{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:01:44Z","timestamp":1753876904872,"version":"3.41.2"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR300844"],"award-info":[{"award-number":["NIHR300844"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Objectives<\/jats:title>\n                  <jats:p>Older people with memory problems living in temporary hostel accommodation have longer stays and higher care needs than those without memory problems. In this ethnographic study, we aimed to elucidate how staff currently support older hostel residents with memory problems, what contextual factors determine support given, and what facilitates positive and meaningful outcomes for staff and residents.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research Design and Methods<\/jats:title>\n                  <jats:p>We conducted interviews and participant observations with older people (\u226550 years) experiencing memory problems and homelessness (interviews n\u2005=\u200517, observations n\u2005=\u200513), hostel staff and managers (interviews n\u2005=\u200515, observations n\u2005=\u200520) from 7 residential facilities (6 hostels and 1 care home), and health and social care practitioners (interviews n\u2005=\u200517, observations n\u2005=\u20057), from September 2021 to December 2022 in London, England. We analyzed thematically from a critical realist position.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 4 overarching themes: (1) compensatory strategies and routines, (2) hostels are not homes, (3) meeting challenging interactions with compassion, and (4) facilitating opportunities for meaningful interactions. Social interactions for people with memory problems were restricted and, although sheltered by living in hostels, this did not equate to safety or provide opportunities for positive interactions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion and Implications<\/jats:title>\n                  <jats:p>Staff worked hard to connect with older residents with memory problems, in resource- and time-poor contexts, often left to provide care beyond their roles in contexts of unmet need. Our ethnographic account has informed co-design of a support intervention for hostel staff working with older people with memory problems, alongside recommendations for policy and practice.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/geront\/gnae187","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T11:52:31Z","timestamp":1734522751000},"source":"Crossref","is-referenced-by-count":1,"title":["Supporting Older People Experiencing Homelessness and Memory Problems in Hostels: Learning From an Ethnographic Study"],"prefix":"10.1093","volume":"65","author":[{"given":"Penny","family":"Rapaport","sequence":"first","affiliation":[{"name":"Division of Psychiatry, University College London , London ,","place":["UK"]},{"name":"North London Mental Health Partnership, NHS Foundation Trust , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6741-5516","authenticated-orcid":false,"given":"Gill","family":"Livingston","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, University College London , London ,","place":["UK"]},{"name":"North London Mental Health Partnership, NHS Foundation Trust , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9006-1410","authenticated-orcid":false,"given":"Jill","family":"Manthorpe","sequence":"additional","affiliation":[{"name":"NIHR Policy Research Unit in Health and Social Care Workforce, King\u2019s College London , London ,","place":["UK"]},{"name":"NIHR Applied Research Collaboration (ARC) South London , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Shulman","sequence":"additional","affiliation":[{"name":"Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Garrett","family":"Kidd","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, University College London , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ava","family":"Mason","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, University College London , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Knapp","sequence":"additional","affiliation":[{"name":"Care Policy and Evaluation Centre, London School of Economics and Political Science , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie Nadia","family":"Gaber","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, University College London , London ,","place":["UK"]},{"name":"Department of Women\u2019s and Children\u2019s Health, Healthcare Services and e-Health, Uppsala University , Uppsala ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,12,18]]},"reference":[{"issue":"4","key":"2025040510471191600_CIT0001","doi-asserted-by":"publisher","first-page":"e240","DOI":"10.1016\/S2468-2667(24)00022-7","article-title":"Prevalence of dementia among people experiencing homelessness in Ontario, Canada: A population-based comparative analysis","volume":"9","author":"Booth","year":"2024","journal-title":"Lancet Public Health"},{"issue":"4","key":"2025040510471191600_CIT0002","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1080\/2159676x.2019.1628806","article-title":"Reflecting on reflexive thematic analysis","volume":"11","author":"Braun","year":"2019","journal-title":"Qualitative Research in Sport Exercise and Health"},{"issue":"4","key":"2025040510471191600_CIT0003","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1093\/geront\/gnw011","article-title":"Geriatric conditions in a population-based sample of older homeless adults","volume":"57","author":"Brown","year":"2017","journal-title":"Gerontologist"},{"issue":"5","key":"2025040510471191600_CIT0004","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/geront\/gnad151","article-title":"Meanings of aging in the right place for older clients of a temporary housing program","volume":"64","author":"Canham","year":"2023","journal-title":"Gerontologist"},{"article-title":"The emerging crisis of aged homelessness","year":"2019","author":"Culhane","key":"2025040510471191600_CIT0005"},{"volume-title":"Participant observation: A guide for fieldworkers","year":"2011","author":"DeWalt","key":"2025040510471191600_CIT0006"},{"issue":"1","key":"2025040510471191600_CIT0007","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1177\/0042098012452329","article-title":"Pathways into Multiple Exclusion Homelessness in Seven UK Cities","volume":"50","author":"Fitzpatrick","year":"2013","journal-title":"Urban Studies"},{"key":"2025040510471191600_CIT0033","article-title":"An Intersectional Perspective on Digital health: Longitudinal Narratives and Observations with Older and Middle-Aged Women Experiencing Homelessness","author":"Gaber","year":"","journal-title":"The Gerontologist"},{"issue":"2","key":"2025040510471191600_CIT0008","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1080\/14036096.2019.1584585","article-title":"Homelessness workers negotiating the relationship between identity and practice: How gender, age and background influence worker-service user relationship","volume":"37","author":"Galbraith","year":"2020","journal-title":"Housing, Theory and Society"},{"issue":"2","key":"2025040510471191600_CIT0009","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1080\/02673037.2019.1687854","article-title":"Conceptualizing the shelter and housing needs and solutions of homeless older adults","volume":"36","author":"Humphries","year":"2021","journal-title":"Housing Studies"},{"key":"2025040510471191600_CIT0010","doi-asserted-by":"publisher","first-page":"1707","DOI":"10.1111\/jgs.15993","article-title":"Homeless veterans in nursing homes: Care for complex medical, substance use, and social needs","volume":"67","author":"Jutkowitz","year":"2019","journal-title":"Journal of the American Geriatrics Society"},{"issue":"3","key":"2025040510471191600_CIT0011","doi-asserted-by":"publisher","DOI":"10.17169\/fqs-6.3.20","article-title":"Focused ethnography","volume":"6","author":"Knoblauch","year":"2005","journal-title":"Forum Qualitative Sozialforschung Forum: Qualitative Social Research"},{"year":"2023","author":"Kushel","key":"2025040510471191600_CIT0012"},{"issue":"10","key":"2025040510471191600_CIT0013","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.jaging.2015.12.002","article-title":"Liminal homes: Older people, loss of capacities, and the present future of living spaces","volume":"37","author":"Leibing","year":"2016","journal-title":"Journal of Aging Studies"},{"issue":"12","key":"2025040510471191600_CIT0014","doi-asserted-by":"publisher","first-page":"2323","DOI":"10.1007\/s00127-021-02084-y","article-title":"Supporting independence at home for people living with dementia: A qualitative ethnographic study of homecare","volume":"56","author":"Leverton","year":"2021","journal-title":"Social Psychiatry and Psychiatric Epidemiology"},{"issue":"9","key":"2025040510471191600_CIT0015","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hsdr07090","article-title":"Service provision for older homeless people with memory problems: A mixed-methods study","volume":"7","author":"Manthorpe","year":"2019","journal-title":"Health Services and Delivery Research"},{"issue":"5","key":"2025040510471191600_CIT0016","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1177\/0008417419833402","article-title":"Boredom and meaningful activity in adults experiencing homelessness: A mixed-methods study","volume":"86","author":"Marshall","year":"2019","journal-title":"Canadian Journal of Occupational Therapy"},{"issue":"1","key":"2025040510471191600_CIT0017","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1177\/1468794106058870","article-title":"Triangulation and integration: Processes, claims and implications","volume":"6","author":"Moran-Ellis","year":"2006","journal-title":"Qualitative Research"},{"issue":"1","key":"2025040510471191600_CIT0018","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1186\/s12939-019-1002-6","article-title":"Making sense of street chaos: An ethnographic exploration of homeless people\u2019s health service utilization","volume":"18","author":"O\u2019Carroll","year":"2019","journal-title":"International Journal for Equity in Health"},{"issue":"1","key":"2025040510471191600_CIT0019","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1186\/s12877-023-03920-3","article-title":"An Australian aged care home for people subject to homelessness: Health, wellbeing and cost\u2013benefit","volume":"23","author":"O\u2019Connor","year":"2023","journal-title":"BMC Geriatrics"},{"key":"2025040510471191600_CIT0020","doi-asserted-by":"publisher","DOI":"10.4324\/9780203864722","volume-title":"Ethnographic methods","author":"O\u2019Reilly","year":"2012"},{"issue":"1","key":"2025040510471191600_CIT0021","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1186\/s12877-022-02978-9","article-title":"A qualitative systematic review on the experiences of homelessness among older adults","volume":"22","author":"Om","year":"2022","journal-title":"BMC Geriatrics"},{"issue":"1","key":"2025040510471191600_CIT0022","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1186\/s12877-023-04250-0","article-title":"A qualitative exploration of older people\u2019s lived experiences of homelessness and memory problems \u2013 stakeholder perspectives","volume":"23","author":"Rapaport","year":"2023","journal-title":"BMC Geriatrics"},{"key":"2025040510471191600_CIT0023","first-page":"132","article-title":"Critical realism and ethnography","volume-title":"Studying organizations using critical realism: A practical guide","author":"Rees","year":"2014"},{"issue":"3","key":"2025040510471191600_CIT0024","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1002\/casp.2162","article-title":"Care versus control: The identity dilemmas of UK homelessness professionals working in a contract culture","volume":"24","author":"Renedo","year":"2014","journal-title":"Journal of Community and Applied Social Psychology"},{"key":"2025040510471191600_CIT0025","first-page":"24","article-title":"Separately and together: Reflections on conducting a collaborative team ethnography in dementia care","volume":"6","author":"Scales","year":"2011","journal-title":"Enquire"},{"issue":"1","key":"2025040510471191600_CIT0026","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1177\/0269216317717101","article-title":"End-of-life care for homeless people: A qualitative analysis exploring the challenges to access and provision of palliative care","volume":"32","author":"Shulman","year":"2018","journal-title":"Palliative Medicine"},{"year":"2023","author":"Skills for Care","key":"2025040510471191600_CIT0027"},{"issue":"7","key":"2025040510471191600_CIT0028","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1080\/09593985.2020.1809045","article-title":"Homelessness and rates of physical dysfunctions characteristic of premature geriatric syndromes: Systematic review and meta-analysis","volume":"38","author":"Suh","year":"2022","journal-title":"Physiotherapy Theory and Practice"},{"issue":"2","key":"2025040510471191600_CIT0029","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1017\/brimp.2019.21","article-title":"Exploring the experiences and needs of homeless aboriginal and Torres Strait Islander peoples with neurocognitive disability [Article]","volume":"20","author":"Townsend","year":"2019","journal-title":"Brain Impairment"},{"issue":"5","key":"2025040510471191600_CIT0030","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/geront\/gnad088","article-title":"Intersections of ageism and homelessness among older adults: Implications for policy, practice, and research","volume":"64","author":"Weldrick","year":"2023","journal-title":"Gerontologist"},{"issue":"3","key":"2025040510471191600_CIT0031","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1093\/geront\/gnr098","article-title":"The meaning of \u201caging in place\u201d to older people","volume":"52","author":"Wiles","year":"2012","journal-title":"Gerontologist"},{"issue":"1","key":"2025040510471191600_CIT0032","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1186\/s12889-024-18052-5","article-title":"Loneliness among homeless-experienced older adults with cognitive or functional impairments: Qualitative findings from the HOPE HOME study","volume":"24","author":"Yuan","year":"2024","journal-title":"BMC Public Health"}],"container-title":["The Gerontologist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/gerontologist\/advance-article-pdf\/doi\/10.1093\/geront\/gnae187\/61225935\/gnae187.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/gerontologist\/article-pdf\/65\/4\/gnae187\/61225935\/gnae187.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/gerontologist\/article-pdf\/65\/4\/gnae187\/61225935\/gnae187.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T10:48:59Z","timestamp":1743850139000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/gerontologist\/article\/doi\/10.1093\/geront\/gnae187\/7927611"}},"subtitle":[],"editor":[{"given":"Sarah L","family":"Canham","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,12,18]]},"references-count":33,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,3,25]]}},"URL":"https:\/\/doi.org\/10.1093\/geront\/gnae187","relation":{},"ISSN":["0016-9013","1758-5341"],"issn-type":[{"type":"print","value":"0016-9013"},{"type":"electronic","value":"1758-5341"}],"subject":[],"published-other":{"date-parts":[[2025,4]]},"published":{"date-parts":[[2024,12,18]]},"article-number":"gnae187"}}