Creating a Therapeutic Milieu in Retirement Communities

Document Type




Format of Original

8 p.

Publication Date



Informa Healthcare

Source Publication

Issues in Mental Health Nursing

Source ISSN


Original Item ID

doi: 10.3109/01612840.2010.541329


Elderly persons’ relocation to retirement communities is a stressful event that requires person-milieu adjustment. Research has shown differences in relocation adjustment for elders residing in different retirement communities. A secondary analysis used findings from a study of relocated elders in order to determine whether certain therapeutic factors were lacking in retirement communities where elders had difficulty in adjusting. Study participants were 104 elders who relocated to six retirement communities in Northeast Ohio. This study analyzed qualitative data from the researchers’ observations and field notes and narratives obtained from the elders who participated in the original study. The analysis focused on data that described the environmental characteristics of retirement communities where elders reported less successful adjustment. These environmental characteristics were evaluated for consistency with the characteristics of Shives’ therapeutic milieu. Most retirement communities in the study did not fulfill all eight dimensions of a therapeutic milieu as defined by Shives. For example, individualized treatment programs were lacking in most of the retirement communities and the activities offered were not based on individual assessment and did not contribute to personal growth. The findings point to the need to create a more therapeutic milieu in retirement communities in order to facilitate successful readjustment for relocated elders.


Issues in Mental Health Nursing, Vol. 32, No. 5 (May 2011): 327-334. DOI.