Older Homelessness: A Brief Overview
Over the past few decades, a growing body of research on older homelessness has emerged, including several Canadian contributions (Burns, Reference Burns2016; Burns & Sussman, Reference Burns and Sussman2018; Burns, Grenier, Lavoie, Rothwell, & Sussman, Reference Burns, Grenier, Lavoie, Rothwell and Sussman2012; Furlotte, Schwartz, Koornstra, & Naster, Reference Furlotte, Schwartz, Koornstra and Naster2012; Grenier et al., Reference Grenier, Barken, Sussman, Rothwell, Bourgeois-Guérin and Lavoie2016; McDonald, Dergal, & Cleghorn, Reference McDonald, Dergal and Cleghorn2007; McDonald, Donahue, Janes, & Cleghorn, Reference McDonald, Donahue, Janes, Cleghorn, Hulchanski, Campsie, Chau, Hwang and Paradis2009; Ploeg, Hayward, Woodward, & Johnston, Reference Ploeg, Hayward, Woodward and Johnston2008; Rothwell, Sussman, Grenier, Mott, & Bourgeois-Guérin, Reference Rothwell, Sussman, Grenier, Mott and Bourgeois-Guérin2016; Walsh, Hewson, Paul, Gulbrandsen, & Dooley, Reference Walsh, Hewson, Paul, Gulbrandsen and Dooley2015; Woolrych, Gibson, Sixsmith & Sixsmith, Reference Woolrych, Gibson, Sixsmith and Sixsmith2015). This literature has brought attention to various definitions, subgroups, policy gaps, service use, and needs of this population. Researchers have made a key distinction between individuals with long histories of homelessness and adults who are encountering homelessness for the first time in later life (Burns & Sussman, 2018; Grenier et al., Reference Grenier, Barken, Sussman, Rothwell, Bourgeois-Guérin and Lavoie2016; McDonald et al., Reference McDonald, Dergal and Cleghorn2007; Petersen & Parsell, Reference Petersen and Parsell2015; Shinn et al., Reference Shinn, Gottlieb, Wett, Bahl, Cohen and Baron Ellis2007). Yet, very little research has explored the experiences of first-time homelessness from the perspective of older adults themselves. Here, we discuss our qualitative study whereby we sought to address this critical gap in knowledge by examining 15 older adults’ experiences of first-time homelessness in Montreal, Quebec, including how societal perceptions of homelessness and aging shape access to housing, services, and perceptions of self.
Understanding the extent of older homelessness is not straightforward because of inconsistent definitions of homelessness and older homelessness in particular. Homelessness can mean being unsheltered (living on the streets), residing in emergency shelters, being provisionally accommodated (couch surfing or living in cars), or residing in substandard housing (Gaetz, Donaldson, Richter, & Gulliver, Reference Gaetz, Donaldson, Richter and Gulliver2013). In Canada, older or senior typically refers to the population 65 years of age and older, as this is the age of retirement and currently the age threshold for accessing entitlement programs such as Old Age Security (Government of Canada, 2014). However, age 50 is more commonly being used by researchers and policymakers to characterize older homelessness, as this population has greater prevalence of complex health conditions, and lower life expectancies (Grenier et al., Reference Grenier, Barken, Sussman, Rothwell, Bourgeois-Guérin and Lavoie2016; Hwang, Wilkins, Tjepkema, O’Campo, & Dunn, Reference Hwang, Wilkins, Tjepkema, O’Campo and Dunn2009; McDonald et al., Reference McDonald, Dergal and Cleghorn2007). As a consequence of divergent definitions, reports have estimated older homelessness to range from making up 2 per cent to 49 per cent of the total homeless population (Gaetz, Dej, Richter, & Redman, Reference Gaetz, Dej, Richter and Redman2016; Latimer, McGregor, Méthot, & Smith, Reference Latimer, McGregor, Méthot and Smith2015; McDonald et al., Reference McDonald, Dergal and Cleghorn2007).
Dating back to Cohen et al.’s (Reference Cohen, Teresi, Holmes and Roth1988) work on chronically homeless older men, research on older homelessness has emerged from various Western contexts including the United Kingdom, Australia, the United States, and Canada (Crane & Warnes, Reference Crane and Warnes2010; Grenier et al., Reference Grenier, Barken, Sussman, Rothwell, Bourgeois-Guérin and Lavoie2016; McDonald et al., Reference McDonald, Dergal and Cleghorn2007; Morris, Judd, & Kavanagh, Reference Morris, Judd and Kavanagh2005). These combined findings suggest that later-life homelessness, like homelessness at other life stages, is a complex phenomenon caused by individual circumstances (e.g., addiction, mental and physical health, family breakdown), combined with structural factors (e.g., lack of suitable jobs and housing). However, compared to younger homeless populations and older adults in general, older homeless people face unique realities that put them at greater risk of losing their housing and remaining homeless. This population is in poorer mental and physical health than older adults in the general population (Furlotte et al., Reference Furlotte, Schwartz, Koornstra and Naster2012; McDonald et al., Reference McDonald, Dergal and Cleghorn2007). Their health status tends to resemble someone 15 to 20 years their senior, which prevents them from working, yet they may be too young to access age-based benefits such as pensions and shelter allowances (Burns et al., Reference Burns, Grenier, Lavoie, Rothwell and Sussman2012; Grenier et al., Reference Grenier, Barken, Sussman, Rothwell, Bourgeois-Guérin and Lavoie2016). If they are able to work, ageist attitudes often preclude them from labor market re-entry (Gélineau, Reference Gélineau2013). The stigma associated with being older is reinforced by the shame of homelessness, which heightens a sense of despair, hopelessness, and isolation, as well as the inability to find and maintain stable housing (Reynolds et al., Reference Reynolds, Isaak, DeBoer, Medved, Distasio, Katz and Sareen2016).
Researchers have begun to pay attention to specific characteristics of a subgroup of older homeless adults—that is, individuals who are ‘new’ to homelessness and encountering homelessness for the first time in later life. In contrast to people who have been homeless over the course of their lives (i.e., chronically homeless), newly homeless older adults have typically led conventional lives in terms of maintaining stable work, family lives, and housing (McDonald et al., Reference McDonald, Dergal and Cleghorn2007; Petersen & Parsell, Reference Petersen and Parsell2015; Shinn et al., Reference Shinn, Gottlieb, Wett, Bahl, Cohen and Baron Ellis2007). They tend to suffer more from depression and spend more time in homeless shelters compared to individuals with long histories of homelessness, often because they are less familiar with the health and social care system (McDonald et al., Reference McDonald, Dergal and Cleghorn2007; Rothwell et al., Reference Rothwell, Sussman, Grenier, Mott and Bourgeois-Guérin2016). Although the expanding knowledge base has begun to shed light on the unique characteristics, pathways, and service use of older adults who are new to homelessness, very little research has considered how broader social factors, including assumptions about aging and homelessness, affect experiences of first-time homelessness. This study sought to address this critical gap in knowledge by exploring how perceptions of homelessness and aging shape 15 older adults’ experiences of first time homelessness including views of self, and hopes and aspirations around finding housing and staying housed.
Methodology
This three-year study (2012–2015) was reviewed and approved by McGill University Ethics Board. Constructivist grounded theory (ConGT) (Charmaz, Reference Charmaz2006; Reference Charmaz2014) was the chosen methodology. Ontologically relativist and epistemologically subjective, ConGT is congruent for a study that does not strive for an objective truth or that assume data and theories are “out there” to be discovered (Charmaz, Reference Charmaz2006; Reference Charmaz2014). Rather, ConGT is underpinned by symbolic interactionism (Blumer, Reference Blumer1969), a philosophy that assumes meaning is co-constructed by individuals who are interacting with other people, places, and things in particular contexts. It acknowledges multiple realities and aims to unearth a range of experiences related to a social process that has received little attention in research – which is the case in terms of understanding experiences of older adults who are encountering homelessness for the first time.
Montreal Homelessness Context: A Brief Overview
Montreal is a large urban metropolis of approximately 3.8 million residents, making it the second most populous city in Canada and the largest city in the province of Quebec (Statistics Canada, 2011). Similar to other large Canadian cities, homelessness has risen considerably in Montreal over the past 20 years, and the population is getting older (Latimer et al., Reference Latimer, McGregor, Méthot and Smith2015). According to a recent citywide homelessness count, 3,016 people were experiencing homelessness the night of March 24, 2015, 41 per cent of whom were 50 years of age and older (Latimer et al., Reference Latimer, McGregor, Méthot and Smith2015). Consistent with the count, Montreal homeless shelters have reported a fourfold increase in residents aged 50 years and older in the past two decades (La Maison Marguerite de Montreal Inc., 2013; Maison du Père, 2014). Although older adults’ use of emergency shelters is on the rise across Canada, the proportion of Montreal shelter residents 50 years and older is nearly double that of recent national estimates (24 per cent of shelter users are 50 years old and older) (Gaetz et al., Reference Gaetz, Dej, Richter and Redman2016).
The alarming increase in Montreal’s older homeless population needs to be understood in its broader context. General socio-political trends occurring over the past few decades including demographic aging, urbanization, reduced social spending, and a widespread national housing crisis have contributed to the rise in homelessness in general and older homelessness in particular (Gaetz et al., Reference Gaetz, Donaldson, Richter and Gulliver2013; Gaetz et al., Reference Gaetz, Dej, Richter and Redman2016; Hulchanski, Reference Hulchanski2009; McDonald et al., Reference McDonald, Dergal and Cleghorn2007). However, Montreal has several particularities. First, the city’s population is aging rapidly; in 2011, 15 per cent of Montreal’s population was 65 or older, representing 250,000 seniors; by 2031, 20 per cent will be 65 or older (André & Payeur, Reference André and Payeur2008). The median age of Montrealers (39.7) is also older than other large Canadian cities including Toronto (38.7), Edmonton (36.0), and Saskatoon (35.6) (Federation of Canadian Municipalities, 2013). Although housing in Montreal is still relatively more affordable than in Vancouver or Toronto, the cost of a two-bedroom apartment increased 29 per cent from 2000 to 2010, which means the city is rapidly becoming inaccessible for those living with low incomes (Institut de recherche et d’informations socio-économiques [IRIS], 2010). Further, older adults residing in Montreal – particularly those born between 1946 and 1964 (currently 53–71 years of age) – are more financially disadvantaged than their younger counterparts as many are unable to find work because of health issues or ageist attitudes in the labor market (Gélineau, Reference Gélineau2013).
Recruitment Site: Montreal Emergency Shelters
Canadian definitions of homelessness have expanded to account for diverse housing circumstances including living on the streets, in emergency shelters, and substandard (unsafe) and precarious housing (Gaetz et al., Reference Gaetz, Donaldson, Richter and Gulliver2013). In this study, participants represented the sheltered homeless. We elected to recruit participants from emergency homeless shelters because of the rise in older shelter residents and an absence of appropriate services (Latimer et al., Reference Latimer, McGregor, Méthot and Smith2015).
In Montreal, emergency homeless shelters are typically gender segregated, which informs their organization in terms of design, rules, and regulations. Montreal men’s shelters tend to be large dormitories with 150 to 200 beds. Emergency shelter users are typically referred to as “night clients” and stays are time limited (e.g., permitted a stay of 15 cumulative days in a 30-day period, after which they are required to leave for 15 consecutive days before they are eligible for readmission). The men are often required to leave the shelter during the day (e.g., leave at 7:00 a.m. and return to re-register the same day at 4:00 p.m.). Shelter life is highly regimented and requires lining up at designated times for all activities of daily living including accessing the shelter itself, showering, toileting, and meals.
On the other hand, the women’s shelters are much smaller in scale and have on average 20 private or semi-private rooms. The women are typically not required to leave the shelter during the day but most require a reservation and have a maximum stay period (e.g. four- to six-weeks). There are typically more shared social spaces available at women’s shelters, such as courtyards, kitchens, television rooms, and indoor smoking lounges that create a more social, homelike atmosphere.
Participant Selection Criteria
To be consistent with existing definitions of older homelessness (Grenier et al., Reference Grenier, Barken, Sussman, Rothwell, Bourgeois-Guérin and Lavoie2016) and newly homeless (Crane et al., Reference Crane, Byrne, Ruby, Lipmann, Mirabelli, Rota-Bartelink and Warnes2005), participants were required to be aged 50 and older and to have experienced their first episode of homelessness in the past two years. However, we made two exceptions: One participant had been homeless for three and a half years, and another had been homeless for a year and was rehoused for a month at the time of the interview. Since both were experiencing their first episode of homelessness after age 50, we decided to expand the inclusion criteria to people who had been homeless for less than four years.
Participant Characteristics
Participants included eight men and seven women, with an age range of 50 to 80 years. Three were native English speakers and 12 were French speakers. All were single; one was a widower, about a third (6/15) were divorced or separated, and the rest were never married. Most had children (10/15), although very few (2/15) remained in regular contact with them. All but two were high school graduates. The large majority (11/15) had some post-secondary education (technical training, university, or college). Work histories were nearly evenly split between those who had sporadic employment and those who had more stable careers, many for 20 years or more.
Prior to becoming homeless, most were living alone in private-market rentals (11/15), two lived in subsidized apartments, one lived in a single-room occupancy hotel, and another lived in a condominium he was sharing with his ex-wife. One third were receiving basic social assistance (approximately $600 per month, or $7,200 per year). One fifth were receiving long-term disability (approximately $900 per month or $11,000 per year). The highest income earner ($2,000/month) was receiving a relatively large private pension; six of the 15 participants were receiving minor contribution–based pensions, three were receiving federal Old Age Security (OAS), and two were receiving the Guaranteed Income Supplement (GIS).Footnote 1 The length of time being homeless at the time of the interview ranged from one week to three and a half years. About half of the participants (7/15) had been homeless less than a year, and the remaining participants had been homeless less than four (see Table 1).
Table 1: Study participant demographics
O = owner; PMR = private market rental; RH = rooming housing; SH = subsidized housing
Housing status: A = apartment; S = shelter; T = transitional housing
N/A = lost home in divorce; couch surfing, live-in janitor; co-residing & not paying rent
* Under Canadian low-income cut-off for single person of $23,861 or $1,988/month in Census Metropolitan Area (CMA) 500,000 inhabitants or more (Statistics Canada, 2013)
Data Collection and Analysis
With ConGT, data collection and analysis are conducted simultaneously through theoretical sampling and the constant comparison method (Glaser & Strauss, Reference Glaser and Strauss1967), two highly interactive and iterative processes that help bring initial codes up to a higher level of theoretical abstraction (Charmaz, Reference Charmaz2006; Reference Charmaz2014). All of the interviews were face to face, semi-structured, and conducted by the first author (VB) in either English or French at a location that was most convenient to participants (most often a private office space at the shelter). Each participant took part in a single interview that lasted on average an hour and a half and was recorded on a digital voice recorder. Two participated in an additional follow-up interview to help flesh out emerging categories, which is common in grounded theory studies (Charmaz, Reference Charmaz2006; Reference Charmaz2014). The interview guide included questions regarding the events leading up to coming to the shelter, housing histories, how participants felt their first night at the shelter, what they missed most since coming to the shelter, and the meaning of home. Although the interviews were semi-structured, the participants guided the interview in the direction they wished to take it, and the interviewer repositioned the questions and duration accordingly (Charmaz, Reference Charmaz2006; Reference Charmaz2014). At the end of the interview, participants were asked a series of socio-demographic questions regarding age, gender, ethnicity, marital status, education, language, employment, and sources of income.
After each interview, VB listened to the audio recordings and wrote eight- to 10-page case summaries for each participant an important first step in distilling and managing qualitative data and advancing the analysis (Charmaz, Reference Charmaz2006; Reference Charmaz2014). Although interviews were the primary method of data collection, VB also conducted observations during her visits to the shelters and recorded notes based on observations in a field journal. The notes included detailed descriptions of the physical space (e.g., sights, sounds, and smells), social interactions, and any surprises or tensions that occurred during the shelter visits and interviews. The authors also reviewed various documents (e.g., homelessness policies, internal agency reports, and shelter regulations sheets), and integrated all of the notes into reflexive, conceptual memos, which were used to guide the analysis (Charmaz, Reference Charmaz2006; Reference Charmaz2014). VB and a bilingual research assistant transcribed all of the interviews in their original language into a Microsoft Word document and transferred all of the de-identified transcripts, memos, and field notes to Dedoose (2016), a web-based, password-protected qualitative software program.
All three authors participated in the analysis using initial and focused coding techniques. For the initial coding phase, we coded each of the transcripts line by line using gerunds, which is a hallmark of grounded theory coding (Charmaz, Reference Charmaz2006; Reference Charmaz2014) (e.g., “acting as if,” “denying experience,” “contemplating suicide,” “refusing to identify as homeless”). In a second step, we reviewed and discussed the codes, comparing and contrasting them between cases and to sensitizing concepts (Glaser & Strauss, Reference Glaser and Strauss1967) in the literature (e.g., grief work, disenfranchised grief, ageism, stigma, and trauma). Through the constant comparative method of analysis, we agreed on the core category “homelessness as disenfranchised grief.” This iterative process continued until the related subcategories (e.g., ageist assumptions, stigma of homelessness, re-enfranchising grief) were sufficiently filled out. We refer to theoretical sufficiency (Dey, Reference Dey1999) rather than the more common concept of theoretical saturation to reinforce the idea that ConGT is situated in a constructivist paradigm (Guba & Lincoln, Reference Guba, Lincoln, Denzin and Lincoln1994) which embraces multiple realities and new constructions of theory from the same data depending on the lens and theoretical sensitivity brought to the study by the individual researchers.
Having three authors with different theoretical and substantive backgrounds (psychology, gerontology, and social work) enhanced the study’s theoretical sensitivity, which in turn reinforced the originality and trustworthiness of the findings (Charmaz, Reference Charmaz2006; Reference Charmaz2014). We also strengthened the study by engaging in several team discussions regarding the interpretation of codes. Further credibility of the findings was achieved by prolonged engagement in the field, maintaining a rigorous audit trail (field notes, memos, coded transcripts, case summaries), and collecting data using multiple methods (interviews, observations, and document review) (Charmaz, Reference Charmaz2006; Reference Charmaz2014; Guba & Lincoln, Reference Guba and Lincoln1989).
Findings
In the following section, drawing on participants’ quotes, we demonstrate how homelessness was experienced as disenfranchised grief. We begin by presenting examples of participants’ initial reactions to homelessness, and then show how the stigma associated with homelessness contributed to disenfranchising participants’ grief. We conclude by discussing how shelter life both helped and hindered processing grief, which in turn affected participants’ sense of self and their ability to move towards exiting homelessness.
Homelessness Evoked a Grief Response: Initial Reactions
Although initial reactions to being homeless varied, when participants were asked how they felt their first night at the shelter, many expressed feelings of shock, disbelief, confusion, anger, and despair. For many, the shock and disbelief were coupled with profound sadness as they attempted to process how they reached the point of being homeless. As Carole, age 51, expressed it:
There are days where I sense how damaged my ego is. There are days where I feel I am going crazy. You’re frustrated, and you ask yourself so many questions. How it is possible to pay for housing your entire life and this happens? You feel sorry for yourself. I don’t understand how it got to this point – I understand in a way, I had cancer and I had an alcohol problem connected to it, but does life have to be this punitive?
The initial shock was so profound that several of the male participants (5/8) had considered or even attempted suicide:
When I came to the shelter to ask for a bed, I said to myself, where am I? How did I get here? I was crying inside. What happened to me? You know, we think it only happens to other people, and not ourselves. I didn’t know where I was going and I was having bad thoughts … thinking about the edge of the river, I was thinking of jumping in. (Patrice, age 69)
When I came to the shelter my first thought was suicide. I thought to myself, what the hell am I doing? What can I do for society? (Pete, age 58)
Yet, alongside the sadness and frustration, some participants also experienced relief when they came to the homeless shelter. This was the case for Anna, age 61, who had been battling substandard housing conditions in a subsidized apartment for over 20 years:
Here [the homeless shelter], it’s the best thing that could have happened to me, because I really had to get the hell out of where I was living! After 22 years, I am really, really burnt out. I’m very broken, psychologically and physically. I am exhausted. I couldn’t stay at home, all by myself with all those problems.
Along similar lines, Mathilde, age 80, was living alone in a poorly heated apartment before coming to the shelter. She felt an immediate sense of comfort and security having her basic needs met and was impressed by the warm welcome she received from service providers:
The shelter is a total comfort and sense of security. It’s fascinating. Hot water all the time, the laundry is done, the meals are made, if you ask for something, you get it right away. It’s fascinating. The first thing I noticed was that the shelter was beautiful. The welcome was marvelous. The counsellors, wow! Pure goodness even! I encountered pure good.
Most participants were very isolated prior to coming to the shelter and expressed positive emotions regarding some of the relationships they had established with shelter residents and staff, sometimes even referring to them as family:
I got a family here [at the shelter]. It’s not the same as the family you’re used to, though. (Tiger, age 58)
Residing in a setting with 24-hour surveillance was particularly reassuring for the women, most of whom had histories of domestic violence, as Nicole, age 54, articulated:
I’m finally starting to feel safe here at the shelter. There are only women and there’s 24-hour surveillance.
Participants’ reactions of shock, disbelief, despair, anger, and even relief have all been associated with initial phases of grief identified in the literature (Kübler-Ross, Reference Kübler-Ross1969; Regehr & Sussman, Reference Regehr and Sussman2004). Seen as the first step towards healing, these emotional reactions suggest an active process of attempting to make sense of a significant loss and moving towards adjustment. However, even for participants who felt a sense of relief coming to the shelter, their ability to process their grief was hindered by the social stigma associated with homelessness, which in turn negatively affected their sense of self.
The Stigma of Homelessness and Aging Complicated Experiences of Grief
Despite some initial mixed feelings of relief about coming to the shelter, participants perceived and experienced homelessness as a deeply shameful state that left them feeling as though they had little worth or value, as Charlotte, age 64, observed:
Homelessness is like being a tourist; you are moving but not really living anywhere. And that’s the bottom line with homelessness, is that you don’t belong to anyone and you don’t belong anywhere, so therefore, if you don’t belong, what’s your value? You don’t have much value.
Participants entered homelessness having experienced a number of losses and traumas, including domestic violence, death of a spouse, loss of employment, and a health crisis. Yet, being without a home seemed to have a more profound negative impact than these experiences had on their sense of self. For instance, David, age 70, explained that he would eventually get over the pain of the sudden deaths of his mother, daughter, and wife, which he expressed as propelling him into homelessness. Yet, he was unsure he would ever be able to come to terms with the fact that he had ended up homeless:
Losing them, let’s just say it evaporates over time. It’s the fact that I wake up like I am here that I can’t accept … homeless … in the street. I sold everything, every single thing! I never thought I’d end up like this. It’s like starting from zero.
The shame of homelessness seemed to be associated with the risk of being perceived as dependent on family and friends:
It’s not that my daughter is mean or anything, or that we don’t get along. Helping my daughter out doesn’t bother me, but having her see me in this state is difficult. … I can swallow my pride, but there is a limit! (Carole, age 51)
For sure, my kids have their own life too. My daughter left for Tunisia for a bit. You know, I can’t always … I can’t impose too much on their lives. My son is in Cuba. It’s not easy. (Florence, age 62)
When participants were asked about the difference between being older and homeless compared to their younger counterparts, many spoke of the difficulties associated with asking for help, as older people tend to fear being a burden:
The young ones – they use the system, they get high, but the old ones, it’s like they are afraid to ask or they forget and they think they are too much of a bother, a … how do you say that?
Interviewer: A burden?
Participant: Yeah, a burden. (Pete, age 58)
Many had maintained stable work, family, and housing over the course of their lives, and reaching out for help from a shelter and “asking for handouts” starkly juxtaposed their former independent identities. Coming to terms with this new reality of being in an extreme state of dependence provoked intense feelings of guilt, shame, and disbelief that were often expressed as frustration and even rage:
Even now, I have difficulty understanding what happened. I understand that I was sick, but not everyone who is sick ends up with their life in shambles! There is something that happened somewhere, in order for this to happen, it just doesn’t make sense! I lost everything! Every fucking thing! I worked 37 years, all my fucking life! I am wearing a dirty shirt. I am used to being clean and putting dirty clothes in the washing machine! You know what I mean? I am used to eating well, you know. Now I am eating handouts! [Crying]. (Danny, age 50)
Similar sentiments were expressed by participants who had more unstable housing and work histories or were on social assistance for a number of years. In both cases, finding themselves in a shelter was a shocking and shameful experience.
To cope with the shame of being homeless, many refused to self-identify as homeless. When participants spoke about homelessness, they tended to use the pronouns “they” and “them”. Many compared themselves to the “real” homeless who were more able to accept this newfound reality:
The first night, it was shock. To meet strange people, that was my impression, heavily medicated, who are miserable, who have fixed ideas, not like me. They [chronic homeless] felt OK living like that, but I didn’t feel good. Because I didn’t have my home. I’m used to eating what I want, and cooking for myself, those kinds of things. (Patrice, age 69)
Participants resisted taking on a homeless identity because it meant accepting a profoundly stigmatizing existence, as the following two quotes highlight:
I’m not homeless, I’m living the life of a homeless. (Pete, age 58)
I can’t say that I am homeless. It’s impossible for me to say that I am; I can’t accept it. One day, I heard something on a show on a radio and I wrote it on my fridge: “This person is not suited to be homeless” – that describes me entirely. (Nicole, age 54)
Resisting a homeless identity allowed participants to protect a damaged sense of self. However, refusing to accept their reality reinforced social isolation and denial, which ultimately hindered processing their grief.
Shelter Life Helped and Hindered Processing Grief
Unpleasant shelter conditions, rigid shelter rules, and perceived lack of support from service providers complicated participants’ emotional processing of grief, thereby extending negative grief reactions. Many participants (both men and women) compared shelter life to being in prison and spoke of impersonal practices from some of the shelter workers:
I didn’t feel free at the shelter. Needing to go down and take a shower downstairs in front of everyone. You know, I found that funny, being called by your number instead of my name Patrice, you know what I mean. I found that humiliating, it is something I wouldn’t want for my worst enemy. (Patrice, age 69)
If you are standing in line for the food, you have to go all the way back in the line to get a knife, the way they speak to us, “no Isabelle, don’t do that!” I’m 64 years old, please! And sometimes you do something because you’re not thinking and they jump on you! I think the worst thing is that I didn’t have the right to express myself. We’re not allowed to say what we’re thinking, what we feel. It made me feel like a piece of shit. (Isabelle, age 64)
Many spoke of living in constant fear at the shelter as a result of violence from other shelter residents. Being constantly in survival mode exacerbated intensely charged emotions, thereby preventing participants from processing their grief:
It’s a world I don’t know. I am not sure I belong here. It’s a world I don’t know, there are people here, there are people who do drugs, there are dangerous people here, there are people who have mental health problems and all sorts of things that I don’t know, so what do I live? In fear. (Christophe, age 54)
The exhaustion and stress associated with trying to survive and adapt to shelter life left participants with little energy to engage in the tasks required to exit homelessness. For instance, because of maximum-stay policies, Carole, age 51, had been required to move to five different shelters over a span of five months. With each move, the shock, fatigue, and exhaustion intensified, and she had no energy left to look for work or housing:
This story of “sure we’ll house you for a month and then get rid of you,” you can’t do anything in a month. You can’t find a job in a month. When you get here, like for me, I got stuck two or three weeks in [Shelter X], so when you get here [Shelter Y], you just want to sleep, you just want peace and quiet.
Shelter life was also difficult because it meant no longer being able to engage in the taken-for-granted comforts of home participants were used to. For instance, Jean, age 60, enjoyed using his laptop but he rarely had the opportunity to use it at the shelter due to room availability and scheduling. These types of daily hassles and frustrations quickly piled up and led many to an immobilizing state of helplessness:
Now I have nothing. I am waiting. I call it vegetating. I am here and I can’t do anything my way. I am not at home. (Jean, age 60)
These organizations push people to be dependent. They push people to be parked; those who don’t commit suicide are parked in a shelter. I am too young to be parked! (Nicole, age 54)
Participants also expressed an overwhelming feeling of frustration related to finding housing. Several had submitted applications for subsidized housing but were not getting their hopes up, as they were aware of long waiting lists, which range from five to seven years in Montreal. One particularly resourceful participant applied to over 80 co-op housing apartments but had not heard back from any of them at the time of the interview. Many were also aware of their age-related challenges, which created additional barriers to finding housing, as Jean, age 60, emphasized:
You know, I’m 60, I’m not 20 anymore. So that’s what makes you tired, you get stressed. So after that, they give you pills as a solution. I told the doctor, sorry I didn’t come here for pills, I came for housing. You know, I didn’t learn how to be a social worker, where to get the applications for the co-op.
Despite the overwhelming sense of despair, participants’ experiences of homelessness were also filled with some hope. For instance, when they had the opportunity to connect with service providers, the negative images associated with homelessness could be challenged, and they seemed to be able to move forward. This was the case for Patrice, who had spent a year in the shelter system and during this time suffered from severe depression and suicidal ideation. He explained that the support from one service provider afforded him the strength to continue living:
I think it took becoming homeless to start to express myself. You know, I didn’t trust anyone. … Through this organization, I met a service provider who I could talk to, and it all came out, from my childhood [on verge of tears]. She [service provider] liberated me. She let me talk and when she listened, I explained my story, I even cried. It all came out.
Connecting with other shelter residents also changed his negative perception of homelessness:
Who am I to judge? I don’t judge anyone.
Similar to Patrice, other participants expressed that their judgments towards homeless people shifted, and the stigma was broken down when they allowed themselves to open up and engage with other shelter residents as David, age 70, noted:
There are three people here who surprised me. That’s when I said to myself, I am not alone.
Some went as far as to establish friendships with shelter residents:
When I find a place, I want to invite some of these new friends with small ‘f’s for Thanksgiving dinner, especially those without family. (Charlotte, age 64)
Connecting with shelter residents and staff broke social isolation, cultivated a sense of empathy, and acceptance of others and themselves, which ultimately helped challenge the double stigma associated with being older and homeless.
Discussion and Implications
This qualitative study explored how societal perceptions of homelessness and aging shaped 15 older adults’ experiences of first-time homelessness including perceptions of self, access to services, and hopes and aspirations around finding housing and staying housed. Findings suggest that experiences of homelessness were marked by intense grief reactions that were either acknowledged and validated or overlooked and disenfranchised. Although participants’ reactions echoed the psychological stages characterized in many models of grief (Kübler-Ross, Reference Kübler-Ross1969; Regehr & Sussman, Reference Regehr and Sussman2004), participants’ grief was rendered disenfranchised by difficult shelter conditions, impersonal practices, and the double stigma associated with being both older and homeless.
Doka (Reference Doka1989) coined the concept disenfranchised grief, defining it as occurring in relation to “a loss that is not or cannot be openly acknowledged publicly, mourned, or socially supported” (p. 4). Increasingly, scholars have begun to recognize that social factors, including perceptions of the type of losses that are worthy of a grief reaction, affect a person’s ability to grieve (Bevan & Thompson, Reference Bevan and Thompson2003; Weinstein, Reference Weinstein2008). Individuals who experience losses that are less conventional (e.g., LGBTQ+ relationships, close relationship with a pet, suicide) are more susceptible to having their grief disenfranchised, as their losses may be viewed as unworthy of sympathy due to stigma and stereotypes (Bevan & Thompson, Reference Bevan and Thompson2003). As this study showed, the grief associated with homelessness was disenfranchised as participants faced the dual stigma of being older and homeless. Importantly, participants themselves and those positioned to help them could either internalize stigmas and disenfranchise grief, or challenge stigmas thereby validating grief and supporting the healing required to move forward.
The Stigma of Homelessness and Disenfranchised Grief
Our analysis revealed that discourses associating homelessness with deviancy and choice served to disenfranchise older homeless adults’ grief by making acceptance of a homeless identity threatening. These associations serve to distance those who are homeless from those who are not, and the surrounding assumptions make it easy to blame rather than empathize (Parsell & Parsell, Reference Parsell and Parsell2012). Perhaps as a consequence, many participants rejected labelling themselves as homeless and saw themselves as different from other residents in the shelter. Although this distancing process temporarily served to preserve a sense of worthiness, it also interfered with their capacity to accept their losses and grieve. However, when they were able to look past their prejudices and connect with co-residents and staff, their attitudes and perceptions about homelessness shifted, which allowed them to move towards greater self-acceptance – a key step in healing grief (Kübler-Ross, Reference Kübler-Ross1969; Worden, Reference Worden1991). We suggest that reframing later-life homelessness as a devastating loss rather than a choice or personal failure could help change daily interactions between shelter workers and residents, and help newly homeless older adults process the profound sense of loss associated with homelessness.
Ageist Assumptions and Disenfranchised Grief
Ageist assumptions also contributed to disenfranchising participants’ experiences of grief. The overwhelming fear of being viewed as needy and dependent prevented many from reaching out for help. The desire to remain independent appeared to play out differently for men and women. The men had a heightened sense of self-criticism around not working and being financially dependent, which in extreme cases resulted in suicidal thoughts and even attempts. On the other hand, the women resisted being perceived as dependent as it meant risking being a burden on other people rather than a provider of care. The negative self-criticism was so engrained for some that even in cases of domestic violence the women felt a deep sense of shame that meant that they could not face the intolerable cost of asking for help from their friends or family.
Research shows that one of the greatest fears in later life is becoming dependent (Bell & Menec, Reference Bell and Menec2013; Grenier, Reference Grenier2003). Policy frameworks and public discourses around what it means to age well – including dominant successful, healthy, and active aging models (Rowe & Kahn, Reference Rowe and Kahn1997; World Health Organization [WHO], 2002) – can reinforce ageist views. Individuals who do not “succeed” in remaining independent feel they have somehow failed the aging process, thus leading them to feel excluded (Billette & Lavoie, Reference Billette, Lavoie, Charpentier, Guberman, Billette, Lavoie, Grenier and Olazabal2010). The men’s reaction of suicidal ideation is not entirely surprising considering that in a capitalistic society so much emphasis is placed on productivity and independence, most often in relation to the paid labor market (Grenier, Reference Grenier2003). Thus, by being outside the paid labor market and in an extreme state of dependence, these participants’ lives became in their views unmanageable and meaningless to the extent that they no longer had the desire to live.
In contrast, although many of the women had work histories, their sense of worth seemed to be more closely tied to appearing independent in the eyes of their families and friends. Their resistance to asking for help is consistent with assumptions about traditional gender roles, where men are the breadwinners and women the caregivers in the family home (Cline, Reference Cline1995). Future research exploring how gender roles may or may not affect experiences of grief at different stages of the life course would provide a useful comparison to findings from this study.
The widespread assumption that loss is a normal part of getting older (Bacqué, Reference Bacqué2004) may have also further disenfranchised participants’ grief. Common losses associated with old age, including good health and death of loved ones, were perhaps seen as normative losses associated with aging rather than critical losses that reshaped capacities to remain housed. Only when these losses culminated into the loss of home did participants realize their significance. Even then, however, the loss of home and the significance it held for participants emotionally (an anchor or a place of terror), symbolically (a place in the world, a sign of independence), and socially (a place to connect with the broader community) were not framed as losses, thereby leaving the significant impact of this loss as unacknowledged and disenfranchised.
Finally, it appeared that negative notions of dependence associated with aging served to hinder reaching out for help before being propelled into homelessness. Until broader, more compassionate notions of what it means to be independent and age successfully are adopted in public discourse, older people who are experiencing difficulties and are at risk of homelessness will be more likely to internalize feelings of shame and not reach out or readily accept the help they need.
Validating Grief through Shelter Design and Practices
Shelter conditions are a factor that may both help or hinder a person’s ability to process grief. While facing the difficult task of adapting to the rules and regulations of each shelter, participants also faced what seemed like unrealistic expectations: finding work and suitable housing as quickly as possible. Ironically, while most participants in our study shared the goals of employment and housing, when rigid rules and regulations interfered with care and empathy, distress, and anxiety took over, making it difficult for them to move forward. In the most extreme cases, rigid rules also resulted in the requirement to change shelters, which meant coping with further displacement, loss, and increased feelings of despair. This distress was particularly acute for women, who were often refused beds because of maximum capacity rules.
In contrast, establishing positive interpersonal relations with shelter staff and other residents helped participants move through their grief towards some form of acceptance and hope for the future. Hence, the shelter had the capacity to support the development of positive emotional ties with workers and other shelter residents. In some cases, participants described having found new friends and “family”, who provided them with the support and confidence they needed to maintain a sense of hope they would find housing and remain stably housed.
Notably, in comparison to the men, the women in this study seemed to more readily establish connections with other shelter residents shelter. Quite possibly this dynamic was supported by specificities of women’s shelters, including more informal social spaces and being permitted to stay at the shelter during the day. These structural features lend some support to the pivotal role of physical design, programming, and policies within the shelter system in either supporting or disenfranchising grief. Thus, this study recommends that redesigning future supportive housing models that more closely aligned with more home-like environments is a promising step forward (Burns, Reference Burns2016; Padgett, Reference Padgett2007). This could include smaller-scale designs that are less institutional and more home-like, private rooms, and congregating spaces for socializing and activities.
In many cases, difficulties accessing shelters coupled with punitive, impersonal approaches to service provision exacerbated feelings of hopelessness among participants, and paradoxically served to immobilize rather than activate them. Given the unique challenges older people face in homeless shelters, we suggest that all shelters be made accessible for residents with mobility issues and that operators be sensitive to the unique health, ability, and social needs of older residents, and modify shelter design, policies, and practices accordingly. Moreover, in addition to making shelters more accessible to ensure that every person in need has ready access to basic necessities, we suggest organizing shelters around principles of care and concern rather than control, fear and rigid regulations (Johnsen, Cloke, & May, Reference Johnsen, Cloke and May2005).
Our findings support previous research on grief and loss suggesting that positive social support and validation are important components in processing grief (Regehr & Sussman; Worden, Reference Worden1991). Thus, we suggest shelters to consider integrating support groups into shelter programming to help residents accept the circumstances associated with their losses, so that they can connect with one another, adjust, and move forward with their lives. We can draw on existing models in other contexts such as St. Mungo’s shelter in London, England, that launched a pilot project in 2008 bridging bereavement therapy with homelessness services for older adults (Caris Islington Organization, 2010; Crane & Warnes, Reference Crane and Warnes2010). This type of program may provide homeless people with the support they need to work through their grief, take action to find suitable housing, and ultimately prevent entrenchment into street life.
Preventing Homelessness by Increasing Income and Affordable Housing
Participants’ experiences of grief and loss were closely tied to poverty, a main contributing factor to entering and exiting homelessness. Most participants fell within the 50-to-64 age group, a population increasingly falling through the cracks, as they are often too old to find employment and too young to access age-based social-assistance programs (Gélineau, Reference Gélineau2013). Many also battled unsafe and unfit housing conditions for years before they came to the shelter. Based on the most recent Canadian definition of homelessness that includes those at risk and precariously housed (Gaetz et al., Reference Gaetz, Donaldson, Richter and Gulliver2013), they were part of the growing invisible homeless population, technically homeless before losing their physical housing. Thus, we suggest, for the 50-to-64 age group, moving towards more flexible eligibility criteria for age-based entitlement programs, such as OAS and the GIS, which are currently available only to those age 65 and older, may reduce the risk of homelessness in later life. However, participants in this study who were accessing OAS and GIS were still under the low-income cut-off measure of poverty in Canada of $23,861; the maximum amount in Quebec for OAS and GIS (combined) is $1,286 per month or $15,438 per year (Government of Canada, 2014). Therefore, we also recommend that in addition to making eligibility more flexible for vulnerable older adults, existing income support programs be increased to match the rising cost of living.
Housing was a key factor contributing to participants’ homelessness. Every Canadian has a right to core housing, which the Canadian Mortgage and Housing Corporation (CMHC) defines as being affordable, adequate, and suitable (CMHC, 2016). Housing is identified as affordable if all of the shelter costs combined (e.g., rent, mortgage, utilities, taxes, and maintenance) total less than 30 per cent of the household’s before-tax income. Suitability refers to crowding and is determined by whether there are enough bedrooms to meet the household’s space needs as defined in Canada’s National Occupancy Standards. Adequacy is a self-reported measure of need for major repairs to the home. A household is in core housing need if their home does not meet at least one of the three standards and they are unable to afford housing that meets all of the standards, which was the case for most participants in this study.
Most participants in this study were spending more than 30 per cent of their income on rent (see CMHC, 2016) – some were spending upwards of 80 per cent. The few who were technically living in affordable housing and putting less than 30 per cent of their income towards housing were also in core housing need, as they faced extreme levels of inadequacy (e.g., bed bugs, substandard appliances and materials) and had few options to relocate because of their limited income. Between 2013 and 2014, rental costs in Montreal rose 2.2 per cent; monthly rates for a one-bedroom apartment ranged from $521 to $1,007 per month (average: $655 per month). Considering participants’ average monthly income was $1,044 per month, even though vacancy rates rose from 3.0 per cent to 4.2 per cent between 2013 and 2014 (CMHC, 2016), the places available to rent were clearly not economically accessible places. Thus, in addition to increasing the total stock of available affordable housing, in order to prevent invisible homelessness, procedures need to be put in place to ensure that the existing private market and subsidized housing stock meets what the CMHC considers as core housing.
Limitations and Future Research
This study has several limitations. First, the study was conducted in Montreal and may not be transferable to other contexts where shelters are set up differently. Second, although rich data was obtained from each interview, in some cases follow-up interviews with additional participants were requested but not possible, as participants’ contact information had changed. Third, our analysis focused specifically on participants’ perceptions and losses associated with homelessness and not the grief associated with the multiple losses and traumas leading up to homelessness (e.g., family breakdown, domestic violence, loss of work, etc.). An in-depth examination considering how validation/non-validation of these losses affects trajectories into late-life homelessness merits further attention. Finally, although the participants in this study had diverse backgrounds and pathways into homelessness, they shared a number of identity markers (e.g., all self-identified as white, were born in Canada, and had French or English as their mother tongue). Thus, their experiences of disenfranchised grief may not be applicable to subgroups of older adults including immigrants (McDonald et al., Reference McDonald, Dergal and Cleghorn2007) and people with stigmatizing illnesses such as HIV/AIDS (Furlotte et al., Reference Furlotte, Schwartz, Koornstra and Naster2012), who may face added discrimination and stigma associated with being part of minority groups. Despite these limitations, conceptualizing late-life homelessness as disenfranchised grief provides a greater understanding of older homelessness and many useful jumping-off points for future research.
Conclusion
This study explored 15 older adults’ experiences of first-time homelessness in Montreal including how societal perceptions of homelessness and aging shape access to housing, services, and perceptions of self. Findings revealed that homelessness evoked intense feelings of despair, anger, frustration, and relief, and that these experiences and emotions were largely disenfranchised by others and themselves. Shelter life both helped and hindered accepting the loss and stigma associated with homelessness and affected the participants’ ability to process their grief and move forward. By reframing homelessness as a normalized experience of grief, this study helps to shift negative perceptions of aging and homelessness towards understanding homelessness as an intense period of loss, which requires validation, empathy, compassion, care, and support. Finally, shelter design, policies, and programming need to be adapted to ensure that shelter life does not exacerbate and extend grief reactions, but rather helps movement through grief, which in the context of homelessness includes not only finding and maintaining stable housing but reconstructing a more positive sense of self.
