Supporting Older Homeless Adults' Relocation to a Care Facility

Background: Most studies on stably housed older adults suggest that older adults prefer to remain at home for as long as possible. While there is a growing body of literature on the conditions that support positive relocation experiences for older adults, almost nothing exists on the relocation experiences of older homeless adults. Yet when facing health related challenges older homeless adults are at increased risk of relocation due to limited aging in place options. 

Methods: This qualitative study explored service providers’ experiences supporting older homeless adults’ relocation into a care facility. Selective purposive sampling procedures were used to determine which service providers to interview. Service providers were invited to participate if they had supported the relocation process of at least one older homeless adult within the last three months. Variation in settings were also sought to ensure representation of service providers involved at different stages of the relocation process including the decision to pursue relocation, the relocation itself, and post relocation support. A total of eight in-depth active interviews were conducted with service providers. Data collection and analysis occurred simultaneously, with early interviews providing ideas of initial themes probed more deeply in subsequent interviews. All interviews were tape recorded, transcribed and analyzed using a four-staged method of analysis consistent with an interpretive grounded theory approach.

Results: Analysis of the data revealed a complex intersection of conditions at multiple layers that challenged service providers’ abilities to support a positive transitional process for older homeless adults. Recommendations to enhance practice at individual, interpersonal, and systemic layers pre and post move are proposed. Implications for social work practice across the continuum of care are discussed including the significance of recognizing and supporting pre move anxieties, the critical importance of post move follow up, the consequences of rigid care facility policies and procedures for older homeless adults and the need for more creative aging in place strategies.

Conclusion: Current service structures and cultures challenge service delivery to older homeless adults at risk of relocation at all stages of the relocation process.