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. 2024 Mar 12;24(1):249.
doi: 10.1186/s12877-024-04791-y.

Specialised residential care for older people subject to homelessness: experiences of residents and staff of a new aged care home in Australia

Costanza Preti  1   2 , Christopher J Poulos  1   3 , Roslyn G Poulos  1   3 , Najwa L Reynolds  1 , Allison C Rowlands  1 , Kyall Flakelar  3 , Angela Raguz  1 , Peter Valpiani  4   5 , Steven G Faux  6 , Claire Mc O'Connor  7   8   9   10
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Specialised residential care for older people subject to homelessness: experiences of residents and staff of a new aged care home in Australia

Costanza Preti et al. BMC Geriatr. .

Abstract

Background: The number of older people experiencing homelessness in Australia is rising, yet there is a lack of specialised residential care for older people subject to homelessness with high care and palliative needs. To address this significant gap, a purpose-built care home was recently opened in Sydney, Australia.

Methods: This qualitative study explores the experiences of both residents and staff who were living and working in the home over the first twelve months since its opening. Residents were interviewed at baseline (n = 32) and after six months (n = 22), while staff (n = 13) were interviewed after twelve months. Interviews were analysed using a reflexive thematic analysis approach informed by grounded theory.

Results: Three main themes emerged: (1) Challenges in providing care for older people subject to homelessness with high care needs; (2) Defining a residential care service that supports older people subject to homelessness with high care needs, and (3) Perception of the impact of living and working in a purpose-built care home after six months (residents) and twelve months (staff) since its opening. A key finding was that of the complex interplay between resident dependency and behaviours, referral pathways and stakeholder engagement, government funding models and requirements, staff training and wellbeing, and the need to meet operational viability.

Conclusion: This study provides novel insights into how the lives of older people subject to homelessness with high care needs are affected by living in a specifically designed care home, and on some of the challenges faced and solved by staff working in the care home. A significant gap in the healthcare system remains when it comes to the effective provision of high care for older people subject to homelessness.

Keywords: Ageing; Homelessness; Long-term care; Palliative care; Qualitative; Trauma-informed care.

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Conflict of interest statement

Authors CP, CJP, RGP, NLR, ACR, and CMCOC are or were employed at some stage during the study by the not-for-profit provider who ran the care home, but none of these authors worked in or managed the care home. Author AR was the provider’s Executive sponsor for the project, and contributed to the study design and this paper, but had no involvement in the conduct of the study. Authors KF, PV and SGF report no other conflict of interest.

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