HammondCare, St Leonards, NSW, Australia.
School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.
Health Soc Care Community. 2020 Sep;28(5):1743-1753. doi: 10.1111/hsc.12999. Epub 2020 Apr 26.
The number of older people experiencing or at risk of homelessness, both long-term and first-time homelessness, is increasing. The proportion of women facing homelessness within that cohort is also increasing. When combined with complex health needs, appropriate long-term care options remain limited. This qualitative study conducted in Sydney, Australia, aimed to explore the care needs of older people with comorbid health issues who are facing homelessness and, from this assessment, derive a preferred model of residential aged care. Interviews and focus groups were conducted with 29 participants from providers in the aged care and homelessness sectors. Data were analysed using a grounded theory approach. Causal and contextual factors, and consequences surrounding the experience of homelessness, informed the wide range of care needs of this group (model of care), and the organisational resources required to deliver them (management issues and staff). A trauma-informed approach to care consistently applied by all staff to all processes throughout the care home was recommended. Such an approach would further strengthen existing models of care and take into account both health needs (such as mental health, substance dependence and acquired brain injury) and significant losses through the life course of this vulnerable population.
越来越多的老年人经历或面临无家可归，包括长期和首次无家可归。在这一年龄组中，面临无家可归的女性比例也在增加。当与复杂的健康需求相结合时，适当的长期护理选择仍然有限。本项在澳大利亚悉尼进行的定性研究旨在探讨面临无家可归的患有合并健康问题的老年人的护理需求，并从评估中得出他们首选的养老院居住护理模式。研究人员与老年护理和无家可归领域的 29 名参与者进行了访谈和焦点小组讨论。使用扎根理论方法对数据进行分析。导致无家可归的因果和背景因素以及无家可归经历的后果，为这群人的广泛护理需求（护理模式）以及提供这些需求所需的组织资源（管理问题和员工）提供了信息。建议所有工作人员在整个养老院护理过程中始终对所有流程采用以创伤为中心的护理方法。这种方法将进一步加强现有的护理模式，并考虑到这一弱势群体在整个生命周期中经历的健康需求（如心理健康、药物依赖和获得性脑损伤）和重大损失。
