Walk in our shoes: older homeless women's perceptions of the challenges of navigating streets and shelter life.

Introduction: Older women experiencing homelessness (OWEH) have been a hidden or invisible population; however, with rising numbers globally, they are gaining attention. Our study examines what it means to be a woman in her 50s who is struggling financially and precariously housed in the United States. Although in their 50s, these women often experience accelerated aging and exhibit chronic health conditions comparable to those of housed women in their 70s and 80s. Lacking access to both public old-age benefits and family support, they often fall between the cracks of the nation's safety net system. While homelessness among women of reproductive age, including the role of gender-based violence in increasing their vulnerability, is now well documented, studies on the unique challenges faced by OWEH remain relatively limited. Research objective: This study explores how daily life on the streets and in emergency housing shelters, a system historically designed for men (particularly younger men), affects the well-being of OWEH and their journey toward stable housing. The aim was to describe, from the perspectives of OWEH, how shelter environment, policies, and practices (including continual displacement to the streets) shape their daily lives, well-being, and pathways to stable housing. Of particular interest was gaining a deeper understanding of how navigating the traumas of homelessness and shelter living affects individuals' sense of dignity, self-worth, adaptive resources, and resilience. Methods: This qualitative study involved 15 semistructured, private individual interviews, each lasting about 60 min, conducted by an MSW social worker. Eligibility criteria included being homeless for at least 1 month, being in one's 50s, and being able to take part in an English-language interview. Using NVivo (qualitative research software), the interview audiotape transcripts were coded and analyzed using a multistep interpretative phenomenological approach to enable exploration of how OWEH make sense of what is happening to them (or the "lived experience') and their views (or "meaning making') of life and these experiences. Results: Trauma was a universal experience, and almost all participants were coping with significant physical and/or mental health issues. Overall, participants perceived that shelter management and staff failed to fully understand the challenges women faced in rebuilding their lives, especially the interconnectedness of health struggles, societal bias against older women, and the social prejudice of people experiencing homelessness. Five superordinate themes were identified, highlighting how shelter physical and social environments contribute to OWEH's daily struggles and sense of disempowerment: (a) dehumanizing and stigmatizing treatment; (b) unsafe surroundings and hypervigilance; (c) harsh living conditions and declining physical and emotional health; (d) disempowering situations and loss of control; and (e) an absence of normalcy and stability. Conclusion: This study contributes to our understanding of how emergency housing shelters create or exacerbate the challenges faced by OWEH and often result in disempowering. The findings suggest the importance of transforming both the physical and social environments of shelters, using trauma- and aging-informed approaches, to better support this growing population of OWEH in their pathway to stable housing.