Rapaport Penny, Livingston Gill, Manthorpe Jill, Shulman Caroline, Kidd Garrett, Mason Ava, Knapp Martin, Gaber Sophie Nadia
Division of Psychiatry, University College London, London, UK.
North London Mental Health Partnership, NHS Foundation Trust, London, UK.
Gerontologist. 2025 Mar 25;65(4). doi: 10.1093/geront/gnae187.
Older people with memory problems living in temporary hostel accommodation have longer stays and higher care needs than those without memory problems. In this ethnographic study, we aimed to elucidate how staff currently support older hostel residents with memory problems, what contextual factors determine support given, and what facilitates positive and meaningful outcomes for staff and residents.
We conducted interviews and participant observations with older people (≥50 years) experiencing memory problems and homelessness (interviews n = 17, observations n = 13), hostel staff and managers (interviews n = 15, observations n = 20) from 7 residential facilities (6 hostels and 1 care home), and health and social care practitioners (interviews n = 17, observations n = 7), from September 2021 to December 2022 in London, England. We analyzed thematically from a critical realist position.
We identified 4 overarching themes: (1) compensatory strategies and routines, (2) hostels are not homes, (3) meeting challenging interactions with compassion, and (4) facilitating opportunities for meaningful interactions. Social interactions for people with memory problems were restricted and, although sheltered by living in hostels, this did not equate to safety or provide opportunities for positive interactions.
Staff worked hard to connect with older residents with memory problems, in resource- and time-poor contexts, often left to provide care beyond their roles in contexts of unmet need. Our ethnographic account has informed co-design of a support intervention for hostel staff working with older people with memory problems, alongside recommendations for policy and practice.
与没有记忆问题的老年人相比，居住在临时宿舍的有记忆问题的老年人停留时间更长，护理需求更高。在这项人种志研究中，我们旨在阐明工作人员目前如何支持有记忆问题的老年宿舍居民，哪些背景因素决定了所提供的支持，以及哪些因素促进了工作人员和居民获得积极且有意义的结果。
2021年9月至2022年12月，我们在英国伦敦对7家住宿机构（6家宿舍和1家养老院）中患有记忆问题和无家可归的老年人（≥50岁）（访谈n = 17，观察n = 13）、宿舍工作人员和管理人员（访谈n = 15，观察n = 20）以及健康和社会护理从业者（访谈n = 17，观察n = 7）进行了访谈和参与观察。我们从批判实在论的立场进行了主题分析。
我们确定了4个总体主题：（1）补偿策略和日常活动，（2）宿舍不是家，（3）以同情心应对具有挑战性的互动，（4）促进有意义互动的机会。有记忆问题的人的社交互动受到限制，尽管住在宿舍里受到庇护，但这并不等同于安全，也没有提供积极互动的机会。
工作人员努力与有记忆问题的老年居民建立联系，在资源和时间匮乏的情况下，往往在需求未得到满足的情况下承担超出其职责范围的护理工作。我们的人种志描述为与有记忆问题的老年人一起工作的宿舍工作人员的支持干预措施的共同设计提供了信息，同时也为政策和实践提供了建议。
