Supporting Older People Experiencing Homelessness and Memory Problems in Hostels: Learning From an Ethnographic Study

Area of Science:

• Gerontology
• Social Sciences
• Healthcare Studies

Background:

• Older adults in hostels with memory problems experience longer stays and higher care needs.
• Hostel environments present unique challenges for supporting residents with memory issues.
• Existing support systems may be inadequate for the complex needs of this population.

Purpose of the Study:

• To understand how staff support older hostel residents with memory problems.
• To identify contextual factors influencing the provision of care.
• To explore facilitators of positive and meaningful outcomes for residents and staff.

Main Methods:

• Ethnographic study employing interviews and participant observations.
• Involved older residents (≥50 years) with memory problems and homelessness, hostel staff/managers, and health/social care practitioners.
• Data collected from 7 residential facilities in London between September 2021 and December 2022, analyzed thematically.

Main Results:

• Identified four themes: compensatory strategies, hostels as non-homes, compassionate handling of challenging interactions, and facilitating meaningful interactions.
• Social interactions for residents with memory problems were restricted, lacking safety and positive engagement opportunities.
• Staff provided care beyond their roles in resource- and time-limited contexts with unmet needs.

Conclusions:

• Staff demonstrate dedication in supporting older residents with memory problems despite resource constraints.
• The study informed the co-design of a support intervention for hostel staff.
• Recommendations for policy and practice are provided to improve care for older adults with memory problems in hostels.