Relationship between housing and palliative needs among hospitalized older adults

TL;DR

This study explores how housing insecurity affects palliative care needs in older hospitalized adults, finding that housing worries increase anxiety and reduce feelings of peace.

Contribution

The study is among the first to link housing insecurity with specific palliative care outcomes in hospitalized older adults.

Findings

15% of participants were worried about housing, and 24.4% reported poor housing conditions.

Housing worries correlated with higher anxiety, less peace, and less satisfaction with information about their illness.

Most participants experienced moderate to severe pain, with significant anxiety reported by 35.8%.

Abstract

In 2024, over 146,000 adults aged 55 and older faced homelessness, many for the first time, with one in four living in poor conditions. Rising housing costs and income loss increase worries over losing housing. Many housing insecure older adults live with chronic health conditions and unmet palliative needs. Our objective is to describe the relationship among homelessness, housing conditions, and palliative needs in a sample of hospitalized older adults. We surveyed 139 hospitalized older adults (≥ 55 years, M = 68 ± 9) about housing conditions and health outcomes during a hospital-based point in time count on January 29, 2025. We used the 5-item Integrated Palliative Care Outcome Scale (IPOS) to assess palliative needs. Most were white (86.4%) men (51.8%) living in a home or an apartment (n = 117), with 16 doubled up and two were experiencing homelessness for the first time. About 15% were worried about their housing; 24.4% reported poor housing conditions with at least one problem. Pain was moderate to overwhelming for 68.9%, 35.8% experienced anxiety most or all of the time, and 46.4% felt at least some peace and most had as much information as they wanted regarding their illness (73.9%). While there were no significant associations between symptoms and housing status, those worried about housing reported greater anxiety over their illness (t(133)= 2.70, p= .008), felt less peace (t(134)= 2.83, p=.003), and did not have as much information as they wanted (t(21.24=3.11, p=.005). Housing worries can heighten health-related anxiety and affect how older adults receive information.