The quality of life of homeless older persons in Housing First facilities in the City of Tshwane : best practices for interdisciplinary teams

Abstract

Increasing homelessness among older persons (from 50 years upward) is a global problem. Scrutiny revealed a lacuna pertaining to the quality of life among homeless older persons in Housing First facilities. To fill the identified gap, this study followed the biopsychosocial perspective and adopted a mixed methods research approach to determine the quality of life of homeless older persons in Housing First facilities in the City of Tshwane. Following a non-probability sampling procedure, quantitative data was collected through face-to-face surveys of homeless older persons (n=38) using the WHOQOL-BREF questionnaire, which measures and assesses the respondents’ perceived quality of life across the domains of physical health, psychological well-being, social relationships, and their environment on a 5-point Likert scale. Quantitative data analysis focused on descriptive and inferential statistics. Furthermore, qualitative data was gathered to explore and describe how interdisciplinary teams (n=5) could promote the quality of life of homeless older persons through face-to-face semi-structured interviews. The reflexive thematic analysis process was followed for qualitative data analysis. For quality of life, the domain of psychological well-being (M=3.77) measured the highest; followed by physical health (M=3.64); the environment (M=3.32); and social relationships (M=3.22); indicating, in totality, a perception of a moderate quality of life. Moreover, participants perceived their quality of life (M=3.26) as neither poor nor good, and they were neither satisfied nor dissatisfied with their health (M=3.55). Qualitative findings complemented these results, suggesting that the quality of life of homeless older persons requires improvement in the domains of biological well-being (through better nutrition, medical care, and hygiene); improved psychological well-being (through emotional and psychological support); and improved social well-being (through higher family support, socialisation, financial functioning and spiritual well-being). The mixed methods results were used to delineate best-practice guidelines to formulate service delivery guidelines that will promote the biopsychosocial well-being of homeless older persons in Housing First facilities, resulting in improved quality of life.