Experiences of Trauma for Older Adults with Lived and Living Experiences of Homelessness in Middle to High Income Countries: A Systematic Review and Meta-Aggregation.

Background And Objectives: Research has identified that the number of older adults experiencing homelessness in middle to high income countries is growing. Coincidingly, in recognition that individuals with housing precarity often have experiences of trauma, there have been increasing calls for trauma-and-violence-informed care in practice and research. We conducted this review to consolidate existing literature that explores experiences of trauma among older adults who have experienced homelessness.

Research Design And Methods: We conducted a systematic review of qualitative evidence and meta-aggregation following the Joanna Briggs Institute methodology, in adherence with PRISMA guidelines.

Results: Our search yielded 24 studies. Through a process of meta-aggregation, we generated five synthesized findings: 1) Being let down by society and systems; 2) The world is not a safe place; 3) Survivor not victim; 4) Living in the long shadow of trauma; and 5) Homelessness as a deeply personal trauma.

Discussion And Implications: Our findings underscore the reality that older adults without housing face multiple experiences of trauma, including the trauma of homelessness itself. Considering these findings, research, practice, and policies need to focus on ways to better support older adults, both in preventing trauma and assisting those who have already experienced trauma. Our findings indicate the necessity of: 1) implementing trauma-and-violence-informed care across all sectors who work with older adults; 2) supporting older adults to age in place in safe, deeply affordable, accessible housing; and 3) creating shelter environments more suitable for older adults, and especially those who have experienced trauma.