Health and Psychosocial Needs of Older Adults Who Are Experiencing Homelessness Following Hospital Discharge

Abstract

Introduction Though hospitals are a common location where older adults experiencing homelessness receive health care, an understanding of the types of supports needed upon hospital discharge is limited. We examined the unique characteristics of older homeless adults and the health and psychosocial supports required upon hospital discharge. Design and Methods Guided by principles of community-based participatory research (CBPR), we conducted 20 in-depth, semi-structured interviews with shelter/housing and health care providers in Metro Vancouver. Results Thematic analyses revealed 6 themes: (a) older people experiencing homelessness have unique vulnerabilities upon hospital discharge; (b) following hospital discharge, general population shelters are inappropriate for older adults; (c) shelter/housing options for older adults who have complex health and social needs are limited; (d) shelter/housing for older adults who require medical stabilization and convalescence after hospital discharge is needed; (e) a range of senior-specific shelter/housing options are needed; and (f) unique community supports are needed for older adults upon hospital discharge. Discussion and Implications As the population of older adults increases across North America, there is a parallel trend in the increased numbers of older adults who are experiencing homelessness. Not only is there often a need for ongoing medical care and respite, but there is a need for both shelter and housing options that can appropriately support individual needs.

Positive health among older Traveller and older homeless adults: A scoping review of life‐course and structural determinants

“…Waldbrook (2015) reported improvements in health outcomes of older homeless adults after being housed, including reduced respiratory problems. Third, improvements in material conditions can help increase the likelihood of older homeless adults utilising services, as they have more time to prioritise and manage their health concerns (Waldbrook, 2015; Brown et al., 2015; Means, 2017; Canham, Custodio, Mauboules, Good, & Bosma, 2019). Brown, Thomas, Cutler, and Hinderlie (2013) provide qualitative evidence from the Hearth Outreach Program in Boston – a specialist program for older homeless adults – which highlights the critical role of supportive housing in improving health experiences.…”

“…Canham et al. (2019) highlighted the needs for unique community supports for older homeless adults upon hospital discharge.…”

Air Pollution-Related Health Impacts on Individuals Experiencing Homelessness: Environmental Justice and Health Vulnerability in Salt Lake County, Utah

“…However, the simultaneous analysis is that for those facing sheltered homelessness, the temporary nature of nightly indoor (and usually institutionalized) sheltering does not provide substantial respite from poor air quality events. Homeless shelters often have inadequate ventilation, unhygienic bedding, and overcrowded conditions [ 20 ], and most shelters are not prepared for including individuals with higher medical needs [ 60 ]. In fact, the nonsignificant findings remind us that homelessness, in large, is experienced in public space, and often outdoors [ 45 ], where environmental exposure is felt most viscerally.…”

Air Pollution-Related Health Impacts on Individuals Experiencing Homelessness: Environmental Justice and Health Vulnerability in Salt Lake County, Utah

“…However, the simultaneous analysis is that for those facing sheltered homelessness, the temporary nature of nightly indoor (and usually institutionalized) sheltering does not provide substantial respite from poor air quality events. Homeless shelters often have inadequate ventilation, unhygienic bedding, and overcrowded conditions [20], and most shelters are not prepared for including individuals with higher medical needs [59]. In fact, the nonsignificant findings remind us that homelessness, in large, is experienced in public space, and often outdoors [44], where environmental exposure is felt most viscerally.…”