Retirement Village Residents Research Articles

The Association between Frailty, Quality of Life and Resilience in Community-dwelling Retirement Village Residents

ObjectivesHousing quality has significant impact on the wider determinants of health and quality of life (QoL). Retirement villages are considered age-friendly accommodation for community-dwelling older people, offering a variable range of services and supports. We wished to explore the relationship among frailty, QoL, and resilience in older people residing in retirement villages. DesignCross-sectional analysis within a longitudinal study. Setting and participantsResidents from 33 retirement villages in Auckland, Aotearoa, New Zealand. MethodsFrailty [using an interRAI-Community Health Assessment-based frailty index FI)], QoL [World Health Organization Quality of Life–Brief Version (WHOQOL-BREF) and WHOQOL–Older Adults Module (WHOQOL-OLD)], and resilience [Brief Resilience Scale (BRS)]. Associations among frailty, QoL, and resilience were examined using regression analysis adjusting for confounders. ResultsMean (SD): FI 0.2 (0.1) in 479 residents, BRS 3.7 (0.8) in 395 residents, WHOQOL-OLD total score 69.9 (12.2). FI was inversely related to BRS [adjusted mean difference (MD) −0.35; 95% CI −0.43 to −0.26; P < .001] and WHOQOL-OLD (MD, −5.45; 95% CI −6.89 to 4.01; P < .001). FI inverse relationship was seen across all facets of WHOQOL-OLD and all WHOQOL-BREF facets except psychological. Conclusions and ImplicationsFrailty was inversely related to resilience and multiple domains of QoL in those living in presumed age-friendly and relatively resource-rich environments. Studies exploring causal relationships between these facets could inform interventions necessary to improve QoL and resilience in those living with frailty. Specific multidimensional needs, wishes, and concerns of older people living with frailty needs to be explored in order to potentially intervene on frailty, QoL, and resilience.

Medicines use and polypharmacy in retirement village residents in Aotearoa New Zealand: a point prevalence observational study

Medicines use and polypharmacy in retirement village residents in Aotearoa New Zealand: a point prevalence observational study

Australian retirement village residents: wellbeing profiles and factors associated with low wellbeing

Abstract The characteristics of Australian retirement village residents, an under-researched population, are not well understood. Knowledge of their wellbeing and modifiable factors associated with low wellbeing would aid in the introduction of health promotion measures and supports to facilitate healthy ageing-in-place. A novel approach utilising latent class analysis (LCA), a statistical method not previously employed to study this population, was undertaken to analyse cross-sectional survey data from 871 participants aged ≥65 years from retirement villages in Queensland, Australia. LCA identified latent, i.e. unobserved, underlying and often difficult to measure, groups within this population based on the responses of individuals to multiple observed variables. Survey participants were divided into groups, each with a distinct profile associated with a wellbeing state, as determined by responses to questions about physical health, unplanned hospitalisations, cognitive health and social connectedness. Multinomial logistic regression explored the relationship between modifiable health and lifestyle characteristics and membership of a particular wellbeing group. The median age of participants was 82 years (interquartile range = 76–88). While 69.0 per cent reported good to excellent health, polypharmacy was evident with 45.6 per cent of participants taking five or more prescription medications. In the previous 12 months, 33.3 per cent had experienced one or more falls and 30.6 per cent an unplanned hospitalisation. Distinct profiles were identified for three wellbeing groups: high (57.7% of participants), moderate (20.6%) and low wellbeing (21.7%). Injurious falls, limited ability to prepare meals and debilitating pain were associated with the moderate and low wellbeing groups. Physical activity significantly lowered the probability of a retirement village resident being in the low wellbeing group. Our findings highlight falls prevention, maintaining adequate nutrition, pain management and regular physical activity as actions that may optimise wellbeing, mitigate functional decline and support the independence of retirement village residents into later years of life.

More than dog walking: Pets as physical activity and social connection facilitators in the lives of retirement village residents

Abstract Objectives: This mixed-methods study examined the relationship between pet ownership status and social connectedness, physical activity engagement, and the quality of life of older adults living in retirement villages. Methods: A survey was distributed to older adults (N = 58) living in retirement villages in South Australia. Those who expressed interest (N = 16) took part in an additional diary study, whereby they reported their social and physical activities over the course of a week. Results: Physical activity, social connectedness, and quality of life did not differ significantly based on pet ownership status. Social connectedness was positively related to the quality of life regardless of pet ownership status. Many pet owners described how their pets were integral to their lives. Discussion: The notion of pet presence offers a promising pathway for future research. The strategies and policies that support pet ownership in retired villages require further investigation.

The prevalence and intensity of pain in older people living in retirement villages in Auckland, New Zealand.

Chronic pain is common in older people. However, little is known about how pain is experienced in residents of retirement villages ('villages'), and how pain intensity and associations are experienced in relation to characteristics of residents and village living. We thus aimed to examine pain levels, prevalence and associated factors in village residents. The current paper is a cross-sectional analysis of baseline data from the 'Older People in Retirement Villages' study in Auckland, New Zealand. Between July 2016 and August 2018, 578 village residents were interviewed face-to-face by gerontology nurse specialists, using interRAI Community Health Assessment (CHA) and customised survey. We used a validated pain scale and multivariable logistic regression analyses adjusted for pre-specified confounders. Residents' median age was 82 years; 420 (73%) were female; 270 (47%) exhibited/reported daily pain, and in 11% this was severe. After controlling for confounders, daily pain was positively associated with self-reported arthritis (OR=3.88, 95% CI=2.57-5.87), poor/fair self-reported health (OR=3.19, 95% CI=1.29-7.93), having no health clinic on-site (OR=1.76, 95% CI=1.10-2.83), and minimal fatigue (diminished energy but completes normal day-to-day activities) (OR=1.77, 95% CI=1.11-2.81). Similar associations were observed for levels of pain. We conclude that levels of pain and prevalence of daily pain are high in village residents. Self-reported arthritis, self-reported poor/fair health, no health clinic on-site and minimal fatigue are all independently associated with a higher risk of daily pain and with levels of pain. This study suggests potential opportunities for villages to better provide on-site support to decrease prevalence and severity of pain for their residents, and thus potentially increase wellbeing and quality-of-life, though as we cannot prove causality, more research is needed.

Factors associated with healthcare utilization and trajectories in retirement village residents.

To study healthcare utilization and trajectories, and associated factors, in older adults in retirement villages (RVs), also known as continuing care retirement communities. Prospective cohort study of 578 cognitively intact residents from 34 RVs in Auckland, New Zealand (NZ). InterRAI-Community Health Assessment (includes core items that may trigger functional supplement (FS) completion in those with higher needs, and generates clinical assessment protocols (CAPs) in those with potential unmet needs). time to acute hospitalization, long-term care (LTC), and death during average 2.5 years follow-up. Three hundred seven (53%) residents had acute hospitalizations, 65 (11%) moved to LTC, and 51 (9%) died over a mean of 2.5 years. Factors associated with increased risk of acute hospitalization included CAP-falls (high risk) triggered, number of comorbidities, not having left RV in 2 weeks prior, moderate/severe hearing impairment, CAP-cardiorespiratory conditions triggered, acute hospitalization in year prior and age, with significant hazard ratios (HR) ranging between 1.03 and 2.90. Factors associated with reduced risk of hospitalization included other (non-NZ) European ethnicity (HR 0.73, 95% CI 0.55-0.98, p= 0.04), presence of on-site clinic (HR 0.62, 95% CI 0.45-0.85, p= 0.003), no influenza vaccination (HR 0.56, 95% CI 0.38-0.83, p= 0.004). Factors associated with LTC transition included FS triggered (HR 3.84, 95% CI 1.92-7.66, p< 0.001), CAP-instrumental activities of daily living (IADL) (HR 2.62, 95% CI 1.22-5.62, p= 0.01), CAP-social relationship triggered (HR 2.00, 95% CI 1.13-3.55, p= 0.02), and age (HR 1.13, 95% CI 1.07-1.18 p< 0.001). Factors associated with mortality included number of comorbidities (HR 3.75, 95% CI 1.54-9.10, p= 0.004 for 3-5 comorbidities), CAP-IADL triggered (HR 3.05, 95% CI 1.30-7.16, p= 0.01), and age (HR 1.11, 95% CI 1.05-1.18, p< 0.001). A large proportion of cognitively intact RV residents are admitted to hospital in mean 2.5 years of follow-up. Multiple factors were associated with acute hospitalization risk. On-site clinics were associated with reduced risk and should be considered in RV development.

Understanding Spatial Distribution of Retirement Villages: An Analysis of the Greater Brisbane Region

The nature of the increasingly ageing populations of developed countries places residential issues of these populations at the heart of urban policy. Retirement villages as housing options for older adults in Australia has been growing steadily in recent years; however, there have been a dearth of geographical studies looking into the distribution of existing retirement villages at the regional level. This study aims to reveal the geographical distributions and cluster patterns of retirement villages in the Greater Brisbane Region of Australia to better understand and serve the living requirements of current and potential retirement village residents. The geovisualization method was adopted to visually explore the distribution patterns of retirement villages. The Global Moran’s I and Local Moran’s I measures were employed to analyze the spatial correlation and the clusters of retirement villages in the study region. The study revealed that distribution of retirement villages was not random (z-score = 7.11; p &lt; 0.001), but clustered in nature and included hotspot patterns, especially along the coastline and Brisbane River areas. Moreover, for-profit and not-for-profit retirement villages have different distribution patterns and adopted significantly different tenure agreements. In the study region, the spatial distribution of retirement villages aligns with the aggregation trend of older residents. The findings of this study disclosed the spatial distribution patterns of retirement villages and will provide developers and policymakers with geographically referenced data for the choice of new development sites to meet the market demand of potential customers, forming aged-friendly development strategies, and eventually leading to improved quality of life for older Australians.

Learning from a multidisciplinary randomized controlled intervention in retirement village residents.

Retirement villages (RVs), also known as continuing care retirement communities, are an increasingly popular housing choice for older adults. The RV population has significant health needs, possibly representing a group with needs in between community-dwelling older adults and those in long-term residential care (LTC). Our previous work shows Gerontology Nurse Specialist (GNS)-facilitated multidisciplinary team (MDT) interventions may reduce hospitalizations from LTC. This study tested whether a similar intervention reduced hospitalizations in RV residents. Open-label randomized controlled trial in which 412 older residents of 33 RVs were randomized (1:1) to an MDT intervention or usual care. RVs across two District Health Boards in Auckland, New Zealand. Residents were eligible if considered high risk of health/functional decline (triggering ≥3 interRAI Clinical Assessment Protocols or needing special consideration identified by GNS). GNS-facilitated MDT intervention, including geriatrician/nurse practitioner and clinical pharmacist, versus usual care. Primary outcome was time from randomization to first acute hospitalization. Secondary outcomes were rate of acute hospitalizations, LTC admission, and mortality. Twelve residents died before randomization; all others (n= 400: MDT intervention=199; usual care=201) were included in intention-to-treat analyses. Mean (SD) age was 82.2 (6.9) years, 302 (75.5%) were women, and 378 (94.5%) were European. Over median 1.5 years follow-up, no difference was found in hazard of acute hospitalization between the MDT intervention (51.8%) and usual care (49.3%) groups (Hazard ratio [HR]=1.01, 95% CI=0.77-1.34). No difference was found in the incidence rate of acute hospitalizations between the MDT intervention (0.69 per person-year) and usual care (0.86 per person-year) groups (incidence rate ratio=0.81, 95% CI=0.59-1.10). Similar results were seen for the proportion of residents with LTC transition (HR=1.18, 95% CI=0.65-2.11) and mortality (HR=0.70, 95% CI=0.36-1.35). Further studies are needed to assess the effects of other patient-centered interventions and outcomes with adequate primary care integration.

Prevalence of frailty and mobility disability in older people living in retirement villages.

To determine the prevalence rates of frail, prefrail, robust and mobility disabled older adults living in retirement villages within regional Victoria, Australia. This cross-sectional, observational study invited residents of retirement villages to complete the self-report questionnaires Fried Frailty Phenotype and Frail Non-Disabled screening tool to classify respondents as frail, prefrail, robust and/or mobility disabled. From 212 respondents, prevalence rates of frail and prefrail status were 34% and 35%, respectively. A fifth (20%) of residents were mobility disabled. The prevalence of residents classified as frail or prefrail (ie, not robust) was higher in women (74%) than in men (58%). Classification as not robust increased with increasing age. This study is the first to estimate prevalence rates of frailty and mobility disability in retirement village residents in regional Australia. Findings from this study have potential to inform the development of facilities and programs to support people living in this setting.

Exploring physical activity changes and experiences of older adults living in retirement villages during a pandemic.

ObjectiveTo explore physical activity changes and participation among physically active older adults living in retirement villages during the coronavirus (COVID‐19) pandemic.MethodsSemi‐structured interviews were conducted over the telephone. The interviews were recorded and transcribed verbatim. Reflexive thematic analysis was conducted.ResultsSeventeen older adults were interviewed, and they engaged in many types of physical activity before the COVID‐19 lockdown. During the COVID‐19 lockdown, the most common physical activity that older adults participated in was walking. Mental well‐being and socialisation were affected during the lockdown, with older adults employing several strategies to help them cope.ConclusionsDuring the COVID‐19 pandemic, physically active residents of retirement villages maintained their physical activity, but with reduced intensity and variety. In some cases, this impacted their mental and physical health. Physical activity resources aimed at facilitating diverse and sufficiently intense physical activity may benefit this group, and others.

Sustainable Living Environment in Retirement Villages: What Matters to Residents?

In responding to the requirements of the sustainable development movement, many retirement village developers endeavor to provide a sustainable living environment for their residents. However, this cannot transpire until a thorough understanding of retirement village residents’ preferences for various features of a sustainable living environment is known. The aim of this paper, therefore, is to reveal retirement village residents’ perceptions of the importance of 23 sustainable living environment features through a questionnaire survey of 81 residents from 15 retirement villages. The survey results reveal that independent and convenient living, justice and fairness, being respected and valued, and privacy protection are the most preferred sustainability features, all of which are in the triple bottom line dimension of social sustainability, whereas capital gain sharing, community diversity, and care and service provision are the least important. In addition, it is found that the residents of different ages, gender, living experience, and retirement village nature have significantly different preferences toward various sustainability features. The findings of this study contribute to the management and development of sustainable retirement villages, which will eventually lead to an improved quality of life for older people.

Health profile of residents of retirement villages in Auckland, New Zealand: findings from a cross-sectional survey with health assessment.

ObjectivesRetirement villages (RV) have expanded rapidly, now housing perhaps one in eight people aged 75+ years in New Zealand. Health service initiatives might better support residents and offer cost advantages, but little is known of resident demographics, health status or needs. This study describes village residents—their demographics, socio-behavioural and health status—noting differences between participants who volunteered and those who were sampled.DesignCross-sectional study of village residents. The cohort formed will also be used for a longitudinal study and a randomised controlled trial. Village managers (sometimes after consulting residents) decided if representative sampling could be undertaken in each village. Where sampling was not approved, volunteers were sought.Setting33 RV were included from a total of 65 villages in Auckland, New Zealand.ParticipantsResidents (n=578) were recruited either by sampling (n=217) or as volunteers (n=361) during 2016–2018. Each completed a survey and an International Resident Assessment Instrument (interRAI) health needs assessment with a gerontology nurse specialist.ResultsMedian age of residents was 82 years, 158 (27%) were men; 61% lived alone. Downsizing (77%), less stress (63%) and access to healthcare assistance (61%) were most common reasons for entry. During the 2 weeks prior to survey, 34% received home supports and 10% personal care. Hypertension, heart disease, arthritis and pain were reported by over 40%. Most common unmet needs related to managing cardiorespiratory symptoms (50%) and pain (48%). Volunteers and sampled residents differed significantly, mainly in socio-behavioural respects.ConclusionsCommon conditions including hypertension, arthritis and atrial fibrillation, are recorded in interRAI as text, and thus overlooked in interRAI reports. Levels of unmet need indicate opportunities to improve health services to better manage chronic conditions. Healthcare service providers and village operators could cooperate to design and test service initiatives that better meet residents’ needs and offer cost benefits.Trial registration numberACTRN12616000685415.

Study protocol: older people in retirement villages. A survey and randomised trial of a multi-disciplinary invention designed to avoid adverse outcomes

BackgroundThere is increasing interest among older people in moving into retirement villages (RVs), an attractive option for those seeking a supportive community as they age, while still maintaining independence. Currently in New Zealand there is limited knowledge of the medical, service supports, social status and needs of RV residents. The objective of this study is to explore RV facilities and services, the health and functional status of RV residents, prospectively study their healthcare trajectories and to implement a multidisciplinary team intervention to potentially decrease dependency and impact healthcare utilization.MethodsAll RVs located in two large district health boards in Auckland, New Zealand were eligible to participate. This three-year project comprised three phases: The survey phase provided a description of RVs, residents’ characteristics and health and functional status. RV managers completed a survey of size, facilities and recreational and healthcare services provided in the village. Residents were surveyed to establish reasons for entry to the village and underwent a Gerontology Nurse Specialist (GNS) assessment providing details of demographics, social engagement, health and functional status. The cohort study phase examines residents’ healthcare trajectories and adverse outcomes, over three years. The final phase is a randomised controlled trial of a multidisciplinary team intervention aimed to improve health outcomes for more vulnerable residents.Residents who triggered potential unmet health needs during the assessment in the survey phase were randomised to intervention or usual care groups. Multidisciplinary team meetings included the resident and support person, a geriatrician or gerontology nurse practitioner, GNS, pharmacist and General Practitioner. The primary outcome of the randomised controlled trial will be first acute hospitalization. Secondary outcomes include all acute hospitalizations, long-term care admissions, and all-cause mortality.DiscussionThis paper describes the study protocol of this complex study. The study aims to inform policies and practices around health care services for residents in retirement villages. The results of this trial are expected early 2020 with publication subsequently.Trial registrationAustralia and New Zealand Clinical Trials Registry: ACTRN12616000685415. Registered 25.5.2016.Universal Trial Number (UTN): U111–1173-6083.

Lonely in a crowd: loneliness in New Zealand retirement village residents.

The number of older people choosing to relocate to retirement villages (RVs) is increasing rapidly. This choice is often a way to decrease social isolation while still living independently. Loneliness is a significant health issue and contributes to overall frailty, yet RV resident loneliness is poorly understood. Our aim is to describe the prevalence of loneliness and associated factors in a New Zealand RV population. A resident survey was used to collect demographics, social engagement, loneliness, and function, as well as a comprehensive geriatric assessment (international Resident Assessment Instrument [interRAI]) as part of the "Older People in Retirement Villages Study." RVs, Auckland, New Zealand. Participants included RV residents living in 33 RVs (n = 578). Two types of recruitment: randomly sampled cohort (n = 217) and volunteer sample (n = 361). Independently associated factors for loneliness were determined through multiple logistic regression with odds ratios (ORs). Of the participants, 420 (72.7%) were female, 353 (61.1%) lived alone, with the mean age of 81.3 years. InterRAI assessment loneliness (yes/no question) was 25.8% (n = 149), and the resident survey found that 37.4% (n = 216) feel lonely sometimes/often/always. Factors independently associated with interRAI loneliness included being widowed (adjusted OR 8.27; 95% confidence interval [CI] 4.15-16.48), being divorced/separated/never married (OR 4.76; 95% CI 2.15-10.54), poor/fair quality of life (OR 3.37; 95% CI 1.43-7.94), moving to an RV to gain more social connections (OR 1.55; 95% CI 0.99-2.43), and depression risk (medium risk: OR 2.58, 95% CI 1.53-4.35; high risk: OR 4.20, 95% CI 1.47-11.95). A considerable proportion of older people living in RVs reported feelings of loneliness, particularly those who were without partners, at risk of depression and decreased quality of life and those who had moved into RVs to increase social connections. Early identification of factors for loneliness in RV residents could support interventions to improve quality of life and positively impact RV resident health and well-being.

Freedom and Fairness in Retirement Villages: An Analysis of the Regulatory Framework

New Zealand’s ageing population has contributed to the rapid expansion of the retirement village sector and will continue to do so in coming decades. It is therefore essential that the regulatory framework governing retirement villages be fit for purpose and that it meet its policy objective of protecting retirement village residents’ rights and interests. The regulatory framework has not been subjected to a comprehensive review since the enactment of the Retirement Villages Act 2003. This paper analyses the degree to which the regulatory framework has achieved its aims. It draws on data from interviews with residents and management from retirement villages to identify ways in which the regulatory framework could be altered to better balance the rights of residents and operators. It proposes amendments to the framework to ensure that residents thoroughly understand their contracts with retirement village operators, and to provide for fairer provisions around the financial terms the contracts may contain. It also recommends the establishment of an independent advisory facility to support residents and intending residents both prior to and after their entry into villages.

Trial feasibility and process evaluation of a motivationally-embellished group peer led walking intervention in retirement villages using the RE-AIM framework: the residents in action trial (RiAT)

ABSTRACTObjective: The Residents in Action Trial (RiAT; ACTRN12616001177448) was a 16-week motivationally-embellished peer-led walking intervention designed to increase walking, reduce sitting, and improve mental health and well-being in insufficiently active residents in retirement villages. In this paper we report on 1) trial feasibility and acceptability, and 2) evaluate the processes involved in the implementation of the intervention using the RE-AIM framework.Method: A mixed methods design was employed, consisting of data from accelerometers, surveys, (individual, pair-based and focus group) interviews, and participant logbooks. Participants included 116 walkers (M(SD) age = 78.37(8.30); 92% female), 8 peer leaders (i.e. ambassadors) and 3 retirement village managers from 14 retirement villages. Descriptives and linear mixed modelling were used to analyse the quantitative data and inductive thematic analyses were employed to analyse the interview data.Results: The intended cluster randomised controlled design became quasi-experimental due to insufficient numbers of recruited ambassadors. The perceived burden of the number and frequency of research assessments was a frequently mentioned reason for a poor recruitment. Facilitators to walking maintenance were the use of self-monitoring, goal setting, social support, and having a routine. Reach was modest (about 14% of eligible participants were recruited from each village), but retention was excellent (92%). The motivational strategies taught appeared to have been implemented, at least in part, by the ambassadors. The walkers in the main experimental condition increased marginally their step counts, but there were no group differences on mental health and well-being outcomes, partly because of low statistical power.Conclusions: Walkers and ambassadors who did take part in the study suggested that they enjoyed the programme and found it useful in terms of becoming more active and making social connections. However, the group format was not appealing to some participants, hence, other delivery options should be explored in the future.

Strategies and challenges associated with recruiting retirement village communities and residents into a group exercise intervention

BackgroundRandomized controlled trials (RCTs) provide the highest level of scientific evidence, but successful participant recruitment is critical to ensure the external and internal validity of results. This study describes the strategies associated with recruiting older adults at increased falls risk residing in retirement villages into an 18-month cluster RCT designed to evaluate the effects of a dual-task exercise program on falls and physical and cognitive function.MethodsRecruitment of adults aged ≥65 at increased falls risk residing within retirement villages (size 60–350 residents) was initially designed to occur over 12 months using two distinct cohorts (C). Recruitment occurred via a three-stage approach that included liaising with: 1) village operators, 2) independent village managers, and 3) residents. To recruit residents, a variety of different approaches were used, including distribution of information pack, on-site presentations, free muscle and functional testing, and posters displayed in common areas.ResultsDue to challenges with recruitment, three cohorts were established between February 2014 and April 2015 (14 months). Sixty retirement villages were initially invited, of which 32 declined or did not respond, leaving 28 villages that expressed interest. A total of 3947 individual letters of invitation were subsequently distributed to residents of these villages, from which 517 (13.1%) expressions of interest (EOI) were received. Across three cohorts with different recruitment strategies adopted there were only modest differences in the number of EOI received (10.5 to 15.3%), which suggests that no particular recruitment approach was most effective. Following the initial screening of these residents, 398 (77.0%) participants were deemed eligible to participate, but a final sample of 300 (58.0% of the 517 EOI) consented and was randomized; 7.6% of the 3947 residents invited. Principal reasons for not participating, despite being eligible, were poor health, lack of time and no GP approval.ConclusionThis study highlights that there are significant challenges associated with recruiting sufficient numbers of older adults from independent living retirement villages into an exercise intervention designed to improve health and well-being.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12613001 161718. Date registered 23rd October 2013.

'An ant against an elephant': Retirement village residents' experiences of disputes and dispute resolution.

To record Victorian retirement village residents' experiences of dispute management and satisfaction levels related to dispute resolution processes. Survey distributed to 6500 retirement village residents. Surveys returned from 1876 residents (29% return rate). Most residents rated life in retirement villages as positive (mean 7.9/10), with an association between life satisfaction and management's ability to resolve disputes (rs = 0.44, P < 0.01). Almost 70% of respondents reported issues of concern to management were resolved satisfactorily; 38% were not resolved to residents' satisfaction. One-fifth reported contacting regional managers or higher personnel regarding issues affecting them, with two-thirds of these respondents reporting a negative outcome. Over 30% did not know if their village had dispute resolution processes in place. Despite finding retirement village life positive, residents of retirement villages found disputes and dispute resolution processes unsatisfactory and desired change to address these concerns.

A market-oriented model for the independent-living retirement village industry

PurposeAs the “baby boomer” generation continues to enter their senior post-retirement years, the provision of affordable retirement housing has become increasingly important for the community, practitioners and policymakers. However, relatively little attention has to date been placed on identifying an effective market mechanism for the industry of the independent-living retirement villages to meet this increased and unprecedented demand. This study aims to develop an innovative and affordable retirement village development model which meets the needs of all stakeholders including seniors, retirement village residents, the retirement village industry and government.Design/methodology/approachThe attributes of this study are as follows: structure of individual living units, retirement village characteristics, retirement village facilities and services and support mechanisms. The analysis was undertaken based on data relating to independent-living retirement villages in five Australian states. A hedonic pricing model was used where the price distributions relating to these four aspects were estimated.FindingsThe results confirmed the structures of the independent living units and the retirement village characteristics were closely related to pricing, followed by services and supports with a lesser relationship, although the facilities were not significantly related to pricing.Research limitations/implicationsThis research is not able to address the entire retirement village market in Australia because the available market data are limited.Practical implicationsThis research uses an innovative supply-side approach to assess retirement village attributes and values, which provides stakeholders with up-to-date market information to assist in guiding the performance of the retirement village industry.Social implicationsThe market evaluations imply that seniors are reluctant to pay for village attributes that are not regarded as highly sought-after. A cost-effective strategy of new retirement village developments and upgrades can be further induced, which in turn can enhance the market efficiency and affordability of the retirement villages.Originality/valueThis pricing model for retirement village units extends previous studies into retirement villages and presents stakeholders with an innovative and reliable market-oriented model.

Why do older people refuse resuscitation? A qualitative study examining retirement village residents' resuscitation decisions.

There is a dearth of qualitative research on resuscitation preferences of older New Zealanders. The aim of this study was to investigate the resuscitation preferences of older New Zealanders in a retirement village or residential care setting, as well as the reasons for these preferences. This study had 37 participants from two retirement villages in Auckland, New Zealand. Participants were interviewed about a hypothetical case vignette about cardiopulmonary resuscitation, and then they completed a semi-structured interview. Interviews were subsequently transcribed and analyzed by two independent researchers using thematic qualitative methodology. The majority of the participants (n = 25, 67.6%) decided against resuscitation, 10 (27.0%) wanted resuscitation, and 2 (5.4%) were ambivalent about their resuscitation preferences. Three main themes emerged during the data analysis regarding participants' reasons for deciding against resuscitation: (i) the wish for a natural death; (ii) advanced age; and (iii) a realistic awareness about the consequences of resuscitation. Responses related to the third these had three subthemes: (i) reduced quality of life; (ii) loss of personal integrity and sense of existence; and (iii) concern that resuscitation could result in unnecessary costs or a burden on others. Among participants who preferred resuscitation, two main themes emerged regarding their reasons for wanting resuscitation: (i) the wish to prolong a good quality of life; and (ii) unrealistic expectations of resuscitation. Older people in this study were able to make reasoned decisions about resuscitation based on balancing their subjective estimations of quality of life and the presumed consequences of resuscitation. It is important therefore to educate older adults about the potential outcomes of resuscitation and explore (and document) their reasoning when discussing resuscitation preferences so their wishes can be respected.