An Environmental Scan of Promising Practices of Shelter/Housing That Support Aging in the Right Place for Older People Experiencing Homelessness in Montreal, Calgary, and Vancouver

Background and Purpose: Montréal, Vancouver, and Calgary are the second, third, and fourth most populated metropolitan areas in Canada, respectively, and have seen an increasing number of older people experiencing homelessness (OPEH) over the last decade. However, little is known about the availability and characteristics of supportive shelter/housing options that can meet their needs. ‘Promising practices’ are innovative solutions that have not been subject to rigorous evaluation, but hold the promise of supporting aging in the right place for OPEH. This study sought to identify promising practice shelter/housing models for OPEH in Montréal, Calgary, and Vancouver.

Methods: We conducted an environmental scan in each city by collecting data from Internet and print materials on shelter/housing models that promote aging in the right place for OPEH, as well as informal conversations with providers. In addition, 51 health, housing, and social service providers and 38 OPEH (N=89) participated in one of three World Cafés (held in Montréal (n=23), Calgary (n=30), and Vancouver (n=36) to identify gaps in the Internet and print material scan and understand the capacity and functioning of the identified promising practices. Lists of promising practices from each city were generated, combined, and compared for similarities and differences by the research team in an iterative process to add, remove, organize, and reorganize the promising practices. Once a final list was determined through multiple rounds of discussion with four researchers, the promising practices were categorized into six shelter/housing types along a continuum.

Results: We identified 52 promising practices, which we categorized into six shelter/housing types along a continuum: 1) Emergency, temporary, or transitional shelter/housing; 2) Independent living with offsite supports (i.e., community-based supports); 3) Supported independent living with onsite, non-medical supports; 4) Permanent supportive housing with onsite medical support and/or specialized services; 5) Long-term care, offering specialized healthcare for individuals with complex health needs; and 6) Palliative care/hospice.

Conclusions and Implications: Findings offer a template of a shelter/housing continuum needed for diverse OPEH to age in the right place and highlight concrete, real-world examples of shelter/housing for OPEH. Cataloguing and categorizing promising practices in Montreal, Calgary, and Vancouver offers a mechanism by which other regions can audit their existing shelter/housing options for OPEH and determine where there may be gaps in supporting OPEH to age in the right place. However, few promising practices were identified that specialize in meeting the cultural needs of racial minority OPEH and none were found that specifically serve Indigenous or sexual minority OPEH. Without available and appropriate shelter/housing options, OPEH are excluded from aging in place and instead left to age in environments that may not meet their needs. Notably, emergency, transitional, or temporary shelter/housing, long-term care, and palliative care/hospice options are limited in all three cities. Finding mechanisms by which to scale up promising practices that meet the shelter/housing needs of diverse OPEH will contribute to more sustainable and inclusive communities.