OLDER WOMEN AND HOMELESSNESS:
LIVED EXPERIENCES OF ACCESSING SOCIAL AND HEALTH SERVICES
by
Sari Lynn Marie Legate
B.S.W., Thompson Rivers University, 2007
B.A., University of Guelph, 1992

THESIS SUBMITTED IN PARTIAL FULFILLMENT OF
THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF SOCIAL WORK

UNIVERSITY OF NORTHERN BRITISH COLUMBIA
August 2017
© Sari Legate, 2017

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Abstract

The purpose of this thesis was to explore the experiences of accessing health and social
services for older women who have lived experience with homelessness.
Women over the age of 50 with lived experience of homelessness participated in face to
face interviews where they were asked to share their experiences with accessing services in the
northern British Columbia (BC) community of Prince George.
They spoke about their experiences of loss and identified gaps in, and barriers to, service
provision as well as challenging interactions with service providers in the community. They also
recounted experiences where services and service provision work well. They shared their hopes
for a better future and expressed strength and resilience in the face of many challenges.
Recommendations for incorporating more client centred and trauma informed service
provision as well as suggestions for future research are outlined.

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Table of Contents

Abstract ........................................................................................................................................... ii
Table of Contents ........................................................................................................................... iii
List of Tables ............................................................................................................................... viii
List of Figures ................................................................................................................................ ix
Acknowledgement .......................................................................................................................... x
Dedication ...................................................................................................................................... xi
Chapter One: Introduction .............................................................................................................. 1
Relevance ................................................................................................................................... 2
To Canadian Society ........................................................................................................... 2
To the Social Work Profession ........................................................................................... 3
To Me.................................................................................................................................. 4
Need for This Research ...................................................................................................... 5
Researcher Social Location ........................................................................................................ 6
Theoretical Position ............................................................................................................ 7
Overview .................................................................................................................................... 8
Chapter Two: Literature Review .................................................................................................. 10
Homelessness ........................................................................................................................... 10
Older in Canada........................................................................................................................ 11

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Older Women ........................................................................................................................... 12
Older Aboriginal Population .................................................................................................... 13
Aboriginal Homelessness ......................................................................................................... 13
Older Homelessness in Canada and Prince George ................................................................. 13
Manifestations of Trauma ........................................................................................................ 14
Trauma and Substance Use Issues .................................................................................... 16
Trauma and Aboriginal Peoples ....................................................................................... 17
Trauma and Older Persons................................................................................................ 18
Substance Use and Older persons ..................................................................................... 18
Mental Health Issues and Older Persons .......................................................................... 20
The Path to Homelessness for Older Women in Canada ......................................................... 21
Poverty as Structural Trauma ........................................................................................... 23
Violence as Trauma .......................................................................................................... 23
Homelessness as Trauma .................................................................................................. 25
Older Homeless Women .......................................................................................................... 25
Service Needs ................................................................................................................... 27
Trauma Informed Practice and Services ........................................................................... 27
Summary ........................................................................................................................... 31
Chapter Three: Research Methodology ........................................................................................ 32
Exploratory Qualitative Research ............................................................................................ 32

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Sample Criteria......................................................................................................................... 33
Sampling Method ..................................................................................................................... 34
Sample Selection .............................................................................................................. 35
Interview Setting............................................................................................................... 36
Confidentiality and Privacy .............................................................................................. 36
Voluntary Participation ..................................................................................................... 37
Acknowledgment .............................................................................................................. 37
Data Collection......................................................................................................................... 38
Data Handling and Storage ...................................................................................................... 38
Data Analysis ........................................................................................................................... 39
Thematic Analysis Steps................................................................................................... 40
Summary ........................................................................................................................... 43
Methodological Integrity.......................................................................................................... 43
Member Checking ............................................................................................................ 43
Reflexivity -The Place of the Researcher in the Research ............................................... 44
Triangulation -Audit Trail ................................................................................................ 45
Chapter Four: Research Findings.................................................................................................. 46
Demographics .......................................................................................................................... 46
Themes ..................................................................................................................................... 47
Theme #1 -Loss and Disempowerment.................................................................................... 48

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Theme #2 -Navigating Services ............................................................................................... 53
Subtheme a) What is Working .......................................................................................... 54
Subtheme b) What is Not Working .................................................................................. 57
Theme #3 -Resilience............................................................................................................... 75
Chapter Five: Discussion .............................................................................................................. 83
Summary of Findings ............................................................................................................... 83
Theme #1 -Loss and Disempowerment ............................................................................ 84
Theme #2 -Navigating Services........................................................................................ 85
Theme #3 -Resilience ....................................................................................................... 90
Challenges and Limitations ...................................................................................................... 90
Challenges......................................................................................................................... 91
Limitations ........................................................................................................................ 95
Researcher Reflection .............................................................................................................. 96
Expectations and Assumptions ......................................................................................... 96
Personal Reflection .................................................................................................................. 98
Recommendations for Practice .............................................................................................. 100
Advocacy ........................................................................................................................ 100
Trauma Informed Service-Service Providers and Organizations ................................... 101
Self-Reflective Service Provision ................................................................................... 102
Social Work .................................................................................................................... 103

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Knowledge Transfer ............................................................................................................... 103
Recommendations for Future Research ................................................................................. 104
Conclusion ............................................................................................................................. 105
References ................................................................................................................................... 108
Appendix A: Definitions ............................................................................................................. 119
Homeless/Homelessness ................................................................................................. 119
Women............................................................................................................................ 119
Older Persons/Older women ........................................................................................... 119
Aboriginal/ Aboriginal peoples ...................................................................................... 120
Appendix B: Demographic Questionnaire .................................................................................. 124
Appendix C: Semi Structured Interview Questions .................................................................... 128
Appendix D: Counselling and Mental Health Resources ........................................................... 132
Appendix E: Poster ..................................................................................................................... 133
Appendix F: Information and Consent Form .............................................................................. 134

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List of Tables

Table 1. Themes, Subthemes and Subtheme Components ........................................................... 49

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List of Figures
Figure 1. Demographic Information ............................................................................................. 47
Figure 2. Themes .......................................................................................................................... 48

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Acknowledgement
Thank you
To the Lheidli T’enneh First Nation for allowing me the privilege of living, working
studying, and conducting research on this unceded territory.
To the women who agreed to participate in the interviews. This research would not have
been possible without your participation. Your strength and resilience are an inspiration.
To my thesis supervisor, Dawn Hemingway and committee members, Joanna Pierce and
Jacqueline Holler, for your patience, wisdom, guidance, and assistance throughout this long
process.
To Central Interior Native Health Society for allowing me the time and space to complete
my MSW.
To Dad and my mother in law, who are no longer with us here on this earth, for teaching
me the incredible importance of forgiveness.
To Bart, for being a great example of a “doer.”
To Mom, for showing me what it is like to live each day with grace and gratefulness.
To Le Club des Trois Mousquetaires for our walks, chats, laughter and precious
friendship.
To Charlie, the wee one with the big personality…for barking at me every morning to sit
and get down to work and for being my loyal foot warmer throughout the writing of this thesis.
And of course, to the other boys - Jake and Monty for being my constant companions too.
To my amazing Zsolt and Matyas who have held down the “fort” during the hours I have
spent trying to fight with and slay this beast! Together we got through some difficult times over
the last few years. Thank you for your patience and for putting up with my mental, emotional
and physical absences. I hope to be fully present for you from here on in! I love you. You are my
world!
To all who have helped me in my journey. I am sincerely grateful.
This process has made clear to me the preciousness of relationship and the importance of
prioritizing it. We never know how much time we have left to walk on this earth. I have been
reminded of this truth often over the last few years.
I've learned that people will forget what you said, people will forget what you did,
but people will never forget how you made them feel.
-----Maya Angelou
(greatly admired by my Dad)

To Matyas
I wish you joy and happiness in all that you do. I know that whatever you set your mind and
heart on, you will achieve. Be kind and gentle with yourself and others and remember that
actions from a place of love go a long way to making things right, just and good. Xo Mom.

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Dedication
River Run
A river runs through me
A river runs through me that cannot be dammed
A river of grief, loss, pain, loneliness, and fear
A river rich with detritus
A river rich…. runs to the ocean
flashes of
obsidian, red, gold, green, silver,
sluicing, and flowing
feeding the forests around and the waters ahead
A river runs through me that cannot be dammed
It cannot be dammed
because
I will not
stand back from the shore
and let that happen.
-----SLML
June 11th 2017

I dedicate this poem and thesis to women who live at the margins of society. I hope, that in some
small way, this research may make some measure of difference.

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Chapter One: Introduction

The connection between mental health issues, substance dependence, and trauma is
recognized by many health and social service providers, while being intimately understood
by individuals affected. There is much literature that discusses this intersection of issues
(Mate, 2008; Menzies, 2007, 2009, 2012) and not surprisingly, studies show that women who
experience homelessness often have lived experiences with these issues, either at a particular
point in time, or repeatedly over the course of their lives (Hopper, Bassuk & Olivet, 2009;
Mate, 2008; Menzies, 2007, 2009, 2012).
Awareness of the links between trauma and many issues has led to the concept of
“trauma informed practice” and from this knowledge has developed the “trauma informed
service” delivery approach. In this research, an attempt has been made to explore how the
understanding and knowledge of the interconnectedness of mental health issues, substance
dependence, and trauma have been incorporated into practice in northern British Columbia.
The question at the heart of this qualitative exploratory research is “How do older
homeless women experience health and social service provision in a northern community?”
To explore this fully, the additional question, “What are the health and social services needs
of older homeless women in a northern community?” was also asked. In this research a
sample of older women who were homeless or had experienced homelessness were
interviewed and asked a series of semi structured questions focused around the two main
research questions. A thematic analysis of these interviews was undertaken to determine the
needs and gaps in service from their perspective. An attempt was made to explore the themes
found through a trauma informed lens.

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Relevance
To Canadian Society
In Canada, as in many countries in the world today, a demographic shift is underway
as the percentage of older individuals continues to expand in relation to the rest of the
population (Cummings & McClure Cassi, 2008; Gellis, 2006; Hemingway & McLeod, 2004;
Turcotte & Schellenberg, 2007). Paralleling the overall aging demographic, the literature
indicates that the number of older homeless persons is also increasing. It is important that
planning and preparations take place so that appropriate services and programming are
designed to ensure better quality lives for our older population in general, and for the
population of focus for this research, older homeless women.
Aboriginal persons in Canada are overrepresented among the homeless population
(Menzies, 2007, 2009, 2012), particularly in northern communities, such as in Prince George,
British Columbia where this research took place (Pateman, Thandi, & Florey, 2016).
Aboriginal people in Canada are left with the legacy of intergenerational trauma stemming
from colonization, government and institutional assimilation policies including the Indian
Act, the residential school system, the Sixties Scoop, and child welfare policies that continue
to this day. Continued systemic discrimination results in the perpetuation of ongoing trauma
experienced by Aboriginal people in Canada (Bowen & Murshid, 2016; Brave Heart, 2007;
Menzies, 2007, 2009, 2012; Ross, 1992, 1996).
The focus population for this research was older women who have experienced
homelessness, and even though the sampling method used was not focused on a specific
group or section of older homeless women, a disproportionate number of those who
volunteered to be interviewed were Aboriginal women, possibly for the reasons outlined
above.

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For those who have experienced psychological and intergenerational trauma, the
literature points to a strong correlation between trauma, substance dependence, and mental
health issues (Bowen & Murshid, 2016; Herman, 1997; Mate, 2008; Menzies, 2007, 2009,
2012; Van Der Kolk, 1987). Structural inequities in society like income disparity and a lack
of appropriate health and social programs often exacerbate psychosocial stressors making
individuals more vulnerable to mental health, substance use, and physical health issues
(Mate, 2008). Many examples of societal and structural inequities are seen which negatively
affect older women and include: the continued wage gap between men and women (McLeod
& Walsh, 2014), low income, low social assistance and pension rates, a lack of prescription
drug coverage, and little access to comprehensive health benefits (Bungay, 2013).
Further contributing realities include inadequate availability of decent, affordable, and
safe housing as well as the criminalization of substance use and mental health issues. Rather
than ensuring a higher quality of life and well-being for individuals as they age, these can
contribute to maintaining the inequity of access to appropriate resources including health and
social services. Managing to avoid or escape a cycle of unstable living circumstances,
exposure to violence, crime, and poverty can be very difficult. An individual experiencing
any or a combination of these issues may end up living at the margins of society and if they
are older, female, and of Aboriginal descent, these vulnerabilities can be compounded.
To the Social Work Profession
A goal of this research was to determine the gaps in, and improvements needed, to the
delivery of health and social services, and to make suggestions that might eventually lead to
improving the quality of life and wellbeing of older homeless women. As such, this goal fits
with a social worker’s obligation to honour the inherent worth and dignity of those we work

4
with, as outlined in the British Columbia Association of Social Workers (BCASW) Code of
Ethics (2003) to maintain, work, and advocate for change in the best interest of our clients
and for the overall benefit of society. Social workers also have a duty to critically analyze
issues to uncover the structural mechanisms leading to the oppression of our clients and to
advocate for change to rectify this (Canadian Association of Social Workers (CASW), 2005).
To Me
My interest in this research topic has its roots in my volunteer and employment
experience. I have worked with vulnerable populations in several different parts of Canada
and the world and was drawn to becoming a social worker because I saw my values and
beliefs reflected in those of the profession.
In recent years, I have worked as a social worker in a health care setting which has
been involved in an ongoing study looking at ways to reduce barriers to care faced by
vulnerable people. In a process of ongoing evaluation, the organization critically examines
how it provides care and looks at ways to improve its services, working to become ever more
client centred and towards the goal of equity in health care (Browne, Varcoe & Fridkin,
2011; Browne et al., 2012). This involves staff discussion and education around ways of
imbedding cultural safety and trauma informed approaches into the services provided. I
believe these are critical goals that each provider of services to vulnerable people likely
intends, and should strive, to provide.
Service users I work with tell me of the daily challenges they face being homeless and
living in poverty, including the difficulties they meet while accessing services in our
community. I marvel at and admire the survival skills and resiliency that service users reveal
in their stories. I was interested to know if their experiences were being heard, understood,
and integrated into the social and health care services provided to them in our community. I

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have been curious about the need for effective integration of service users’ perspectives for
some time, and was keen for the opportunity to explore this question with a subset of the
homeless population: older women who have experienced homelessness.
It is important to me to be involved in working towards greater social justice and
equity, to make positive change for individuals, society, and the world. I think it is critical
that individuals have a right to self-determination and to be consulted about the services they
receive. This meshes with my desire to continue to advocate and try to be an ally in working
towards accessible, fair, respectful, non-judgmental, culturally, and trauma informed service
provision.
Need for This Research
The literature reviewed for this research confirms the need for further exploration of
the topic. Davis-Berman (2011) explains the need for more in depth detailed reports and
studies of the experience of being older and homeless that include the perspective of those
who are homeless themselves. Salem and Ma-Pham (2015) identify that research on older
women and the homeless shelter system is limited and more is needed. McLeod and Walsh
(2014) recommend further studies on the trajectory of older women’s homelessness for the
first time at older age, and on further aspects of aging and homelessness with regards to
health accessibility, access, and use of income supports. Bowen and Murshid (2016) call for
the extension of trauma informed practice and service provision to include the incorporation
of a trauma informed framework lens when addressing or developing wider social policy.
They suggest that this is particularly relevant when working with vulnerable populations
where there are trauma histories which include: crime, violence, homelessness, substance
dependence, and chronic disease. This change in approach would recognize that issues of
race, social class, gender, age, sexuality, and ethnicity intersect, and that these multiple

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marginalizations and vulnerabilities are predictors of trauma experience. Such an approach
would acknowledge the connection of trauma with many health and social problems for
which people seek services. These recommendations from the literature underpin my
rationale for choosing the topic for my research and for using a trauma informed lens through
which to view the data collected and to assist in framing and determining the themes of the
data analysis.
Researcher Social Location
I come to the research from a position of privilege as a white employed middle class,
educated settler woman and mother. I am not an older person by the Canadian government’s
definition, nor do I have a diagnosed mental illness or substance dependence issue (Appendix
A Definitions). I have always had stable housing, adequate access to food, clothing, finances,
social, and health services and I have never experienced homelessness. However, I am an
upper middle aged woman and have some degree of understanding, from personal and work
experience, of trauma, substance dependence, and mental health issues. However, even with
this experience, I readily acknowledge that I cannot fully comprehend these issues in the
same way that the participants of this research, older women who have experience with
homelessness, will know and understand this reality.
As an outsider researcher, I do not know the experience of older women who have
lived homelessness, but I wanted to avoid the tendency of western research towards
“problematizing the indigenous” (Smith, 2004, p. 91). I wanted to attempt to avoid power
imbalances and disempowering the women who I hope may ultimately benefit from this
research or, as Merata so aptly describes, I wanted to avoid doing observer type research or
the type of research where researchers are “the ones doing the looking …giving themselves

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the power to define” (Smith, 2004, p. 58). My goal in undertaking this research was to strive
to be an ally (Bishop, 2002), by being aware of my research methodology and the potentially
disempowering elements of this research process to participants. In addition, my hope was to
facilitate the opportunity for older women who have experienced homelessness to have a
voice, influence and power over how services are designed and delivered to them, in a client
centred, culturally sensitive, and trauma informed way. My intent was to include individuals
in the research and results while balancing the practical element of doing research within a
limited timeline and level of complexity expected of a master’s thesis.
Theoretical Position
I see the issue of homelessness, trauma, and aging through a social justice, antioppression, and structural social work lens (Mullaly, 2010). Trauma and its effects are social
problems which can lead to multiple issues. Our current socio-economic system discourages
the recognition and acceptance of societal responsibility for “the individual’s problems”, and
the structural systems in place that contribute to issues such as substance use, mental health
issues, and homelessness. Often individuals facing these issues experience exclusion and
discrimination by others who may think that people facing these issues are at fault and have
brought the problems on themselves. Often individuals feel guilt and blame themselves. Both
blaming the “other” for their situation or internalizing this blame are forms of oppression
(Mullaly, 2010).
My hope and intent in undertaking this research was to do so in an anti-oppressive
manner. Sakamoto and Pitner (2005) sum up this concept when they say that anti-oppressive
projects should involve addressing the needs and strengths of the service users and most
importantly must “critically challenge the power dynamics in the service-provider/ serviceuser relationship” (p. 435). Any intervention or form of assistance that takes the power away

8
from the person, by not involving them in decision making, design, or planning is not helpful
to the individual and could be detrimental. According to Herman (1997), it is clear that
recovery will only result from the empowerment of the survivor of trauma. There is usually
an inherent power differential between service providers and service users because one group
has access to resources and the power to provide them to another group of people who need
them. This system in and of itself is disempowering if it results in providers making decisions
about what and how they will provide service without consulting service users. Service users
can be left feeling unheard and undervalued having been unable to express their opinions and
needs. My work experience has shown me that people who are marginalized are survivors,
are resourceful and have strengths and assets that are often unacknowledged in social
services and policy making (Norman & Pauly, 2013; Sakamoto et al., 2008; Saleebey, 2006).
This research attempts to be empowering by listening to, and sharing, the experience of
service users.
Overview
Within this thesis, the key concepts relevant to the research question and topic are
defined and discussed. These include the population of focus in this research: homeless, older
women. Substance dependence, mental health, and trauma issues often affect health and
wellbeing and can lead to the need for health and social services with this population. Several
of these terms are more fully defined in Appendix A. These issues and their connection to the
need for client centred and trauma informed practice and service provision are also defined
and explored in the literature review. In addition, the research design and the lens through
which my research was conducted, are explained. The thematic analysis process and findings
are discussed; personal reflections about the process as well as some of the challenges and

9
limitations of the research are reviewed; and finally plans for knowledge transfer and
recommendations for practice and further research are outlined.

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Chapter Two: Literature Review
Homelessness
In the first half of the twentieth century in the United Kingdom and United States,
most homeless persons were middle aged and older men with two thirds being over the age
of 50 and a quarter over the age of 60. The profile of homelessness began to change in the
70s and 80s when more young people and women began to be identified among homeless
individuals (Crane & Warnes, 2010).
In Canada, the problem of homelessness emerged in the public consciousness as a
serious social issue in the 1980s and 1990s, at a time when government spending on new
social and affordable housing projects was substantially reduced. Many communities
responded to the issue by setting up emergency services such as shelters, food banks, soup
kitchens, and day programs, usually run by non-profits, charitable organizations, and
churches. Though initially intended to be temporary solutions, charitable and non-profit
services are now heavily relied upon in our communities by those in need and even by our
governments, who often expect people to access these service organizations prior to
government assistance. Sundin and Baguley (2015) indicate that the numbers of homeless
people in the Western World have either remained stable or risen over the last decade. This
can be attributed to growing structural inequities resulting in lowered incomes, higher levels
of unemployment, poverty, and unmanageable housing costs (Crane & Warnes, 2010; Sundin
& Baguley, 2015).
While important in crisis situations, stop-gap solutions, like homeless shelters, are not
viable civilized long term solutions to homelessness. Shelters offer very little privacy or quiet
space and often have no place to keep personal possessions safe. It is very difficult to address
mental health or substance dependence issues, look for employment or seek permanent

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housing while staying in such a setting. When people are homeless their ability to stay well is
compromised and they often become more marginalized and street entrenched making it
more and more difficult to get off the street and out of the cycle of homelessness (Gaetz,
Gulliver & Richter, 2014; Londerville & Steele, 2014).
On a positive note, making available a variety of permanent affordable, safe, and
appropriate housing options to individuals has been demonstrated to have positive outcomes
and seems to hold promise as a way forward in addressing homelessness in Canada (Gaetz et
al., 2014). Many hopes are pinned on our current federal government (elected in Fall 2015)
and the efforts of the Housing First Initiative to bring a change of focus, investment in
subsidized housing and programs that will help to alleviate current homelessness. Among
communities which have made the issue central, Medicine Hat, Alberta claims to have
eliminated homelessness entirely. They are being looked to with optimism as an example of
the positive outcomes of taking an approach which makes housing a priority for all
(Canadian Broadcasting Corporation [CBC], 2015). However, it remains to be seen if older
women’s homelessness will be served by this government initiative since women often
experience more complex homelessness (Gaetz et al., 2014; Klassen, 2015). Given that the
Housing First focus is on chronic and episodic homelessness, “it is quite likely that many
women experiencing hidden homelessness will be left out of the equation” (Klassen, 2015).
Older in Canada
People in western industrialized countries are generally living longer lives influencing
how aging is perceived as well as defined. Richardson and Barusch (2006) note that as
people continue to live longer the age at which “midlife” and “late life” are considered to

12
begin is being pushed back. The authors suggest that the new midlife may soon be deemed to
begin at around 50 and late life at 70.
The total number of Canadians who will be older than 65 is expected to steadily
increase and by 2036 the number of persons 65 and over is estimated to reach approximately
11.5 million which will represent 27.2% of the total projected Canadian population at that
time (Turcotte & Schellenberg, 2007).
In addition to people living longer, they are healthier, and financially better off today
on average, than aging persons of previous generations (Minister of Public Works and
Government Services Canada, 2002, 1998). However, there are substantial disparities
between regions, communities and individuals within Canada and within British Columbia.
Many older persons in Canada, Aboriginal people, people with disabilities, and women, in
particular, live in poverty.
Older Women
Although the gap in life expectancy has begun to narrow and is expected to continue
to do so over the coming years, women continue to live longer than men in Canada on
average (Richardson & Barusch, 2006; Turcotte & Schellenberg, 2007). It is estimated that
those 80 years of age, or the oldest old, will equal 3.1 million persons in Canada by 2041. In
general, the older an individual is, the more likely they are to be a woman, live alone, live in
poverty and have health-related problems (Minister of Public Works and Government
Services Canada, 1998; Ministry of Public Works and Government Services Canada, 2002;
Turcotte & Schellenberg, 2007).

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Older Aboriginal Population
Overall the Aboriginal population is much younger than the non-Aboriginal
population in Canada and this trend is likely to continue for some time. In 2001, more than
976,000 Canadians reported they were Aboriginal and of these 4% or 39,600 were Aboriginal
seniors (65 years of age or older) (Turcotte & Schellenberg, 2007). Life expectancy among
Aboriginal people is lower than the Canadian average at 68.9 years for status males and 76.6
years for status females, differences of 8.1 years and 5.5 years respectively (Minister of
Public Works and Government Services Canada, 2002; Statistics Canada, 2015). Aboriginal
people continue to represent a large percentage, and often make up the majority, of rural and
remote populations, particularly in the northern regions of Canada (Turcotte & Schellenberg,
2007).
Aboriginal Homelessness
Aboriginal people are more likely to experience homelessness than the rest of the
Canadian population (Belanger, Weasel Head & Awosoga, 2012; Gaetz et al., 2014; Patrick,
2014). They face ongoing systemic and overt racism and discrimination in addition to
experiencing the effects of intergenerational trauma. As a group, Aboriginal people in
Canada experience higher levels of poverty, domestic violence, poorer health outcomes, and
face systemic and structural violence, and discrimination when accessing services,
employment, and housing. All of these factors contribute to the high numbers of Aboriginal
persons experiencing homelessness in Canada (Gaetz et al., 2014).
Older Homelessness in Canada and Prince George
Though the literature does not list exact numbers, older persons represent a minority
among the homeless population in Canada. However, this should not lull us into thinking that

14
this is not a serious social issue as it is probably due to higher mortality rates and shorter
lifespans among those who are homeless. The average lifespan of 39 years is likely the result
of poor living and lifestyle circumstances among those who are homeless (Barken et al.,
2015; Trypuc & Robinson, 2009). Estimates are that 6% are over the age of 65 and 9% are
over the age of 55 (Barken et al., 2015), still a significant number, and one that is increasing
as the size of our older population continues to grow (Barken et al., 2015; Crane & Warnes,
2010; Edmondston & Fong, 2011). In Vancouver 212 people aged 55 years or over were
identified as being homeless in 2008 compared with 51 in 2002, and in Edmonton, the
numbers increased from 81 in 2000 to 306 in 2008 (Crane & Warnes, 2010). A homelessness
count conducted in Prince George, BC, in 2016, revealed that 69% of those who were
considered homeless self-identified as being Aboriginal; 47% of those counted were between
the age of 45 and 74 and, of this number, 16.6% were women. Of note, 25.8% of the total
homeless population were between the age of 55 and 74 and 6.4 % of this number were
women (Pateman et al., 2016).
Manifestations of Trauma
As a result of experiencing trauma, a person may have a sense of helplessness at
being a victim which may undermine their sense of well-being and their ability to trust
(Herman, 1997; van der Kolk, 1987). Many can integrate this experience and move forward
with their lives but often trauma leaves lasting and profound effects and many of these
consequences can be debilitating, at least for a time. Trauma can be a result of, or end up
resulting in, an absence or breakdown in secure stable nurturing connections to others.
Herman (1997) and Mate (2008) indicate that human connection is the basis for healthy
personality development and, if damaged due to trauma, can have serious and lasting

15
detrimental effects on an individual. A person’s degree of resiliency to stress and trauma is
likely dependent on several factors including personality traits, the existence and quality of a
social support system, and the incidence, frequency, and severity of the trauma experienced
(van der Kolk, 1987). Everyone reacts differently to stressful events but exposure to
traumatic events is often associated with emotional, psychological and sometimes even
physical health problems as well.
Though the effect of trauma on individuals varies widely, the literature has identified
some common characteristics. Survivors of trauma may have difficulties with concentration
and focus. They may experience flashbacks and nightmares about their trauma experience. In
addition, they may feel a sense of loss of control, helplessness and vulnerability along with
difficulty trusting others. Survivors of trauma may develop problems with low self-esteem,
mental health issues including depression and anxiety, social isolation, self-stigmatization,
hyperarousal, frequent irritability, or some may be emotionally numb and detached. In some
cases, survivors experience dissociative states that include memory loss of some, or all
trauma experience. On the other hand, there may be a continuous reliving or ruminating on
the experience. Some may react with a tendency towards unsafe coping mechanisms or risky
lifestyles, including substance use (Gitberg & Van Wyck, 2004; Herman 1997; van der Kolk,
1987). Anda et al. (2006) and Bowen and Murshid (2016) refer to the literature which has
linked childhood traumatic experiences with physical, mental health and substance use issues
in adult and later life, as well as earlier age of mortality.
In addition, there is now some scientific evidence which seems to show that trauma
can be passed on genetically from one generation to another (“epigenetic inheritance”) as
reported in a study conducted by Rachel Yehuda and her team at Mount Sinai Hospital with
32 Jewish Holocaust survivors and their children (Thomson, 2015). This study may have

16
particular relevance to the Aboriginal population in Canada and their experience of
intergenerational trauma, and this study, given the number of participants who identified as
being Aboriginal or First Nations.
Trauma and Substance Use Issues
Van der Kolk (1987) suggests that in trauma there is a very close relationship and
interdependence between psychological experiences and physiological reactions. This can
explain the strong connection that has been made between trauma and substance use issues
(Mate, 2008; Menzies, 2009; Savage, Quiros & Dodd, 2007). Studies reveal that an
inordinately high percentage of people with substance use issues have experienced childhood
trauma. Nearly two thirds of heavy injection drug users report that they experienced
childhood trauma (Mate, 2008). Exposure to trauma can reduce our resilience to and
tolerance of stress. However, substances may temporarily help people to cope by dulling the
emotional and physical sensations they may have in reaction to it. It is not uncommon for
people with substance use issues to explain that they use to numb or soothe the pain; often
emotional and possibly trauma related in root cause, but which can manifest itself in physical
health issues such as chronic pain (Mate, 2008). It can be argued that the act of using
substances, in and of itself, can lead to trauma since it can be a precursor to violence,
criminal activities (sometimes undertaken to procure a substance) or traumatic accidents,
because of the effects of substance use.
There is some reference in the literature to the connected incidence of trauma and
chronic pain. An example refers to a study looking at the incidence of pelvic pain of
unknown cause among women which discovered that a substantially large number of patients
experiencing pelvic pain had experienced sexual and or physical abuse as children and adults
(van der Kolk, 1987). In addition, an article by Otis, Keane and Kerns (2003) notes the close

17
relationship between chronic pain and Post Traumatic Stress Disorder (PTSD). In a study of
US Veterans, the co-occurence of PTSD and chronic pain was frequently observed. Those
who experienced both conditions tended to have increased severity of one or the other issue
or even both conditions in combination.
From personal observation, and within the addictions community, it is widely
understood that withdrawal from some substances, particularly from opiates, can result in
intense and substantial physical pain, which can also translate into frequent or chronic
experiences with pain. It would seem plausible to suggest that substance abuse, trauma and
chronic pain likely intersect (Browne et al., 2011; Otis et al., 2003). In addition, the concept
can be extended to the idea that there is an interconnection between pain and trauma to older
persons if there is an intersection seen among younger people with these issues.
Trauma and Aboriginal Peoples
Aboriginal peoples are often among the most marginalized people in the north, in BC
and in Canada. Ross (1992) explains that the residential school system was the final
statement of the Canadian government in dismissing Aboriginal culture. Taking Aboriginal
children away from their home communities and families to residential schools was
devastatingly traumatic to Aboriginal communities (Ross, 1996). As deVries (1996) notes,
culture is a strength and a protective and supportive force for people, and the disruption of
culture with its knowledge, values, spirituality, and lifestyle can be very detrimental to
members of the cultural group. Trauma not only shakes the foundation for the individual, but
it can also alter an entire cultural system. The result of this form of cultural trauma is being
witnessed today among Aboriginal people. Menzies (2009) points to the intergenerational
trauma history of Aboriginal people in Canada as a cause of substance and mental health
issues resulting in high rates of homelessness among urban Aboriginal men.

18
Trauma and Older Persons
Much of the early research on trauma was done with WWII, and Vietnam War
veterans and Holocaust survivors. Studies indicate that in some cases trauma effects can be
virtually absent or unrecognized for years and then the process of aging can trigger the
symptoms of trauma and PTSD (Aarts & Op den Velde, 1996; Coleman, Hautamaki &
Podolskij, 2002). There is also some evidence to indicate that those with a history of trauma
have a greater risk and incidence of somatic illness and dementia in their later years (Qureshi
et al., 2010).
Substance Use and Older persons
Use of substances can be relatively innocuous and is sometimes reported to have
beneficial health effects for older persons, such as alcohol’s purported blood pressure and
cholesterol lowering, antioxidant, and relaxation effects (Richardson & Barusch, 2006). In
some cases, substances such as prescription medications are necessary to treat acute or
chronic health conditions such as infections, or for symptom management and pain control.
However, moderation is important and under certain circumstances, most commonly in the
case of pain management, substances can end up being misused or individuals can become
dependent upon them. This dependence can sometimes occur very gradually without an
individual recognizing it until they stop using a substance, such as when a prescription
medication runs out.
Alcohol is the substance most frequently used by, and the cause of the most negative
consequences arising from substance use for, older individuals. Estimates vary widely,
indicating that between 3-25% of older persons drink heavily with possibly up to 15% having
an issue with “problem drinking.” Even higher rates are reported in nursing homes and
retirement communities where as many as 49% of residents may have a problem with alcohol

19
dependence (Richardson & Barusch, 2006). After alcohol, prescription drug use among older
persons is the second leading cause of problems stemming from substance use (Richardson &
Barusch, 2006).
Research shows that older women are more at risk for problematic prescription drug
use than men, particularly in connection to the use of benzodiazepines. This may lead one to
query if there is still a tendency, as there was historically, to over-prescribe psychoactive
drugs to women. Withdrawal from these types of medications can be particularly difficult
and cause serious consequences such as increased depression and anxiety resulting in higher
risk for suicidal ideation (Richardson & Barusch, 2006).
Substances and substance use can have cultural significance, and in addition to being
an important part of some ceremonies and rituals, the interpretation and perception of
problematic use is a social construct, and as such, is highly variable from place to place and
among ethnicities, religions, and individuals. Within the context of this research, substance
use is of concern when it begins to have detrimental effects on the physical, emotional, and
cognitive functioning of an older person (Mate, 2008).
Effects of substance use on older persons.
Some of the resulting detrimental effects of substance use for older persons can
include health issues such as; malnutrition, anemia, pancreatitis, gastritis, increased
possibility of falls (and resulting bone breakage, which can have a domino, and life
threatening, effect on health), motor vehicle accidents, vulnerability to illness due to lowered
immunity, chronic disease, decreased cognition, memory decline, and mental health issues
such as anxiety and depression among a host of other problems (Gellis, 2006; Richardson &
Barusch, 2006). In addition, dependence on a substance can make older individuals
vulnerable to all types of abuse and can result in the breakdown of important support

20
networks and relationships, leading, in turn, to increased levels of isolation, loneliness,
inactivity, and difficulty keeping up with daily responsibilities including medication
adherence and payment of bills, such as rent.
Mental Health Issues and Older Persons
As the Canadian population ages, larger numbers of individuals with mental health
issues will be living longer, and more resources will need to be allocated to assist these
persons to have healthy, enjoyable lives (Gellis, 2006; MacCourt, 2008). The DSM-5
(American Psychiatric Association, 2013) defines mental disorders as those seriously
impacting and hindering the social, occupational or other important areas of functioning, and
is a very similar definition to the one for substance use issues.
Current estimates are that between 15-25% of older adults are living with a mental
health issue. Some estimates are that at least 25% of older persons are living with depression
and 20% with anxiety. Elevated rates of suicide exist among the very old, particularly among
men, and are often a result of late onset depression (Gellis, 2006). It is recognized that older
persons are chronically underserved by mental health services for assessment and treatment
(Aarts & Op den Velde, 1996; Gellis, 2006; Richardson & Barusch, 2006).
Growth in demand for services is anticipated because of the increasing numbers of
mental health issues identified among older individuals. This may be due to more consistent
assessment and increased acceptance of mental health problems within society and among
older individuals due to public education efforts aimed at reducing the stigma of mental
health issues (Gellis, 2006; MacCourt, 2008). As with substance use disorders, an important
consideration when working with diverse populations is the idea that the concept of mental
health issues or disorders is a social construct. What is considered to be a mental health issue
can vary depending on location and cultural context (Littlewood, 2002).

21
The Path to Homelessness for Older Women in Canada
There is a strong consensus that many of the causes of homelessness are a result of
structural inequities (Novac, Brown & Bourbonnais, 1996) and interlocking oppressions
existing in society. From a feminist and structural social work perspective, the intersection of
multiple layers of oppressions in society, like sexism, heterosexism, ageism, classism, and
racism, contributes to older women becoming and remaining precariously housed or
homeless (Allen, 2016; Zufferey, 2009).
Many more adult men report being homeless than do women. However, the literature
reports that this is not necessarily a true reflection of the prevalence of homelessness or
precarious housing for women, but may be indicative of the fact that women’s homelessness
takes different forms and is underreported. This may be because of its often more episodic
and hidden nature due to strategies women use to avoid outright homelessness like couch
surfing or exchanging sex for food and accommodation (Novac et al., 1996; Salem & MaPham, 2015; Sikich, 2008). Homelessness may be less visible due to women’s purposely
hiding to seek safety in escaping intimate and partner or domestic violence (Novac et al.,
1996). Women often end up having to choose between living with violence at home and
violence on the street (Klassen, 2015). Women may not engage with emergency and social
support services to the same extent that men do (Gaetz et al., 2014), for a variety of reasons,
including concerns around personal safety and victimization in addition to inappropriate
service availability and provision.
Homelessness is more often a first-time experience for older homeless persons (Crane
& Warnes, 2010; Davis-Berman, 2011) and often results from economic and personal crisis
or from an accumulation of issues and lack of social supports as well as fundamental
structural issues. Some causes of homelessness among older persons are similar between

22
genders such as family conflict and breakdown, substance use and mental health issues, and
financial problems. However, the literature indicates that more women than men become
homeless for the first time in later life, making this an important gendered and age related
social issue regarding this demographic (Cohen 1999; Crane & Warnes, 2010; McDonald,
Dergal & Cleghorn, 2007; McLeod & Walsh, 2014). Tutty, Ogden, Giurgiu and WeaverDunlop (2014) also suggest that the experience of homelessness and risk of homelessness is
gendered. For women homelessness is a result of interlocking oppressions that result in
women’s increased vulnerability to issues of power leading to greater marginalization
(Zufferey, 2009; 2017). The intersection of vulnerabilities such as intimate partner abuse,
substance use issues, mental health issues, being a visible minority and having been
institutionalized in a prison or facility can all lead to homelessness.
The literature identifies some causes for first time homelessness for women over the
age of 50: widowhood (Salem & Ma-Pham, 2015; Washington & Moxley, 2008), sudden
rapid deterioration of health, domestic violence and interpersonal conflict, moving to a new
community, job loss, family member abuse and neglect, and criminal justice system
involvement (Davis-Berman, 2011; McDonald et al., 2007; McLeod & Walsh, 2014; Salem
& Ma-Pham, 2015). Facing any of the above situations, complicated by having little or no
income, can make it extremely difficult to secure safe and affordable housing. As a result,
older women may end up facing the dilemma of having to choose between essentials such as
medication, transportation, food, or paying rent (Callaghan, Farha & Porter 2002; Kozak &
Hemingway, 2010; McLeod & Walsh, 2014).
This research views the issues of service provision through a trauma informed lens
and the path that has led older women to homelessness was looked at from this perspective.
The literature indicates that for most women of all ages, oppression and trauma in some form,

23
have played a part in their lives and a role in their experience with homelessness. In many
cases, women may not actually recognize that they are survivors of trauma due to trauma’s
having been such a regular or “normalized” part of their lives (Covington, 2012). The
traumas homeless women have been exposed to may include: structural trauma resulting in
poverty and violent traumas from emotional, sexual, physical abuse, crime, and
intergenerational trauma, especially in the case of Aboriginal women.
Poverty as Structural Trauma
The literature indicates that 30% of unattached women age 45 to 54 and 40% of
women 55 to 64 fall below the low-income cut-off in Canada (Collin & Jensen 2009;
McLeod & Walsh, 2014). It is often the structural inequities women are subjected to
throughout their lives that result in more women than men living in poverty in Canada
(McLeod & Walsh, 2014). These inequities include the ongoing wage gap between women
and men and the fact that 60% of Canadians earning minimum wage are women (McLeod &
Walsh, 2014; Townson, 2009). Women are more likely to have part time employment and the
literature indicates they are more likely than men to spend 30% or more of their income on
shelter costs (McLeod & Walsh, 2014; Williams, 2010). Historically, women have often been
the stay at home caregivers of young children, older, and ill family members, with little or no
financial recognition of this as work and little compensation through government pension
plans or employment insurance programs (Ivanova, 2017). Finally, the structural
marginalization and oppression of older women due to sexism, racism, and ageism (Salem &
Ma-Pham, 2015) contribute to the higher rates of poverty and homelessness they experience.
Violence as Trauma
The relationship between violence and homelessness for women is often very
complex. Rates of physical and sexual abuse, in childhood and in adulthood, are high among

24
homeless women (Novac et al.,1996). Often women may experience homelessness as a result
of fleeing violent and abusive living situations (Klassen, 2015; Novac et al., 1996). A
resulting unfortunate irony is that often women may form intimate relationships with people
to protect themselves from violence, and then these relationships, in turn, end up being
abusive. Ultimately, the realities of homelessness put women at increased risk for being
exposed to violence (Novac et al., 1996).
As noted earlier, the literature points to a link among mental health, substance use
issues and trauma experienced in childhood and adulthood (Callaghan et al., 2002; Crane &
Warnes, 2010; Hecht & Coyle, 2001; Kisor & Kendal-Wilson, 2002; McLeod & Walsh,
2014). Studies link traumatic childhood experiences such as abuse and domestic violence
with mental, physical health, and substance use issues in adulthood. In a study by Cook,
Pilver, Dinnen, Schnurr and Hoff (2013), women who were physically or sexually assaulted
decades earlier, report significant mood and anxiety disorders into late adulthood. In addition,
the literature indicates that those who have experienced trauma have higher than average
rates of adult mortality (Anda et al., 2006; Bowen & Murshid, 2016).
Women of all ages who live in poverty are more likely to be victims of physical and
sexual assaults (McLeod & Walsh, 2014; Pavao, Alvarez, Baumrind, Induni & Kimerling,
2007; Wenzel, Tucker, Elliott, Marshall & Williamson, 2004). In addition, having mental
health or substance use issues and being street involved increases the risk for women to be
victims of all types of violence (Kushel, Evans, Perry, Robertson & Ross, 2003; McLeod &
Walsh, 2014; Wenzel et al., 2004). Older homeless women are at particular risk as they are
more likely to be exposed to physical and sexual violence and other crimes, such as theft,
than men of the same age (McLeod & Walsh, 2014).

25
Such issues can contribute to a progressive decline in quality of life with age, making
older women increasingly more vulnerable to economic downturn, health care and housing
costs, which in turn, can increase the risk of exposure to violence and abuse of all types.
These factors as well as the intersection of ageism, poverty, sexism, and racism lead to the
growing international issue of persons becoming homeless for the first time in their older
years (Barken et al., 2015; McLeod & Walsh, 2014; Minister of Public Works and
Government Services Canada, 1998; Morris, Judd & Kavanagh, 2005). As our population
ages, we can anticipate that more individuals will be identified as having a history of trauma
and there will likely be an increasing need for resources and services to address the complex
issues that result.
Homelessness as Trauma
It can be argued that the state of being homeless, with its chaos, upheaval and
uncertainty, is itself a traumatic experience (Lewinson, Thomas & White, 2014). As well, it
is known that most women who are homeless have experienced trauma from interpersonal or
intimate violence, sexual or physical abuse (Hopper et al., 2009; Lewinson, et al., 2014;
Rayburn et al., 2005; Yeater, Austin, Green, & Smith, 2010) and that the risk of further
exposure to violence increases once women have become homeless (Dietz & Wright, 2005;
Goodman, Saxe, & Harvey, 1991.; Lee & Schreck, 2005; Lewinson, et al., 2014; Novak,
1996).
Older Homeless Women
Though many have lived their lives at the margins of society, sometimes
homelessness is a relatively new experience for older women who find themselves in the
situation. For some, dealing with social services and with shelter systems can be unfamiliar

26
and overwhelming. Systems are often not set up to appropriately and adequately meet the
needs of older homeless women (Sikich, 2008). Lengthy waits for help for services and chaos
in the shelter systems can be very difficult for this population to negotiate. A study by Davis–
Berman (2011) indicates that older women may find shelter systems noisy and intimidating,
finding it stressful and difficult to be housed with younger women. They may worry about
potential conflict, find the verbal and physical aggression in shelters difficult, and see staff as
disrespectful as well as lacking compassion. For multiple reasons, older homeless persons
may also have difficulty trusting service providers (Mackelprang et al., 2014). For the abovementioned reasons and out of fear for their own safety, many older homeless women avoid
the shelter system (Davis-Berman, 2011).
Some barriers around health care for older homeless persons are noted in the literature
and include not knowing where to go for services, long office waits to get care, lack of
money, and transportation to and from health services (Lewis, Anderson & Gelberg, 2003;
Salem & Ma-Pham, 2015). Older persons can have unique health needs and these can be
exacerbated by homelessness (Salem & Ma-Pham, 2015). Challenges faced by older
homeless persons can include difficulty with managing chronic health conditions, safely and
securely storing medications and belongings, as well as accessible and appropriate medical
care. Difficulty obtaining healthy, appropriate and adequate nutrition, and physical activity
(Salem & Ma-Pham, 2015) is of particular relevance for those with existing chronic health
issues, like diabetes, but also important for the prevention of illness. In addition, older
homeless persons are at increased risk for falls and injuries, and for the growing problem of
Sexually Transmitted Infections (STIs) among older persons (Salem & Ma-Pham, 2015). In
addition, substance use issues can be more serious and can lead to their own set of unique
complications among older homeless individuals (Davis-Berman, 2011; Dietz, 2009).

27
Service Needs
The literature strongly supports the development of specific services for older
homeless adults, as well as indicates that programs housing low income older populations
often do not meet their specific needs (Cohen, 1999; McDonald, Donahue, Janes & Cleghorn,
2006; McLeod & Walsh, 2014; Sikich, 2008). Suggestions are that services should include
designing shelters to meet the specific needs of this growing population which separate the
older homeless female population from the younger, intensive case management to assist
older homeless persons with income, social assistance and housing issues in addition to
training of shelter and other service provider staff around the specific needs of, and ways of,
working appropriately with older homeless persons (Davis-Berman, 2011).
Older homeless women report that one of the most important things for them in
regards to shelter stays are their relationships and interactions with the staff. Staff who are
non-judgmental and compassionate as well as services with the option to meaningfully
participate, are identified by older women shelter users as making a positive difference in
their experience. The importance of respect between service user and service provider has
been identified in the literature as being critical to this population (Hecht & Coyle 2001;
McDonald et al., 2006; McLeod & Walsh, 2014). Also reported as important to homeless
women is the desire for autonomy and decision making power, which many say was lost
when they became homeless (McLeod & Walsh, 2014; Novak et al., 1996).
Trauma Informed Practice and Services
The literature indicates that trauma informed practice is becoming more widely
understood and utilized. Stemming from the research around Post Traumatic Stress Disorder
(PTSD) first identified in Vietnam war veterans, then recognized in the adult and child
survivors of physical and sexual abuse, it has evolved into a model for providing social

28
services provision and policy development (Bowen & Murshid, 2016; Elliott, Bjelajac,
Fallot, Markoff & Glover Reed, 2005; Harris & Fallot, 2001; Wilson, Pence & Conradi,
2013).
Working with trauma survivors and with an awareness of the impact of trauma has
always been a part of the social work profession. Trauma informed practice blends a range of
social work theories and practices. It takes an anti-oppressive and strengths based approach
(Hopper et al., 2009), viewing trauma as caused by the intersection of different structural
injustices and multiple oppressions (Bowen & Murshid, 2016; Zufferey, 2017). It is very
much a person centred practice in assessing and providing assistance based on an individual’s
particular circumstances and needs. It promotes the self-determination (Hopper et al., 2009)
and empowerment of individuals, as it calls for service delivery to be designed based on
feedback and collaborative input from service users (Levinson, 2017).
For an organization or service to be trauma informed requires an understanding of the
role violence and victimization play in the lives of many social service users, particularly
those with mental health and substance use issues. Trauma informed services are not about
treating the root causes or symptoms of trauma but are about the way in which services are
provided to ensure they meet service users’ needs in a respectful, appropriate, comfortable,
safe, and effective way (Harris & Fallot, 2001). This includes, but is not limited to, services
designed to assist with meeting the social determinants of health like, employment, housing,
food security, financial assistance, and health (Harris & Fallot, 2001).
Trauma Informed Service (TIS) provision to older homeless women.
Since it is recognized that older homeless women have high rates of mental health
and substance use issues, often going hand-in-hand with lived experiences of trauma, this
should be taken into consideration when providing services to them. Further, since evidence

29
suggests that many women who experience trauma may use substances as a coping
mechanism and have mental health issues, Elliott et al. (2005) recommend that, as a form of
“universal precaution,” all women with these issues should be assumed to be trauma
survivors, whether they acknowledge or disclose a trauma history or not (Peck & Capyk,
2012).
Lack of awareness about this interconnection can mean it may be overlooked by
service providers and, as a result, needed services and referrals may not be accessed or
inappropriate and insensitive service provision may result. Services may be delivered in a
confrontational or intrusive style or the environment may not feel safe to service users
(Harris & Fallot, 2001). Many survivors of trauma have experienced a resulting sense of loss
of control over their lives and the manner in which service is provided can replicate this
experience for them (Chambers, 2012). This may inadvertently cause re-traumatization or the
exacerbation of trauma effects for the individual. In addition, a negative experience with
services and service providers may mean that an individual will leave and not return in the
future and, as a result, they may not access the assistance they require (Chambers, 2012;
Harris & Fallot, 2001).
A woman who has experienced trauma may have difficulty expressing and
modulating her emotions; she may over respond to neutral cues and under respond to danger
cues (Covingon, 2012). Seeing things through a trauma informed lens is about standing back
and asking if the behaviours exhibited by an individual are due to a trauma history
(Covington, 2012), normalizing them to the survivor and being able to see these from a
strengths perspective for what they are (coping, self-protection, and survival mechanisms)
rather than blaming the individual for their behaviours (Peck & Capyk, 2012).

30
In many settings, the service user is viewed as a passive recipient of service and the
service providers as experts and the gatekeepers to accessing resources. This is an inherently
hierarchical system with power imbalance where the service providers’ views, opinions and
knowledge are given more importance. This power over relationship can mirror the
experience of trauma for service users (Harris & Fallot, 2001) and thus, continue the pattern
of oppression that many older vulnerable women have experienced throughout their lives.
With the provision of trauma informed service, the goal is to build a collaborative
relationship where both service user and provider are respected and valued for the equally
important knowledge and experience they offer. This ideally involves open and honest
communication between service provider and service user and works to ensure that the
service user has choice about what service, when, how, and where they will receive service
and who they will receive service from (Harris & Fallot, 2001).
The following are 10 trauma informed service principles developed through a
consensus process with nine service agencies addressing substance dependence, mental
health, and violence-against-women issues;
“Principle 1. Trauma-Informed Services Recognize the Impact of Violence and
Victimization on Development and Coping Strategies.
Principle 2. Trauma-Informed Services Identify Recovery from Trauma as a Primary
Goal.
Principle 3. Trauma-Informed Services Employ an Empowerment Model.
Principle 4. Trauma-Informed Services Strive to Maximize a Woman’s Choices and
Control over Her Recovery.
Principle 5. Trauma-Informed Services Are Based in a Relational Collaboration.

31
Principle 6. Trauma-Informed Services Create an Atmosphere That Is Respectful of
Survivors’ Need for Safety, Respect, and Acceptance.
Principle 7. Trauma-Informed Services Emphasize Women’s Strengths, Highlighting
Adaptations over Symptoms and Resilience over Pathology.
Principle 8: The Goal of Trauma-Informed Services Is to Minimize the Possibilities of
Re-traumatization.
Principle 9. Trauma-Informed Services Strive to Be Culturally Competent and to
Understand Each Woman in the Context of Her Life Experiences and Cultural
Background.
Principle 10. Trauma-Informed Agencies Solicit Consumer Input and Involve
Consumers Designing and Evaluating Services.” (Elliott et al., 2005, p. 465-469).
Summary
The above literature review explores the background history of the issue of
homelessness and some of the contributing factors to it. It attempts to focus on issues and
realities faced by older women with lived experience of homelessness, with the idea that they
are likely many of the same issues faced by the women who volunteered to be interview
participants for this research. Finally, the concepts of trauma informed practice and trauma
informed service provision are outlined, as this is the lens through which the research for this
thesis was conducted, as outlined in the following chapter.

32
Chapter Three: Research Methodology

This research aimed to explore the experience of accessing social and health services
for older women with lived experience of homelessness. An exploratory qualitative research
design employing a semi-structured interviews and a thematic analysis approach for the data
collection and analysis was used. The intent in conducting this research was to do so in a
manner that values and involves older women with lived experiences of homelessness by
providing them an opportunity to confidentially voice their needs for, and experiences with,
service provision. Of paramount importance was to attempt to minimize further harm or
traumatization to women who have so often experienced this.
Exploratory Qualitative Research
Since qualitative methods and an exploratory approach can be useful when looking at
new issues, hard to study groups, or to determine the meanings people make of their lives and
actions (Engel & Schutt, 2005), it was thought to be an appropriate method to use for this
research with its target population.
Qualitative research “is any kind of research that produces findings not arrived at by
means of statistical procedure or other means of quantifications” (Strauss & Corbin,1990, p.
17). It provides researchers with the possibility of accessing individual experiences (Corbin
& Strauss, 2008) and focuses on “the meaning individuals or groups ascribe to a social or
human problem” (Creswell, 2007, p. 37). Its goal is to look at social processes and settings,
while considering the different perspectives of those affected, by exploring the lives of
individuals and groups within the wider social context (Engel & Schutt, 2005; Shaw &
Holland, 2014). An advantage of qualitative research is that it “can effectively give voice to

33
the normally silenced and can poignantly illuminate what is typically masked” (Greene,
1994, p. 541).
Exploratory research is qualitative inquiry that can be useful for finding out more
information on an issue where little is known and few studies have been previously
undertaken (Engel & Schutt, 2005; Maschi & Youdin, 2012). Often a relatively unstructured
approach (Maschi & Youdin, 2012), it attempts to uncover more information about “social
phenomena without expectations” (Engel & Schutt, 2005, p.12) and to develop ideas for
possible further research (Marshall & Rossman, 2006).
Since there are few studies based on accounts from this population about this topic, it
was thought that further qualitative, exploratory research would be useful to hear directly
from older women with lived experiences of homelessness about how and whether their
needs are being met. It was hoped that this research would also provide additional orientation
with respect to how one might approach further research.
Sample Criteria
Interview participants had to self-identify as female, over the age of fifty, and
currently homeless or with lived experience of homelessness in Prince George to fit the
sample criteria for this research.
The age for participation in the research was set at 50 and older since it is recognized
in the literature that people who are homeless tend to age more quickly; have age related
health issues much earlier and live shorter lives on average. For these reasons, some of the
literature on homelessness categorizes homeless people who are 50 years of age and up as
“older” (Barken et al., 2015; Crane & Warnes, 2010). Given the 50 year old lower limit as
indicated previously, I was also concerned that by limiting the age range further (for example

34
to 65 years of age and older), I might be excluding important voices since the literature also
indicates that woman tend to make up a small percentage of the older homeless population
(Pateman et al., 2016; Novac et al., 1996; Salem & Ma-Pham, 2015).
Women defined homelessness on their own terms, as homelessness for women can
take many forms and can often be more hidden (Novac et al., 1996; Salem & Ma-Pham,
2015). In the end, the interview participants included women who identified as having couch
surfed with strangers, temporarily stayed with friends or family, or stayed in shelters or
transition housing. There was no minimum period of time that women interview participants
had to have experienced homelessness in order to meet the criteria for participation in this
research.
Sampling Method
A snowball type of sampling (Engel & Schutt, 2005; Marlow, 2005) was used to
reach and recruit six women 50 years of age and older who had experienced homelessness in
Prince George and who were interested and willing to participant in semi-structured
interviews (Creswell, 2013, 2014; Marlow, 2005). The intent at the outset of the recruitment
of participants was to interview five to seven women. Six participants were interviewed as
this was the point at which there were no new identifiable ideas or themes emerging, and
when it seemed that saturation from the collected information was reached (Corbin &
Strauss, 2008; Creswell, 2014).
I chose to use snowball sampling in this research design because, as a form of nonprobability sampling, it is primarily used in exploratory research with hard to reach
populations, when random sampling will not work, which suited this research targeting older
women with lived experience of homelessness (Engel & Schutt, 2005; Rubin & Babbie,

35
1993). I wanted to find research participants not known to me and not referred to me by
service provider staff and organizations. The objective was to find a sample of older women
service users in an ethical way by avoiding bias and keeping client confidentiality and safety
at the forefront. My concern was to avoid a situation where interview participants, thinking
that providers might know of the information they shared, could limit accessing certain
service providers and agencies for their needs, as a result of their participation in the
interviews. Conversely, I wanted to limit the potential of affecting and biasing service
provision by providers to interview participants who they might know as having participated
in the interviews. Both situations could potentially jeopardize the health and wellbeing of
research participants.
Since identified members of the population spread the word about the interviews to
other older women who have experienced homelessness, this assisted in finding interview
participants who fit the criteria in a less intrusive and public way. In addition, asking one
participant to pass the word on to another and have them contact me, avoided the ethical
issue of making direct contact with individuals without their consent (Engel & Schutt, 2005).
I felt that snowball sampling was an appropriate way to address these concerns and
find interview participants in a way that would minimize the potential for biasing the data or
for influencing and impacting participants access to the services they need.
Sample Selection
My first attempt at recruiting participants was done by visiting a Thanksgiving dinner
hosted by a non-profit agency held at a church hall. I spoke to several women as they were
coming and going from this function; I gave out posters (Appendix E) and explained the
purpose of my research, the participation criteria, and provided my personal cell number as
contact information. This process led to the recruitment of one participant who contacted me

36
several weeks later. In the meantime, I visited one drop in centre and one soup kitchen centre
several times and spoke to many women and was permitted to put up posters in these
agencies by staff. Any time I spoke to individuals about my research and my search for
interview participants I purposefully did not mention an honorarium (see Acknowledgment
section that follows regarding details of the honorarium process) so as not to unduly
influence the recruitment of participants. On one of these visits, I explained my research to an
older woman and she decided to come with me immediately to do the interview. Following
her interview, this participant told another woman and from that point forward, the word
spread from one women to another, and interested individuals contacted me by phone. All
except the initial two interview participants were recruited through this snowball sampling
method.
Interview Setting
When interview appointments were set up with each participant, they were asked if
they would prefer the interview take place in a private or public location. All the prospective
interview participants decided to be interviewed in the quiet, private, confidential space I told
them I had secured. Nutritious snacks, fruit, meal replacements, and beverages were provided
to ensure that participants were not hungry or thirsty and to make the atmosphere as inviting
and safe as possible.
Confidentiality and Privacy
Prior to the start of the interview, each potential participant was given a copy of the
information and consent letter (see Appendix F) which was read out loud and discussed
together with the participant. I chose to do this to ensure participants clearly understood the
interview process, and could freely ask questions; this approach was also a way of navigating
sensitively around the issue of literacy. In addition, the letter that was read explained the

37
process for protecting the individual participant’s privacy and confidentiality, including the
storage and disposal of the interview data.
Participants were asked several times if they had any questions and once I was
confident that participants understood the information and the process, had the capacity to
consent, and were willing to be interviewed and agreeable to have the interviews audiotaped,
they were asked to sign the consent form indicating they understood and agreed to participate
in the research. Each participant was given a copy of this information letter and consent form
to keep, with my contact information and that of my supervisor clearly identified and pointed
out to them. In addition, participants were given the list of counselling resources (Appendix
D) and encouraged to access these if they needed to, either during or following the interview.
I asked participants to ask questions or to stop the interview at any time they felt they needed
to.
Voluntary Participation
It was explained to participants that participation was entirely voluntary and they
were free to discontinue their participation or to withdraw their interview from the research at
any point during or after the interview, and that this choice would remain confidential.
Each participant was asked if they would like to provide their contact information so
that I could provide them with a copy of their interview transcription and thematic analysis
for their review and feedback. I also let them know that they would be able to access a copy
of the completed thesis at the university library or by contacting me.
Acknowledgment
Participants were then given an envelope containing two grocery store gift cards
totalling $20, equivalent to BC’s current minimum wage of $10.45 per hour, for a little under
2 hours, the estimated maximum time the interviews would take. As well, interview

38
participants were given two bus tickets, to assist with transportation costs to and from the
interview. It was explained that interview participants were receiving this in recognition and
appreciation for their time, ideas, and input given, which were vital to this research
proceeding. This was given to participants prior to the interview to avoid unduly influencing
their continued participation in the interview. Participants were advised that even if they
decided to discontinue participation in the interview process, the gift cards and bus tickets
were theirs to keep.
Data Collection
Once interview participants were comfortable and settled, and the paperwork was
completed as above, the interviews proceeded. To begin, several demographic questions
(Appendix B) were asked of each interview participant followed by a series of semistructured interview questions (Appendix C). All 6 participants agreed to the audiotaping of
their interview and completed the interviews without deciding to withdraw from the research.
The demographic information and thematic analysis of the data are outlined in the findings in
Chapter 4. Semi structured interviews were chosen as a data collection method because they
can provide a structured flexibility to gathering information allowing for the ability to follow
up and explore further the answers participants might give to the set questions asked (Alston
& Bowles, 2013; Shaw & Holland, 2014).
Data Handling and Storage
The audio recordings, interview transcriptions and associated research, journal notes
(discussed further in this chapter under the section on reflexivity), and drafts were securely
stored on my password protected computer and in a locked cabinet in my home office
throughout the research and writing process; all the information associated with the

39
interviews will continue to be stored this way. All potential identifying information about
interview participants and service providers has been removed from the research data,
interview transcriptions, and the thesis document to try to ensure confidentiality and safety
for all. All stored electronic files will be deleted and paper files will be shredded and
disposed of by a professional bonded company a maximum of 5 years after the completion of
the thesis.
Data Analysis
Thematic analysis was chosen to examine the participant interview data because it
offers a systematic approach to search for meaningful patterns while providing a way to
manage and examine large amounts of data in context (Braun & Clarke, 2006; Lapadat,
2010). It is useful for “immersing oneself in the data, for organizing and summarizing, and
for focusing the interpretation” (Lapadat, 2010, p.1). This approach was thought to be suited
to the goal of this exploratory research to look at the “experiences, meanings and the reality
of participants” (Braun & Clarke, 2006 p. 9). It was used in a “contextualist” way by
attempting to place interview participants’ experiences within the wider social context,
during the data analysis and in the discussion of the findings (Boyatzis,1998; Braun &
Clarke, 2006).
As a novice researcher, thematic analysis seemed an appropriate approach to
examining the data since it “does not require the detailed theoretical and technological
knowledge” required by some approaches and “it can offer a more accessible form of
analysis, particularly for those early in a qualitative research career” (Braun & Clarke, 2006,
p. 9). However, as noted later in the “Researcher Reflection” section, the process of thematic
analysis was more complex than I had anticipated.

40
Braun and Clarke’s (2006) article outlining their six phases of thematic analysis was
used as a guide for the step by step process of analysing the information gathered from the
interviews. A lens of trauma informed practice (Elliott et al., 2005; Harris & Fallot, 2001)
guided the development of the semi-structured interview questions, as well as assisted in the
examination and discussion of the findings of the thematic analysis.
Thematic Analysis Steps
The first step was to familiarize myself with the data. The data collected from
research interview participants were transcribed from the audio recordings by a hired
professional transcriptionist. The transcriptionist signed a confidentiality agreement prior to
receiving any of the audio recordings to be transcribed.
I reviewed and compared the transcriptions to the original audio recorded interviews
to check for accuracy and make any changes necessary. I did this by listening to each
interview while reading along with the transcript and made the needed corrections. At times,
voices were not easily heard and words were not clear and this led to a few errors in
transcription. Comparing the transcriptions to the recordings gave me a chance to carefully
listen to the interviews, and to get a sense of the essence of what participants were saying in
their answers to my interview questions and in telling their stories. It also allowed me to
begin to hear some of the key ideas and emergent themes that were repeated throughout the
interviews.
The second step was generating initial codes. I read through each of the six transcript
documents and highlighted ideas, statements, and concepts that initially struck me as
important. Then I went through the transcripts a second time and assigned labels or “initial
codes” (Boyatzis, 1998), to the highlighted sections in the margins of the document in
comment boxes next to the relevant section of text. A running list of these codes was created,

41
with a short one-or two-word description (Boyatzis, 1998; Braun & Clarke, 2006) as a code
legend in a separate document.
As I moved forward from one interview to the next, previously identified codes were
assigned to new material if appropriate and new codes were created and assigned as needed.
In many cases, statements by participants ended up being labeled with several different codes
as sections of the interviews were often made up of a combination of ideas and elements that
could stand alone or overlapped. As I reached the sixth interview transcription, I was no
longer coming up with any new codes, and so this was my point of saturation (Corbin &
Strauss, 2008; Creswell, 2014).
The third step involved searching for themes. This involved going through each
interview transcript again and searching for codes I had generated earlier, by using the
navigation search tool of the word processing program. At this stage, codes were combined
where sections of texts initially had multiple codes; codes were narrowed down to the most
fitting or “key code” for each item of text. Each section that fit under a code was cut and
pasted into a new document named by that code. Each of these documents made up of text
from the various interviews were reviewed and, where necessary, excerpts were reassigned
and moved to other codes. Codes were also combined with one another if there were enough
threads and similarities between the excerpts of text to fit together. These documents then
became the initial themes. Two key themes were initially identified: “Loss and Strengths”
(which later became “Loss and Disempowerment”), and “Strengths -taking back the power.”
Several other themes were also identified at this stage, which were later expanded into more
than one theme, or renamed multiple times, but began as: “Positive Experiences,” “Negative
Experiences”, and “Unmet Needs.”

42
The fourth step was reviewing the themes. This step involved refining and combining
themes further. It was important to accurately capture the key ideas, and even if an idea was
raised only once in the data, if it was informative and important, it was captured under a
theme. At this stage, text was sorted through again and coded material was moved around to
the most fitting theme heading. This process of reviewing the material and refining the
themes was done several times. Also, I spent more time thinking and becoming clear about
my themes and excerpt examples. In some cases, it was not obvious where sections of text fit
best and I had to rethink my definition and names for some of the themes.
The fifth step was finalizing the theme names and defining the themes. It was at this
point in the thematic analysis that I could clearly identify and explain each theme and finalize
the selection of examples from the interview data to highlight each theme. The three final
overarching themes, subthemes, and subtheme components, thus identified were:
1. Loss and disempowerment
2. Navigating Services
a) What is Working
b) What is Not Working
subtheme components: Barriers, Interactions, and Gaps
3. Resilience
The sixth and final step of the thematic analysis was producing the report. This
involved an analysis for each theme and subtheme, and creating a summary and explanation
of the interview text excerpts to put the theme headings into context, including identifying
the purpose and meanings captured in each theme.

43
Summary
The information collected in the interviews was examined and the issues identified
were categorized into themes using thematic analysis. An inductive approach was attempted
to avoid fitting the identified themes “into any ‘pre-existing ideas’ held by the researcher”
(Braun & Clarke, 2006), and aimed to uncover “lived experiences and meanings” and to
“capture the idioms and contents of an individual’s views, experiences and sentiments”
(Luborsky, 1994 p.190). The data analysis moved from the narrow (significant statements) to
broader (meaning) analysis, to summarize the essence of what and how individuals have
experienced service provision (Moustakas.1994).
Methodological Integrity
Member Checking
When asked, all six participants had initially indicated that they wanted the
opportunity to review their interview transcript for accuracy and completeness, a process
called ‘member checking’ (Creswell, 2014). Participants’ contact information was collected
at the time of the interviews and my cellular number was provided so research participants
could contact me with any questions about the research or to call me if they did not hear from
me to review the transcripts of their interview. I wanted to ensure that they had a way they
could reach me if I could not reach them. Once the transcripts were ready several attempts
were made to contact each woman in the manner they had indicated in the interviews, to
provide them with a copy of their transcribed interview and to do “member checking” to
ensure their words and voices were accurately captured. Although I was able to leave
messages for each of the participants, only three got back in touch. Two of the participants
wanted to see their transcribed interview and these were provided to them. A few weeks later,

44
I attempted to make contact again with these participants several times to see if they had
corrections or changes they wanted made. One of the participants returned my call with a
correction; a word was misheard on the recording and this was corrected in the original
transcript. None of those reached were interested in reviewing the themes that I identified in
their interviews.
Reflexivity -The Place of the Researcher in the Research
The research method for this thesis is influenced by the concepts of researcher
reflexivity and researcher location in “the space between” (Corbin Dwyer & Buckle, 2009).
This research attempted to collect information from first-person reports in the form of
descriptions, prompted by semi structured interview questions, with the intention of gathering
the meanings and essences of individuals’ experiences (Creswell, 2014; Moustakas, 1994),
through a process of thematic analysis. While attempting to minimize my personal influence
on the data, I recognize that suspending my own experience and opinions is not realistic or
even possible. The research process of data collection and analysis used was filtered through
who I am personally and who I am as researcher. “How we write… and how we do research”
is a reflection of “the cultural, social, gender and class and personal politics that we bring to
the research” (Creswell, 2013 p. 215). I tried to be very self-aware: one of the ways I
attempted to do this was to make notes in a journal, to use as an audit trail for the data, but
also to note my feelings and thoughts around the impact of my social location on how
interviews unfolded, on the interview data collection process, and on the outcomes. In this
way, I attempted to reflect on the part I played within the research process, and how I
influenced the interviews and the subsequent thematic analysis of the data (Creswell, 2013). I
acknowledge that my life, work as a social worker, education, and family situation interacted
with the research, and the way I saw and interpreted the data, which inevitably impacted the

45
findings, interpretations, and conclusions I came to (Creswell, 2013; Shaw & Holland, 2014).
I can identify both as an insider (being a service provider with work-related experience with
homeless individuals), but ultimately as an outsider, as I have never been homeless or lived
many of the experiences that the women I interviewed have lived. For this reason, the
concept of researcher occupying the “space between” resonates for me because “the intimacy
of qualitative research no longer allows us to remain true outsiders to the experience under
study and, because in the role as researchers, it does not qualify us as complete insiders”
(Corbin Dwyer & Buckle, 2009 p.61), therefore we can only ever occupy the space between.
Triangulation -Audit Trail
Attempts were made to adhere to the seven steps of triangulation, as outlined by
Farmer, Robinson and Elliott (2006) “sorting, convergence, coding, assessment, review for
completeness, comparison and feedback” (p. 372). This was done by reviewing the journal
notes I made following the interviews that summarized the key points from the interviews.
The data was sorted by ideas and then these were examined for convergence in themes which
served to triangulate the data (Creswell, 2014). As well, any “discrepant information that
runs counter to the themes” (Creswell, 2014, p. 202) was noted and attempts were made to
provide a “rich thick description” of the themes and various perspectives to “add to the
validity of the findings” (Creswell, 2014, p. 202).

46
Chapter Four: Research Findings
Demographics
Some demographic information was collected during the interviews from the six
women participants who had personal experience with being homeless. This data was
gathered using a series of questions (Appendix B) to have some sense of the background of
the lives of the participants. This was felt necessary for the purposes of setting the context in
which to understand the outcomes of the thematic analysis of the interviews held with the
participants.
Figure 1 lists some of the demographic and other information collected. The six
women interview participants for this research ranged in age from 51 to 68 years of age. Four
of the six participants self-identified as being of Aboriginal or First Nations heritage and all
four stated they had First Nations status. Two of the participants identified as being of
Canadian background. Two spoke of currently being in relationships with men though they
were not living with them and the other four indicated they were single. One was widowed
29 years ago. All except one had stayed in a shelter or in transition housing or had couch
surfed with acquaintances or friends in the past 6 months and all identified as having been
homeless at least one time, and in most cases, repeatedly over the last 5 years. Two had just
recently found market housing, two were living in transitional housing and two were staying
in shelters. One participant was in receipt of Old Age Security (OAS) and Canada Pension
Plan (CPP) benefits. The other five participants were receiving provincial social assistance
with two being on regular provincial hardship assistance, one with provincial Persons with
Persistent Multiple Barriers (PPMB) status and two with provincial Persons With Disability
(PWD) status. One participant completed elementary school, three participants had
completed up to grade 10, another finished grade 11, and one participant had some college

47
training. Two were currently taking courses with the Street Humanities program through the
College of New Caledonia (CNC) in Prince George, BC. Five of the six participants had
children; four had adult children and one participant had one child, a teenager.
Figure 1. Demographic Information

Notes: OAS = Old Age Security; CPP = Canada Pension Plan; PPMB =BC Persons with Persistent
Multiple Barriers; SA = BC Regular Social Assistance; PWD = BC Persons with Disabilities.

Themes
Three overarching themes were identified through the process of thematic analysis of
the data from the six participant interviews: #1-Loss and Disempowerment, #2 -Navigating
Services, and #3 -Resilience. Under the theme Navigating Services, two subthemes were
identified: a) What Is Working and b) What Is Not Working. Under the subtheme, What Is
Not Working, three subtheme components were identified: (i) Barriers, (ii) Interactions and
(iii) Gaps (Figure 2 and Table 1).

48
Theme #1 -Loss and Disempowerment
During the interviews, most of the participants identified experiences of loss and
disempowerment which were impactful events influencing the course of their lives and
playing some role in leading them to periods of homelessness and their current
circumstances. Though not directly asked or explored during the interviews, references to
experiences of grief and trauma were interwoven throughout the responses and stories.
Elements of this are seen in the following excerpts under the theme of Loss and
Disempowerment.
Figure 2. Themes

#1 Loss &
Disempowerment

a) What is working

i) Barriers

b) What is not
working

ii) Interactions

#2 Navigating
services

#3 Resilience
iii) Gaps

49

Table 1. Themes, Subthemes and Subtheme Components
Themes

Subthemes

Subtheme components

#1 -Loss and disempowerment

Topics
Housing; Employment;
Relationships; Autonomy;
Health care.

#2 -Navigating Services

a) What is Working

Supports; Shelters; Health care;
Activities.

b) What is Not Working

(i) Barriers

Connecting with services;
Bureaucracy; Client centred
services; Poor fit.

(ii) Interactions

Police; Lawyers; Health care;
Shelters; Service users.

(iii) Gaps

Things to do and places to go;
Housing;
Transportation; Storage;
Health care; Free resources;
Service user input.

#3 -Resilience

Education; Employment and
volunteer work; Self identified
strengths; Growing older;
Advocacy and self esteem.

50

Housing
One participant highlighted the loss of stable, safe housing, which she had been so
happy to have, due to health issues (poorly controlled diabetes), as well as her limited income
through the provincial PWD social assistance program.
I’m used to not having a permanent residence because I did live at [residence]. I had
an apartment there. They actually made me go back to [shelter name] from the
apartment which is too bad because I had my own nice place there. They said
because of my diabetes and my sugar going so high and stuff like that. They’re
worried I’m going to pass out and go into a coma because it’s already happened four
times.
I thought at [residence] I was settled there. You know, I made it all homey and cozy
and everything and now my room is just, there’s nothing in there, just my bed and I
have a dresser in there. I’m tired of feeling like I don’t have a permanent residence.
Because they kind of made me move back to [shelter]. But again, it works a little
better because I was having trouble supporting myself at my apartment…paying my
cable bill and food.
Employment
A participant spoke of her inability to work anymore due to her health issues.
Well, I did like a lot of seasonal work …. picking and peeling logs. Yeah, and other
than that I did mostly chamber maid and waitress… Lived on tips. But that’s been a
long time. My legs are screwed and you know, … I walked today just to [pharmacy]
from 7th. Anyway, I got home and my legs I barely made those stairs. And I get
sometimes really weak, I don’t know what it’s from, but that’s how I was today and
I barely made it. Like I used to walk all the time and my legs never bothered me.
They feel weak plus I get a lot of pain in the back here and in my knees now so I’ve
got to lose some weight for sure. Maybe that’s why my sugar is up too. Yeah, cause
really the stuff that I’m eating there is not the healthiest.
Relationships
One participant reported that periods of episodic homelessness began for her when
her husband died nearly 30 years ago. He was the breadwinner and looked after paying the
bills.

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I’ve had a lot of experience. Since my husband died, I find myself homeless a lot of
times. I couldn’t cope. I’m not used to doing stuff, like my husband did everything.
We had our own home. He paid the bills and I just, he told me he’d look after those,
he said my job was to look after the home and the kids. And that’s what I did. I
didn’t even know how to pay bills or nothing. So now I gotta learn to budget and I
hate that word.
Another participant spoke of the breakdown of her marriage; “Married but separated.
[for six years]. Yeah, he wanted a divorce but I wouldn’t give him one.” This same interview
participant spoke of family dissolution resulting in no contact with her grandchildren for
some time., in response to the question “Do you have any grandchildren?”
Yeah, but I haven’t seen them because they were taken away by my son-in-law. He
kidnapped them. I had them for, well since they were little, but I haven’t seen them
since they were little. But one is here though. Apparently, she turned out really good
… It’s been a long, long time. Well, she’s, I think she’s 21 and I have a
granddaughter that lives in Vancouver and she’s just messed up [unclear]. She’s 22.
This participant spoke of wanting to live in closer proximity to her daughter. “I’m
hoping to move to the Island, actually. It’s so expensive just to move and even if I don’t
move there, I just want to go visit my daughter.”
Another interview participant reported that she had no family she could rely on at all.
“Single. No children, no dependents. No support system of any kind. I have a half-sister and
half-brother that disowned me upon my mom’s death.”
Another interviewee described relationship breakdown as being directly connected to
her loss of housing.
I shouldn’t have been homeless. No, because both times it was my boyfriend. We
split up and yeah, well I had to leave cause he’s packing up clothes so I had to leave
too…because I couldn’t afford to get a place right away.
Another spoke of the difficulty of having to carry her belongings with her all the time
and not having her own place to keep them safe and getting along with others. “Well, I was

52
packing my stuff around. And then the ignorance of people that you thought were your
friends. You find out that they really aren’t.”
Autonomy
One woman talked about the challenge of not having control over time and activities
when homeless, as well as the challenge of not having her own space to do things when and
how she wants.
Yeah, just put your feet up and watch a movie if you want or eat whatever time you
want. Or take a bath whenever you want. Eat the food you want. Instead of having a
certain time to eat. You’re on the clock all the time. It’s like you’re at work but
you’re homeless. You have to …. run over here, get some sandwiches, then I gotta
run over here. It’s like you’re on a clock. If you want to eat, you’ve got to run.
Another spoke of not being able to do things for herself like she can when she was
housed. “Oh yeah, when I have my own place, I do all those things [cook, grocery shop], I do
my own laundry.”
Another participant referred to her loss of independence without a home and kitchen,
since she cannot cook the food that she might be able to get from the food bank. “Well, I
can’t right now ‘cause I don’t have a place to cook.”
When asked about what it is like having to stay in a shelter, one participant said “I’m
very frustrated in there. I don’t like being there. It’s hard.” Another one said:
Oh, I hate it but there’s nothing I can do about it. Well, you know what, when I get a
home, I’m going to look after it, because being homeless is terrible. I will not go
through that again. I know. It’s degrading. It’s terribly degrading being homeless.
Living in a shelter at my age.
Another interview participant talked of the difficulty following someone else’s
imposed rules: “I’m sick of rules. Like at [residence], I thought oh my God, there’s so many
rules here, but they said I was a model tenant.”

53
Another spoke of homelessness as “It’s a rough life.” She recently has secured
housing after many months of homelessness and because of it reported that “I’m so happy
right now.”
Another talked about the challenge of not having a choice of where to stay and having
to stay in a shelter with some people who talk about their substance use:
Cause I used to be an addict once upon a time. But I just get frustrated and I tell
them drugs don’t belong in here when there are people who are trying to stay clean.
Go talk about your drugs elsewhere, so we don’t have to hear it. It just gets very
frustrating.
Another participant relayed the challenge of having to stay in a place where others
use drugs and alcohol, but also to the fact that she felt avoided by other women:
Very rough. Well, you know, there’s women that drink and do drugs and when they
get mad, it’s pretty rough. And basically, I keep to myself because other women
they all know that I’m Christian and I just noticed that they don’t, they shy away
from me, that’s all. It’s sad it’s like that, that’s okay, it’s their choice.
Health care
One woman talked about lack of control regarding her health care:
Yeah, they got women doctors. So, I go there. It’s okay. They’re very good there
because they don’t do anything you don’t want to do like I’ve never had that with
male doctors before. They never gave me options or anything. They just told me I
had to do this. They even told me I had a sickness, one said I have diabetes and I
didn’t even have diabetes. That’s a doctor told me that. I argued with him about it.
He said “you have diabetes.” I said “no, I don’t.” And he said “yes you do” and we
argued back and forth like that. Can you imagine that? Argue with a doctor.
Theme #2 -Navigating Services
Many of the issues that came out of the interviews were to do with experiences and
what did and did not work for participants when navigating through systems to meet their
daily needs such as for food, shelter, clothing, finances and health care.

54
Subtheme a) What is Working
There were many instances mentioned during the participant interviews of positive
experiences navigating and accessing services and interacting with service providers. These
examples of service access and delivery working well are highlighted below as the subtheme
“What is working” with examples quoted from the participants’ interviews.
Supports.
Several women spoke of the availability of places to get free prepared food and free
food hampers in the community:
You can’t starve in this town. Like you can go to [ shelter name ] or stay overnight
there and have breakfast. Or you can have breakfast at [soup kitchen name], go in
the sandwich line at night. On weekends, you can go and get sandwiches at 2:30
every Saturday and Sunday. [ shelter name] has good meals and the [drop in centre
name]. But you just have to walk around.
Another spoke of sources of food: “There’s a lot of places like [organization name]
kitchen for meals and sandwich lines. Even a vegetable line.”
Another spoke of getting assistance from an advocate’s office for “my income tax and
to get clothes. And just to use the phone. It is good.”
Several interviewees talked about securing transportation assistance. One spoke of the
assistance provided to older woman who have mobility issues at one of the shelters: “They
always help those elderly women. They can’t walk good sometimes, they always give taxi
vouchers for those older women to go to their appointments, or they’ll take them there
themselves.” Another spoke of her personal experience with this. “Well, actually they
[shelter] usually drive me places. Especially, you know, if I ask them. Or they give me a bus
chit, so that’s really handy.” And another also mentioned receiving assistance with bus
tickets. “They [shelter] usually give me bus tickets when they have them.” Another

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participant spoke of her positive interactions with the bus drivers. “Oh yeah, the bus drivers,
they’re always teasing me.”
Shelters.
One participant spoke highly of the treatment of the clients by the staff at one shelter:
They’re very good with all age groups. As far as I could see, they get along with
everybody, they treat everybody with respect. Yeah, but it’s nice to be treated with
respect because most of us, we’re not used to that. They try to help us in every way
they can. In some ways, they’re strict which is good. It’s only expected, but you
know, in a shelter especially where there’s drinking and drugs, it gets rough. But
they always can phone the police, so that’s okay. There’s nobody really at risk so
that’s the good part.
Another participant talked about the willingness to examine, take feedback and
improve services on the part of some agencies:
“I think [shelter name] tries. Yeah, and like a lot of places, they’re always trying to
better themselves. Especially the [drop in centre], I’ve seen so much stuff they did to
improve. People can give their opinions. They used to have a [comment] box.”
Yet another spoke of having had to use a transition house in town. “Oh I liked it there.
Yeah, they’re really nice. I felt safe.”
Health care.
Several of the participants mentioned they were happy with aspects of their health
care. One spoke highly of her doctor because she felt he was thorough and efficient:
Oh, good. He’s a good doctor. I like him. He gets right on top of things. He says
okay I want you to go get x-rays on that leg of yours because it sounds like it’s
broke, or I mean something’s wrong inside my leg.
Another woman reported being happy with her health care because she can now
access a female provider which was very important to her and makes the difference in the
frequency or likelihood that she will access health care:
I find it’s good. Before I didn’t feel comfortable with male doctors because I felt like
they couldn’t understand how I talked to them and like try to explain stuff and they

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don’t understand. But now that I’m going to a female doctor. I feel a lot better. I
could tell them what’s bothering me and they understand.
Another participant said, in reference to her family physician: “He’s a nice person, he
tries to be nice.”
Another interviewee expressed satisfaction with care for her diabetes in the past: “Oh
the diabetes centre in the hospital. Actually, I should go see them to get all checked out
again. They’re really nice.”
One participant preferred to access health care services from a female health care
provider who regularly comes to a women’s drop in centre, where she spends time and
volunteers, rather than having to go for appointments at a medical office or clinic. “I see a
doctor through where I volunteer at the [drop in centre]. They’re really good. I just see her
and she just faxes it in. I like the way I am doing it. Because then I don’t have to deal with
them [doctors office /medical clinic].”
Activities.
One woman was very pleased to be participating in a collaboration between a shelter
and a local college that provided education and other helpful benefits:
I have a bus pass, until the end of March. Yeah, I ‘m in this program now and they
give me a bus ticket so I can access all these places now, but before that, I had to
scrounge around to get bus tickets and just to go up to [food bank]. Plus, you get
supper every night too. Yeah, tonight, like when I go there, they buy you dinner.
One participant spoke of the challenge of trying to keep busy during the day and that
the library is one of the places where she spends her time. “I go to the library. I love the
library.”
Another spoke of a regular event she attends. “Yeah, I went to the Elder’s luncheon at
the [organization name]. My sister and I always go. And they have a really good lunch.”

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An interview participant explained that she had very recently found housing. When
asked if she found it on her own she responded, “No, they found it” in reference to assistance
she received from a local Housing First program.
Two of the participants mentioned their appreciation of an organization for women in
the sex trade, and one spoke in detail about the services provided by them.
They’re doing pretty good. I think they’ll need more funding ‘cause they don’t get
enough funding for us, sometimes we can do treatment, or a program or something
and maybe get paid.. We do a lot of stuff. We do art …we can watch movies or if
somebody needs to sleep, they can sleep. I like that place a lot better than [another
agency name]. Too bad [drop in centre] it’s small.
Subtheme b) What is Not Working
The interviews also revealed many challenges that participants experience in
accessing services. Examples of these taken from the participant interviews are grouped
under the subtheme “What Is Not Working” and include: barriers encountered navigating
existing services, issues arising from interacting and communication with service agencies
and service providers, and gaps in the existing services or the absence of services to meet
their day to day needs.
Subtheme component (i) Barriers.
This subtheme component encompasses examples of the challenges interview
participants identified in trying to access services that do currently exist in the community. In
some cases, this may be due to the way the service is delivered such as the processes, rules,
and eligibility criteria that must be navigated to gain access to these services. Of course,
services and agencies have their reasons for having policies, rules and systems in place. This
research did not explore these from the service provider perspective but was focused on the
clients’ experience with service provision.

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Connecting with services.
An interviewee described her difficulty getting timely service or responses, and
missed opportunities to connect with service providers with the following example.
Well, there’s a lot of services, but they don’t seem to get back to you, like with
mental health [services], I called I don’t know how many times. They never got back
to me for over a month or something, then, she was busy that day and I wanted to go
do some things. But anyway, she got busy and then I haven’t seen her since.
Another participant spoke of the difficulty getting through on the phone to make an
appointment with her family doctor: “I just gotta go, [in person, into the office] I was trying
to get hold of him this morning but he’s hard to get hold of. Yeah. they just, they’re so busy
all the time.”
The challenge one interview participant identified was the location of some of the
services she and others rely on and the difficulty getting to them: “But they should have
[food bank] down here where they used to.”
Bureaucracy.
An interviewee describes how she finds her physician’s office to be very rigid about
appointment times and lateness:
What makes me mad about them is I’ve been there, I get there either early or right
on time and if I show up there, which has happened I think twice in the last year, and
oh shit, there goes my brain injury, I don’t know what I was talking about. Oh yeah,
if I show up two minutes late I have to re-book my appointment…That makes me
really mad.
A participant interviewee described the eligibility barriers she faced trying to get food
assistance from the food banks as a single person:
Yeah, the [agency name], I was pretty regular there for a while, ‘cause it helped
supplement the food I was eating, healthy food. ‘Cause really, you get a lot of health
food from the food bank. I can’t do it anymore because I have to renew a card. I
forgot to mention on my bills to them …well I didn’t want to mention it really cause
it’s to the cash store, right. Yeah, well they said I’m making enough money that I

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shouldn’t have to go to the food bank, but like I can still access the bread line.
That’s the impression I got... And then with my cable and everything, they still said
I’m just right on the line or something. You’re only allowed to make so much
money.
Another participant mentioned the intrusiveness of the process required when seeking
food assistance:
No. The first question is what is your income? How much and then, you know, like
sometimes I run out of food and it happens to anybody. So, I go and ask for food
and I gotta fill out a questionnaire and then bring a letter or a bill … like why can’t
they just help us once or twice and tell us after that you have to start producing stuff.
Like help a person out instead of just, you know, that’s very degrading when we
have to go ask for help. And then they give us the third degree. They just ask what’s
your income and why are you here? How much do you get? What are your bills?
Onerous requirements for paperwork was identified as a barrier to accessing needed
services by several participants, such as with finding housing and accessing financial
assistance, and personal identification. One participant spoke of looking for housing and
encountering landlords wanting applications completed with references from their previous
tenancies. The challenges this poses for many older women can include not having references
as they may have been living under a partner’s tenancy in the past, owned their house and
lost it, or have no references due to unsuccessful tenant landlord relationships.
Yeah. It’s just where I used to stay before. I had to get phone numbers and dates and
I’ve got them in storage but I don’t know where. So, I’m just trying to guess dates
now. I’ve got a couple phone numbers so I’m okay now, I just have to submit that.
Another interview participant described a barrier encountered getting paperwork
completed by a doctor, a requirement for applying for PWD status and many other Ministry
of Social Development and Social Innovation (MSD & SI) benefits.
I don’t know what’s going on. Well, I have been trying and nothing’s been done.
Like I did a survey thing with the [clinic] downtown on [street name]. They keep
telling me they’re going to help me apply for disability and they haven’t done
anything. Yes, like I’ve been battling with that for years.

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In addition, one interview participant spoke of having finally found a doctor to take
her on as a patient but the physician did not feel that she knew the patient well enough to fill
out the paperwork that is required to apply for disability assistance.
I just got a doctor now at the [office] ‘cause it was hard for me to get in to see a
doctor. I had to go back to [community], hire someone to take me to [community] to
see my doctor and to get back to Prince George, so it was pretty costly, $100 for two
ways… the doctor I’m seeing now cannot fill in my book for disability because of
the fact that she don’t know nothing about me.
Some participants spoke of the challenges faced trying to access services from the
Ministry of Social Development and Social Innovation office and one participant described:
It was awful. I don’t know, they don’t care if you’re on assistance or not. They just
like, they don’t care. They don’t care if you get through or not. I waited this last time
for two months before I could get help. ‘Cause I was working or whatever, they
didn’t believe me … they wanted an ROA so I took that in so then they kept telling
me they didn’t get it, so, I thought oh my God. What they told me to do I did and it
was still, went on and on and on.
Another participant’s response when asked about how it is to go to the MSD & SI
office said:
I find it so stressful. I can’t deal with them. I get very angry with them. I swear at
them because they piss me right off. I just can’t deal with them. They make me wait
and wait and wait, or go get this paper and do this work, do that work. Like I can’t
run all over the place when I’m very ill. But I have to. I find it easier to talk with
them on the telephone than to deal with them face to face. The waits on the phone
are…they’re usually 45 minutes to 35 minutes. I’ll phone another day when it’s not
so busy.
Client centred service.
One participant said she feels there is unequal treatment and assistance by service
providers and agencies:
I had a bad experience from [shelter name] they stole $60 from me…and they
couldn’t even help me, like they said they help everybody and they helped my
cousin. He owed $500 on an instant loan and they paid it off for him and I asked
them to pay my storage fee, $60 and they didn’t want to help me. Yeah, so I said
thanks a lot, I said every time I ask you guys for help, you don’t help me. I asked

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them for a warm coat, oh we don’t have any. My cousin goes there, I need a coat, oh
here’s one, it’s a brand new one, it might fit you. So, I asked for boots, oh we don’t
have any. Yeah, they have favorites.
A participant recounted an incident where false assumptions made about behaviours
she was exhibiting, could have resulted in her eviction from her supported housing situation:
I almost got kicked out of [removed name] because I was walking down the hallway
and I was staggering and they thought I was drunk. Yeah, no my sugar was just
high. Like its weird cause when it goes really high, I get really tired and it’s high
right now, too. But like I said, it’s 27, but I mean it’s been a lot higher.
An example of a bureaucratic barrier to client centred health care is short medical
appointments and limits on how many issues a patient can raise in one appointment. It can
discourage patients from going to the doctor if they do not feel validated or heard, and feel
frustrated when all their concerns are not addressed:
He [physician] will only deal with one thing per visit. When you have multiple
issues, that’s hard to keep it to one thing. Then he gets frustrated, and he says, to be
fair it’s only supposed to be one per patient. How often do you want to see me? Can
I see you in an hour? You know. Some of it’s ridiculous too and it has to do with
how they’re paying the doctors. The doctors have gone through all that specialized
training and they should be getting paid for it but perhaps they’re being overpaid and
being greedy, some of them too. Very few, like the previous place I had which was
the clinic, allowed you three things per visit. Even with three things, I’d have a
paper full. One thing is bothering me which leads to another thing which leads to
another thing.
Another interviewee indicated her strong preference for female medical and mental
health counsellors and spoke of the reality that there is often no choice in whom they can see.
For some this means that they will choose to not access this service.
I’ve tried going to a couple guys[name of agency] and somebody else but they don’t
seem, I didn’t like them. I got not very good vibes from them. So, I swore off men
counsellors. You know, so I don’t want a male doctor either. I just don’t like having
checkups with a male doctor. I don’t feel comfortable with that. Never did. In the
past I just felt I didn’t have any say in anything.

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Poor fit.
An interviewee described the situation she was facing in not being able to access
homeless shelters with a pet. For her, this presented a barrier to her being willing and able to
access service, but it also points to a gap in service availability as many older women who
are homeless have pets for companionship or security.
When shelters do not accommodate client pets, a client can be faced with the heart
wrenching decision of giving up her pet or finding a place to sleep where the pet can stay
with her which can include unsafe situations or even sleeping outside. In order to be client
centred, some flexibility is required to take into consideration individual circumstance and
need.
Well, with women that do have a pet, they should allow them to keep their pet with
them because irregardless, you’ve got nowhere to go and I can’t, I’m not just going
to give my dog away when he’s part of my family. I’ve had him since he was a
puppy and he’s only a little tiny dog. He’s got his kennel. He’s not a barking dog. …
Like he’s a clean dog, I take him out when he needs to go pee and I clean up behind
him…. That’s not a problem. …It’s so stupid because I can have him during the day
and I can’t have him at night. That don’t make sense. Something’s wrong there. I
think it’s just them, they don’t want me to have my dog there. I don’t take him to the
kitchen. He doesn’t beg for food from anybody and he’s a well-mannered dog and
he’s well looked after. They wanted me to find somewhere to keep him. And I’ve
asked people, I said okay if you can’t do that, then I’ll sleep outside with my dog.
A barrier for some women to accessing services such as shelters (that can lead to
women couch surfing or unsafe situations) may be due to women using drugs or alcohol.
This situation may reflect a gap in service and suggests the need for wet and dry shelters.
“They’re supposed to be no drinking but the women they do and it kind of makes if rough for
those of us who don’t drink.”
One participant spoke of a barrier to housing she encountered that also indicates a gap
in service caused by a shortage of viable housing options. She felt she had to turn down an

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offer of housing for her own well being as she is trying to stay clean and sober and change
her life. This situation often arises where clients feel they are faced with choosing between
shelter, their autonomy or health.
They wanted me to move into [building name] but I don’t want to move there. I’ve
heard a lot of rumours that those women they’re still drinking, living there. So I
don’t want to be around that at all. It’s enough that I’m downtown now. So, I told
them I don’t want it. I said first of all I heard rumours about this place, and then I
said it’s on the [number] floor. I said what’s going to happen if there’s a fire or
something below me. How am I going to get down? I don’t mind a place like that a
high rise, but not the [higher floor levels] floor.
Subtheme component (ii) Interactions.
Interview participants recounted some good experiences but also many unpleasant
ones involving interactions and communication when accessing needed services. Though
negative interactions can be categorized as a barrier to accessing service, it was felt that due
to the frequency of it coming up in the interviews, its importance to the interview participants
and its critical relevance to client centred and trauma informed service provision, it is a sub
theme component of its own. Examples from interview participants describe interactions that
were a result of poor communication skills or disrespectful and discriminatory attitudes. In
some cases, participants experienced outright confrontational or even threatening interactions
with service agencies, providers and other service users. This situation is the opposite of
client centred or trauma informed practice and service provision. Clients may be less inclined
to access services and even give up on trying to obtain needed services due to the types of
interactions described below.
Police.
Several interviewees spoke of negative interactions with the police.
No, I’ve had bad experiences cause I’m an alcoholic. I don’t drink now, I haven’t
drank for two years but when I did, I ended up in the drunk tank and they weren’t

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very nice there. Then again I wasn’t either. I was drunk, right. …that was a long
time ago. … they were pretty rude. But yeah, when you’re drunk they treat you like
shit.
Another participant also recounted an interaction with police where she felt
threatened.
Oh gee, when I used to be drinking a long time ago, when I was young and up at the
drunk tank they’re pretty rough. My friend [name removed] she got, they put a
phone book on her face and they were punching her like that, so they wouldn’t leave
bruises she said. So, I just told that cop, I saw him going like that, he was getting
mad because I wouldn’t answer the questions and then I said, “Don’t even think
about hitting me.” I said “If you do, I’ll make a big stink about it.” Then he said “oh
I wasn’t going to hit you.” I said “liar.” So, they never touch me.
Lawyers.
A participant recounted her poor experience with a lawyer who worked on her
residential school settlement;
It wasn’t good. I didn’t like him. I was terribly disappointed with his service. He
never talked to me once. And that woman who was working with him, … she told
me I didn’t have to talk to the lawyer, then I just left and then I thought about it and
then I thought well, how’s he going to know what I want? I found that very strange.
Health care.
Several participants spoke of incidents where unpleasant interactions took place with
health care professionals when accessing care for their medical issues. One participant
described two separate incidents with different physicians: “I consider arguing with my exdoctor a bad experience. Another physician, a male doctor even told me you can leave right
now if you want, in a mean way. I told him I’m not going through that again.”
An interviewee described how she experienced the interaction between staff and
patients at the health care office she attends: “They’re always putting natives down. They
laugh at natives and discuss us, just cause we’re natives. Like they mistreat them because of
their health issues.” This participant later went on to say: “I think they should have meetings

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with their boss or whatever, their boss have meetings with them and make sure that
everything is done right or whatever. Like we don’t have to be treated like that.”
Several participants mentioned negative experiences with the staff at the Emergency
Department, as well as the wait and processing times while accessing services there. One
participant recounted feeling poorly treated and discriminated against for her health issues by
staff during a hospital admission.
Yeah, and they put me down to another room and I don’t know, the whole time the
nurses were real bitches there. I’m sorry but yeah. They’re really ignorant and rude
and made me feel like a piece of shit, to be honest with you. Like they wouldn’t
come near me or nothing ‘cause I have a health problem that is contagious but I take
care of it so nobody’s going to get it. Yes, they were, [treating me] really badly. And
I’m normally a really good person, easy to get along with, you know. And I tried to
be nice to them and they starting being really rude with me so I started being rude
back because I ended up staying there like a week and a half or something.
Another participant recounted a similar experience with the hospital staff.
The nurses were kind of ignorant. Like I was coughing and that one nurse covered
her mouth, like really rude. I just looked at her and I was in a lot of pain. I said oh
my God you’re ignorant. I thought nurses were supposed to be nursing, nice. You’re
sick already and you’re in there and you don’t want to be in there. They should be at
least courteous. I had to be admitted to the hospital and I think they put me in a
room. But I didn’t like it, the nurses were really ignorant. They should, because you
know the people that go there, they’re already sick or they’re hurting. They need a
little of, like, you know, compassion. Not rudeness.
Shelters.
A few of the participants spoke of their experiences as women over the age of 50 in
some of the shelters in town. When asked how they found the services, some reported
positive experiences as outlined earlier, but there were also negative experiences, along with
some mixed and contradictory experiences: “It was alright. They treat people pretty bad
there, they’re rude and they’re mean. But then again they’re funny and they always joke
around. I find them kind of rude.”

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Another interviewee described some of her shelter experiences.
They’re pretty mean there, they’re not very nice. Like how do you say that? [shelter
name] they’re nice to you, you could tell [a different shelter] you could tell when
they don’t seem to like you. They don’t smile, they’re not polite at all. They’re just
abrupt. I don’t think that’s right. I feel like telling them you shouldn’t be here if
you’re going to have an attitude like that.
Two separate participants described similar interactions with some shelter staff:
Some of them are very rude, some of them are just not very nice workers, even at
[agency name], …], we ask her to do something and she treats us older people like
we’re, she’s better than us. She’s not very nice at all. She favors a lot of other people
and nobody likes that woman, [staff name], in that shelter. Not one girl likes her. So
we all put in a complaint about her. I get very angry and it’s an instant hate with that
tone. … she treats us like we’re a piece of shit, like we’re nothing, we’re nobodys.
She’s better than us. She uses a power trip as far as I’m concerned.
And the other participant said:
It’s bad. They look down at you. They treat you like a kid. And they do things that
you’re not supposed to do, like they either kick you out or they tell you go for a
walk cause they’re trying to correct something. They always talk like they’re not
helping, they’re bringing you down instead of helping you. And it’s hard for most of
them, they lose their stuff when it’s not necessary. Just goes in the garbage. And I
don’t think they keep stuff confidential. They laugh at clients. They talk about
clients. Like it’s getting worse. It’s not helpful, like it used to be really good but it’s
gotten worse now. …. Now it’s just not good at all. I don’t know why. And there’s a
lot of times where those employees, like they’re power tripping. Like they shouldn’t
bring their problems to work cause they mistreat the clients ... And a lot of times
they’re not doing stuff they’re not supposed to do. Sometimes I hear some of those
workers swear and I know there was a few times where there was money taken from
the clients. And that’s not fair that, we’re not being treated equally, like I even like
do a lot of stuff with cleaning and stuff in there, we’re always the same people
cleaning. And like I am always doing it to help them cause they give me a place to
say. But most of the time, the staff is no good. I hate to say it but it’s the truth.
…some of them are good and some of them are not. Most of them don’t belong
there. Like there’s a few ladies that are really good which is the outreach.
Service users.
Several interview participants spoke of challenges they face in their interactions and
relationships with some of the younger women living on the street or in the shelters. These
experiences can be barriers to older women because in order to avoid these difficult

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interactions, the women sometimes also avoid accessing needed services. One participant
said, “There’s a couple younger ones, they don’t like me. I ignore them, they ignore me”. An
interview participant spoke of rude interactions: “Oh, they’re very disrespectful. They’re very
disrespectful. They call me cunt or [unclear] whore. Excuse me? You don’t see me standing
out there. But yeah.” And another participant described threatening interactions with other
clients: “Oh, they’re ignorant. That’s the only problem I had with being homeless is you have
to put up with those certain women that are just ignorant. And they’re nasty.”
Subtheme component (iii) Gaps.
The final subtheme component identified under the theme “what is not working” is
that of “Gaps”. Missing or non-existent services or service delivery were recurrent issues
raised in the participant interviews. As mentioned earlier, there is often an overlap between
the subthemes of gaps and barriers. Barriers that participants spoke of are often indicative of
gaps in services or service delivery and often point to a problem with providing services in an
accessible client friendly manner.
Things to do and places to go.
A participant referred to issues related to rules at homeless shelters around access to
the shelter and dorms. This points to a gap in services for those who are older or sick and
would like the opportunity to rest during the day.
Years back when we were there, we could come and go which was nice. We can’t
even do that anymore now. They lock the dorms. From 10:30 in the morning to 7:00
in the evening which is just sort of all day and when we ask them to even put
something in our room for us, they won’t do it. Sometimes some of them are good
and sometimes…There used to be couches and stuff, they took all that out too. They
just have chairs and tables now. And most of the time there’s seniors sometimes in
there. Like there’s a senior in there now, they won’t even let her…Sometimes they
won’t [let her go to lie down in the dorm]. And there’s a lot of girls that are sick,
they won’t let them go in.

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Another participant spoke similarly about the rule of no access to shelter rooms
during the day.
There’s a woman there, she’s a native woman, she’s got to be close to 100 but they
still won’t let her go in the rooms during the day to go have a nap. So, she’s just got
to fall asleep at the table. So that’s not right.
The requirement for people to leave the shelters during the day means the clients have
to find things to do and places to go to stay warm and out of the elements. Several
participants referred to this and one said; “Yeah, some of us we’re searching for a place
where, you know, that makes time pass by quicker.”
Another spoke of a resource that just received additional funds to stay open.
I like going in there, making things and they’re all so nice there. And the dinners.
Because of all those homeless people, they have nowhere to go. They get kicked out
of their shelters where they sleep and then so they have no place to go except for
[drop in centre] and [soup kitchen].
Housing.
One woman voiced her concerns about the type, size and scarcity of subsidized
housing or assisted living accommodation options for older persons in Prince George. “And
then those old folks home, they put you in a mini room. The closets are that big. Where your
clothes is.”
Another participant suggested a solution to the affordable housing scarcity. “Yeah, I
think they should have more places like [transition house], they’re all $375 a month and I
think they should have like a big building like the men’s shelter.” When asked about finding
housing for the shelter allocation amount from social assistance her response was; “For $375,
you can’t.” She listed the options to rent for this amount that she was aware of;
Rooming houses, the floor at [shelter] or [apartment building], [transition house],
[shelter] upstairs. Yeah. And not very many, they should have a big building for

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women that are older and I think just these poor women, you know, want to live,
right. And to see the depression when they come downtown. It’s terrible.
One participant spoke of social assistance rates being too low to be able to afford
housing and this had led to a period of homelessness for her: “Cause it’s usually direct
deposit but they don’t give me enough to live on. My rent when I was renting his trailer while
he goes to town, it was $500 a month. So it’s stupid. It’s hard to live.”
Another participant spoke of social assistance being too low to be able to afford the
apartment she recently moved into with her son but that she was fortunate to be getting a
rental subsidy for the time being through a community program:
It’s the government, they just don’t give enough. Like um, good thing for [program name],
they’re helping me for a year ‘cause I have my son now and they’re giving me a supplement.
So that helps out with my rent, then I have more money for food, plus I can go to the food
banks.
Another participant reported: “It’s very hard, like the rent is way higher than you get
from income assistance. Way higher. And that makes it hard. Whereas on my own I had to
always rent a place, like a rooming house or something.”
The need for separate shelter arrangements for younger and older women was also
identified as a gap:
Yeah, I think that they should have a part in there, in [shelter], for the younger
women, like when they get to stay on this side. Like this side is way better than the
big room where you’ve got to go share. But if you scrimp on the rules and that, then
they put you back over the in the big one. So you had to earn your way. And I think
they should put the younger women and us older women separate cause those
younger women, I think they have to be in by 1:00 so they’re coming in at 1:00 in
the morning and even 7:00, you know, going in and out, in and out. Can’t sleep. The
doors are closed. If you’re out you can’t get back in until 7:00.
Yeah, and even if you get to come in at 7:00 or you do, you can’t come to bed, you
have to stay up (laughs). And then they’re all mad. They get angry with the workers
and that and I said well gee it’s your own fault. They don’t want them to stay out
there all night.

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One participant mentioned crowding at a shelter: “Yeah, they crowd the room though,
they put a mattress on the floor. I think if the fire department seen that, they would disallow
that. It’s not safe.”
Transportation.
Many participants mentioned the difficulty and expense of getting around to
appointments, to find housing or to be able to access the social and other services that they
rely on to get by. This represents a gap in service due to the unaffordability of transportation
and represents a barrier making it more difficult to access services.
As a brain injury survivor, one of the participants spoke of having been connected to
a support service in the past but due to her mobility issues and lack of affordable
transportation said: “I haven’t gone since I was at [apartment building]. It’s too hard to get
there.”
Another spoke of the expense of travelling on the bus system which limits her access
to services. When asked if she had a bus pass she responded that she did not know how to
apply for the seniors bus pass program (discounted rate of $45 a year). “Well, I haven’t filled
an application so I pay $48 a month for a senior bus pass.”
When asked about how she gets to places another participant responded: “Oh, it’s
really hard like um, I have to scrounge around and get bus tickets here and there.”
Another mentioned that a shelter gives out bus tickets but:
They can only give you so much at the shelter, … it’s not fun trying to get tickets or
whatever to get around where I want to go. At times like when I need to be at the
hospital, I can’t sometimes. I’m always walking ‘cause it’s hard trying to get where
you want to go.

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Storage.
One participant who was homeless and staying at a shelter, spoke of renting a storage
locker to keep some of her belongings. “Yeah, I have stuff in storage. Gotta pay a monthly
fee for it. It’s my personal papers and some stuff that’s just household stuff. Furniture … the
big stuff is gone.”
Another interview participant who just recently found housing, talked about the
limited locked storage options at a shelter and the challenge of having to carry all her
belongings around with her.
Yeah, we have lockers. They give us a bin, plastic tote, and we got two lockers,
about yea big. You just put a code in. So you’re only allowed limited stuff and
otherwise stuff gets thrown in the garbage. Um, the biggest challenge for me was
when I was staying at [shelter name] I had to pack my stuff all over with me. And I
couldn’t get … more clothes or dishes or anything I wanted, … ‘cause I had
nowhere to store it and so that was a big thing for me.
Another participant also mentioned the challenge posed by lack of storage when
homeless:
I got lots of stuff stolen because they didn’t have lockers … some had lockers, or
you can store it down in the basement at [shelter name] but if you wanted something
out of there, you had to take everything. Yeah, they didn’t want you going down
there and getting stuff out all the time.
Another participant response to whether they had experienced a gap in resources and
services in the community said: “Yeah, transportation and lockers.”
Health care.
One participant described being flown to a hospital in Vancouver for health care, but
then becoming stranded there when she was discharged from hospital.
Oh, they just flew me to Vancouver… I stayed there a couple days then I had to find
my own way back up here. Stayed on skid row three nights. They told me before I
left that they’d fly me down but I’d have to find my own way back here. Like I was
too much in pain to comprehend that..

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Many of the participants spoke of the challenge of finding a family doctor, and going
without a family physician for long stretches of time after moving to Prince George, or when
their doctor retired:
I used to have Dr. [name] but he retired…Yeah, that was hard. I was doctor-less for
about six months almost a year, Yeah. Um, I went over to that, you know that
pharmacy or whatever over here. Right there. They told me to go to see Dr. [name]
Yeah, so he’s taking new patients.
Another participant’s experience:
For a long time, I couldn’t find a doctor. … what I ended up doing to find a doctor
was I went through the medical buildings, door to door, to find a doctor that would
accept patients and I tried like five others before I finally found mine. … But my old
doctor that I used to have here in Prince George before I went to Vancouver, when I
come back and asked, [doctor name] was the doctor, asked him if I could come back
on, he said I have 5000 patients already. Unless you’re here once a year to see how
your general health is, I can’t take you on. No matter if I like you and you’re my old
patient or whatever the scenario, I’m so overwhelmed with patients I couldn’t
possibly look at your case. Which is terrible. For somewhere that has a university
supposedly training doctors, why do we not have doctors?
Several interview participants mentioned that they had not had regular or recent eye or
dental care. In further discussion, it became evident that this aspect of health care is often
overlooked and that there are often financial barriers for older homeless women to access these
services. In response to the question about whether they had had a recent appointment with
these services, several participants said they had not but realized that they needed to access
them. In response to whether they had been to an ophthalmologist recently “No. I haven’t. I
should though, right? I’ve noticed since I’ve been getting older, I have to wear reading glasses
now so I should go get them checked.” Another responded; “No. that’s what I need.” During
the interviews, the issue of dental care also came up with several participants.
Oh yeah, like right now, oh my God, my teeth, this down at the bottom, right here, is
aching. The top over here, oh my God, my teeth are, I owe the [business name]
Dental $50 so it’s just, it’s a hassle. Because I missed an appointment. So, I have to
go pay that. I’m going to go do that this month. I always say that this month.

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There’s certain dentists now, they take down people’s status cards, so you’ve got to
be careful who you go to ‘cause you still have to end up paying. And sometimes
they don’t even tell you until after it’s done. You know, why didn’t you tell me this
‘cause I don’t have any money.
Another spoke of her dental care; “I got to switch back to where I was before cause
this [business name] dental place, new place, I don’t like it cause they only call you when
they’re ready and that’s like maybe twice a month. That’s no good.”
Another participant spoke of the challenges with eating the prepared food due to
dental issues faced by many women accessing cooked meal services:
Yeah, better meals or hire a better cook ‘cause the girl that’s cooking there, usually
serving us raw potatoes, half cooked and half raw, or carrots half cooked and half
raw. Like the girls are bitching ‘cause the majority of us don’t have teeth.
One participant spoke of the assistance she received through a local agency denture
program which was very helpful to her; this example points to an underlying gap in the
system whereby dental care is not adequately funded by the government, and the not-forprofit sector must attempt to fill the gap: “Yeah, they helped me get my dentures… that really
helped because welfare only paid half.”
Free resources.
Some of the participants spoke of the limits to accessing free resources from not for
profit service agencies in the community which likely points to the gaps in funding, public
donations and scarcity of resources.
“Yeah. Well, [thrift store], I got a table for free.” Another participant spoke about the
fact that this agency assists with start-up kits when people are moving into housing. “They do
and that’s a once in a lifetime thing too.” Another participant spoke of assistance she was
able to secure from a place she wanted to keep secret.

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I buy my own stuff because you have to qualify [meet certain eligibility criteria to
get assistance]. That’s why I always know where to go and I even found out some
other place that I’m not going to mention where I can get furniture free and it can be
delivered. I just found that out not long ago and I’m really happy with that.
Speaking about access to clothing, one woman stated:
To try and get something, like clothing to keep warm, winter boots or winter coat.
And I usually get told just like certain cheap stuff we can get, if it’s over $15.00 we
can’t have the boots. Like that’s crazy.
Several interview participants mentioned the challenges accessing food hampers at some
places as a single woman without dependents: “They say oh you’ve got to have family or
they don’t help you. Or you can go to stand in a line-up at this place to get food, so I just
basically stay wherever I get to eat”.
Service user input.
Interview participants were asked if they are ever consulted for their opinion on how
services are delivered. One participant simply responded “No” in general; another said “No”
that their feedback by the Ministry of Social Development and Social Innovation (MSD &
SI) regarding service provision has never been asked for. Two others responded with respect
to meetings held at a shelter they have stayed at saying that:
No, they don’t. [seek out clients input or feedback] Sometimes they put on a
meeting but nobody attends them. No matter that you voice your opinion, … nothing
happens. We have been to meetings where we’ve talked about the dealing and all
that goes on in there. The girls get kicked out for a certain period of time, 24 hours,
and then they’re allowed back in and it’s still the same thing. Why let drug dealers
in a shelter, you know, cause they’re dealing in drugs, they’re selling their dope in
there.

clients.

Another spoke about the challenges one of the shelters has holding meetings for
They have client meetings and they’re allowed to voice their opinion and
everything. …They wouldn’t listen anyways because like it’s hard, it’s really hard to

75
get along with other women (laughs). So you know and then they’re not even there
to see the results anyways. Well some of them.
One interview participant commented; “I think that would make a difference [if
service users were asked for their input and feedback on services] because then the more
answers the better. Cause they’re the ones that are coming to the service, needing the
service.”
Another spoke of trying to advocate for change and approaching shelter services with
feedback but to no avail.
Like the AC is still on and like a few times, there’s one senior and two girls, two of
us got sick. And we keep asking them, it’s still on. I don’t understand that. I’m sure
ways to go around it and fix it. For them to be like running a shelter and it’s not
done yet. Yeah, they don’t monitor enough.
Another participant sounded discouraged when she spoke of her own and fellow
service users’ efforts to advocate for change at the shelter: “I don’t know. I think something
should be done because we talk to the manager and whatever like it seems like they don’t
want to do anything. Yeah, it’s just getting worse.”
Theme #3 -Resilience
The previous themes outlined interview participants’ positive experiences with social
and health services in the community, but also challenges, stigma, discrimination and barriers
they faced while accessing these same or different services. At the same time, many of the
women interviewed spoke of determination to undertake actions to help others and to work
towards a better future for themselves. Patterns of resilience, perseverance, compassion and
hope for a better future ran through many of the participant interview accounts. The
following examples demonstrate these strengths under the theme “Resilience.”

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Education
Five of the six participants indicated that they wanted to continue their education and
skills training.
When asked about her level of education, one participant indicated that she had plans
to return to school: “I’m equivalent to a Grade 11 student. Yeah, I was taking up social work
as well. I’m going back to school hopefully in January, to get my social work. To be a
childcare worker.”
Two interview participants were currently attending the Street Humanities program at
the local college. One of them has her child living with her again after several years of
separation and she recently started this program:
Right now, I’ve got income assistance and I am planning on going, like I’m taking a
course at night. It’s Streets for Humanity and it’s for people that want to get back
into college life and get more education. That’s what I want to do.
Two of the interview participants voiced an interest in pursuing training in computers.
One explained that she felt people should be provided with opportunities to improve
themselves and not be limited by lack of opportunity because they cannot afford computers
and internet access. She spoke of the value to society of providing computer training to those
who cannot afford it like herself. She explained that if she were to get a computer and
training she would like to give back by volunteering her services to train others or help them
to access information and services online.
Why should I become a mushroom in the dark, just because I can’t afford it (a
computer and the internet) and I’m not allowed to afford it… just because you’re
broke doesn’t mean you can’t use your brain cells to take a class or two. What’s
wrong with learning new things, hey they might even get a job in the end from it.
…there’s a lot of people like me even that will take on 10, 15, 20 people and show
them how to run around the keyboard, how to run around the screen and use the
computer free of charge. I don’t need money, I’d be happy, you give me a computer,
I’m happy that I’m using it. …. I’ll show some other people how to use it in

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exchange. So it’s kind of trade system. If you help me, I’ll help you and I’ll help the
other 10 people that need help. And everything snowballs, instead of snowballing in
a negative way, it snowballs in a good way.
The other interview participant indicated: “I don’t do computers because I’m not very
good at it. I think that’s why I want to go back to school, the main reason to learn how to use
computers.”
In addition, this participant spoke of her frequent visits to the library because of her
ongoing love of learning and reading. She spoke of the loss of her book collection due to her
loss of housing as she was not able to store these books. “I read, I do lots of reading. I used to
have major books. I gave most of them away. I used to have lots of books. Mostly Christian
and about learning English and just learning stuff. Heritage, that’s another one.”
Employment and volunteer work
None of the interview participants were currently working in paid employment, but
several had periods of work within the last few years and two had worked in the service
industry as recently as 3 to 6 months ago. One of the participants interviewed volunteered
regularly with agencies where she also accessed services, as a way of giving back for the help
she has received and to keep busy:
I volunteer lots and like before when I was working, we were feeding the homeless.
I’m going through a lot of stuff right now. I have lost lots of family members so
we’ve been through a lot and I volunteer here and there and I keep busy. I’m a
people person … they seem to like to talk to me.
Aside from enjoying giving back and helping people she was hopeful that her
volunteer work could lead to employment opportunities:
Like I want to do a lot of stuff where, like to volunteer somewhere where … maybe
they can hire me on the payroll. Yeah, that’s what I’ve been kind of looking into
because they have to do a criminal check and stuff so I have a good background.

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During a stable period in her life another participant had plans to start volunteering
but then had a health crisis which set her back with her housing situation and also with her
volunteer plans, but she was still hopeful for the future: “Something like that I’d like to get
into. I got to the point though, just before I moved to [apartment building], …where I was
ready to go volunteering and doing this and that and then something happened.”
Another participant also described wanting to spend time volunteering:
I’d like to even go spend time with the elderly that need somebody to watch over
them anyhow. Play some cards with them on my spare time or something. Or show
them something, maybe they’ll show me something, maybe I’ll learn to crochet from
them, or how to do a preserve I’ve never done before. In the meantime, I can show
them how to use the computer or how to play a game or something simple on the
computer, so they’re comfortable. How to use a cell phone or how to access their
bank account and their information on the Internet that should be available to them.
So they can show me things. We can learn from each other.
Self-identified strengths
When asked what they felt their strengths were, several participants had responses.
One said: “Uh, my biggest strength is to help my Aboriginal people. My people and others.”
Another participant mentioned her perseverance with figuring things out and her
realization that respect and kindness towards others is important:
Yeah, I know how to access that, like in the past I didn’t know how to do anything. I
had to learn. I really had to learn and I found out that I have to be, you know, treat
people with respect in order to get back respect. Because I see meanness and stuff
like that all around me and then I become part of it and then I act like they do and I
don’t get good ….
Another spoke of the strength she finds in spirituality:
Well, being a prayer warrior is my greatest gift. My strength is my faith in God. I
know through God all things are possible. That’s what it says in the Bible and that’s
what I believe because I’ve been through a lot. Even my counselor told me I’ve been
through a lot and she said now you’re a very strong person. A lot of people tell me
that, I said what do they mean strong person? Because I’ve been through so much, a
lot of it is sexual abuse as a child and I don’t know how in the world I survived. The
Lord certainly was looking after me and I thank him often for that.

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She went on to speak of her past and evolution of spirituality for her:
Yeah, because in residential school we had to go to church every morning, twice on
Sunday but now I broke away from that, from Catholicism, now I’m a Christian.
And I find it much better now. I don’t go to church necessarily, sometimes I do but
not often. Like we don’t need to go to church to talk to God, so that’s what I learned
so that’s what I do, I read my Bible often.
A different participant said: “I’m resourceful and strong. Nobody else is going to
help. You have to do it yourself, fight for yourself.” Another participant responded: “I always
try to keep, try to think positive, always. Do stuff in a positive way.”
A participant spoke of learning from her life’s challenges and experiences, staying
positive and wanting to pass this experience on to help others:
Years back when I was 20, 21 I didn’t know what to do or whatever. But I learned
from my mistakes and I try not to go there. But I’m slowly getting the hang of it and
hopefully things will get better in the future. So it’s getting better…, especially with
friends or family or friends or even a stranger … I would help in any way …. I used
to do a lot, … there’s a few people of my people that were illiterate so I am that kind
of person, I always like to help.
Growing older
Two of the interview participants were just recently housed in market housing. Two
other participants were staying in shelters and two in transitional housing. All the women
interviewed had hopes and intentions of either staying, or eventually being, housed
independently. At the same time, all mentioned the difficulty finding appropriate, safe,
decent and affordable housing in Prince George.
Participants were clear that they had no desire to be homeless now or as they get
older. Participants generally had a hopeful outlook about the future and the possibility of
avoiding homelessness as they age. When asked about whether she had any concerns about
this, one participant responded; “No, because I know when I’m getting older I’m not going to
be in a shelter. I know that for a fact. Cause either way, one of my daughters will take me in.”

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This participant was staying in a shelter at the time, and reported that neither of her daughters
could house her as they did not have stable living situations.
This is another participant’s response to whether she had concerns about being
homeless and growing older:
Uh, well, sort of I sometimes think about it, but I’m pretty strong. I’m a pretty
outgoing person that deals with a lot of stuff. Like I say I always deal, like try to
think of it in a positive way. I don’t let it bother me (laughs).
Another participant’s response showed her determination for a better future:
And I want to get out of that mode because I don’t want to be, it’s not good to be
homeless, especially at my age, I should be a good example for others. Instead I’m
in a shelter and I don’t like that one bit.
During the interview, this participant reported that she had been homeless
episodically for many years but was adamant when she said: “… that’s the last time I’m
going to be homeless. I’m going to make darn sure it doesn’t happen again. I know how to
get out of it now.”
Advocacy and self esteem
A participant spoke of how she stands up for herself and others when she witnesses
things she does not feel are just. In this instance, she was speaking of the clinic where she
receives care: “Sometimes, I always speak my mind. I always tell them it’s wrong. I don’t
just blurt it out, I just say excuse me, like I just speak my mind. I just try to correct it.”
Another spoke of organizing a unified complaint against a shelter worker.
And I told them it’s not necessary to do that. …a few times already and I got a lot of
people to, like I sort of did a petition, sort of, cause it’s not good. And I’m hoping
that scared them a bit because I never seen that [name] there anymore after that. …
most of them, they shouldn’t be there when they don’t want to be there.

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When asked about her experience with services at MSD & SI, one participant
described a scenario dealing with the bureaucracy of accessing her monthly social assistance
cheque and her self-advocacy skills:
I said okay if I can’t get through with you, then I want to talk to the supervisor. I
said excuse me supervisor, can I please talk with you and he says well in a half an
hour. I said fine, I’ll wait right here for half an hour. I said … how the hell am I
supposed to get back to [community name] …Am I supposed to hitchhike? I said …
I can’t get any of the paperwork you want because it’s all in [community]. So they
said okay, well this time we’ll release it but then you gotta bring in all this
paperwork. So I did. And again, because I didn’t check off that there was no warrant
for me, they have my cheque again. … So I had to go and wait in that line, and I
can’t stand up that long, I sat down and waited and waited and finally got in. She
brought me my paper and I checked it off and I said oh my God it was that simple,
you couldn’t do it? She said we’re not allowed to. …. So then she goes, your cheque
you’re going to have to pick it up tomorrow … I said no I can’t do that you have to
get it done as soon as possible… and then the supervisor released it. I said because
I’m not going to come back here again tomorrow, I can’t do that. I said, so you
could’ve just put my cheque in my account instead of making me have to come all
the way back here again. I said so no I’m not going to keep doing this. I’ve never
had to do this living in [community], never. My cheque is always in my account,
always.
Another participant described her challenges but ultimate success with navigating
Service Canada and Revenue Canada systems:
Well, I went to the government office, I didn’t know, I found out on Friday I could
contact them myself. I asked them to change my address and they didn’t. And I told
them I need my income, how much I got, to do my income tax. So she got a hold of
them but she forgot to change my address and then there’s the mail strike and then
the government send me a letter and they said because we send numerous letters to
you, they sent two, and I phoned at taxation and they told me they can’t mail the
papers just yet because of a mail strike might happen so finally on August 14th I got
the papers. Then August 23rd, I had my income tax filed and then I phoned, I didn’t
know what else to do after that, I didn’t know so Friday I just went to that
government office and … I showed her that letter …, I said I don’t know what I
have to do, phone them or what? She said yes you should because she said they’re
the ones withholding the money from you. So she just dialed the number for me and
then I waited about 10 minutes and that was it. I did it! I did something for myself. I
was very proud of myself for that.

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One of the participants expressed an attitude of positivity when she discussed her
hope of getting into seniors subsidized housing, but also a feeling of confidence in her
abilities to come up with an alternate plan should this housing not come about:
Well, there’s always a back-up plan. Now nothing seems hopeless anymore. It’s just
I didn’t know how to access things. I didn’t even know how to do a lot of things but
I learned. So I’m not worried anymore. Everything is worked out. I was never
positive like this in the past. [Being homeless] Sometimes it’s a blessing. Cause it
wakes you up. It is a wake-up call. That’s what I took it as. Oh Yeah, I’ll find
something.
Older women participants in this research spoke of their positive and negative
experiences accessing social and health services in the interviews held as well as their
experience with loss and their strengths and resilience. The findings from the participant
interviews are discussed in more detail in the next chapter.

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Chapter Five: Discussion

In this chapter I will discuss the research findings presented in Chapter 4 in relation to
my own work experience and the literature; describe the challenges and limitations of the
research; review my reflections on the research process; make recommendations for practice
arising from the findings; explain the plan for knowledge transfer; and make
recommendations for possible future research.
Summary of Findings
The overarching themes identified through a process of thematic analysis of the six
participant interviews were Loss and Disempowerment, Navigating Services, and Resilience.
The interviews and the themes identified reveal some of the types of services
accessed, how older women participants experience accessing these services and how their
voices and needs are considered and integrated into service provision in a northern British
Columbia community. Missing services and issues with service provision were revealed in
the interviews and are reflected in the subtheme components of Barriers and Gaps and some
recommendations for improvements to service delivery are summarized in subsequent
paragraphs. Under the subtheme component, Interactions, some excerpts from the participant
interviews demonstrate examples of the power imbalance experienced by some clients of
services but also the resilience of the older women participants interviewed.
The experiences of loss, barriers and gaps in service, difficult interactions with
service providers, and resilience mirror my work experience. Many of the issues shared by
participants in the interviews were similar to those my work clients often ask me to assist

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with. These represent the challenges that older homeless women and other vulnerable people
face every day when navigating systems to access services they need to get by.
The findings also reflect what the literature explains about the interconnected
relationship between homelessness and trauma history, substance use, and mental health
challenges, since many of the interview participants alluded to or openly referred to having
experienced these issues.
Theme #1 -Loss and Disempowerment
The interview excerpts under the theme of “Loss and Disempowerment” point to the
experiences of trauma in addition to loss and include the following elements: loss of family
relationships (due to family breakdown, distance, or death); grief; loss of trust; loss of
employment (sometimes due to health issues); loss of income; loss of housing and
belongings; loss of power and autonomy due to homelessness; loss of ability to self-direct
activities of daily living (such as cooking, laundry, bathing, food choices, and mealtimes);
having to rely on others to provide services at their discretion, on their timelines and rules;
exposure to drug use, verbal and physical violence; loss of mobility due to health issues or
transportation difficulties; and loss of control around health care. In addition, some
participants identified loss of pride or feelings of shame about being homeless.
Women spoke of experiences which indicated, though not explicitly stated, that they
had a sense of disempowerment or loss of control over their own lives. The examples they
gave often indicated being in positions of power imbalance and powerlessness when having
to request assistance for their everyday essential needs from those service agencies and
service providers who are in positions to either help or deny help.
Many of the losses alluded to in the research interviews were remarkably similar to
many of the reasons for homelessness identified by individuals surveyed during a Prince

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George homelessness count (Pateman et al., 2016), and observed through my work
experience.
Theme #2 -Navigating Services
In the interviews, participants spoke of both positive and negative experiences with
services and this is captured by the theme, “Navigating Services” under the two subthemes:
What is Working, and What is Not Working which has three additional subtheme
components: Barriers, Interactions, and Gaps.
Subtheme (a) -What is working.
Some responses to the interview questions described positive experiences with
services and service providers. Several participants mentioned that there were many sources
of food assistance in the community in the form of prepared meals, special holiday suppers,
and food hampers. Some participants described positive experiences at shelters and transition
homes and felt that staff and management were kind, helpful and trying their best to make
improvements. Others described good experiences at two drop in centres where they could
pass the time with craft, educational and cultural activities, companionship, and refreshments.
Others spoke of how they were enjoying the challenge of Street Humanities, an innovative
education program offered through the College of New Caledonia (CNC). Several described
some good experiences with their family physicians or with health care services. A few
participants described receiving very useful assistance to successfully find housing through
an outreach program run out of one of the shelters. Others spoke of several service agencies
where they could access limited free clothing, furniture, bus tickets, rides, as well as free
income tax filing services.

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Subtheme (b) -What is not working.
Many responses to the interview questions described negative experiences with
accessing services and with service providers. These were found to fit under the subtheme
components Barriers, Interactions, and Gaps.
Subtheme component (i) Barriers.
Interview participants spoke of experiencing barriers to accessing services. These
included difficulties contacting services, government, and doctors’ offices sometimes due to
having little access to phones because of financial and living constraints (phone lines being
busy, long hold times, long waits for or very impractical and inconvenient service call back
times, etc.) These challenges have been discussed in the news and by advocates as well
(Brend, 2017). Response times from agencies and availability of service agency staff were
often described as barriers making it difficult for participants to obtain access to the services
they needed.
Due to challenges with transportation, unstable living situations, and limited phone
access, participants spoke of difficulties they sometimes face getting to appointments, and the
barriers that the consequences posed for them.
Participants talked about the inflexibility of some health service offices. Some dental
and doctors’ offices charge for missed appointments, or will not make allowances for
lateness; some will refuse to see clients again if they miss an appointment, or if they do not
pay the associated fine. Several participants mentioned the common rule that due to
physicians’ limited appointment times, only one or two issues can be addressed during each
appointment.
Several also mentioned the barrier they encounter when they have paperwork to fill
out, sometimes due to literacy and comprehension issues. This included having to have forms

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filled out by physicians (with associated fees sometimes charged), applying for housing
(providing landlord references), identification, social assistance, OAS and CPP applications.
The lack of choice in providers (particularly with regards to the gender of counsellors
or health care providers) can mean clients may decide not to access health care or other
critical and needed services.
The accessibility of locations of services was mentioned as a barrier, for example
when food banks and other services are not downtown near shelters or other commonly
accessed services or are out of reach for clients.
Bureaucracy, computer literacy issues, telephone, processing wait times and
eligibility requirements for assistance from non-governmental and government programs like
the MSD & SI were identified as big barriers for many, and are also reflected in the news and
by community advocates (Brend, 2017).
Women indicated that they may avoid accessing services if they are trying to stay
clean from substance use and they perceive a risk that accessing an available service may
mean being triggered to relapse.
Subtheme component (ii) Interactions.
The examples under the subtheme component of “Interactions” include
uncomfortable and unpleasant experiences interview participants described when interacting
or communicating with service providers and agencies. These experiences included situations
when interview participants were trying to access services they needed to meet basic needs,
including emergency services to keep individuals safe such as hospital care and police
encounters.
Some participants spoke of experiences in which staff at the hospital were rude,
discriminatory, and lacking compassion and sensitivity, at the emergency department or

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when being admitted to the hospital. Others experienced disrespect and rudeness from nurses
and doctors. Another participant spoke of witnessing discrimination where service users were
being treated unequally, rudely, were laughed at, and talked openly about by service agency
staff because they are Aboriginal.
In addition, participants described some staff at shelters as being patronizing,
unfriendly, uncaring and abrupt with shelter users. Some interview participants reported that
they felt services were provided unequally whereby some people were favoured and treated
better than others.
Underlying these experiences relayed in the interviews was the importance of how the
interactions made participants feel. It was often about how participants experienced
interactions and felt they were treated by others, particularly by those they rely on for
services to meet their basic needs and the social determinants of health such as, income, food,
shelter, and health care.
Subtheme component (iii) Gaps.
Excerpts from the participant interviews under the subtheme component of “Gaps”
identified several missing aspects in service and service provision. A shortage of places to go
and things to do during the day was mentioned by several women. Of concern was the lack of
places to rest or nap during the day if an older woman was tired or not feeling well and
needing to lie down to rest. Several women interviewed mentioned that shelters would not
allow women to access the rooms during the day to sleep.
Talked about by several interview participants was the unaffordability and the
inconvenience of public transportation including HandiDART, a door-to-door transportation
service for persons with disabilities who are unable to use the regular public bus. The BC

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seniors bus pass program does not cover the cost of $2.25 per one way fare, the routes are
convoluted and long, and waits sometimes lengthy.
Interview participants spoke of housing issues, high rental costs and low supply of
affordable, supported or subsidized housing options.
Low provincial income and disability assistance rates with their limited shelter
assistance, transportation, dental, and eyewear benefits, and inadequate federal Old Age
Security rates, were spoken about by participants, and are reflected in the experiences of
those I work with and are reported by advocacy organizations and in newspaper articles
(Citizens for Accessible Neighbourhoods & BC Poverty Reduction Coalition, 2017; Klein &
Reano, 2017; MacLeod, 2017a; MacLeod, 2017b).
Also mentioned by several interview participants, was the issue of storage of personal
effects. Related to this was the issue of not being able to keep personal belongings due to
lack of affordable storage solutions or a lack of storage space at shelters, when housing is
lost. There are few options for assistance with coverage of moving and storage expenses. As
a result, homeless women must carry their belongings around with them during the day or
risk losing them.
Mentioned in the interviews and encountered in my practice are issues to do with
family physician shortages, gaps in coverage for dental, dentures, eye glasses, medical
equipment and supplies, and prescription medications for older women, if they have aged out
of social assistance and do not have First Nations Status health benefits.
Many non-profit service organizations do their best to assist clients, but are usually
constrained by a lack of financial support. They must place limits on free resources such as
bus tickets, rides, clothing, toiletries, food hampers, furniture, and household items such as
bedding and kitchen items to those seeking assistance.

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Finally, women interview participants indicated that they are rarely asked for input or
feedback from the social and health services they access in the community. The prevalence
and significance of this is outlined in the literature (Elliott et al., 2005; Hopper et al., 2009;
Lived Experience Advisory Council, 2016; TIP Project Team, 2013).
Theme #3 -Resilience
The theme of “Resilience” ran through the participant interviews. Women spoke of
advocating for themselves or on behalf of others for improving services as well as to
successfully navigate through governmental bureaucracy to get assistance, like MSD & SI for
social assistance and Service Canada for; Old Age Security (OAS), Guaranteed Income
Supplement (GIS), and Canada Pension Plan (CPP). Several women spoke of their pride in
being able to successfully stand up and advocate for themselves, and, as a result, their
increased self-confidence.
Women participants demonstrated hope and determination for a better future for
themselves. Some spoke of wanting to give back to the service agencies from which they
received assistance by volunteering to help others. Others talked of their interest, and in some
cases current endeavours, towards continuing their education and skills training, and some
were wanting to find employment. Many of the interview participants were confident that
they would not be homeless as they got older and that, somehow, they would be housed.
They described their personal strengths including their spirituality, resourcefulness,
being independent, and their ability to stay positive.
Challenges and Limitations
There were several challenges and limitations encountered while planning and
undertaking this research. I have listed the challenges as finding interview participants,

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contacting interview participants, and honorariums. As well, there were some issues that
needed careful thought and special consideration during the planning and interviewing:
conflict of interest, re-traumatization, and capacity. The limitations identified were the age
range of the interview participant sample, and the applicability of the research to other
communities and population groups.
Challenges
Recruiting participants.
It took some time and effort to find potential interview participants. My initial
strategy included putting up posters and spending time at a Thanksgiving community dinner
and at drop-in centres where meals are provided and leisure activities take place. I
approached visibly older women and explained my research to see if they might be interested
in further information and in participating in the interviews. As I had hoped, after finding the
first participant, the process of recruiting other participants became easier, as participants
spread the word to other women, and the process of snowball sampling began. My sample of
interview participants for this research was composed of the first six women who were
willing to participate, fit the age, and experience-with-homelessness criteria, and with whom
I managed to connect at an appointed time and date for the interview.
Contacting.
Connecting and follow up with interview participants proved to be a challenge. In
several instances, it took multiple attempts and calls to set up the interviews. Five out of the
six women did not have a phone and used a community messaging service or agency number
where messages could be left for them, or email. In several instances, we played “telephone
tag” where messages were left back and forth but connecting did not happen. In some other

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cases, appointments were cancelled by potential participants and sometimes appointments
were rebooked several times before they took place.
Being homeless, having unstable housing and limited finances and often without easy
telephone access, the women interviewed were often difficult to contact, both to set up the
interviews, but also in follow up after the interviews to offer copies of the transcripts and
thematic analysis. This often meant multiple messages being left back and forth and, mostly
unsuccessful, attempts to reach the individual.
Honorariums.
The fact that refreshments, bus tickets, and an honorarium in the form of grocery
store gift cards were provided to participants may have biased the participation as this fact
was likely passed along from one interview participant to other potential participants, and
may have influenced their interest and willingness to take part in the interviews. Since a
snowball selection was used, whereby participants spread the word to one another, the
sample of individuals interviewed was not random. Women who were interviewed may have
approached those in similar situations or locations as themselves, thus potentially introducing
a bias to the data collected.
When conducting research with a population that is vulnerable and has limited
financial resources, providing material supports to participants could be viewed as
introducing an ethical challenge to recruitment (e.g., an incentive to participate could be
considered coercive, given participant circumstances and need for material resources).
However, I made the decision that it was only fair to have some reasonable degree of
recognition and compensation for the time given by the women who agreed to participate in
the interviews.

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Special considerations: conflict of interest, re-traumatization, and capacity.
An initial challenge proved to be finding individuals who fit the criteria and would be
willing to be interviewed.
I grappled with the ethics of having women I knew (through my work as a social
worker in the community) participate in interviews for my research. After weighing the pros
and cons in the search to find a balance between ethics and effective gathering of useful
information, I made the deliberate choice not to interview women who I knew I had worked
with. Although interviewing women I knew would have made the process of finding
participants easier, I decided that my approach was more straightforward, potentially less
fraught with ethical dilemmas, and most importantly would provide more anonymity,
confidentiality and perception of safety for the women interviewed.
Further, I did not discuss my search for research participants with fellow staff or
clients or put up recruitment posters at my workplace to try to avoid having to turn away
women that I knew. However, during the interviews one participant spoke of her experiences
accessing services from my workplace and another referred to a clinic that I could infer was
my workplace. Although these participants may have accessed services from my workplace,
they had not accessed services from me and we did not speak about where I worked. Since
the research was being undertaking for my studies I felt it was ethical to continue with the
interviews with these participants. I approached the interviews realizing that it was possible
that participants may access services from me or from my co-workers in the future. I was
careful to explain that the research I was conducting was for my own personal education and
not affiliated with any organization, my employer, or a paid job. It was also explained that
participation or information shared in the interviews would be used in a confidential way so

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as not to identify the individuals who shared the information. In this way, I sought to protect
participants’ privacy and not impact their future access to services.
Avoiding re-traumatization.
Serious consideration was given to the possibility that interviewing individuals might
delve into sensitive, emotionally laden memory and reminiscence, which could lead to retraumatization or could trigger or exacerbate substance use and mental health issues for
participants. In abiding by our code of ethics, social workers have an obligation to conduct
research in a responsible and purposeful manner and to “strive to protect research participants
from physical, mental or emotional discomfort, distress, harm or deprivation” (CASW Code
of Ethics, 2005). For this reason, the demographic information collection and the semistructured interview questions were designed to try to minimize the possibility of retraumatization or triggering of those interviewed. Though I watched carefully for it, I was not
aware of any serious issues coming up for interview participants during the interviews. In
addition, each of the women was provided a list of counselling resources (Appendix D) at the
beginning of the interview; they were also reminded of these resources after the interviews
and encouraged to access them as needed following the interviews.
Participant capacity and vulnerability.
For the purposes of this research, I felt it was important to attempt to capture the
varied voices of those who fit the participation criteria with the understanding that this was
likely to include women who had histories of substance use, mental health, and cognitive
issues.
My intent was to make every effort to ensure that each participant had capacity prior
to beginning the interview process. I felt confident in my ability to assess this because of my
work and personal experience. The determination of ability to consent was based on a lack of

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obvious visual signs of cognitive impairment or intoxication due to substance use (without
administering intrusive cognitive or substance use tests). There was no evidence of cognitive
impairment among the participants I interviewed.
Limitations
There are two main limitations of this research identified; age range and applicability.
Since the research was conducted in a small city in northern British Columbia, and many of
the services that women access here are specific to this community, the information and
findings may not be entirely applicable to other places, thus limiting its relevance to other
communities and other populations of older homeless women. At the same time, some
services accessed by interview participants, are provided by not-for-profit and by
governmental agencies, that exist province and even Canada wide.
Due to various possible reasons, including the sampling method used and the limited
sample size, this research did not capture the experiences of women over the age of 68, since
all but one of the participants were in their 50s. It would have been informative to have
interviewed more women over this age. Older women who have experience with
homelessness may have reported different experiences, barriers, and gaps to services than
younger women. There is a small but important and significant number of homeless women
above the age of 68 in our community, and I know from my own work experience that they
often have very complex issues and needs (Davis-Berman, 2011; Dietz, 2009; Pateman et al.,
2016; Salem & Ma-Pham, 2015).
In addition, as our population ages, this number of older women facing homelessness
may increase in the future, unless our social programs are expanded to keep pace with the
growth of this older demographic (Cohen & Franco, 2015; Killian, 2015; Morgan, et al.,
2015; Morgan, 2017).

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Researcher Reflection
I came to this research with very little experience planning and undertaking
qualitative research. The prospect of doing the interviews was daunting and locating research
participants was beyond my comfort zone. In the end, it was a positive experience as I
enjoyed meeting and talking with the women participants of this research. The thematic
analysis process of organizing my data and thoughts was much more complicated and
difficult than I had anticipated. As well, I realize that undertaking social work from a
structural orientation also impacted the categories, codes and themes that I ultimately
identified in the participant interviews.
In reflecting on, and in reviewing my journal notes made during the research process,
there were a few things that struck me. In addition, with the benefit of hindsight, there are
several ways I could have undertaken the research process differently as described below.
Expectations and Assumptions
It was challenging to try to suspend my own expectations and predetermined ideas
around the outcomes of the research. Though I tried to suspend judgmental or leading
comments, I realized in listening to the interview recordings that due to my inexperience, this
was challenging to do, and not always accomplished (Alston & Bowles, 2013).
I expected complaints, so I was surprised by the number of good things women
participants had to say about services in the community and by their positive outlook on life
and for their future, as well as by their resilience. What also struck me was the amount of
emotion underlying many of the responses in the interviews and how this indicated the
critical importance of how people are made to feel during and after the interactions they
have.

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Trust.
Though a process was put in place to try to ensure that the information shared by
participants would remain confidential, and participating would not affect the women’s
access to services in the community, many potential participants approached were unwilling
to take part. They did not share their reasons for not wanting to participate and I did not feel
it was appropriate to ask or to probe further.
The mere mention of “social work” or “social worker” can bring up unpleasant
experiences and traumatic memories for individuals, and make some people think
automatically of children and family services and child apprehension. This can affect the
dynamics between interviewer and participant, and alter the perceptions of power differential
and level of trust. I wondered at times whether this may have had something to do with the
lack of interest in participating in the interviews.
As well, despite my efforts to ensure privacy and confidentiality, it is quite possible
that participants may not have felt at ease to share their thoughts freely and those who did
participate in the research may have limited what and how they discussed issues in the
interviews. Why would older women with experience with homelessness trust me, a stranger
asking them questions about services, institutions, organizations that they rely on to meet
some of their most basic needs? Or was it a rare and welcome opportunity for interview
participants to share their experiences with someone who they saw as neutral? Either way,
my privilege, social location, gender, age, education, and class most certainly affected how
the interviews unfolded.
I cannot assume that I got full responses to my questions or that they were not filtered
through some degree of distrust. I cannot know for certain how comfortable the participants

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were to express their true sentiments about accessing services. At the same time, I believe I
did get some quite genuine, impactful, and informative responses.
Done differently.
At the outset, I was hoping to capture the experiences of a wider age range of women
participants in this research. In the end, the voices of women beyond their late 60s with
experiences of homelessness are missing from this research. This may be partially because
people over the age of 65 usually represent a fairly small percentage of the overall homeless
population, and older women represent an even smaller percentage than older men. This is
reflected in the homeless statistics for Prince George, BC (Pateman et al., 2016). In addition,
as outlined in the literature review in Chapter 2, it is known that homelessness seems to
accelerate aging and reduce longevity, likely because of the difficult lives people who
experience homelessness experience. To try to include this upper age group in this research, I
could have made the sample size larger, used a targeted sample selection strategy, or looked
more widely in my search for participants. I could have targeted this population age group by
seeking assistance from shelters, or other service providers and agency staff. However, if not
done carefully, involving service provider staff could have impacted participant anonymity
and may have contributed to biasing the results.
Personal Reflection
In my job as a social worker, it can be difficult to not feel overwhelmed and
discouraged in the face of the challenges that vulnerable populations face in simply trying to
live and get by. My work days are spent advocating and working through bureaucracy, trying
to problem solve, and make repairs with a patchwork quilt of solutions to temporarily fill
holes that exist in the system. Many of the experiences interview participants shared with me

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during the research phase mirror the realities of my clients at my work, who are facing the
systems in place. However, this research reminded me that there are good things happening
in this community and these are being experienced, observed, and appreciated by service
users. Some services may need some fine tuning to improve the way they are provided, but
much good intention exists and good work is being done by many good people with their
hearts in the right place trying to help. Even more of an impact for me was the evident
positivity and strength residing in many of the women I interviewed, reminding me of their
incredible resilience in the face of, what often seem to me to be, insurmountable challenges.
Sometimes I become mired in the injustice, unfairness, and inequity and I forget about the
hope and good things that are happening. The interviews with the amazing women
participants was a reminder to me of the good being done, and the dreams and resilience
within the clients that I work with daily.
Still, it is the older clients that I work with that concern me the most; the cracks they
fall through are numerous and deep. I see a lack of resources and money put into providing
services such as senior’s subsidized and supported housing, life skills support and home care
services and other arrangements to best suit the individual needs of older persons (Cohen &
Franco, 2015).
In my view, the solutions involve closely listening to older homeless people, with
respect for their ideas and feelings, recognizing them as the experts of their own lives, to
truly get a sense of their needs and to design services that fit and address these needs. It is
one thing for the government to say that older people should be encouraged to live
independently for as long as possible, and an entirely different thing to put in place the
resources to ensure they have housing and can successfully maintain quality independent
living. Resources need to be mobilized for older people to have the supports they require to

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live long, productive, and independent lives (Cohen & Franco, 2015). For older homeless
women, this starts with securing affordable, decent, appropriate housing.
Recommendations for Practice
Advocacy
Service users, providers of services, and the social work profession can provide
leadership to continue advocating for increased government investment in improving the
social determinants of health for older women which can in turn reduce poverty and
homelessness among older women. We should continue to push for improvements, such as:
the reduction or elimination of Medical Services Plan (MSP) premiums; for universal
Pharmacare to make prescription medications free for older people (Killian, 2015; Morgan et
al., 2015; Morgan, 2017); wage equity for women (Ivanova, 2017) ; universal childcare;
government compensation for time spent childrearing or caregiving of the sick and elderly by
a family member, both of which usually fall to women; fairer Canada Pension Plan rules
around eligibility and contributions (Ivanova, 2017); free or affordable transportation for
older persons; increased provincial welfare and disability rates (Brend, 2017; Citizens for
Accessible Neighbourhoods (CAN) & BC Poverty Reduction Coalition, 2017; Klein &
Reano, 2017; McLeod, 2017a; McLeod, 2017b); more affordable and subsidized housing;
increased numbers of publicly funded spaces and options in assisted living and complex care;
more low barrier housing options; increased resources put towards publicly funded supported
living, home support and home care services (Cohen & Franco, 2015); reducing violence
against women and elder abuse; increased funding for addictions and mental health services
for older woman; and homeless shelter services tailored to older women (Hopper et al.,
2009).

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In addition to working towards minimizing the gaps in services and service delivery
for older homeless women, the findings of this research around the themes of loss and
disempowerment and barriers to access, support the need for continued and improved efforts
at trauma informed service provision for older homeless women in our community.
Trauma Informed Service-Service Providers and Organizations
A recommendation of this research is for service agencies and providers to continue
to use or adopt a trauma informed service approach, described in the literature reviewed in
Chapter 1, as a “universal precaution” (Elliott et al., 2005). It should be assumed that women
who experience homelessness will often have histories of substance misuse and mental health
issues, combined with trauma histories, as the literature indicates (Peck & Capyk, 2012). This
approach includes providing services in a non-confrontational, non-hierarchical, or nonintrusive way (Harris & Fallot, 2001). It attempts to give service users a sense of self-efficacy
and control by providing choice and opportunity for input (Chambers, 2012; Elliott et al.,
2005; Hopper et al., 2009; Lived Experience Advisory Council, 2016; TIP Project Team,
2013), rather than providing services in an autocratic manner which may mirror trauma
experiences for women (Harris & Fallot, 2001). It means providing positive, compassionate
experiences to clients so that they will not avoid accessing a service thus endangering their
health and wellbeing (Chambers, 2012; Harris & Fallot, 2001). It may include the need to
shift perspectives to be able to view behaviours exhibited by service users as coping
mechanisms. Rather than defining individuals by their behaviours, it involves making efforts
to understand the root reasons for these coping mechanisms. This means not labeling or
blaming, and most importantly, not excluding people from access to services, but instead
providing services in ways that diffuse and deescalate these behaviours, and provide safety
and comfort to service users (Peck & Capyk, 2012). Trauma informed services treat service

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users in a collaborative, cooperative, and consultative manner, providing them with a say in
how and what services are provided (Elliott et al., 2005; Hopper et al., 2009; Levinson, 2017;
Lived Experience Advisory Council, 2016; TIP Project Team, 2013; Wilson et al., 2013).
Bowen and Murshid (2016) call for taking a step further, to encourage a wider social
policy change to incorporate a trauma informed framework lens when working with
marginalized populations where trauma histories are prevalent. Such a lens recognizes the
intersection of age, gender, race, social class, sexuality, and ethnicity, and that these multiple
marginalizations and vulnerabilities are predictors of trauma experience. It would
acknowledge the connection between trauma and the many health and social problems for
which people seek services. Ultimately, it would be an approach to working with vulnerable
people, like older homeless women, with the view that they likely have experienced at least
one form of trauma and often, multiple interconnecting traumas.
Self-Reflective Service Provision
Being trauma informed and providing trauma informed service delivery requires
organizations and staff to be receptive to being self-reflective and willing to make change
(Hopper et al., 2009). It requires an openness to criticism and to welcoming feedback from
service users. It involves continual self-assessment and reflection, periodic operational
review and evaluation, and implementing mechanisms for seeking input and ongoing
feedback from service users. Service users should be sought out and encouraged to play
active roles in the organization of service delivery, by sitting on boards and participating on
service user improvement committees, for service organizations. A willingness to be more
client centred, trauma informed, and practice oriented may require education and a
philosophical shift on the part of organizations, management, administrators, and front line
staff.

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Social Work
The social work profession has always worked in an inherently trauma informed way
(Wilson et al., 2013) and can continue to take a leadership role in promoting the expansion of
this practice lens to the wider social service realm by encouraging staff and organizational
support and training, and by facilitating staff engagement in regular self care practices
(Hopper et al., 2009).
Knowledge Transfer
A community meeting will be organized within four months of the defence of this
research, inviting service providers and service users to participate, as a mechanism to
disseminate the information collected and discuss the issues identified during the interview
research with service users. The hope is that the themes compiled can be used as a launching
off point to examine the way service is provided to older homeless women in the community,
and to find strategies to encourage the integration of the clients’ voice in the way services are
delivered, and to make service provision trauma informed, client centred, and gender and age
appropriate. The community gathering will be conducted using a guide made up of the
extraction of themes and commonly raised issues from the interviews in this research. These
will be used to encourage and stimulate discussion among the participants.
Staff from a range of agencies providing services in the community will be invited by
letter to participate in the community gathering. This will include community advocates and
shelter staff; health care and social service professionals such as social workers, mental
health and addictions counselors, as well as doctors, nurse practitioners, nurses, policy
makers and possibly politicians. The letter of invitation will encourage the recipients to
spread the word and to suggest colleagues they know who may be interested in participating.

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Every attempt will be made to contact the older women service users interviewed for
this research to invite them to participate. A broader invitation will be issued, using various
methods such as posters, word of mouth, and through various social service agencies, to
advertise the event to try to encourage attendance by older women who have experienced
homelessness and use or have used services.
The hope is that from this event, some ideas for positive changes might be discussed
and implemented by agencies providing services to older women experiencing homelessness
in our community.
Recommendations for Future Research
This research topic exploring the experience of accessing services by older women
homeless women was chosen due to the gap in information around the topic, in the literature
in general, but also specifically in relation to the northern BC context. This research touches
on some aspects of the issue of service provision to older homeless women but is in no way
exhaustive. There remains much room for additional research to be undertaken on the wider
subject of whether the community is meeting the needs of older women experiencing
homelessness adequately and appropriately in a trauma informed manner.
According to the literature, further study of the experience of older homeless
individuals from their own perspective is still needed (Davis-Berman, 2011). In particular,
research is needed to explore the specific experiences of homeless women accessing services
such as shelters (Salem & Ma-Pham, 2015), but also addressing health and income support
accessibility issues for older homeless women (McLeod et al., 2014). Further research that
can contribute to the discussion on these topics and move towards making client centred and

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trauma informed service delivery and provision improvements for older homeless women is
needed.
Additional research focusing on women experiencing homelessness who are older
than 60 would also be important. Only one of the interview participants for this research was
over this age, though I had hoped at the outset to interview more. It would be beneficial to be
able to determine whether there are differing issues of concern that older women face as they
continue to age.
It would also be interesting to supplement this research with the views of advocates
working side by side with older women experiencing homelessness who assist with
navigating the services, to see how their perspective compares to the findings of this research
and to hear of the gaps and barriers they identify as being faced by this population. In
addition, it would be useful to compare these views to the perspective of decision makers and
administrators in government and non-profit agencies to see how they perceive the
effectiveness of service delivery by their agencies. A possible method to try to gather this
information could be the administration of a questionnaire to a wide range of service users,
service providers, advocates, administrators, and policy makers.
Conclusion
Recognition of the importance of our older population is critical to ensure they are
valued for their ongoing contributions to society, and to ensure that the services are in place
to allow older people to remain vibrant and engaged members of our communities. The social
work profession, and the wider society, have an obligation to seek out the views and needs of
older persons, including those who are the most vulnerable among them, such as older
homeless women, the focus of this research.

106
This research recognizes that the problem of homelessness among older women is
partly a result of a complex combination of interlocking oppressions found within the
structures of society (Sokoloff & Dupont, 2005; Zufferey, 2017). The intersection of sexism,
ageism, classism, and racism contribute to the reality that most older women with
experiences of homelessness have encountered physical, sexual, emotional, and structural
violence throughout their lives (Allen, 2016). This research reinforces the perspective that
these different forms of oppression should be viewed through a trauma-informed lens. These
interlocking oppressions reinforce one another (Allen, 2016) and can result in mental health
issues, poverty, and housing insecurity or homelessness.
Suitable and needed services for older homeless women are not afforded the
importance and financial support that some other issues relating to other population groups
might get. This results in services being inadequate and inappropriate, and thus engenders a
reluctance on the part of older women to access them. These overlapping issues of
oppressions and neglect have led to women experiencing homelessness being pushed to the
margins of our society where they usually have little voice or power over many aspects of
their lives. This includes having little decision making power over the services they have
access to or how these services are provided to them.
This research attempted to give older women with lived experience of homelessness
the space to describe their experiences accessing services they rely on. Their experiences
were organized into themes and barriers and gaps in services were identified. These issues
were viewed in relation to those I encounter working with women with lived experience of
homelessness and other vulnerable people. Some improvements in service provision, arising
from the interviews and my work experience, are suggested to make services more client
centred and trauma informed.

107
The intent and hope of this research was to identify improvements that are needed and
can be made to the current models of delivering services to homeless older women (Mullaly,
2010). As well, it was hoped that sharing the findings may lead to more awareness and
positive changes to push back against oppression and neglect, and to help improve older
homeless women’s lives in this community.
It is important that social work and other professions continue to incorporate and
advocate for trauma informed and client centred approaches within their respective practices.
A gendered and structural social work perspective seeks an understanding of power that
enables women to resist and challenge domination, and oppression (Zufferey, 2009). To
appropriately advocate on the behalf of homeless women, or to facilitate their own advocacy,
social workers and other social and health service providers need to ensure they correctly
understand the wishes, views, and needs of their older women clients (Hemingway &
MacLeod, 2004). If for no other reason than self-interest (since most of us hope to live long
and fulfilling lives in a place that values our contributions), we should each be encouraging a
society which facilitates a high quality of life, happiness and wellbeing for older community
members. It is my sincere hope that this research will, in some small way, contribute to
understanding the need for more comprehensive trauma informed and client centred service
provision for those living at the margins: older women experiencing homelessness in our
community.

108
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Zufferey, C. (2009). Making gender visible: Social work responses to homelessness. Affilia:
Journal of Women and Social Work, 24(4), 382–393.
Zufferey, C. (2017). Homelessness and social work: An intersectional approach. New York,
NY: Routledge.

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Appendix A: Definitions

Homeless/Homelessness
The Canadian Homelessness Research Network (CHRN) describes homelessness as
“the situation of an individual or family without stable, permanent, appropriate housing, or
the immediate prospect, means and ability of acquiring it” (Gaetz et al., 2014). This includes
the unsheltered, the emergency sheltered, provisionally sheltered, and those who are
precariously housed or at risk of homelessness (Barken et al., 2015).
“Precariously housed” means that due to “external hardship, poverty, personal crisis,
discrimination, a lack of other available and affordable housing, insecurity of tenure or the
inappropriateness of their current housing (which may be overcrowded or does not meet
public health and safety standards) residents may be “at risk” of homelessness” (Gaetz et al.,
2014).
Homeless and homelessness will be used interchangeably in this research to identify
those who are living in emergency shelters, insecure or precarious housing situations,
including couch surfing or “sleeping rough” (sleeping outside) (Sundin & Baguley, 2015).
Women
The Merriam-Webster dictionary defines “woman” as “an adult female human being.”
(Woman, n.d.) The American Psychological Association defines “gender identity” as “one’s
sense of oneself as male, female, or transgender” (2006). For the purposes of this research the
term woman will refer to those who self-identify as female or as a woman.
Older Persons/Older women
To find an agreed upon and consistently used definition in the literature for people in
their later years of life is challenging. Statistics Canada defines those 65 or older as “older

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persons” (Turcotte & Schellenberg, 2007) and is the minimum age for eligibility for many
government and service agency benefits, programs and discounts. However, for the purposes
of this research I will focus on women over the age of 50 and use the term “older person or
older women” to reflect this age group for the reasons outlined below. The average life
expectancy for women in northern British Columbia is 81.91 years as compared to the
provincial average for women of 84.64 years (Service BC Ministry of Labour and Citizens'
Services, 2017). Aboriginal people make up a substantial part of the population in the
northern regions of Canadian (Human Resource and Skills Development Canada, 2003;
Turcotte & Schellenberg, 2007) but a disproportionate number of the population
experiencing homelessness in northern British Columbia. The average life expectancy in
Canada in 2009 was 81.1 years however the average life expectancy for those with registered
Indian status in Canada in 2001 was 70.4 years (Human Resource and Skills Development
Canada, 2003). A review of the literature on aging and homelessness indicates that 50 is the
widely accepted age for defining homeless persons as older. Numerous studies point to
evidence indicating that people experiencing homelessness tend to have shorter lifespans and
experience aging related health and disability problems approximately 10 years earlier than
the general population due to the challenges of lifestyles and living circumstances they face
(Barken et al., 2015; Crane & Warnes, 2010). In line with this, the 2009 British Columbia
Office of the Auditor General reports the average lifespan of those who experiencing
homelessness in Canada as 45 years.
Aboriginal/ Aboriginal peoples
“Aboriginal Peoples” is the “collective name for all of the original peoples of Canada
and their descendants. Section 35 of the Constitution Act of 1982 specifies that the

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Aboriginal Peoples in Canada consist of three groups – Indian (First Nations), Inuit and
Métis” (National Aboriginal Health Organization (NAHO).
For the purposes of this research the terms Aboriginal or Aboriginal persons will refer
to those who self-identify as aboriginal, status Indians, non-status Indians, Inuit and Metis
people.
Mental Health Issue
The World Health Organization (WHO), defines mental health as “a state of wellbeing in which the individual realises his or her own abilities, can cope with the normal
stresses of life, can work productively and fruitfully, and is able to make a contribution to his
or her community” (WHO, 2016).
The Canadian Chronic Disease Surveillance System (CCDSS) states that “Mental
illnesses are characterized by alterations in thinking; mood or behaviour associated with
significant distress and impaired functioning” (Public Health Agency of Canada (PHAC),
2015. p. 3) and can be the result of a mixture bio psychosocial, economic and genetic factors
and can range from short term intermittent or long term chronic issues (PHAC, 2015).
For the purposes of this research the term “mental health issue” will be used to
indicate problems with mental health or a state where total mental wellbeing is absent, as
described above, and may indicate the possible presence of mental illness.
Service Provider
In this research this term will refer to those employed or in volunteer positions
providing health or social services.

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Service User
For the purposes of this research this term will refer to those persons who access and
use health and social services. The focus population of this research is older women service
users who have lived experience with homelessness.
Substance Dependence/Substance Dependence Issue
Substance use disorder is listed as a mental illness in both the Diagnostic and
Statistical Manual of Mental Disorders Fifth Edition (DSM-5) (American Psychiatric
Association, 2013) and the CCDSS (Public Health Agency of Canada, 2015). In the latest
edition of the DSM the terms “substance abuse” and “substance dependence” have been
replaced by the term “substance use disorder” which is measured on a continuum from mild
to severe. In the manual each substance is referred to as a separate disorder such as alcohol
use disorder or opiate use disorder. A diagnosis of “substance use disorder” is used when use
is recurrent and results in social and functional impairment, loss of control, risky use, health
problems or disability, and failure to meet major life responsibilities such as those at work,
school or home (DSM-5, 2013; SAMHSA, n.d.)
“Dependence” as defined by Mate (2008) is “any repeated behaviour…., in which a
person feels compelled to persist, regardless of its negative impact on…(the individuals life)
and the lives of others and involves…..states of mind such as craving and shame and
behaviours such as deception manipulation and relapse” (p. 214). Substance dependence is
often a result of complex interactions between biopsychosocial and even spiritual
contributing factors (Ogborne, 1997).
In this research the term “substance dependence” or “substance dependence issue”
which is a combination of the above terms, will be used to refer to all of the above resulting
symptoms and consequences.

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Trauma
Trauma is a result of exposure to shocking events or prolonged periods of stress. It is
the result of overwhelming experience inflicted on, or by, an event that an individual has no
control over (Herman, 1997; van der Kolk, 1987). It can include interpersonal trauma, from
physical or emotional abuse, intergenerational trauma, as experienced by Aboriginal people
in Canada, or trauma experienced during events like wars, natural disasters or accidents.
Each individual reacts differently to stressful events but exposure to traumatic events is often
associated with short term or enduring negative emotional, psychological and physical health
consequences. This is the definition of trauma that will be used in this paper.
Trauma Informed Practice / Trauma Informed Service
This following is the definition of Trauma Informed Practice (TIP) and Trauma
Informed Service (TIS) to be used in this research. TIP and TIS are services, and a manner of
delivering them, which are sensitive to and aware of the special needs of trauma survivors.
This type of practice and service provision “adopts a universal assumption of inclusion…. it
assumes that all consumers receiving services are trauma survivors” (Harris & Fallot, 2001.
p. 4) and views the consumer “as a whole person” whose symptoms are “interconnected and
embedded” with her history of trauma (Harris & Fallot, 2001.p. 13).

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Appendix B: Demographic Questionnaire
Contact info for follow up purposes:
Name:
Address:
Preferred mode
of communication
Ok

Tel

Texting

Voicemail

email

NOT OK to leave voicemail message identifying who I am and why I am calling

Demographic Information:
Age ( 50 +)

Self-identified heritage/ancestry:
Canadian

Aboriginal

Asian

European

other

Marital status:
single
Other

in relationship

common law

married

separated divorced

widowed

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Family:
Children
Grandchildren
Current dependents

#

Adult

Under 18

Education –what level of education do you have?
Elementary
High School
College or university
Trades/profession
Other

partial

completed

certificates/diplomas/degrees-other notes

Source of income:
Employment income

CPP

Work pension

EI

OAS

Other

CPP disability

GIS

BC-SABC-PWD

CPP Survivors Benefit

Work History:
Yes
Currently
employed
Unemployed
Work at home

No

Length of time/
start & end date

Type of work

Housing Situation:
Yes

No

Length of time in current location

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Housed
are you happy with your current
housing/are you planning to stay
Homeless
staying in shelter
couch surfing
staying with family or friends
Other

When did you last have your own place to live? Within the last:
0-6 months

6 mos to 1 year

1-2 years

2-3 years

Other

How many times have you moved in the past?
0-6 months

6 mos to 1 year

1-2 years

2-3 years

Other

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How would you rate your health and wellness today?

physical
mental
emotional
spiritual

very poor

poor

satisfactory

good

very good

excellent

If any of these are poor or very poor explain:
___________________________________________________________________________
___________________________________________________________________________

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Appendix C: Semi Structured Interview Questions
Social determinant of health domains
1. What kind of services do you use in the community – for physical wellbeing, for
emotional wellbeing, for mental wellbeing, spiritual wellbeing? For other needs?
Food security:
Groceries stores/
convenience stores

Food Banks

cook for self

AWAC
ASA P

Farmers market

Other

Firepit
St Vincent de Paul
Society

Money/Financial:
Employment
Work pension
Band

BC- MSD & SI Office
for:
SA
PWD
Other

Bank /Personal Bank
account
Loans/credit
cheque cashing stores
other

Health services:
Hospital ER

Dental care- and
dentures

Other

Federal Gov’t (Service
Canada) for:
CPP
CPP-D
OAS
GIS
EI

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Family Dr’s office

Eye exams /glasses

Walk in clinics

Counselling

Specialists
Pharmacy
Public health office

Housing services:
Shelters/
transition

Subsidized housing

AWAC

BC Housing-

ASAP advocates

ASAP

Aboriginal Housing -

Phoenix

PGNFC Tse Koo/ Friendship
Lodge
Northern Health Seniors
Housing
Elizabeth Fry housing

Housing First
Program
AWAC, Ketso
Phoenix, Asap

Amber House
Other

Market
housing

Housing
assistance/advocacy

Legal and Safety:
RCMP/Police
Court
Probation

OTHER services accessed:

Jail
lawyers
legal aid/native
courtworkers

Other

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Spiritual
services,
Churches,
temples,
traditional
ceremonies

Household items
Furniture/
clothing/
kitchenware

Seniors /Elder
organizations
& programs

Transportation
Bus
HandiDART

Stores

IDBC Service
Card,
Status Card
BC care card
Service BC
Service
CanadaGovernment
offices

Other
2.
When accessing these services:
i) What is the most important thing for you?
ii) How is it for you accessing these services?

iii) How do the staff/service providers treat you? How does that make you feel?
iv) What makes accessing these services a bad experience?
v) What makes accessing these services a good experience?
vi) How could it be better, what could be done to make the experience better for you?
vii) How could these community services be improved? What works /what doesn’t
work so well?
3. Do you feel all of your needs are being met in this community?
a. Which ones are and which ones are not being met?
b. What services do you need but are not available in our community or for
whatever reason you cannot access?
4. How do you manage/get by?
a. What skills do you use to manage without stable housing?
b. What are your greatest strengths and gifts?

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c. Are family and friends a help to you?
5. How do you think your voice is included in the way services are provided?
6. How should you have a say and what would you say re social service, health care and
other service provision?
a. Do any of the services you access ask for your opinion on the way services are
offered or delivered?
b. How would you like your wishes and needs to better included?
7. The following 4 questions are adapted from Davis Berman (2011) study questions
a. If you have stayed in shelters describe your experience in the shelter system.
b.

What is good what is bad about staying in a shelter?

c. If you are currently staying there what is keeping you in the shelter system?
d. Have you experienced threats or violence while homeless?
8. Are there any issues and concerns you have with being 50 and over, homeless (or
having issues with unstable housing) and growing older.
9. What is your vision for yourself as you get older?
10. Is there anything else that you want to say about being over 50, a woman and being
homeless?

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Appendix D: Counselling and Mental Health Resources
CRU (Community Response Unit)-250-565-2668
Crisis Line – 1-800-784-2433
UHNBC Hospital Emergency (ER) - Edmonton St.
RCMP- Car 60- 911
Family Physicians Offices – various locations
o CINHS – for patients – 365 George St. Ph: 250-564-4422
o Blue Pine Clinic – for patients - 102-1302 7th Ave. Ph: 250-596-8100
Prince George Native Friendship Centre – Healing Centre- 1600 3rd Ave. Ph: 250-564-3568
SOS Society, 193 Quebec St. Ph: 250-564-8302
Elizabeth Fry Society, 1575 – 5th Ave. Ph: 250-563-1113, 24 Hour Crisis Line-250-5625868, 1-866-563-1113
Canadian Mental Health Association (CMHA), 1152 - 3rd Ave. Ph: 250-564-8644
Nechako Day treatment program, 1350 Alward St. Ph: 250-565-2387

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Appendix E: Poster

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Appendix F: Information and Consent Form

Information Letter / Consent Form
October 2016
MSW Thesis Title: Accessing social and health services: the experience of older homeless
women in downtown Prince George, B.C.
Who is conducting the study?
Sari Legate
University of Northern British Columbia
Prince George, BC V2N 4Z9
legate@unbc.ca (250) 552-6964
Dear Participant,
Hello, my name is Sari Legate. I am a Master’s of Social Work student at the University of
Northern British Columbia (UNBC) in Prince George, BC. I am doing interviews with older
women (50 years and older) who have experienced homelessness for my thesis research. I am
doing this research study as part of my studies, not as part of my role as a social worker or for
my job.
Why are you being asked to take part in this study?
The purpose of the study is to learn about the experience of accessing social and health
services for older homeless women in Prince George. I want do this by interviewing women
50 years of age and older like yourself who have experienced homelessness. This is to be
able to determine gaps in, and possible ways to improve, the provision of social and health
services to older homeless women in Prince George.
What will happen during the project?
Each interview will take approximately 45 minutes to 1.5 hours. The interviews will take
place at a time and place that you and I agree on. There are a series of questions that you will
be asked. The interview will be audio recorded and I will take written notes during it with
your permission.
Will you be paid for taking part in this research study?
You will be offered a gift card as a thank you in recognition for your time given for the
interview, as well as bus tickets to assist with getting to and from the interview location.

135

Participation is voluntary.
Participating in the interview is completely voluntary. Your written and/or verbal consent
will be required before the interview begins. You do not have to answer questions that make
you feel uncomfortable. As well you are free to end the interview at any time without any
consequence to you. If you choose to end the interview the audio recording and any notes
made will be removed from the study and securely destroyed. Whether you finish the
interview or not you are welcome to keep the gift card and bus tickets.
How will your privacy be protected?
To the best of my ability I will ensure that your name and identity, as well as your
participation in this research project, will be kept confidential. Your audio recording and any
notes taken and transcriptions of the audio recordings will not have your name attached to
them. The audio-recordings will be stored and uploaded onto a secure password protected
site and written documents will be kept in a locked cabinet in my locked home office. All
audio-recordings and data will be destroyed by shredding paper files and deleting digital
files, five years after the completion of my thesis. A hired transcriber (who has signed a
confidentiality agreement), my UNBC master’s supervisor Dawn Hemingway and I will be
the only ones with access to the audio recordings and documents.
Limits to confidentiality
If, during the interview, you reveal that there has been an incident that involves abuse and/or
neglect of a child (or that there is a risk of such occurring) or threats of harm to others or to
yourself, by law, I have to report this information to the authorities.
Is there any way that participating in this study could harm you?
I do not think there is anything in this study that could harm you. Some of the questions
asked may seem sensitive or personal. You do not have to answer any question if you do not
want to. If, at any point in the study, you feel uncomfortable or upset and wish to end your
participation, please let me know and your wishes will be respected. A list of counselling
resources will be given to you and assistance with accessing these services will be provided
should you feel you need them.
Will being in this study help you in any way?
I do not think taking part in this study will help you directly. However, in the future, others
may benefit from what is learned from this study and it may lead to improvements in the way
services are provided to homeless older women.
Study Results
You are welcome to review your interview once it has been written out. The results of this
study will be reported in a graduate thesis and may also appear in other documents and
publications. You are welcome to a copy of the finished thesis. A copy will also be available

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at the UNBC library to look at. A community meeting will be held within 4 months after the
thesis is finished. This will be set up to present and talk about the findings of the study. You
and the other research participants, the public and community social and health service
agencies will be invited to attend.
Questions
If you have any questions about this project please contact;
Student researcher:
Sari Legate at 250-552-6964 (cell), legate@unbc.ca
UNBC Thesis supervisor:
Dawn Hemingway, Tel: 250-960-5694, Dawn.Hemingway@unbc.ca
Concerns about the project or your rights
If you have any concerns or complaints about your rights as a research participant and/or
your experiences while participating in this study, please contact the UNBC Office of
Research at 250-960-6735 or by e-mail at reb@unbc.ca.
Thank you,
Sari Legate
250-552-6964 (cell), legate@unbc.ca

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CONSENT
I have read or been described the information presented in the information letter about the
project:
YES

NO

I have had the opportunity to ask questions about my involvement in this project and to
receive additional details I requested.
YES

NO

I understand that if I agree to participate in this project, I am free to end the interview or
withdraw from the study at any time or up until the report completion, with no consequences
of any kind. I have been given a copy of this form.
YES

NO

I agree to be audio-recorded.
YES

NO

Follow-up information can be communicated to me by phone or sent to me at the following
e-mail or mailing address:
YES

NO

Phone/ email/ mailing address information:

Signature:
Name of Participant (Printed):
Date: