Characteristics of the old and homeless: identifying distinct service needs

Kimbler, Kristopher J.; DeWees, Mari A; Harris, A

doi:10.1080/13607863.2015.1088512

Cited by 17 publications

(9 citation statements)

References 24 publications

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“…Consistent with results of previous studies among homeless people, we found that older age was associated with worse physical health (Abdul‐Hamid, ; Brown & Steinman, ; Garibaldi et al, ; Gelberg et al, ; Kellogg & Horn, ; Kimbler et al, ; Nakonezny & Ojeda, ; Tompsett et al, ) and that about 30 percent of both the older and younger homeless people had elevated levels of psychological distress (DeMallie et al, ; Garibaldi et al, ) and were screened positive for suspected intellectual disability (Hurstak et al, ; Spence, Stevens, & Parks, ). Among both older and younger homeless people in our study, levels of substance use were lower than generally reported in studies among homeless populations (DeMallie et al, ; Garibaldi et al, ; Landefeld et al, ; Nielsen et al, ; Tompsett et al, ).…”

Section: Discussionsupporting

confidence: 90%

“…As many as 33.0% and 27.8% of the older participants, compared to 19.6% and 14.6% of the younger participants in our study reported to only rarely or never receive social support from family and friends or acquaintances, respectively. This finding warrants attention, all the more because several studies in other Western, high‐income countries did comparable observations, showing that older homeless people had fewer informal social contacts (Gelberg et al, ) and smaller social networks (Tompsett et al, ), and stayed in shelters that were further removed from their emergency contacts (Kimbler et al, ) than younger homeless people. Moreover, lack of social support has found to be predictive of new episodes of homelessness (Duchesne & Rothwell, ).…”

Section: Discussionmentioning

confidence: 83%

“…Nevertheless, only few studies have specifically examined health‐related characteristics of older homeless people (Brown et al, ; Brown, Kiely, Bharel, & Mitchell, ; Landefeld et al, ) or investigated health differences between older and younger homeless people (Abdul‐Hamid, ; Brown, Kimes, Guzman, & Kushel, ; Brown & Steinman, ; DeMallie, North, & Smith, ; Garibaldi, Conde‐Martel, & O'Toole, ; Gelberg, Linn, & Mayer‐Oakes, ; Hategan, Tisi, Abdurrahman, & Bourgeois, ; Kellogg & Horn, ; Kimbler, DeWees, & Harris, ; Nakonezny & Ojeda, ; Tompsett, Fowler, & Toro, ). The studies that have made such age comparisons consistently reported poorer physical health among older than younger homeless adults, but yielded conflicting results with regard to mental and psychosocial health, substance use, healthcare service use and health‐related needs (Abdul‐Hamid, ; Brown et al, ; Brown & Steinman, ; DeMallie et al, ; Garibaldi et al, ; Gelberg et al, ; Hategan et al, ; Kellogg & Horn, ; Kimbler et al, ; Nakonezny & Ojeda, ; Tompsett et al, ). Moreover, none of these studies have been conducted outside Canada and the United States, where healthcare and social relief systems are different than in Europe.…”

Section: Introductionmentioning

confidence: 99%

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Self‐reported health, healthcare service use and health‐related needs: A comparison of older and younger homeless people

Dongen

Straaten

Wolf³

et al. 2019

Health Soc Care Community

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The number of older homeless people with a limited life expectancy is increasing. European studies on their health‐related characteristics are lacking. This study compared self‐reported health, healthcare service use and health‐related needs of older and younger homeless people in the Netherlands. It is part of a cohort study that followed 513 homeless people in the four major Dutch cities for a period of 2.5 years, starting from the moment they registered at the social relief system in 2011. Using cross‐sectional data from 378 participants who completed 2.5‐year follow‐up, we analysed differences in self‐reported health, healthcare service use, and health‐related needs between homeless adults aged ≥50 years (N = 97) and <50 years (N = 281) by means of logistic regression. Results show that statistically significantly more older than younger homeless people reported cardiovascular diseases (23.7% versus 10.3%), visual problems (26.8% versus 14.6%), limited social support from family (33.0% versus 19.6%) and friends or acquaintances (27.8% versus 14.6%), and medical hospital care use in the past year (50.5% versus 34.5%). Older homeless people statistically significantly less often reported cannabis (12.4% versus 45.2%) and excessive alcohol (16.5% versus 27.0%) use in the past month and dental (20.6% versus 46.6%) and mental (16.5% versus 25.6%) healthcare use in the past year. In both age groups, few people reported unmet health‐related needs. In conclusion, compared to younger homeless adults, older homeless adults report fewer substance use problems, but a similar number of dental and mental problems, and more physical and social problems. The multiple health problems experienced by both age groups are not always expressed as needs or addressed by healthcare services. Older homeless people seem to use more medical hospital care and less non‐acute, preventive healthcare than younger homeless people. This vulnerable group might benefit from shelter‐based or community outreach programmes that proactively provide multidisciplinary healthcare services.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

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Self‐reported health, healthcare service use and health‐related needs: A comparison of older and younger homeless people

Dongen

Straaten

Wolf³

et al. 2019

Health Soc Care Community

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“…Although emerging epidemiological surveys (Kimbler et al, 2015;2015;Brown et al, 2011) and qualitative studies (Mills-Dick, 2012;Lewinson et al, 2014) offer insights into the broad characteristics of older homelessness, few researchers have investigated the interdependent roles of gender and age (Kisor and Kendal-Wilson, 2002). This study sought to address this gap through an in-depth investigation of the intersectionality of gender, age and homelessness for older women who find themselves without stable housing.…”

Section: Introductionmentioning

confidence: 99%

Older homeless women’s identity negotiation: agency, resistance, and the construction of a valued self

Gonyea

Melekis

2016

The Sociological Review

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There is a growing awareness that the adult homeless population is ageing, mirroring the general US population trend. Although men still outnumber women among the adult homeless population, there has been a dramatic increase in the number of women, including older women, seeking shelter each night. The concept of 'home' is widely associated with women and serves as a source of identity and social order. Thus, homeless older women represent an intersection of stigma. This qualitative study utilized narrative analysis to investigate the intersectionality of gender, age and homelessness among six homeless urban women in their fifties and early sixties. Findings highlight how older homeless women experience stigmatization within the context of multiple marginalized identities. Data illustrate the women's agency, resistance and resilience as they engage in 'identity work' to address the tension between how others view them and how they view themselves, and construct a sense of a valued life and self.

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“…These changing demographic profiles also present new challenges when considering social services and healthcare access for this population. For example, 1 in 3 transgender individuals are rejected from shelters due to their gender identity or gender expression (Canadian Observatory on Homelessness 2019b), while older adults who are experiencing homelessness are more likely to have poorer health, and mental health issues (Kimbler et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Investigating the attitudes of Canadian paramedic students towards homelessness

Cochrane

Pithia

Laird

et al. 2019

Preprint

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Introduction: When paramedics are dispatched, it is expected that every patient receives the same level of care regardless of variable factors. Homelessness is a growing social issue across Canada that is particularly prevalent in urban areas. The quality of healthcare delivered to individuals experiencing homelessness may be influenced by negative attitudes held by healthcare professionals. There is an absence of literature quantifying the perspectives of paramedics towards homelessness; therefore, the focus of this study was to identify the attitudes of paramedic students towards homelessness and to continue the conversation in regards to the evolving educational needs of paramedic students. Methods: This study employed a longitudinal design of a convenience sample of first year paramedic students in a college program in Ontario, Canada. The Health Professional's Attitude Towards the Homeless Inventory (HPATHI) was distributed to participants before and after placement and clinical exposure. The questionnaire includes 19 statements which participants respond to on a Likert scale. Mean scores were calculated, and statements were categorized into attitudes, interest, and confidence. Data were collected post-placement on interactions with persons experiencing homelessness. Results: A total of 52 first year paramedic students completed the HPATHI pre-placement and 47 completed the questionnaire post-placement. Mean scores for attitudes (pre 3.64, SD 0.49; post 3.85, SD 0.38, p=0.032), interest (pre 3.91, SD 0.40; post 3.84, SD 0.39,p=0.51) and confidence (pre 4.02, SD 0.50; post 3.71, SD 0.67, p=0.004) were largely positive, but there was a demonstrated decreasing trend in confidence with, and interest in, working with those experiencing homelessness. Participants reported an average of 60 hours of placement, during which 15 participants (32%) reported interactions with people experiencing homelessness. Conclusion: First year paramedic students demonstrate overall positive attitudes towards those experiencing homelessness, and the mean score for attitudes improved over the surveys. However, there were demonstrable decreases in confidence and interest over time, which may be related to the type and frequency of interactions during clinical placement. Paramedic education programs may benefit from the inclusion of focused education on homelessness, specific clinical experiences, and education related to social determinants of health.

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Characteristics of the old and homeless: identifying distinct service needs

Abstract: The various characteristics that differentiate older homeless populations (e.g., health, social support, homelessness duration, and employment) could create potential barriers to overcoming homelessness that should be considered when serving this population.

Cited by 17 publications

References 24 publications

Self‐reported health, healthcare service use and health‐related needs: A comparison of older and younger homeless people

Self‐reported health, healthcare service use and health‐related needs: A comparison of older and younger homeless people

Older homeless women’s identity negotiation: agency, resistance, and the construction of a valued self

Investigating the attitudes of Canadian paramedic students towards homelessness

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