A qualitative exploration of older people’s lived experiences of homelessness and memory problems – stakeholder perspectives

BMC Geriatrics

Research

Martin Knapp¹  Jill Manthorpe²  Caroline Shulman³  Ava Mason⁴  Rosario Espinoza Jeraldo⁴  Garrett Kidd⁴  Penny Rapaport⁴  Gill Livingston⁵ 

[1] Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK;NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London, London, UK;NIHR Applied Research Collaboration (ARC) South London, London, UK;Pathway, London, UK;Healthy London Partnership, London, UK;Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, London, UK;UCL Department of Mental Health of Older People, Division of Psychiatry, Wing B, Floor 6 Maple House, 149 Tottenham Court Rd, W1T 7NF, London, UK;UCL Department of Mental Health of Older People, Division of Psychiatry, Wing B, Floor 6 Maple House, 149 Tottenham Court Rd, W1T 7NF, London, UK;Camden and Islington NHS Foundation Trust, London, UK;

关键词: Memory problems;    Ageing;    Homelessness;    Inclusion health;    Qualitative;   

DOI  :  10.1186/s12877-023-04250-0

 received in 2023-05-12, accepted in 2023-08-23,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe numbers of older people experiencing both homelessness and memory problems are growing, yet their complex health, housing and care needs remain undelineated and unmet. There is a critical gap in understanding what can improve the care, support and experiences of this group. In this qualitative study we explore how stakeholders understand memory problems among older people in the context of homelessness and consider what they judge gets in the way of achieving positive outcomes.MethodWe conducted reflexive thematic analysis of qualitative interviews (n = 49) using a semi-structured topic guide, with 17 older people (aged ≥ 50 years) experiencing memory problems and homelessness, 15 hostel staff and managers, and 17 health, housing and social care practitioners. We recruited participants from six homelessness hostels, one specialist care home and National Health and Local Authority Services in England.ResultsWe identified four overarching themes. The population is not taken seriously; multiple causes are hard to disentangle; risk of exploitation and vulnerability; and (dis)connection and social isolation. The transience and lack of stability associated with homelessness intensified the disorienting nature of memory and cognitive impairment, and those providing direct and indirect support required flexibility and persistence, with staff moving beyond traditional roles to advocate, provide care and safeguard individuals. Memory problems were perceived by frontline staff and older people to be overlooked, misinterpreted, and misattributed as being caused by alcohol use, resulting in pervasive barriers to achieving positive and desired outcomes.ConclusionsEfforts to meet the needs of older people living with memory problems and experiencing homelessness and future interventions must reflect the complexity of their lives, often in the context of long-term alcohol use and current service provision and we make suggestions as to what could be done to improve the situation.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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