While experiences of later-life homelessness are known to vary, classification of shelter, housing and service models that meet the diverse needs of older people with experiences of homelessness (OPEH) are limited. To address this gap, a scoping review was conducted of shelter/housing options, supports and interventions for OPEH. Fourteen databases were searched for English-language peer-reviewed and/or empirical literature published between 1999 and 2019, resulting in the inclusion of 22 sources. Through a collaborative, iterative process of reading, discussing and coding, data extracted from the studies were organised into six models: (1) long-term care, (2) permanent supportive housing (PSH), including PSH delivered through Housing First, (3) supported housing, (4) transitional housing, (5) emergency shelter settings with health and social supports, and (6) case management and outreach. Programme descriptions and OPEH outcomes are described and contribute to our understanding that multiple shelter/housing options are needed to support diverse OPEH. The categorised models are considered alongside existing ‘ageing in place’ research, which largely focuses on older adults who are housed. Through extending discussions of ageing in the ‘right’ place to diverse OPEH, additional considerations are offered. Future research should explore distinct sub-populations of OPEH and how individual-level supports for ageing in place must attend to mezzo- and macro-level systems and policies.
Despite widespread use and acceptance of alcohol, discussions of age-related changes that impact alcohol consumption behaviors are rare. The objective of this community-engaged qualitative research study was to gain insight into how to promote knowledge dissemination regarding newly developed low-risk drinking guidelines for older adults. A convenience sample of 66 older adults and service providers participated in three Knowledge Café dialogue workshops and discussed their opinions about alcohol use in later life and ideas for sharing alcohol-related research evidence with the community. Participants discussed (a) low-risk drinking knowledge dissemination, (b) personal choice in drinking alcohol and adherence to low-risk drinking guidelines, and (c) preferences for engaging in discussions about alcohol use. Community dialogues fostered knowledge dissemination while participants engaged in rich conversations about a rarely discussed topic. Sharing evidence-based clinical advice with community stakeholders through dialogue events offers an innovative opportunity for health promotion efforts.
Background:
Older persons with lived or living experience of homelessness (PWLEs) often live with complex physical and/or mental health conditions which are challenged by poor access to health services, especially primary care. To fill the gap in the continuum of care following hospital discharge for PWLEs, medical respite provides health and shelter support for PWLEs who do not have acute care needs that qualify for a stay in a hospital bed, yet are too sick or frail to recover on the streets or in a traditional shelter.
Objective:
This study examines how a medical respite could be designed for older PWLEs in Metro Vancouver, BC.
Research Design:
Using a community-based participatory research approach, in-depth interviews and focus groups were conducted with PWLE (n=15) and service provider (n=11) participants.
Results:
Participants offered rich suggestions about (a) the culture of the medical respite, (b) the physical design of a medical respite, (c) individuals who should be involved in medical respite delivery, (d) services a medical respite should provide, and (e) who the medical respite should serve.
Conclusions:
When designing a medical respite for older PWLEs, considerations include providing an environment where patients can rest, but also feel safe and be surrounded by persons who they trust and who care for them. Developing a medical respite that adheres to the tenets of trauma-informed and patient-centered care acknowledges the mistrust and traumatization that often accompanies homeless patients presenting to health care.
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