Homelessness Week 2020: New research develops enhanced trauma-informed care for older homeless people

New research has recommended a trauma-informed approach to aged care for older people facing homelessness with more than half of older homeless people in urban areas reporting trauma experiences alongside a wide range of physical and mental health issues.

darlinghurst kitchen 580The inclusion in care delivery of trauma awareness with an emphasis on safety, cultural diversity and the opportunity to rebuild control, is vital to avoid re-traumatising residents.

The research, ‘Designing residential aged care for people at risk of, or experiencing homelessness’ was conducted by leading health and aged care provider, HammondCare, as part of the establishment of a new care home in Darlinghurst, Sydney.

Head of Research, Prof Chris Poulos, said the research was vital in informing the delivery of care at the 42 place HammondCare Darlinghurst which has been established exclusively to cater for older people who are homeless or at risk of homelessness.

“We know the number of older homeless people has increased by more than 28 per cent since 2006 and as part of this, the number of homeless older women and indigenous people is also on the rise,” Prof Poulos said.

“Our researchers have collected and analysed data from a broad range of homelessness stakeholders to better understand the best approach to care for this group who we know have complex health care needs arising from rough living, poorly managed healthcare and exposure to violence.

“Many older people facing homelessness have a history of child abuse, including in institutional care, as well as other exploitative, violent relationships, leading to a fear of residential aged care.”

The research has led to the development of an enhanced model of trauma-informed residential aged care for older people experiencing homelessness, which is person-centre and affords dignity and safety.

Lead researcher, Dr Allison Rowlands, said the enhanced trauma-informed model of care, when consistently applied by all staff to all processes, would ensure that care would address health needs, including substance dependence and acquired brain injury, as well as significant losses.

“We know from previous research that home-like cottage environments deliver improved quality of care for older people more generally, including those with dementia, but in this context a trauma framework is also necessary,” Dr Rowlands said.

“Many older people who are homeless have limited options to access residential care, and shelters and transitional accommodation are not resourced to provide the nursing and specialised care they need.

“As well, mostly they do not have the network of family supports or close family relationships that might be seen in the broader aged population, and so many of the older adults are not only without a secure home, but without a friend or family member.”

“So when these people are referred to a care home like ours, it is perhaps a rare opportunity to break the cycle of health, social and emotional decline that perpetuates homelessness and loss.

“We need to get this right, for the sake of these vulnerable people, which is why this research is so important.”

The research outlines a comprehensive model of care that builds on earlier trauma-informed models of care, as well as HammondCare’s existing mode of care that operates more broadly in its aged care services.

The research is published in the journal, Health and Social Care, (Wiley) April 2020, and is also in the recently released HammondCare 2019 Research Report.


Paul has recently moved into HammondCare Darlinghurst. ‘I’ve got cancer and last night about midnight I came out for some medication for pain. Staff were able to help me straight away. I went back to my room, was a bit restless, and there was a knock at my door. I answered, and a carer came in with a toasted sandwich and cup of tea for me. How good is that?!’ Paul says before his new home, he spent most nights riding the trains to Newcastle or Kiama. He has also experienced violence on the streets and in shelters. 

Jani has a long history of experiencing domestic violence. She speaks of surviving being strangled because the perpetrator only held her throat for a minute. Violence towards her is something she has known for a long time, being too afraid to leave while her child was growing up. When she finally left, as an older woman, she had no where to go. She was contemplated boarding houses but thankfully HammondCare Darlinghurst became her home. She is safe, free and says she is ready to be pampered!