Poster #95 - Barriers and Facilitators to Staying Housed for Formerly Homeless Older Adults in New York City

• In Event: Friday Poster Reception

Abstract

Introduction: Adults aged 55 and older represent a rapidly growing segment of the population experiencing homelessness in the United States. Homeless older adults contend with unique health needs while navigating housing instability. Though prior studies have documented reasons for homelessness and health needs of homeless older adults, gaps remain in our understanding of how formerly homeless older adults maintain housing and age in place after leaving shelter for permanent housing. 

Purpose: In this community-engaged qualitative study, we explore the post-shelter housing experiences of formerly homeless older adults in New York City, focusing on the unique barriers and facilitators to staying housed. Methods: We conducted in-depth interviews with formerly homeless older adults (n=17) and four focus groups with service providers (n=16, 4 per focus group). Hybrid inductive-deductive coding and the constant comparison method were used to identify emergent themes.  

Results: Two overarching themes emerged from the data: 1.) The mental, physical, and social impacts of gaining housing and 2.) Barriers and facilitators to aging in the right place. In the first theme, we explore how stable housing enabled better management of chronic conditions and improved mental health, even while older adults continued to struggle with ongoing health declines from pre-existing conditions. We also explore how participants described loneliness and social isolation after regaining housing.  In the second theme, three domains emerged: 1.) participants’ sense of attachment to and permanence of housing varied, 2.) staff took on a frontline response role in addressing residents’ aging-related needs but faced substantial resource constraints, and 3.) older adults reported getting “stuck” in housing that didn’t meet evolving needs. 

Conclusion: Our results show that adults aged 55 and older face unique challenges staying stably housed and receiving appropriate health and social supports after experiencing homelessness. At the federal level, the United States lacks centralized and expansive safety nets for supporting needs related to health, aging, and economic security. As such, the role of states has become more relevant in addressing these issues. Older adults who have experienced homelessness present unique and complex health, housing, and social needs that span multiple state and city agency mandates. Opportunities for states to intervene to improve the health, housing, and social outcomes of older adults who have experienced homelessness include using Medicaid 1115 waivers, implementing rental assistance programs, and expanding access to in-home health care and social supports.

Author

• Lauren Mulcahy, New York University
  Presenting Author