Centre for Positive Ageing, HammondCare, Sydney, Australia.
UCL Institute of Education (Culture, Communication and Media), London, England.
BMC Geriatr. 2024 Mar 12;24(1):249. doi: 10.1186/s12877-024-04791-y.
The number of older people experiencing homelessness in Australia is rising, yet there is a lack of specialised residential care for older people subject to homelessness with high care and palliative needs. To address this significant gap, a purpose-built care home was recently opened in Sydney, Australia.
This qualitative study explores the experiences of both residents and staff who were living and working in the home over the first twelve months since its opening. Residents were interviewed at baseline (n = 32) and after six months (n = 22), while staff (n = 13) were interviewed after twelve months. Interviews were analysed using a reflexive thematic analysis approach informed by grounded theory.
Three main themes emerged: (1) Challenges in providing care for older people subject to homelessness with high care needs; (2) Defining a residential care service that supports older people subject to homelessness with high care needs, and (3) Perception of the impact of living and working in a purpose-built care home after six months (residents) and twelve months (staff) since its opening. A key finding was that of the complex interplay between resident dependency and behaviours, referral pathways and stakeholder engagement, government funding models and requirements, staff training and wellbeing, and the need to meet operational viability.
This study provides novel insights into how the lives of older people subject to homelessness with high care needs are affected by living in a specifically designed care home, and on some of the challenges faced and solved by staff working in the care home. A significant gap in the healthcare system remains when it comes to the effective provision of high care for older people subject to homelessness.
在澳大利亚，经历无家可归的老年人人数正在增加，但对于有高护理和姑息治疗需求的无家可归老年人，缺乏专门的住宿护理。为了解决这一重大差距，澳大利亚悉尼最近开设了一家专门建造的养老院。
这项定性研究探讨了在养老院开业后的头 12 个月内居住和工作的居民和工作人员的经验。在基线时（n=32）和六个月后（n=22）对居民进行了访谈，而工作人员（n=13）则在 12 个月后进行了访谈。使用基于扎根理论的反思性主题分析方法对访谈进行了分析。
出现了三个主要主题：（1）为有高护理需求的无家可归老年人提供护理的挑战；（2）定义支持有高护理需求的无家可归老年人的住宿护理服务；（3）对在养老院开业六个月（居民）和十二（工作人员）个月后的生活和工作的看法。一个关键发现是，居民的依赖性和行为、转诊途径和利益相关者参与、政府资金模式和要求、员工培训和福利以及满足运营可行性之间存在复杂的相互作用。
这项研究提供了关于有高护理需求的无家可归老年人的生活如何受到专门设计的养老院影响的新见解，并探讨了工作人员在养老院工作中面临的一些挑战和解决方案。在为无家可归的老年人提供有效的高护理方面，医疗保健系统仍然存在重大差距。
