Aging Adults Living in the Streets Comprehensive Nursing Essay Example

Sub-Populations within a Population: Aging Adults Living in the Streets Comprehensive Nursing Essay Example

Introduction

Homelessness among older people is on the rise, and it is expected to strain the existing social and health care amenities. Old age is associated with the early onset of age-related mental and physical health issues. Understanding the composition of the homeless population is essential for planning and policy (Grenier et al., 2016).  Therefore, homelessness among older adults should be considered a critical health issue and prioritized in healthcare policy-making and implementation. The purpose of this assignment is to conduct a literature review about ageing adults living in the streets, their health issues, nurses’ interventions, and suggest changes to improve the health care system for the benefit of this population.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Literature Review

Ageing adults living in the streets fall in the category of the homeless population. The Canadian Homeless Research Network (CHRN) defines homelessness as “the situation of an individual or family without stable, permanent, appropriate housing, or the immediate prospect, means and ability to acquire it” (CHRN, 2012). A crucial category of the homeless population includes the unsheltered, homeless individuals living on the streets. An appropriate marker for ageing individuals living in the streets is quite elusive. Besides, ageing occurs across an individual’s life and is affected by experiences, social practices, and institutional structures. For instance, studies have shown that homeless people aged 50 and above consider themselves old (CHRN, 2012). As a result, it is arguable to consider those aged 50 and above living on the streets to be older. For this reason, this paper refers to ageing individuals living in the streets to be aged 50 and above and living in urban streets.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Statistics indicate that the number of homeless older adults in Canada is growing. More than 230,000 Canadians are classified as homeless yearly, and up to 35,000 are experiencing homelessness daily (Gaetz et al., 2016). Although older adults, including those aged 50 and above, make up a small percentage of the homeless population, shelter use among this population has increased over the last decade. Moreover, women, indigenous/aboriginal people, LGBTQ, and immigrant persons tend to be more among the homeless population considering the unique challenges they face accessing housing schemes (Gaetz et al., 2016; Advocacy Centre for Tenants & Tenant Duty Counsel Program, 2020). Furthermore, the rise in the homeless population is partly explained by the ageing population and indicated by senior citizens’ rising need for sheltered occupancy.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Issues Faced by Older Adults Living in the Streets

The immediate challenge facing older adults living in the streets is housing. This population cannot afford safe and secure housing (Grenier et al., 2016). The housing problem is more severe in older adults with limited mobility, suffering from chronic health issues, or low incomes. As a result, the older adults living in the streets experience fatigue and are frustrated with their inability to access hospital beds, wander the streets, worry about living with other homeless people, and theft of personal belonging. The health conditions exacerbated by mobility problems and exhaustion impact their perception and energy, making it difficult to survive in the streets or exit homelessness.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Older adults experience shame and stigma associated with living in the streets in later life. A study by Grenier et al. (2016) found that social perceptions and responses towards individuals’ homelessness in their later years worsen their feelings. As such, stigmatization and shame become prominent, as people feel judged for being unsheltered at a critical stage in their lives. This population is worried and vexed about their daily experiences and means for their immediate future. The declining physical and mental health, together with the inherent awareness of their end of life, contributes to stressful feelings, leading to an emotionally tiring state (Grenier et al., 2016). Significantly, stress is related to the fact that older adults living in the streets have limited time left on their earthly lives, contributing to constant anxieties exacerbated by limited resources and social support. Together, these aspects of homelessness make it challenging for individuals to picture a pathway out of street life.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Older adults living in the streets also experience a feeling of marginalization from the conventional society. According to Grenier et al. (2016), homeless older adults often feel distance from the community, family relationships, and labour markets. Considering their age, inherent health issues, and lack of education in some instances makes it difficult to find employment from the street, which could be a pathway to breaking a cycle of homelessness in an individual’s life. Moreover, this marginalization presents a significant barrier to social contribution and involvement, leading to feelings of social exclusion and isolation.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Significantly, limited social interactions among homeless older adults continue to worsen experiences of social exclusion, isolation, and segregation. In Grenier et al.’s (2016) study, older adults living in the streets described lacking long-term and meaningful social relationships and experiencing broken or unstable relationships with close friends and families. While those with children, grandchildren, siblings, or parents tend to have close relationships, the concern or the wellbeing of their loved ones exacerbates their chronic mental and physical health conditions. However, the feeling of shame makes this population downplay their social woes and emotional losses to keep going.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

The older population living in the streets experience difficulties managing their health with the limitations of the existing healthcare system. This population experiences numerous health issues, including chronic conditions such as heart failure, lung conditions, diabetes, and other preventable medical problems such as dental health and foot ulcers, and challenges accessing care services (Grenier et al., 2016). These conditions, coupled with the unhygienic living conditions and environmental factors such as cold and excess heat, make most people living on the streets to have higher illness rates. According to Barken et al. (2015), the older population living in the streets has complex needs and challenges, including mental and physical health needs and substance use problems. This population faces significant challenges interacting and integrating with the existing health and social care programs and services and is often excluded due to behaviour or social status.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

The challenges this population faces means that their access to health services is limited. Older people reluctantly use health services, a situation that challenges and is exacerbated by limited healthcare resources due to the increasing homeless population and dynamics of population health issues (Barken et al., 2015). Other issues such as lack of identification cards, long queues and wait lines in hospitals, and the stigma associated with community-based care also affect their access to health care services. Ideally, everyday realities of living in the streets, such as waiting for shelter and food, and the inability to afford transportation, affect the older population’s capacity to seek health and counselling services.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Studies show that older adults living on the streets survive through tough life lessons, resilience, strength, and hope. Gaining wisdom throughout life in the streets and the associated life lessons allows this population to amass respect in every aspect of their street life, skills, and resources (Grenier et al., 2016). However, there is a need to provide social-emotional support and link this population to resources to ease their daily lives. Emotional support is instrumental in managing anxiety and feelings of shame, isolation, and exclusion. Equally, providing all social and health care services in one place with a full-time nurse(s) can allow individuals to access comprehensive support. Significantly, this population requires hands-on support and peer connector to help find relevant programs and resources.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Furthermore, studies have highlighted a need for the homeless population to have hope for their present and future. Generally, having hope includes the need for stable housing, family relationships, employment, and stable life in one’s later years (Grenier et al., 2016). However, the feeling of having less time on earth means less time to exit homelessness and move forward, albeit the intrinsic desire to spend their remaining life in stable housing.  Despite these challenges, having hope for a better tomorrow and reminiscing better times acts as a source of strength, providing support and guidance for a better future. This allows them to cope with their current situation, protecting them from suicide ideation, distress, or relinquishing their desire for a better life.  (Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Role of Nurses

Nurses are a significant source of help for the homeless older adults living in the streets. Due to the nature of their work, nurses inevitably encounter homeless people and provide direct and indirect solutions across the care continuum.  According to Mcenroe-Petitte (2020), nurses are better positioned to assess and provide individualized and person-centered care for the homeless population. Nurses can integrate easy-to-understand and open-ended questions with the aid of local interpretation to provide health care services to this population. Nurses can work as liaisons between the homeless population and entities that support affordable housing and increase patient participation in health screening and promotion programs through a one-on-one relationship with the homeless individuals (Gerber, 2013). The multidisciplinary nature of nurses’ work, i.e., incorporating input from other health and social care professionals to enhance the comprehensiveness, safety, and quality of available health services, is crucial for the sustainability of this population.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Moreover, nurses contribute to the interventions aimed at preventing homelessness and illnesses. Access to adequate housing, healthcare resources, and employment opportunities through community referrals and from social interaction interfaces is vital for the health and stability of homeless older adults (Maness et al., 2019; Gerber, 2013; Bowen et al., 2019; Mcenroe-Petitte, 2020). Nurses contribute to the prevention of health care and homelessness problems by carrying out healthcare education and handing handouts containing health and social care information such as affordable housing schemes, shelters, food pantries, healthcare sources, and support services.  The soaring cost of living may leave older adults on the brink of homelessness, and information on affordable services can help them achieve their dreams of living a comfortable life in later years. Furthermore, nurses can help this population by referring them to social workers and case managers to avoid uncertain utilization of existing resources due to lack of knowledge, stigma, and shame associated with accessing these resources (Maness et al., 2019; Gerber, 2013; Mcenroe-Petitte, 2020). This protects the homeless adults from experiencing difficulties of living in the street and provides the needed assurance and moral support, which is a crucial pathway out of homelessness.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Implications for healthcare System and Recommendations 

The growing number of homeless older adults and the associated social and health care challenges present a significant challenge to the existing social and health care systems. Literature findings reveal that this population experiences distinct housing, health, and social needs. In this sense, the information from the literature review sheds more light on the public discourse about housing in later life and its impact on mental and physical health. The need for affordable, safe, and stable housing, among the older population, adds nuance to the need for appropriate government policies on affordable housing schemes to protect them from the health problems associated with homelessness and provides a secure setting where community health nurses can provide health care services.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Furthermore, these findings point to the need for more medical and physical care for the older population living in the streets. Combined with the inability to access care services, there is a need to integrate services, i.e., social and health services. For this case, there is a need to link housing with services to support older people, safeguarding appropriate housing and social services (Grenier et al., 2016). For instance, providing onsite services, i.e., visiting nurses sensitizing the affected people on issues associated with homelessness and ageing, while providing varied medical services. At the same time, a social worker accompanying the medical team provides relevant information on accessing available benefits or services.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

It is crucial to establish structural changes in health and social care organizations to facilitate access to their services by homeless older adults. Ideally, the existing public health and social care programs cannot meet the needs of every older person residing on the streets (Grenier et al., 2016). Therefore, the existing programs must be challenged through policies that guarantee their flexibility so that the target population is not affected by the challenges they face on the streets.  The population should be equipped with knowledge of accessing pension benefits, low-income housing for seniors, and homecare services. Besides, the population should be protected from eviction and integrated into novel programs that support medical, physical, and emotional needs.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Conclusion

This paper discusses the experiences and challenges of older adults age 50 and above living in the streets.  The findings highlight the daily lives of older people living in the streets and contribute to literature exposition on homelessness among older adults. Specifically, the discussion reveals physical and mental health problems as determinants and outcomes of street life. This population experiences challenges due to common chronic health conditions, such as lung diseases, health failure, and diabetes,  lack of adequate safe and affordable housing, and health/social care services. These experiences contribute to stigmatizations, shame, exclusion, and social isolation, impairing their capacity to access and utilize existing health and social care services.(Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

Furthermore, the discussions highlight the increasing prevalence of homelessness among older adults and the associated pressure on the general health and social care services. This exposition provides a nuance on the need for novel policies to support the establishment of safe and affordable housing schemes and community health programs to protect and prevent the older adults from the adverse outcomes of homelessness. Therefore, there is a need for support from all sectors to ensure comprehensive support to this population. In particular, nurses are better positioned to help this population and act in various capacities, directly or indirectly, to support various needs presented by homeless individuals. Nurses’ actions require and multidisciplinary approach to aid health and social care education among homeless individuals. (Aging Adults Living in the Streets Comprehensive Nursing Essay Example)

References

Barken, R., Budd, B., Grenier, A., Sussman, T., Rothwell, D., & Bourgeois-Guérin, V. (2015). Ageing and homelessness in Canada: A review of frameworks and strategies. Hamilton, Ontario, Canada: Gilbrea Centre for Studies on Aging, McMaster University. (Aging Adults Living in the Streets Comprehensive Nursing Essay Example)https://aginghomelessness.com/wp-content/uploads/2012/10/PolicyReview-FINAL-REPORT-April-2015.pdf

Grenier, A., Sussman, T., Barken, R., Bourgeois-Guérin, V., & Rothwell, D. (2016). ‘Growing old in shelters and ‘on the street’: Experiences of older homeless people. Journal of Gerontological Social Work, 59(6), 458-477. (Aging Adults Living in the Streets Comprehensive Nursing Essay Example)https://doi.org/10.1080/01634372.2016.1235067

Advocacy Centre for Tenants & Tenant Duty Counsel Program. (2020). Fact Sheet | Homelessness in Canada and Ontario. Retrieved November 19, 2021, from (Aging Adults Living in the Streets Comprehensive Nursing Essay Example)https://www.acto.ca/production/wp-content/uploads/2017/07/Factsheet-4-Homelessness-in-Canada-and-Ontario2.pdf

Canadian Homelessness Research Network (2012). Canadian definition of homelessness. Retrieved November 19, 2021, from (Aging Adults Living in the Streets Comprehensive Nursing Essay Example)www.homelesshub.ca/CHRNhomelessdefinition

Gaetz, S., Dej, E., Richter, T., & Redman, M. (2016). The state of homelessness in Canada 2016. Toronto. : Canadian Observatory on Homelessness Press(Aging Adults Living in the Streets Comprehensive Nursing Essay Example). https://homelesshub.ca/sites/default/files/SOHC16_final_20Oct2016.pdf

Mcenroe-Petitte, D. M. (2020). Caring for patients who are homeless. Nursing2021, 50(3), 24-30. (Aging Adults Living in the Streets Comprehensive Nursing Essay Example)https://doi.org/10.1097/01.nurse.0000654600.98061.61

Bowen, E. A., Lahey, J., Rhoades, H., & Henwood, B. F. (2019). Food insecurity among formerly homeless individuals living in permanent supportive housing. American Journal of Public Health, 109(4), 614-617(Aging Adults Living in the Streets Comprehensive Nursing Essay Example). https://doi.org/10.2105/ajph.2018.304927

Maness, S. B., Reitzel, L. R., Hernandez, D. C., Maria, D. S., Batson, M. A., Zingg, T., … & Businelle, M. S. (2019). Modifiable risk factors and readiness to change among homeless adults. American Journal of Health Behaviour, 43(2), 373-379. (Aging Adults Living in the Streets Comprehensive Nursing Essay Example)https://doi.org/10.5993/ajhb.43.2.13

Gerber, L. (2013). Bringing home effective nursing care for the homeless. Nursing2020, 43(3), 32-38. (Aging Adults Living in the Streets Comprehensive Nursing Essay Example)https://doi.org/10.1097/01.nurse.0000426620.51507.0c