A missing piece of the puzzle: Health care providers’ experiences supporting older homeless adults in outreach settings
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Date
2020-12-18
Authors
Sacco, Veronica
Journal Title
Journal ISSN
Volume Title
Publisher
University of Waterloo
Abstract
BACKGROUND: The older homeless population in Canada is on the rise. Older homeless adults often face multiple health and social challenges, as well as have distinct service needs. While more research is emerging on the characteristics and experiences of older homeless adults, there is limited information on the experiences of health care providers working closely with this population.
OBJECTIVES: The purpose of this study was to gain a better understanding of the experiences of frontline health care providers who support older homeless adults (defined as homeless adults aged 50 or older) in outreach settings. This study specifically investigated how they work in their roles with older homeless persons, as well as the challenges and rewards associated with supporting this unique population.
METHODS: This qualitative research followed an interpretive description approach. The study consisted of in-depth, semi-structured interviews with a diverse sample of 10 health care providers who support older homeless adults in outreach settings in a mid-sized metropolitan area located in southern Ontario. Concurrent data collection and analysis, along with an iterative approach, were used to conceptualize patterns and key themes in the data.
FINDINGS/DISCUSSION: Four key themes emerged from data analysis, including: 1) the client-provider relationship as an essential building block; 2) progression of care that acknowledges the ‘whole person’; 3) collaboration as integral to providers’ work; and 4) system navigation. These themes demonstrated that health care providers offer more than clinical services to their clients. They provide social and health support, are collaborators, system navigators, advocates, and educators. Through their multifaceted roles, health providers encounter individual and systems- level challenges, the latter of which posed the most barriers to delivering optimal care to clients. Some prominent systems-level challenges in their work were: limited funding, insufficient resources and supports tailored to an older homeless population, coordinating care with different sectors, the cyclical nature of homelessness, and stigmatization. Nonetheless, providers also highlighted the rewarding aspects of their roles. They attained personal and professional fulfillment through witnessing their clients’ resilience, celebrating the small wins, having strong interprofessional relationships with colleagues, and having substantial flexibility in their work.
CONCLUSION: Facilitating a greater understanding of these health care workers’ experiences can be used to identify strategies on how to further support providers in their roles. Furthermore, findings from this study may assist in informing how service provision can be improved to better meet the needs of older homeless individuals. In line with interpretive description’s emphasis on producing practical knowledge for practitioners, a series of proposed recommendations for practice, policy and future research were outlined.
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Keywords
homelessness, older adults, health care providers, outreach