“No Home,No Place”: Addressing the Complexity of Homelessness in Old Age Through Community Dialogue

The aging-in-place agenda supports the right of seniors to live in their preferred environment, as the place where they can retain a sense of independence and control in old age. This right is compromised for vulnerable seniors who are homeless or at risk of becoming homeless. Causes of homelessness in old age are complex, and pathways into and out of homelessness are multifaceted, including financial insecurity, relationship breakdown, and addiction, compounded by barriers to accessing services, shrinking social support networks, and complex health challenges. Addressing the multidimensional nature of homelessness in old age requires holistic solutions that bring together the knowledge and expertise of multiple stakeholders, not least seniors themselves. With this aim, this paper reports on findings from multistakeholder community dialogue sessions conducted across Metro Vancouver with seniors’ organizations, service providers, and local government to prioritize the challenges of senior homelessness in Metro Vancouver and propose strategies and solutions for addressing the issue. The paper highlights some of the ways in which services and housing supports can be designed to support older adults who are homeless or at risk of becoming homeless.     

Transportation and homelessness: a systematic review

ABSTRACT

Transportation disadvantage can negatively impact access to employment and educational opportunities, healthcare, and social services. Cost of transportation, in particular, has been found to prevent individuals’ upward mobility out of homelessness. Given the vulnerability of persons of color and those living below the poverty line and the negative implications of transportation disadvantage, the author undertook the current study to assess the extent to which scholars are analyzing transportation and its impact on adults experiencing homelessness. An exhaustive search yielded 3102 potentially relevant studies. Thirteen of these studies met the inclusion criteria for further analyses. A priori inclusion criteria included studies: (1) published between 1997 and December 2017 in refereed academic journals; (2) published in English; (3) sampling a population of adults who self-identify as currently or formerly homeless; (4) conducted using empirical quantitative or mixed methods (excluding purely qualitative, theoretical and policy analyses), and; (5) which analyzed transportation as a primary variable of interest. Findings of this research demonstrate that transportation is a critical, although under-researched, variable in the lives of individuals experiencing homelessness. Homelessness service providers, therefore, should work to shift the conversation from transportation as a privilege to transportation equity for all.     

Age and gender differences and predictors of victimization of the older homeless

Using data from the National Survey of Homeless Assistance Providers and Clients (NSHAPC) and an application of Felson's Routine Activities Theory, this paper examines gender and age differences in victimization experiences of a sample of more than 4,200 homeless and near-homeless people, mostly adults. Results suggest that there are no differences in victimization experience by homelessness status and that the negative relationship between age and victimization rates found in the general population is also found in the homeless population. However, the relationship is relatively weak and erratic, suggesting that homeless older adults who are at least 50 years old are at increased risk of becoming victims, a finding consistent with Routine Activities Theory. In addition, similar to research with other populations, younger homeless males are statistically more likely to report being victims of theft and physical assault while females of all ages are more likely to report being victims of sexual assault. However, for older homeless adults, the gender difference in likelihood of victimization disappears. Perhaps because older homeless women are labeled as easy targets, they were equally as likely as men to be victims of physical assault and theft in old age. This is also consistent with Routine Activities Theory.     

A portrait of homelessness.

The homeless elderly are vulnerable, silent, and fearful. Their trajectory into homelessness more often than not precludes recovery and takes them on a course toward early death or nursing home placement. Psychiatric nurses who work in community or acute care settings are in key positions to recognize elderly victims of homelessness, assess their needs, match them to services, start them on the road to recovery, and become their advocates. The definition of a homeless person as agreed on in the Report of the Federal Task Force on Homelessness and Severe Mental Illness (1992) is the one used in the Stewart B. McKinney Homeless Assistance Act (Public Law 100-77). A homeless person is someone "who lacks a fixed, regular, and adequate nighttime residence" and whose main nighttime residence is a "supervised public or private shelter designed to provide temporary living accommodations; an institution that provides a temporary residence for individuals intended to be institutionalized; or a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings." This definition, then, excludes those individuals living on the "fringes" in substandard or condemned housing, a condition that warrants attention in general and particularly among the elderly.     

Anatomy of a Mean City: Including People Experiencing Homelessness in the Discussion

Abstract

In January 2006, a survey released by the National Coalition for the Homeless and the National Law Center on Homelessness and Poverty named Lawrence, Kansas the second “meanest city” to people who experience homelessness in the United States. The survey focuses on the increase in ordinances that make behaviors such as panhandling and sleeping on sidewalks illegal. A critical perspective missing from the 2006 study were the views of those experiencing homelessness. Therefore, this study was developed with the intention of providing a voice to individuals in the homeless community and to encourage other advocacy efforts to include those absent voices. Findings indicate that Lawrence may not be “mean” in terms of ordinance enforcement but suggest that homeless individuals encounter negative attitudes from the community at large and face barriers to employment and participation in community life. Implications for social welfare practice, policy and research are discussed.     

Successfully exiting homelessness: experiences of formerly homeless mentally ill individuals

This study aims to identify and describe processes of change enabling achievement of stable housing among homeless individuals. Twelve previously homeless individuals who had maintained stable housing for a period of at least 24 consecutive months provided information through semi-structured interviews on the following topics: (1) the personal experience of homelessness, (2) the process of becoming housed, and (3) the role of significant life relationships. Only the second and third topic areas were included in this discussion. Eight categories were developed and analyzed from the qualitative interviews, including: work/employment difficulties, substance use and/or mental illness, cyclical nature of homelessness, personal motivation, housing-related issues, lessons learned, relationships with family/friends and relationships with service providers. The participants highlighted relationships with family, friends and service providers as central in the processes of achieving stable housing.     

Japan's “New Homeless”

Since the mid-1990s, homelessness has become a major issue of public discussion in Japan, and is often viewed as a new social problem facing Japanese society. The issue of homelessness contrasts images of the absence of poverty and homelessness in postwar Japan, often explained based on the unique features of Japanese-style employment and welfare, containing poverty and unemployment. This paper contrasts these views with a perspective on the continuity of poverty, and homelessness in postwar Japan. Specifically, I discuss the characteristics of homelessness in Tokyo, how they relate to the structure of the economy and employment practices, and how the problems of today's homeless are accommodated in the welfare system. I argue that the homeless cast light on patterns of loss of employment, housing, and means of subsistence, characteristic to Japan's economy and welfare system, and contribute to a new understanding of the dynamics of poverty in contemporary Japan.     

Barriers and facilitators to shelter utilization among homeless young adults

Rates of shelter use among homeless youth are low compared to use of other supportive services, yet research on barriers to shelter use has been conducted in limited regions, specifically in West Coast or Midwest cities. Additionally, while studies have generally focused on barriers to shelter use, studies on what might facilitate shelter use are lacking. This study explores barriers and facilitators to shelter use among homeless young adults from a large city in the Southwest region. Focus groups were conducted with a diverse sample of 49 homeless young adults ages 18–24. Drawing on models of health service use, findings were categorized into two domains – attitudinal and access. Themes related to attitudinal barriers include stigma/shame and self-reliance/pride. Attitudinal facilitators include the desire to extricate themselves from street life and turn their lives in a new direction. Access-related themes include barriers such as a lack of shelters and services available to meet the needs of youth, adverse shelter conditions, staff attitudes that are not acceptable to youth, restrictive shelter rules, restrictive definitions of homelessness, and a desire to differentiate themselves from older homeless individuals. Certain characteristics or circumstances (e.g., being pregnant), having supportive others, and shelters’ ability to connect them to other services emerged as access facilitators to shelter use. Implications for policymakers, service providers, and future research are discussed.     

The invisibility of disability for homeless youth

A largely unexplored complexity in the lives of youth who have experienced homeless is the presence of intellectual, developmental and/or learning disabilities. Although emerging research shows that youth with cognitive disabilities are more likely to become homeless and that rates of cognitive disabilities are higher among the homeless population than the population in general, exploring the intersection of disability and homelessness for youth has not been a priority. In this study, a critical disability and systems failure lens is brought to bear on the vulnerability of youth who experience this intersection. Based on interviews with key informants in the disability, homelessness, education, employment and child welfare sectors in three sites in Ontario, Canada, the invisibility of disability among homeless youth is brought to light. We explore the ways youth with a disability in the homelessness sector are made vulnerable, the insurmountable barriers to getting access to the requisite assessment for disability services and the siloed nature of the homelessness and disability service sectors. An argument is made that “working outside the box” to assist youth to navigate significant system disjunctures is insufficient.     

Homelessness in Ottawa County Michigan: The “Gap” Population

Abstract

Homelessness has gained increasing attention since the 1980s in the United States. And the numbers of individuals and families experiencing homelessness are growing, with a 20,000 person, or 3% increase, from 2008 through 2009 (“State of Homelessness,” 2011). In spite of persistent investigation and activism on how to prevent and end homelessness, there is not agreement on what causes homelessness or how to stop it (McNamara, 2009). What is apparent, however, is that the homeless population is not homogenous. Therefore, the standard models of service, whether from governmental or non-governmental organizations (NGOs), end up neglecting the needs of portions of the population of people who face homelessness. Governmental and non-governmental service providers have recognized the existence of the unique sub-populations of people who are homeless and are attempting to understand and meet the needs of people outside the prevailing understanding of homelessness. This project works with a collaborative of such service providers through a multiple methodological approach to generate better understanding on the two key areas necessary to create models of service for people who are in the “gap” subsector of the homeless population. First, investigation was undertake to learn systematically who is included in the “gap” population among the homeless community, or, in other words, what traits those who continue to cycle in and out of homelessness, and thus are part of this “gap” population, share. Secondly, the project explores what organizations are currently serving these people, and how are they doing so. In other words, this project also ask what are the trends or practices that exist nationally and locally for serving people who fall into this category of homelessness? Findings suggest central traits including mental illness, substance abuse and a history of incarceration as factors spanning members of the “gap” population. Though there are caveats and practices to be avoided, these people are surviving or even thriving through the service primarily of faith-based non-governmental organizations, unfettered by the policy and funding constraints of governmental entities.     

Emerging adult homelessness in geographic perspective: A view from the Rust Belt

This study provides a place-centered analysis of homelessness among emerging adults (age 18–24) by examining this issue in the context of the U.S. Rust Belt. In-depth interviews were conducted with a diverse sample of 30 homeless young adults in the small post-industrial city of Buffalo, New York. Our qualitative analysis focused on how place intersects with other factors to shape participants' experiences of homelessness and their views of the city and local social services. Participants described a sense of limited opportunity in Buffalo as well as the frustration that the service spectrum was too small, yet confusing to navigate. These findings point to directions for expanding employment prospects and housing and service options for homeless young adults in small cities.     

“I’m not homeless,I’m houseless”: identifying as homeless and associations with service utilization among Los Angeles homeless young people

Little is known about homeless young people’s identification of being homeless and how that identity may or may not be associated with service utilization. This study of 444 homeless young people attending Los Angeles area drop-in centers explores the associations of demographic characteristics, homelessness characteristics, negative lifetime experiences, mental health symptoms, technology use, and past month service utilization with identifying as homeless. Fifty-two percent of the sample identified as being homeless. Being Black, a current traveler, and history of injection drug use were all significantly associated with a decreased likelihood in identifying as homeless. However, having fair/poor health, accessing shelter services, and reporting one’s own substance use as a reason for homelessness were all significantly associated with identifying as homeless. There are important service implications for reaching young people who are in need of services but may not identify with the target population label of homeless.     

Identity in transition: how formerly homeless individuals negotiate identity as they move into housing

It is unclear what happens when stigmatized individuals undergo status transitions into non-stigmatized groups. This paper explores changes in housing status, identity, and social relationships over time and their impact on formerly homeless individuals. Drawing on longitudinal qualitative interview data collected over six months from seven individuals transitioning out of homelessness and into government supported housing, this paper examines identity changes during such a status shift. Analysis shows that individuals distanced themselves from both homeless and formerly homeless people, and connected with others through groups not affiliated with homelessness or shelter life. When exiting a stigmatized status, like homelessness, social distancing may be particularly important as it helps redefine the self as apart from that previously held stigmatized status. Implications for research and policy are discussed.     

Japan’s “New Homeless”

Since the mid-1990s, homelessness has become a major issue of public discussion in Japan, and is often viewed as a new social problem facing Japanese society. The issue of homelessness contrasts images of the absence of poverty and homelessness in postwar Japan, often explained based on the unique features of Japanese-style employment and welfare, containing poverty and unemployment. This paper contrasts these views with a perspective on the continuity ofpoverty, and homelessness in postwar Japan. Specifically, I discuss the characteristics of homelessness in Tokyo, how they relate to the structure of the economy and employment practices, and how the problems oftoday’shomeless are accommodated in the welfare system. I argue that the homeless cast light on patterns of loss of employment, housing, and means of subsistence, characteristic to Japan’s economy and welfare system, and contribute to a new understanding of the dynamics of poverty in contemporary Japan.     

Agency in advanced liberal services: grounding sociological knowledge in homeless people's accounts

This paper aims to understand how people who are homeless respond to advanced liberal social services that endeavour to promote their autonomy and responsible actions. We prioritize the experiences and positions of people who are homeless, and what agentic action means to them. Sociological literature is selective about what accounts are deemed agentic. Agency is associated with accounts that resist or subvert dominant neoliberal framings of homelessness as failure of individuals. When people experiencing homelessness or poverty themselves foreground autonomy or responsibility, sociologists treat them as cultural dopes who have internalized neoliberal discourse. Our analysis is driven by an ethnographic study in an Australian homelessness shelter. We demonstrate how people who are homeless neither outright reject nor completely embrace advanced liberal practices to influence their actions and promote autonomy. People engaged in relational reasoning. Paternalist and advanced liberal social services were both lauded and rejected for their capacities and limitations to realize a good life. We contribute to the discussion for sociology to value people's accounts and experiences, rather than broader social process explaining their accounts. From the perspectives of people who are homeless, we show that just because something appears neoliberal does not mean it should be automatically rejected.     

Identity and everyday experiences of homelessness: Some implications for social work

It is important for the complexities of homelessness to be considered when constructing policy or practice relating to people who are without safe and stable accommodation. These complexities can be loosely categorised around the definitions, causes and experiences of homelessness. While definitions and causes are topics of current debates, study of the lived-experiences of homelessness remains an area that is largely under-researched. This paper explores some of the implications for social work and social workers when the individual's understanding and experience of her/his identity as a ‘homeless person’ and consequent relationships with service providers are not factored into policy and practice. This article draws on the findings of a study of homeless adults in inner city Adelaide to illustrate the author's arguments. It outlines the importance of listening to service users' perspectives in order to assess whether dominant constructions of social work, homelessness and ‘homeless people’ are meeting the needs of and improving outcomes for individual clients. More broadly, it is hoped that making these perspectives visible will assist in the development of ‘client-focused’ practice and policy.     

Somewhere to be permanent for a minute: Time and space perceptions of older adult men experiencing chronic homelessness in Detroit

Within the landscape of postwar era Detroit, space is vast, but places are hard to find. As people tumble down the side of Maslow’s pyramid into abject homelessness, they attempt to anchor themselves in locations that suspend the otherwise situational free fall. This article analyzes how time and space are perceived by people experiencing chronic homelessness and how those individual perceptions are informed by the objective time and space urban environment. We conducted our community-based participatory research into the experiences of chronic homelessness both from perspectives of chronically homeless older adult men and from front-line service providers. Themes that emerged are as follows: (1) temporary permanence, (2) permanent temporariness, and (3) lostness. The article concludes with policy implications regarding the procedures for measuring the extent of homelessness and the needs of those who live it.     

Perceptions of and reactions to the homeless: A survey of fourth-grade, high school, and college students in a small Midwestern community

A total of 459 fourth-graders, high school students, and undergraduates completed a Homelessness Questionnaire developed for use in this study. Although participants generally expressed positive and supportive attitudes toward the homeless, attributing homelessness to either social maladjustment (e.g., drug problem) or negative characteristics (e.g., laziness) within the homeless was positively associated with “fear of and anger toward the homeless” for all groups of participants. In addition, perceptions of and reactions to the homeless were influenced by both the participants’ gender and age group. Although high school and college students’ interest in helping the homeless was associated with various attitudes and reactions (e.g., feelings of sympathylsupport), their indication that they had ever helped homeless people (either directly or indirectly) was consistently associated only with the acknowledgement that their mother and father had ever helped homeless people (either directly or indirectly). Among these older participants, homelessness in the United States was rated as a more serious problem at the end of the questionnaire than at the beginning.