Giving Voice to Older Homeless Women with Depression

Schedule:
Sunday, January 18, 2015: 11:03 AM
Balconies K, Fourth Floor (New Orleans Marriott)
* noted as presenting author
Karen, L. Caremon, PhD, Instructor, University of Portland, Portland, OR
Background:There is a strong connection between homelessness and mental health—this relationship is particularly acute for older homeless women.  Yet, little is known about the unique experiences, treatment needs, and coping strategies of older homeless women with depression. Therefore, the purpose of this qualitative descriptive study was to describe how seven older homeless women with depression characterized their homelessness, depression, and aging. The goal of this study was to offer a gendered perspective that would advance knowledge and develop a foundation of understanding for clinicians regarding older homeless women with depression.

Methods:. Semi-structured, hour-long interviews with seven women, aged 52 to 57 years were conducted around the guiding research question: how do older homeless women with depression describe growing older, their depression, and homelessness? Participants were recruited via convenience and snowball sampling in an urban setting, and asked to describe how they understood their experiences of aging, depression and homelessness. Interviews were transcribed in their entirety and coded for themes using content analysis.

Results:  “Coping with the realities of life” was the overarching theme in this study. Older women with depression coped by remaining in the present moment and focusing on what they needed to do each day: standing in line, finding food, talking with case managers, filling out paperwork, or making appointments for health care. A few women coped with their homelessness and depression through substance abuse. Experiences of homelessness and depression were more readily discussed during interviews than experiences of aging.  All of the women reported untreated pain stemming from a variety of chronic conditions. Most of the women reported that pain and their aging bodies complicated their ability to exit homeless in relation to finding secure housing and sufficient income.

Conclusion: All health care providers could benefit from becoming more aware of the lived experience of older homeless women with depression – and particularly how they are simultaneously managing their aging bodies, depression and homelessness. It is important that service providers be aware that barriers to exiting homelessness are more complex for older homeless who are suffering from both physical and mental health issues. Practitioners could pay closer attention to the complaints of pain that older homeless women with depression express during clinic visits as the presence of chronic pain is not addressed in homeless populations. Treating older homeless adults as geriatric clients might assist in ensuring the complex health needs of older homeless adults are addressed.