An Aging in Place Approach to Barriers and Facilitators of Shelter Utilization by Older Adults Experiencing Homelessness in Upstate South Carolina |Biomedgrid

The concept of aging in place discusses policies, strategies and methodologies that meet the complex needs of older people in their living environment. For marginalized individuals, however, what defines place is more complex and subject to conflicting influences. This research investigates the determinants of emergency shelter utilization by older people experiencing homelessness using an aging in place framework. Qualitative interviews were conducted with a group of 53 sheltered and unsheltered homeless persons aged 55 and older in Upstate South Carolina, United States of America. Collected data were examined using a thematic content analysis. Recurring themes were categorized into barriers and facilitators. Multigenerational living, regulations, lack of privacy, security concerns and a lack of elderly-friendly accommodations were identified as barriers. Conversely, shelters that established trust, protection, and relationships, complemented with an array of social and medical services, facilitated shelter utilization. These factors were classified into two interacting domains: homeless individuals' psychosocial needs and the shelters' institutional characteristics. An aging in place approach integrates individuals' experiences, social interactions, community-based services, mobility, and the built environment. This study offers a new framework for designing and modifying emergency shelters to increase uptake by elderly clients in a perspective of healthy aging for all.