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Keywords:

  • case management;
  • continuity of care;
  • elderly people;
  • homelessness;
  • outreach

Abstract

The aims of this study were to describe: (1) how the Homelessness Intervention Programme addressed the needs of elderly people who were homeless or at risk of homelessness; and (2) the factors that influenced the ability of the programme to address client needs. The programme was offered by a multi-service non-profit agency serving low-income families and individuals in an urban neighbourhood in Ontario, Canada. Using a case study approach, we conducted 10 individual interviews and three focus groups with programme clients, programme providers, other service providers and programme funders. Programme providers completed intake forms, monthly follow-up forms and exit/housing change forms for each of the 129 clients served by the programme over a 28-month period. Approximately equal proportions of clients were between 54 years old and 65 years old (47%) and over 65 years (53%). There were equal proportions of women and men. In addition to being homeless or marginally housed, clients lived with multiple and complex issues including chronic illness, mental illness and substance abuse. Through the facilitation of continuity of care, the programme was able to meet the needs of this vulnerable group of elderly people. Three types of continuity of care were facilitated: relational, informational and management continuity. The study confirmed the value of a continuous caring relationship with an identified provider and the delivery of a seamless service through coordination, integration and information sharing between different providers. Study findings also highlighted the broader systemic factors that acted as barriers to the programme and its ability to meet the needs of elderly people. These factors included limited housing options available; limited income supports; and lack of coordinated, accessible community health and support services. The central findings stress the importance of continuity of care as a guiding concept for intervention programmes for homeless and marginally housed elderly people.