Yuan Yeqing, Knight Kelly R, Weeks John, King Stephen, Olsen Pamela, Kushel Margot
School of Social Work, University of Alaska Anchorage.
Department of Humanities and Social Sciences, School of Medicine, University of California - San Francisco.
Res Sq. 2023 Nov 13:rs.3.rs-3517416. doi: 10.21203/rs.3.rs-3517416/v1.
Loneliness is more common in older adults and those who face structural vulnerabilities, including homelessness. The homeless population is aging. We know little about loneliness among older adults who have experienced homelessness. We aimed to describe the loneliness experience among older adults who have experienced homelessness and the individual, social, and structural conditions that shaped these loneliness experiences.
We purposively sampled 22 older adults from the HOPE HOME study, a longitudinal cohort study among adults aged 50 years or older experiencing homelessness in Oakland, California. We conducted in-depth interviews about participants' perceived social support and social isolation. We conducted qualitative content analysis.
Twenty participants discussed loneliness experience, who had a median age of 57 and were mostly Black (80%) and men (65%). We developed a typology of participants' loneliness experience and explored the individual, social, and structural conditions under which each loneliness experience occurred. We categorized the loneliness experience into four groups: 1) "lonely - distressed", characterized by physical impairment and severe isolation; 2) "lonely - rather be isolated", reflecting deliberate social isolation as a result of trauma, marginalization and aging-related resignation; 3) "lonely - transient", as a result of aging, acceptance and grieving; and 4) "not lonely" - characterized by stability and connection despite having experienced homelessness.
Loneliness is a complex and heterogenous social phenomenon, with older adults who have experienced homelessness exhibiting diverse loneliness experiences based on their individual life circumstances and needs. While the most distressing loneliness experience occurred among those with physical impairment and mobility challenges, social and structural factors such as interpersonal and structural violence during homelessness shaped these experiences.
孤独在老年人以及面临包括无家可归在内的结构性脆弱因素的人群中更为常见。无家可归者群体正在老龄化。我们对曾经历过无家可归的老年人中的孤独情况知之甚少。我们旨在描述曾经历过无家可归的老年人的孤独体验，以及塑造这些孤独体验的个人、社会和结构状况。
我们从“希望之家”研究中有目的地抽取了22名老年人，该研究是一项针对加利福尼亚州奥克兰市50岁及以上无家可归成年人的纵向队列研究。我们就参与者感知到的社会支持和社会孤立情况进行了深入访谈。我们进行了定性内容分析。
20名参与者讨论了孤独体验，他们的年龄中位数为57岁，大多数是黑人（80%）且为男性（65%）。我们构建了参与者孤独体验的类型学，并探讨了每种孤独体验发生时的个人、社会和结构状况。我们将孤独体验分为四类：1）“孤独 - 痛苦型”，其特征为身体损伤和严重孤立；2）“孤独 - 宁愿孤立型”，反映因创伤、边缘化和与衰老相关的顺从而导致的刻意社会孤立；3）“孤独 - 短暂型”，是衰老、接纳和悲伤的结果；4）“不孤独型”，其特征是尽管经历过无家可归，但仍有稳定感和人际关系。
孤独是一种复杂且多样的社会现象，曾经历过无家可归的老年人根据其个人生活状况和需求表现出不同的孤独体验。虽然最令人痛苦的孤独体验发生在有身体损伤和行动困难的人群中，但无家可归期间的人际暴力和结构性暴力等社会和结构因素塑造了这些体验。
