus group study revealed that the opportunity for socialization provided by SLCs was a key factor influencing older adults’ relocation decisions. Many participants emphasized the lack of social engagement while aging in their own homes, reporting feelings of loneliness, isolation, and depression. This finding aligns with previous research showing that over 20% of older adults in the U.S. are socially isolated [56,57] and many experience shrinking social networks due to factors such as retirement, age-related losses, declining health, disability, and mobility limitations, all of which contribute to increased feelings of loneliness and isolation [58,59,60]. According to a report by the U.S. Census Bureau, 16.2 million older adults were living alone in their communities in 2023 [2], further exacerbating social isolation. Consequently, relocation to an SLC is often perceived as an opportunity to establish social connections with other residents and staff members through various programs and events, ultimately helping to mitigate feelings of loneliness and isolation.

As only a small proportion of older adults in the United States reside in SLCs, this study aimed to identify factors that hinder successful relocation to formal community settings. The findings revealed that older adults encounter various barriers in the relocation decision-making process, which were categorized into four key themes: family-related barriers, economic constraints, socio-psychological barriers, and barriers related to knowledge and information about SLCs.

Although family recommendations were a significant motivator for relocation, the reluctance of family members toward moving to community settings emerged as a major obstacle. Many children preferred their aging parents to live with them and were unsupportive of the idea of relocating to senior living communities (SLCs). Additionally, some older adults faced disagreements among their children regarding the relocation decision, which further complicated the decision-making process. Furthermore, family responsibilities, such as caregiving for parents, spouses, or disabled children, can also hinder relocation, even when individuals are otherwise motivated to move.

Another significant barrier faced by older adults was economic constraints. Affordability emerged as a critical concern when considering relocation to SLCs of their choice. Even among those without immediate financial constraints, the perceived high cost of these communities remained a concern. Many older adults expressed anxiety about depleting their financial resources and felt insecure about their long-term financial stability. There was a unanimous consensus among participants that the government should implement more affordable housing solutions. They also emphasized the need for policy-level interventions to better support the aging population and ensure access to suitable housing and care options.

Making a relocation decision is a significant life event that represents a major transition for older adults and can be a source of considerable stress. For some, it is perceived as the final move they will make in their lifetime. This study highlights that older adults encounter various socio-psychological barriers, including fear and anxiety associated with the anticipated risks of relocation, the prospect of leaving their familiar living environment, concerns about losing connections with family and friends, and the challenges of adapting to an entirely new setting. The psychological and emotional responses to relocation are complex and relocation is considered as a threat to their way of life by older adults [4,13]. Additionally, negative experiences such as cases of elder abuse and neglect involving spouses, parents, or siblings in nursing homes and care facilities further exacerbated these fears. Concerns about maintaining personal freedom and autonomy were frequently mentioned by participants. Many also expressed apprehensions about sharing their living space with individuals of an advanced age or fellow residents experiencing physical or cognitive decline. This exposure served as a poignant reminder of their own potential future, eliciting feelings of melancholy and apprehension.

Knowledge and information barriers were closely intertwined with socio-psychological barriers. Due to a lack of familiarity with the senior living industry, older adults primarily relied on the experiences or information shared by friends and family. Many individuals entered the decision-making process without a clear understanding of what to expect from SLCs, which further complicated their transition. Consistent with previous research, older adults exhibited limited knowledge regarding senior housing options, fee structures, and the range of services and amenities available in SLCs [61,62]. The absence of information about different facility types, levels of care, age requirements, financial considerations, and the available services and amenities made the relocation process particularly challenging and stressful for participants. Other studies have confirmed this finding that navigating long-term care options caused substantial psychological and emotional challenges among older adults due to lack of information and guidance [63].

5. Implications

The findings of this study have several significant implications for practitioners and policymakers involved in supporting older adults’ relocation to senior living communities (SLCs). First, health-related factors, including a declining health status and concerns about future health challenges, emerged as key drivers of relocation decisions. This underscores the importance for healthcare providers, social workers, and caregivers to proactively engage with older adults and their families to address health concerns and provide guidance regarding the benefits of relocating to an SLC. Practitioners can help older adults make more informed decisions by discussing the advantages of early relocation as a preventive measure, which may alleviate the stress of last-minute decisions during a health crisis.

Family dynamics also play a significant role in the decision to relocate, with family support often being a key motivator. This finding suggests that family members, particularly children, should be involved early in the decision-making process to ensure that the needs, preferences, and concerns of older adults are addressed in a collaborative manner. Policymakers should also consider the impact of family support on relocation decisions when designing programs that assist families in navigating the SLC decision-making process. Additionally, recognizing the role of socio-psychological factors, such as loneliness and the desire for social engagement, can guide the development of services and programs that encourage older adults to consider relocation to communities that offer robust social and recreational activities.

Given that the location plays a crucial role in older adults’ decision-making, providers should prioritize the proximity to family members and familiar environments when selecting sites for new facilities or promoting existing ones. Even though older adults may not want to live directly with their children, they often prefer to be close to them for potential future support. Additionally, SLF providers should emphasize the importance of familiarity with the neighborhood, offering easy access to transportation, shopping, healthcare, and other public services. This study also underscores the growing demand for diverse amenities that cater to older adults’ preferences, such as hotel-like designs, upscale services, and opportunities for social engagement. SLF providers should focus on creating welcoming, comfortable environments that offer recreational and educational activities, as these elements foster a sense of purpose and engagement. Finally, given the significant role of socialization in mitigating feelings of loneliness and isolation, SLFs should actively promote social programs and foster a sense of community among residents, helping to improve their overall well-being and quality of life.

Economic constraints and the perceived high cost of SLCs represent substantial barriers to relocation. This finding highlights the need for policy-level interventions to ensure that senior living options are more affordable and accessible to a wider range of older adults. Expanding affordable housing options and providing financial assistance programs could help alleviate financial concerns and encourage more older adults to consider relocation. Furthermore, addressing knowledge gaps and providing clear, comprehensive information about senior living options and the relocation process is crucial. Providing older adults with accurate, easily accessible information will reduce stress and confusion, empowering them to make informed decisions about their future living arrangements.

Finally, this study’s findings emphasize the importance of understanding the complex emotional and psychological aspects of relocation. Practitioners should be sensitive to the fears and anxieties older adults may have regarding their autonomy and independence in SLCs. By offering tailored support, including counseling and reassurance, professionals can help mitigate these concerns and facilitate a smoother transition for older adults moving to senior living communities. This approach can help older adults feel more confident in their decision to relocate and ensure that their physical, emotional, and social needs are adequately addressed. Overall, the findings from this study provide valuable insights that can guide practitioners, policymakers, and senior living providers in improving the relocation experience for older adults, ensuring that they can make informed decisions that support their well-being and quality of life.

6. Conclusions

As the population of individuals aged 65 and older continues to grow, the demand for senior housing and care will increase. This study identified key factors influencing older adults’ relocation decisions, including health, family dynamics, and housing situations. Contemporary older adults seek more than just a place to reside; they value opportunities for social engagement, mental and physical well-being, and continued personal development. Understanding these factors is crucial for developing services and programs that facilitate their transition to housing that aligns with their needs.

The senior housing and care industry must adapt to these evolving expectations by modifying care environments and service offerings. A deeper understanding of older adults’ motivations and housing preferences will enhance the effectiveness of current housing options. Recognizing the challenges faced during the decision-making process allows for more effective communication, addressing uncertainties early and facilitating smoother transitions for older adults.

7. Limitations and Directions for Future Research

While this study offers valuable insights into the relocation experiences of older adults transitioning to SLCs, several limitations must be acknowledged. The sample was limited to 44 older adults residing in SLCs in the southeastern United States, which may affect the generalizability of the findings to older adults in other geographic regions or cultural contexts. Relocation experiences, motivations, and barriers may vary significantly across regions and based on different socio-economic factors and cultural expectations related to aging and long-term care. Future research should consider expanding the study to include diverse locations and populations to enhance the applicability of the findings.

Although the study provides insights into general factors influencing relocation decisions, it does not account for potential subgroup differences. Future research could explore how relocation experiences vary according to the type of SLCs (e.g., independent living, assisted living, memory care), demographic variations (e.g., age, gender, socio-economic status), and individual preferences (e.g., lifestyle choices, care needs, socialization preferences). Examining these subgroup differences would help refine the findings and provide more targeted insights for senior living operators, policymakers, and caregivers.

Furthermore, this study primarily included participants who had already relocated to SLCs, thus excluding the perspectives of older adults who considered moving but ultimately decided to remain at home. Understanding the experiences and concerns of those who chose not to relocate could provide a more comprehensive view of the barriers to transitioning to SLCs. In this regard, future studies could adopt a longitudinal design to track older adults’ decision-making processes over time, capturing the perspectives of both those who relocate and those who do not.

Additionally, this study did not incorporate the perspectives of key stakeholders involved in the relocation process, such as family members, senior living facility administrators, healthcare professionals, or social workers. These individuals play a crucial role in shaping older adults’ decisions and transition experiences. Future research could adopt a multi-perspective approach by integrating interviews or surveys with family members and professionals involved in the relocation process, thereby offering a more holistic understanding of the factors at play. Despite these limitations, this study contributes meaningful insights into the complex decision-making process associated with senior living relocation. Future research should build upon these findings by incorporating diverse methodologies, broader participant groups, and multiple stakeholder perspectives to further enhance the understanding of older adults’ relocation experiences.