Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)




The purpose of this qualitative research study was to develop a model focused on spiritual influences within older adults undergoing relocation to long term care (LTC) facilities. Today, there are 1.5 million Americans aged 65 or older who experienced relocation and reside in LTC facilities. Nothing has been done to qualitatively study the spiritual aspects of this experience. While the profession of nursing has a diagnosis for Relocation Stress Syndrome, as found in the North American Nursing Diagnosis Association (NANDA) reference, it does not incorporate the specific spiritual stressors older adults undergo during relocation; rather addressing only physiological and psychosocial distrubances. To holistically approach care for the older adult, research is needed to reveal the spiritual influences and stressors during relocation.

The research questions of this study identified the influences (past and present) and uses of spiritual and religious practices by older adults in LTC which supports their state of being during relocation. Blumer's Symbolic Interactionism was the theoretical underpinnings for this study. Seventeen adults, age 65 or older, who lived in a rural area in an upper great plains state and were relocated to one of three long term care facilities, were interviewed during the first six months from time of admission. Constant comparative analysis was used to analyze the data.

The emergent theoretical model depicts God as the core variable and presents three central with their unique properties: (1) spiritual relationships and resources, (2) spiritual blessings, and (3) spiritual barriers. An axial coding model and a theoretical model were developed, to visually depict the results.

Implications of this study are specific to understanding and supporting spiritual growth of older adults. The findings support implications for practice changes in the areas of assessment of spirituality and the education of older adults, their families, nurses and spiritual caregivers. Teaching of geriatric theory to student nurses must incorporate the spiritual findings of this study. NANDA should be petitioned to include the role and influences of spirituality in the "Relocation Stress Syndrome" nursing diagnosis.

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