{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:07:33Z","timestamp":1790838453783,"version":"4.1.0"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institute on Aging at the National Institutes of Health","award":["R01AG050630, R01AG041860, K24AG046372"],"award-info":[{"award-number":["R01AG050630, R01AG041860, K24AG046372"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Gerontology and Geriatric Medicine"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Many older homeless adults maintain contact with family. We conducted a qualitative study examining the role of family caregiving for older homeless adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>We conducted semi-structured qualitative interviews with a sample of 46 homeless participants who reported spending at least one night with a housed family member in the prior 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 13 of 46 older adult participants provided caregiving. Themes included (a) the death of the care recipient led to the participant\u2019s homelessness; (b) feeling a duty to act as caregivers; (c) providing care in exchange for housing; (d) caregivers\u2019 ability to stay was tenuous; (e) providing care conflicted with the caregiver\u2019s needs; and (f) resentment when family was ungrateful.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>In a sample of older homeless adults in contact with family, many provided caregiving for housed family. For some, caregiving precipitated homelessness; for others, caregiving provided temporary respite from homelessness, and for others, caregiving continued during homelessness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2333721419894765","type":"journal-article","created":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T07:34:26Z","timestamp":1576827266000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["\u201cWe Really Help, Taking Care of Each Other\u201d: Older Homeless Adults as Caregivers"],"prefix":"10.1177","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2885-9605","authenticated-orcid":false,"given":"Sarah","family":"Rosenwohl-Mack","sequence":"first","affiliation":[{"name":"UCSF School of Medicine, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margot","family":"Kushel","sequence":"additional","affiliation":[{"name":"Zuckerberg San Francisco General Hospital and Trauma Center, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Ramsey","sequence":"additional","affiliation":[{"name":"Justice in Aging, Oakland, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Handley","sequence":"additional","affiliation":[{"name":"Zuckerberg San Francisco General Hospital and Trauma Center, CA, USA"},{"name":"University of California, San Francisco, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly R.","family":"Knight","sequence":"additional","affiliation":[{"name":"Zuckerberg San Francisco General Hospital and Trauma Center, CA, USA"},{"name":"University of California, San Francisco, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,12,20]]},"reference":[{"key":"bibr1-2333721419894765","doi-asserted-by":"crossref","unstructured":"Adelman R. D., Tmanova L. L., Delgado D., Dion S., Lachs M. S. (2014). Caregiver burden: A clinical review. Journal of the American Medical Association, 311(10), 1052\u20131060. https:\/\/doi.org\/10.1001\/jama.2014.304","DOI":"10.1001\/jama.2014.304"},{"key":"bibr2-2333721419894765","doi-asserted-by":"crossref","unstructured":"Bower M., Conroy E., Perz J. (2017). Australian homeless persons\u2019 experiences of social connectedness, isolation and loneliness. Health & Social Care in the Community. https:\/\/doi.org\/10.1111\/hsc.12505","DOI":"10.1111\/hsc.12505"},{"key":"bibr3-2333721419894765","doi-asserted-by":"crossref","unstructured":"Brown R. T., Goodman L., Guzman D., Tieu L., Ponath C., Kushel M. B. (2016). Pathways to homelessness among older homeless adults: Results from the HOPE HOME Study. PLOS ONE, 11(5), e0155065. https:\/\/doi.org\/10.1371\/journal.pone.0155065","DOI":"10.1371\/journal.pone.0155065"},{"key":"bibr4-2333721419894765","doi-asserted-by":"crossref","unstructured":"Culhane D. P., Metraux S., Byrne T., Stino M., Bainbridge J. (2013). The age structure of contemporary homelessness: Evidence and implications for public policy. Analyses of Social Issues and Public Policy, 13(1), 228\u2013244. https:\/\/doi.org\/10.1111\/asap.12004","DOI":"10.1111\/asap.12004"},{"key":"bibr5-2333721419894765","unstructured":"Department of Health and Human Services. (n.d.). State medicaid manual part 3: Eligibility. https:\/\/www.cms.gov\/Regulations-and-Guidance\/Guidance\/Transmittals\/downloads\/r75sm3.pdf"},{"key":"bibr6-2333721419894765","unstructured":"Eligibility for Assistance and Occupancy. (2013). In HUD occupancy handbook 4350.3: Occupancy requirements of subsidized multifamily housing programs. (2013). https:\/\/www.hud.gov\/sites\/documents\/43503HSGH.PDF"},{"key":"bibr7-2333721419894765","unstructured":"Estate Recovery and Liens. (n.d.). https:\/\/www.medicaid.gov\/medicaid\/eligibility\/estate-recovery\/index.html"},{"key":"bibr8-2333721419894765","unstructured":"42 CFR \u00a7 433.36\u2014Liens and recoveries. (n.d.). Retrieved June 19, 2019, from https:\/\/www.law.cornell.edu\/cfr\/text\/42\/433.36"},{"key":"bibr9-2333721419894765","doi-asserted-by":"crossref","unstructured":"Gardiner C., Brereton L., Frey R., Wilkinson-Meyers L., Gott M. (2016). Approaches to capturing the financial cost of family care-giving within a palliative care context: A systematic review. Health and Social Care in the Community, 24(5), 519\u2013531. https:\/\/doi.org\/10.1111\/hsc.12253","DOI":"10.1111\/hsc.12253"},{"key":"bibr10-2333721419894765","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1990.tb01503.x"},{"key":"bibr11-2333721419894765","volume-title":"Doing grounded theory: Issues and discussions","author":"Glaser B. G.","year":"1998"},{"key":"bibr12-2333721419894765","volume-title":"Living with ageing and dying: Palliative and end of life care for older people","author":"Gott M.","year":"2011","edition":"1"},{"key":"bibr13-2333721419894765","doi-asserted-by":"crossref","unstructured":"Grenier A., Sussman T., Barken R., Bourgeois-Gu\u00e9rin V., Rothwell D. (2016). \u201cGrowing old\u201d in shelters and \u201con the street\u201d: Experiences of older homeless people. Journal of Gerontological Social Work, 59(6), 458\u2013477. https:\/\/doi.org\/10.1080\/01634372.2016.1235067","DOI":"10.1080\/01634372.2016.1235067"},{"key":"bibr14-2333721419894765","doi-asserted-by":"crossref","unstructured":"Hahn J. A., Kushel M. B., Bangsberg D. R., Riley E., Moss A. R. (2006). Brief report: The aging of the homeless population\u2014Fourteen-year trends in San Francisco. Journal of General Internal Medicine, 21(7), 775\u2013778. https:\/\/doi.org\/10.1111\/j.1525-1497.2006.00493.x","DOI":"10.1111\/j.1525-1497.2006.00493.x"},{"issue":"1","key":"bibr15-2333721419894765","first-page":"248","volume":"83","author":"Honig M.","year":"1993","journal-title":"The American Economic Review"},{"key":"bibr16-2333721419894765","doi-asserted-by":"crossref","unstructured":"Hurstak E., Johnson J. K., Tieu L., Guzman D., Ponath C., Lee C. T., Kushel M. (2017). Factors associated with cognitive impairment in a cohort of older homeless adults: Results from the HOPE HOME study. Drug and Alcohol Dependence, 178, 562\u2013570. https:\/\/doi.org\/10.1016\/j.drugalcdep.2017.06.002","DOI":"10.1016\/j.drugalcdep.2017.06.002"},{"key":"bibr17-2333721419894765","unstructured":"Institute of Medicine U.S. Committee on the Future Health Care Workforce for Older Americans. (2008). Retooling for an aging America: Building the health care workforce. National Academies Press. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK215401\/"},{"key":"bibr18-2333721419894765","doi-asserted-by":"crossref","unstructured":"Lee C. T., Guzman D., Ponath C., Tieu L., Riley E., Kushel M. (2016). Residential patterns in older homeless adults: Results of a cluster analysis. Social Science & Medicine, 1982(1982), 153131\u2013153140. https:\/\/doi.org\/10.1016\/j.socscimed.2016.02.004","DOI":"10.1016\/j.socscimed.2016.02.004"},{"key":"bibr19-2333721419894765","doi-asserted-by":"crossref","unstructured":"Lopez Hartmann M., Anthierens S., Van Assche E., Welvaert J., Verhoeven V., Wens J., Remmen R. (2016). Understanding the experience of adult daughters caring for an ageing parent, a qualitative study. Journal of Clinical Nursing, 25(11\u201312), 1693\u20131702. https:\/\/doi.org\/10.1111\/jocn.13195","DOI":"10.1111\/jocn.13195"},{"key":"bibr20-2333721419894765","doi-asserted-by":"crossref","unstructured":"Montgomery P., Bailey P. H. (2007). Field notes and theoretical memos in grounded theory. Western Journal of Nursing Research, 29(1), 65\u201379. https:\/\/doi.org\/10.1177\/0193945906292557","DOI":"10.1177\/0193945906292557"},{"key":"bibr21-2333721419894765","unstructured":"National Alliance for Caregiving and American Association of Retired Persons Public Policy Institute. (2015, June). Caregiving in the U.S. https:\/\/www.aarp.org\/content\/dam\/aarp\/ppi\/2015\/caregiving-in-the-united-states-2015-report-revised.pdf"},{"key":"bibr22-2333721419894765","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.92.3.409"},{"key":"bibr23-2333721419894765","doi-asserted-by":"publisher","DOI":"10.7758\/9781610448673"},{"key":"bibr24-2333721419894765","doi-asserted-by":"crossref","unstructured":"Pope N. D., Kolomer S., Glass A. P. (2012). How women in late midlife become caregivers for their aging parents. Journal of Women & Aging, 24(3), 242\u2013261. https:\/\/doi.org\/10.1080\/08952841.2012.639676","DOI":"10.1080\/08952841.2012.639676"},{"key":"bibr25-2333721419894765","doi-asserted-by":"crossref","unstructured":"Roth D. L., Fredman L., Haley W. E. (2015). Informal caregiving and its impact on health: A reappraisal from population-based studies. The Gerontologist, 55(2), 309\u2013319. https:\/\/doi.org\/10.1093\/geront\/gnu177","DOI":"10.1093\/geront\/gnu177"},{"key":"bibr26-2333721419894765","doi-asserted-by":"crossref","unstructured":"Sandelowski M., Leeman J. (2012). Writing usable qualitative health research findings. Qualitative Health Research, 22(10), 1404\u20131413. https:\/\/doi.org\/10.1177\/1049732312450368","DOI":"10.1177\/1049732312450368"},{"key":"bibr27-2333721419894765","doi-asserted-by":"crossref","unstructured":"Sherwood P. R., Donovan H. S., Given C. W., Lu X., Given B. A., Hricik A., Bradley S. (2008). Predictors of employment and lost hours from work in cancer caregivers. Psycho-Oncology, 17(6), 598\u2013605. https:\/\/doi.org\/10.1002\/pon.1287","DOI":"10.1002\/pon.1287"},{"key":"bibr28-2333721419894765","unstructured":"State of Homelessness. (n.d.). Retrieved June 25, 2019, from https:\/\/endhomelessness.org\/homelessness-in-america\/homelessness-statistics\/state-of-homelessness-report\/"},{"key":"bibr29-2333721419894765","doi-asserted-by":"crossref","unstructured":"Stokols D. (1996). Translating social ecological theory into guidelines for community health promotion. American Journal of Health Promotion, 10(4), 282\u2013298. https:\/\/doi.org\/10.4278\/0890-1171-10.4.282","DOI":"10.4278\/0890-1171-10.4.282"},{"key":"bibr30-2333721419894765","volume-title":"Basics of qualitative research: Grounded theory procedures and techniques","author":"Strauss A. L.","year":"1990"},{"key":"bibr31-2333721419894765","doi-asserted-by":"crossref","unstructured":"Tretteteig S., Vatne S., Rokstad A. M. M. (2017). Meaning in family caregiving for people with dementia: A narrative study about relationships, values, and motivation, and how day care influences these factors. Journal of Multidisciplinary Healthcare, 10, 445\u2013455. https:\/\/doi.org\/10.2147\/JMDH.S151507","DOI":"10.2147\/JMDH.S151507"},{"key":"bibr32-2333721419894765","unstructured":"24 CFR \u00a7 5.403\u2014Definitions. (n.d.). Retrieved June 19, 2019, from https:\/\/www.law.cornell.edu\/cfr\/text\/24\/5.403"},{"key":"bibr33-2333721419894765","unstructured":"24 CFR \u00a7 982.551\u2014Obligations of participant. (n.d.). Retrieved June 19, 2019, from https:\/\/www.law.cornell.edu\/cfr\/text\/24\/982.551"},{"key":"bibr34-2333721419894765","unstructured":"U.S. Department of Health and Human Services. (2014). Long-term care providers and services users in the United States: Data from the national study of long-term care providers, 2013\u20132014 (Series 3, No. 38). https:\/\/www.cdc.gov\/nchs\/data\/series\/sr_03\/sr03_038.pdf"}],"container-title":["Gerontology and Geriatric Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2333721419894765","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2333721419894765","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2333721419894765","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:58:16Z","timestamp":1777445896000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2333721419894765"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":34,"alternative-id":["10.1177\/2333721419894765"],"URL":"https:\/\/doi.org\/10.1177\/2333721419894765","relation":{},"ISSN":["2333-7214","2333-7214"],"issn-type":[{"value":"2333-7214","type":"print"},{"value":"2333-7214","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1]]},"article-number":"2333721419894765"}}