Homeless seniors: life in the shadows

Homelessness has long become a problem in wealthy Switzerland. According to the Federal Office for Housing, more than 2000 people live without a permanent roof over their heads. Some have been living for years in assisted living facilities, in emergency shelters or in public spaces, on the streets.

But what happens when they get older, when they start to have permanent health problems, or when they suddenly have to deal with physical limitations and need care? What can be done to help them cope with the resulting even more precarious existence? Due to the lack of reliable information, there are no answers. With its research project, BFH aims to lay the foundations for providing more needs-based support for homeless seniors.

No contact with the outside world

“People who have not had a permanent home for years often live in isolation, and in many cases in precarity,” says Sabrina Laimbacher. The research associate and her colleague Sabrina Gröble know the reality of homelessness. They already forged contacts with homeless people as part of the «ReachOut» research project, which aimed to explore the subjective needs and strategies related to the mental health of homeless people and undocumented immigrants in Switzerland.

In their encounters and observations, they found that many of the homeless were already old, or had aged prematurely, probably due to the harsh conditions in which they lived.

How homeless people experience age-related physical and cognitive changes, how they cope with them and how these changes affect their support needs is still unknown. Often, long-term homeless populations live withdrawn and tend to avoid contact with the outside world, underlines Sabrina Laimbacher. “We also noticed that certain homeless people ran away from any form of interaction, or pretended to sleep, when social workers tried to talk to them”.

Developing fundamental knowledge

This prompted Sabrina Laimbacher, Sabrina Gröble and their colleague, researcher Simone Gäumann, to investigate what it is like to grow old when you are homeless. “Our ‘Connect’ project aims to develop fundamental knowledge into the processes of ageing and premature ageing. We want to find out how they affect the health, livelihoods and support needs of homeless people.”

The researchers want to include the perspectives of those primarily affected, as well as experts and people in the community. According to Sabrina Laimbacher, the findings will be used to develop recommendations on how to support people “so that they can cope with the consequences of premature ageing and maintain their right to exercise self-determination for as long as possible”.

But what causes people to lose access to housing, and then either end up in temporary shelters or spend years living on the streets? “Mental health problems, addiction, but also unemployment and poverty, are some of the top causes of homelessness,” stresses Sabrina Laimbacher.

At the same time, it also happens that people leave their homes voluntarily to live on the streets. The desire for freedom and independence from social, institutional and other constraints is a common motivation. Over the years, however, it often leads to a downward spiral of survival and coping with daily life, according to the researcher.

Moving fates

As part of a preliminary project, Sabrina Laimbacher and her colleagues visited several support services for the homeless in Bern and Zurich and talked to specialists and people affected by homelessness. This gave them a first insight into the lives of older homeless people, the challenges they face and their needs.

They were moved by their stories, often affected by them, and certainly impressed: “We were impressed by their resilience, and by how they survive and shape their lives under adverse circumstances.” Sabrina Laimbacher remembers vividly one encounter in particular. “Near a residential area, we met a woman who had arranged her shelter with her personal belongings.”

Avoid abrupt transitions

During the initial exploratory discussions, the researchers identified clear gaps in the provision of services for older homeless people. “Most of the services are still not sufficiently age-friendly,” explains Sabrina Laimbacher. Accordingly, the focus of support services is on survival assistance: “They ensure survival and basic needs, such as providing those affected with food or sleeping bags.” But health or age-related issues are often given less attention.

In the planned project, the researchers also want to look more closely at what forms of support older homeless people already receive and how these could be better tailored to their needs. Sabrina Laimbacher explains that by involving those primarily affected, recognising typical age-related changes in them at an early stage and improving their health, not only can their quality of life be improved, but abrupt life transitions can also be prevented.

Experts speak of “involuntary placement”. When homeless people’s health is acutely threatened or their lives are in danger, they are admitted to emergency facilities such as psychiatric clinics or hospitals, even against their will. But this rupture is often more difficult to cope with than all the hardships of life on the streets.

It is therefore important to involve those affected. “We want to develop participatory, target-group-oriented solutions.” This increases the likelihood that those primarily affected most affected will actually make use of what is on offer, emphasizes Sabrina Laimbacher.