Understanding the phenomenon of older adult homelessness in North America: A qualitative interpretive meta-synthesis

Research demonstrates that homelessness among older adults will significantly increase in the coming decades due to population ageing, a trend of first-time homelessness at mid-life and continued economic vulnerability into old age without appropriate prevention and policy response. The objective of this study was to generate a rich description of homelessness as told by older adults using a qualitative interpretive meta-synthesis (QIMS). This approach is appropriate to synthesise multiple qualitative studies into a more holistic, broader understanding of the phenomenon (Aguirre and Bolton, 2014). An exhaustive search yielded 144 potentially relevant studies. Eight of these studies met the inclusion criteria for further analyses. A priori inclusion criteria included studies: (i) published in peer-reviewed journals or dissertations; (ii) published in English prior to January 2017; (iii) sampling older adults experiencing homelessness in the USA or Canada; (iv) conducted using qualitative or mixed-method designs, and (v) including the voices of participants through direct quotes. Synthesis of the eight studies resulted in two subthemes that describe older adult homelessness: systemic failings and coping mechanisms and survival behaviours. Micro- and macro-level practice and policy recommendations are addressed.