Homelessness: Breaking the cycle

The Bottom Line

  • Homelessness encompasses a variety of situations ranging from living on the street to sleeping in emergency shelters, temporary housing or with friends. 
  • The causes of homelessness stem from a combination of individual, social and structural factors.
  • Homeless adults are subject to more accelerated aging, have poorer overall health, and die younger.

For many years, seniors have been encouraged to "age in place" (or to live safely and independently in their home or their community for as long as they wish and are able). Aging in place can help to maintain their sense of belonging, social-support networks and overall health. However, this view does not take into account the growing number of older adults who do not live in supportive environments or who are homeless. 

In the United States, more than 15% of the 634,000 people experiencing homelessness are 50 years of age or older.(1) In Canada, nearly 25% of those sleeping in homeless shelters are 50 years of age or older.(2) And this phenomenon is accelerating...

There are many reasons why people become homeless: lack of affordable housing, decrease in social assistance and support programs, financial insecurity and job loss, difficulty accessing the labour market, mental health problems, addictions, death of a loved one... Whether they sleep in cars or parks, in emergency or temporary shelters, homeless people are more likely to suffer from age-related illnesses, functional, hearing, visual and neurological impairments, frailty and emotional distress. Indeed, the street ages them prematurely: they are considered elderly as early as 50, as they suffer from physical, cognitive and psychological problems such as Alzheimer's, arthritis and dementia at a younger age. 

What are the needs and challenges of homeless older adults?

What the research tells us

A recent systematic review identified seven studies addressing this question.(1) Three main themes were identified: 

1- Factors that lead to homelessness

There are two pathways into homelessness: the fast track and the gradual track. The fast track involves older adults who have experienced sudden loss and a sudden disappearance of social support such as the death of a loved one or a divorce.

Factors that lead to gradual homelessness are, for example, addiction or physical and mental health problems, family or romantic breakdowns, poverty, unemployment, insecure housing, geographic distance, etc. These individuals do not have access to social support to help them cope with their distress, lose their housing and end up on the street. 

2- The effects of homelessness

Older adults who are homeless have unmet physical, emotional and social needs, which exacerbate the decline associated with aging. Indeed, not having a stable home and lacking social connections is associated with cognitive impairment, stigma, shame, stress, anxiety and depression. Loneliness, lack of support, and poor physical and psychological health make it more difficult for these individuals to cope with adverse life events.

3- Breaking out of the cycle of homelessness

Some older adults manage to break the cycle of homelessness.

It is known that stable housing generally promotes physical health and general well-being. Homeless people also need stability, security and independence, which is not possible if they are constantly changing shelters or sleeping in unfavourable environments. Furthermore, some shelters are not adapted to their realities: the lack of privacy and autonomy, the rigid rules and difficult interpersonal relationships do not allow them to feel at home and obtain the services they need. In addition to safe housing, consider easier access to food, satisfactory healthcare services and financial support. 

Whether they succeed in getting off the street or not, older adults who are homeless are resilient and seek meaning in their lives, often through religion, to improve their well-being. 


Let's not look away anymore

Perhaps you know someone who is experiencing financial and housing insecurity? Ask about emergency resources available from social workers, health professionals or government websites.

Would you like to offer your support to homeless people? Volunteer at homeless shelters, donate clothing or food, or join the Canadian Alliance to End Homelessness.



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References

  1. Om P, Whitehead L, Vafeas C, Towell-Barnard A. A qualitative systematic review on the experiences of homelessness among older adults. BMC Geriatrics, 2022, 22 (1), 363.
  2. Gaetz S, Dej E, Richter T, Redman M. The state of homelessness in Canada 2016. Toronto : Canadian Observatory on Homelessness Press, 2016.

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.