“Homeless Life to Hopeful Life of Elderly Beggars”-: Before and After Rehabilitation: A Qualitative Approach

Abstract

This qualitative study explores the experiences of elderly beggars who transitioned from a life of homelessness to a hopeful life through rehabilitation programs. The aim is to gain insights into their lived experiences, challenges faced during their homeless phase, and the transformative effects of rehabilitation interventions. The study employs Case study approach applying thematic analysis to capture the narratives of elderly individuals who have undergone rehabilitation. The data was collected directly from the elderly using purposive sampling method. The in-depth interview guide was used to collect data from 30 elderly people in Atchayam Beggars Rehabilitation centre at Erode. From the findings, it was clear that homeless phase is characterized by extreme poverty, social exclusion, health issues, and a lack of basic necessities. The elderly beggars face numerous challenges, including stigma, discrimination, and a sense of hopelessness. The study documents the transformative journey of the elderly beggars, highlighting the positive changes they experience after rehabilitation. These changes include improved physical and mental well-being, restored self-esteem, regained social connections, and the acquisition of new skills. The elderly experience a renewed sense of hope, dignity, and empowerment as they move from vulnerability to independence and self-sufficiency. The study also highlights the significance of destigmatization efforts and community involvement in fostering the successful reintegration of elderly beggars into society. The study also contributes to the existing literature by shedding light on the possibilities for positive change and the journey from homeless life to a hopeful life among this vulnerable population.

Introduction

The presence of homeless elderly beggars represents a poignant and complex issue within societies worldwide (Khan, 2013). These individuals, in their advanced age and dire economic circumstances, find themselves without stable housing and resorting to begging as a means of survival. The phenomenon of homeless elderly beggars raises significant concerns related to their vulnerability, health and well-being, economic opportunities, social stigma, lack of support and rehabilitation services tailored to their unique needs. The number of elderly individuals experiencing homelessness is on the rise, driven by factors such as inadequate retirement benefits, limited income sources, rising housing costs, and a lack of affordable housing options. As a result, a growing population of elderly individuals finds themselves destitute, relying on begging to meet their basic needs (Khan, 2013). This vulnerable segment of society faces numerous challenges that are compounded by their age, physical limitations, and often deteriorating health.

The health and well-being of homeless elderly beggars are of particular concern. They are more susceptible to chronic physical ailments, mental health issues, malnutrition, and a lack of access to appropriate healthcare. The harsh conditions of living on the streets, combined with inadequate nutrition and healthcare, exacerbate their health problems, leading to a deteriorating quality of life and premature mortality. Economic opportunities for homeless elderly beggars are severely limited. Age-related discrimination, physical limitations, and a lack of marketable skills make it challenging for them to secure employment. Consequently, they often resort to begging as a means of survival, trapped in a cycle of poverty and dependence.

The social stigma and discrimination associated with begging further marginalize homeless elderly individuals, isolating them from society. Negative stereotypes and perceptions contribute to their devaluation, making it difficult for them to reintegrate into the community. The stigma attached to begging creates additional barriers to accessing support and resources, perpetuating their disadvantaged position. Despite the pressing need for support and rehabilitation, homeless elderly beggars often lack access to comprehensive services that address their specific needs. There is a gap in the provision of shelter, healthcare, vocational training, and social integration programs tailored to the unique challenges faced by this population. The absence of specialized interventions makes it difficult for them to escape the cycle of begging and achieve self-sufficiency. Addressing the complex issue of homeless elderly beggars requires a comprehensive approach that encompasses social welfare, healthcare, income support, and social inclusion. Efforts should focus on developing targeted interventions that address their unique needs, combat stigma and discrimination, create economic opportunities, and provide access to comprehensive support systems. Collaboration between governmental and non-governmental organizations, community engagement, and the active involvement of homeless elderly individuals themselves are crucial for implementing effective solutions.

This study aims to shed light on the experiences and challenges of the homeless elderly beggars, with a particular focus on their journey from homelessness to a life of hope and dignity. By understanding their circumstances and needs, society can work toward developing strategies that offer meaningful support, empowerment, and opportunities for homeless elderly beggars to regain stability and improve their overall well-being.

Review of Literature

Homelessness is a serious and social developmental concern as it is increasing. Elderly facing homelessness is viewable problem even in a developed country. Kushel (2020) in his study on homelessness among older adults highlighted the supply of affordable housing facilities for the elderly. Similarly, a study by Brown et al. (2022) remarked on the pressing policy initiatives are required in the United States to prevent and end homelessness among older individuals. Another study by Kertesz et al. (2009) examined the effectiveness of the scheme “Housing First approach” and found challenges of providing immediate housing without requiring sobriety as a precondition. Similar study by Raphael et al. (2015) revealed the experiences and perspectives of older homeless individuals in a transitional housing program. It sheds light on their unique challenges, coping strategies, and needs for support. Another study by Loubiere et al. (2022) evaluates the effectiveness of the Housing First approach for older homeless adults. It assesses housing outcomes, health, and well-being improvements, and highlights the importance of stable housing for this population. “The State of Homelessness in America” report offers valuable insights into the scale and nature of homelessness across the country (The Council of Economic Advisors 2019). The report by the National Law Center on Homelessness and Poverty (2019) on criminalization of homelessness in U.S. cities stated that individuals experience homelessness and also examines the impacts for alternative approaches that focus on housing and support. Another study by Shinn et al. (2013) focused on the causes and consequences of family homelessness, the effectiveness of interventions, and the distinct requirements and experiences of homeless families in US. The preceding studies emphasizes the need of providing affordable homes for the elderly in order to reduce the number of senior homeless people.

Health is another concern for all the individuals. The Sustainable Development Goal 3 “Good health and well-being for all ages” also speaks about the importance of health and wellbeing of all ages. Elderly face many health problems due to their age factor, it is more worsen for elderly beggars who don’t have accessibility and affordability for health care by Ye et al. (2019). The study conducted by Dey et al. (2012) revealed that the elderly suffer from more illnesses than people of other ages, according to an analysis of morbidity patterns by age. Another study explores the connection between homelessness and health outcomes in Canada. It examines patterns of healthcare utilization, chronic health conditions, and mortality rates among homeless individuals, shedding light on the complex health challenges they face (Hwang, 2001). Health is one of the major aspects of elderly beggars across county. A study by Kuluski et al. (2017) highlighted the complex health needs of this population and the importance of providing appropriate healthcare services. Another study on mental health of homeless older adults by Fazel et al. (2008) observed the prevalence of mental health disorders, risk factors, and barriers to accessing mental healthcare services. The study on homeless older adults by Gutwinski et al. (2021) explained the experiences shared by the homelessness older adults and insisted to develop effective interventions and support systems. The aforementioned research covered the health issues that elderly homeless people face as well as discussed about the interventions and their unique needs related to the health.

Homelessness is not a recent issue of concern as it been existing since 1980s (Rishi, 2022). A study by Malik and Roy (2012) discussed the living circumstances of beggars and their knowledge of various government initiatives. The study also clarified why people resort to begging and provides insight into the financial situation of beggars. At the end comprehensive programing and reorientation of the current programs are required. Similar study states that homelessness and mental illness act as a risk factor for each other. The study also highlighted that to assist this elderly population, there is a need for government-NGO cooperation and additional psychosocial rehabilitation centers (Tripathi et al., 2021). Another study sheds light on the socioeconomic circumstances of beggars, identifies the causes and contributing elements that lead to their life of begging, pinpoints the difficulties they encounter while begging, and offers corrective actions for enhancing their socioeconomic situation (Vaithiyanathan & Geetha, 2016). Effective action must be taken because homelessness affects everyone, regardless of country, religion, or caste.

Statement of the Problem

The phenomenon of homeless elderly beggars presents a multifaceted problem that necessitates attention and intervention. The statement of the problem related to homeless elderly beggars encompasses several key aspects:

Vulnerability and Housing Instability: Homeless elderly beggars face heightened vulnerability due to their advanced age, economic insecurity, and lack of stable housing. They often lack access to affordable housing options, adequate social support systems, and income sources, leaving them susceptible to homelessness and the necessity of resorting to begging.

Health and Well-being Challenges: Advanced age, prolonged exposure to harsh living conditions, limited access to healthcare, and inadequate nutrition contribute to physical and mental health issues. They are more prone to chronic illnesses, malnutrition, injuries, and mental health disorders, further exacerbating their overall well-being (Omerov et al., 2020).

Social Exclusion and Stigma: Negative perceptions and stereotypes associated with homelessness and begging contribute to their devaluation, isolating them from social networks and support systems. The resulting social isolation and discrimination worsen their psychological well-being and hinder their chances of reintegration.

Limited Resources and Income Opportunities: Age-related barriers, physical limitations, and a lack of marketable skills make it challenging for them to secure employment. This lack of viable income sources perpetuates their reliance on begging as a means of survival and traps them in a cycle of poverty.

Inadequate Support and Rehabilitation Services: There is a scarcity of specialized programs that provide shelter, healthcare, counseling, vocational training, and social integration initiatives specifically designed for elderly individuals experiencing homelessness.

Policy and Legal Frameworks: The problem of homeless elderly beggars is influenced by gaps in policy and legal frameworks. There are no specific policies that address the requirements of the elderly beggars. These shortcomings hinder the development and implementation of effective strategies to address the issue.

Intersectional Factors: The problem of homeless elderly beggars is also influenced by intersectional factors, including gender, ethnicity, and migration status. Certain subgroups, such as elderly women, minorities, or migrants, may face compounded vulnerabilities and encounter additional barriers in accessing support and resources.

In light of all these factors, this study was done to understand more about the issues and difficulties experienced by the elderly and how lives changed after completing rehabilitation programs.

Need of the Study

The need for a study related to homeless elderly beggars arises from several pressing factors which includes:

Understanding the Unique Challenges: There is a need to comprehensively understand the specific challenges faced by homeless elderly beggars. This includes exploring the factors that contribute to their homelessness, the impact on their physical and mental health, the barriers they encounter in accessing resources and support, and the social dynamics that perpetuate their marginalization.

Identifying Effective Interventions: This involves studying existing programs, policies, and services to determine their efficacy, identifying best practices, and highlighting areas for improvement. It is crucial to assess the impact of interventions on housing stability, healthcare access, income generation, and social integration for this population.

Health and Well-being Outcomes: Understanding the health and well-being outcomes of homeless elderly beggars is essential. Research should focus on examining the physical and mental health conditions they face, the impact of homelessness on their overall well-being, and the long-term consequences of inadequate housing and support services. This knowledge can inform the development of targeted healthcare interventions and policies.

Social Inclusion and Stigma Reduction: There is a need to explore strategies for reducing social exclusion and combating stigma toward homeless elderly beggars.

Research can investigate the role of public perceptions, media representations, and community attitudes in shaping social interactions and opportunities for social integration. Additionally, studying successful initiatives that promote social inclusion and destigmatization can provide valuable insights for future interventions.

Policy and Advocacy: Research can contribute to evidence-based policy development and advocacy efforts. It can shed light on the systemic issues that contribute to homelessness among the elderly population and inform policy recommendations for improving housing affordability, income support programs, healthcare accessibility, and specialized services for homeless elderly individuals.

Intersectionality and Diversity: There is a need to examine the intersectional dimensions of homelessness among elderly individuals. Research should consider how factors such as gender, ethnicity, race, and migration status intersect with age to create unique challenges and vulnerabilities. This knowledge can help tailor interventions and services to address the diverse needs of homeless elderly beggars.

By addressing these research needs, it will be easy to understand the complexities surrounding homeless elderly beggars. This will facilitate to develop evidence-based strategies to improve their well-being, social inclusion, and overall quality of life. Ultimately, such a study can contribute to the development of comprehensive policies, programs, and services that effectively support and empower homeless elderly individuals to transition out of homelessness and lead dignified lives in their later years.

Objectives of the Study

1. To explore the root cause of their journey as homeless beggars.

2. To understand their way of living before and after rehabilitation process.

3. To suggest recommendation based on the findings to improve their well-being.

Research Methodology

Field of Study: Atchayam Beggars Rehabilitation centre at Erode.

Figure 1.

Individual interpretations of homelessness.

Research Design: The respondents' problems were described using a descriptive and diagnostic research design

Sample Size: The researcher interviewed 30 homeless elderly in “Beggars rehabilitation home” at Erode.

Sample Technique: Non-probability purposive sampling method was used.

Approach: The methodology of this study is a qualitative case study analysis from 30 respondents based on their transformation of life before and after rehabilitation. In-depth Interview guide was used for data collection.

Data source: Primary data source of data was collected directly from the respondents and the Secondary source of data was collected from UN reports, Research articles, Newspaper articles and Government report related to elderly and aging.

Theoretical Framework of the Study

Structural Theory of Homelessness

Structural theory of homelessness defines “Individual interpretations hold that homelessness is caused by personal defects such as substance usage and social disaffiliation, whereas structural interpretations hold that it is caused by systemic reasons such as a lack of affordable housing and employment prospects” (Main, 2008).

In this study, the individual interpretations mentioned that homelessness is caused due to

According to Structural Interpretations, homelessness is caused by

Figure 2.

Structural interpretations of homelessness.

Findings

Figure 3.

Components related to the journey of homelessness.

Reason for Homelessness

Breakdown of Marriage Life

Out of 30 respondents, 15 started their journey of homeless beggars due to breakdown in marriage life.

“Due to some conflicts with my wife and childrens I left the home. I was able to manage for 10 days, with whatever I had. After that I had no money for food. So I started begging nearby shops and bus stand. It became my routine. I’m doing this for more than 10 years. No one is there to take care of me. Without home, proper food and shelter I’m residing near the bus stand. Due to age factor I cant walk, having body pain. Life is going on without any hope.”

Loss of Job

Eight of the respondents, started their journey of homeless beggars due to loss of job.

“ My wife and I left the home because our childrens didnt take care of us after their marriage. My wife cant do any work due to severe leg pain. I worked as a watchman in a private company nearby our home. Then we shifted to Erode and stayed near the railway station. Due to my age factor no one was willing to give job for me. It was pathetic situation, so we began to beg, in need of food we started begging. Some people will give food, dresses etc.. at their special occasions. We are doing this for more than 4 years.”

Loss of Loved One

Fifteen of the respondents out of 30, started this journey of homeless beggars due to loss of loved ones.

“I lost my wife and childrens in a bus accident, after that I had no hope for my life. Lost all my property and my investment in lottery ticket, Alcohol etc.. later no money to feed myself. So started begging for buying drugs. I’m doing this for more than 5 years.”

Substance Abuse

Five of the respondents, started this journey of homeless beggars due to substance abuse.

“Due to peer pressure I have started consuming alcohol during my teenage, it continued till my wife and my childrens left me. After that no one is there to take care of me and I started begging for in need of food. I have been doing this for more than 15 years .”

Emergence of Nuclear Family System

Out of 30 respondents 12 started the journey of homeless beggars due to emergence of nuclear family system.

“We had 2 childrens, after their marriage they moved to cities due to their employments. They got the properties from us and left us in some old age home. We were not interested to stay in the home. So we left that place and without money we cant go anywhere, so we stayed near the railway station. For in search of food we started begging. We were doing this for more than 7 years.”

“A home is more than just a shelter”

Poverty

Ten of them stated that they started their journey of homeless beggars due to poverty.

“My husband and me depend on Agriculture, due to some poor situation, we have no money as well as no water for the agriculture. We were unable to manage our expenses, so we migrated to else and got job for 2 months. After that no one was willing to give job for us nor we had a place to stay. In need of food we started begging. We were doing this for more than 6 years.”

Natural Disaster

Two respondents were started their journey of homeless beggars due to natural disaster.

“ Due to natural disaster in our native I lost my family and migrated, there I couldn’t find any proper job or home for rent due to caste discrimination. I was unable to come to my native at that time due to money constrain. So in need of food started begging. I’m doing this for more than 10 years.”

Unaffordable Housing

Out of 30 respondents five started their journey of homeless beggars due to unaffordable housing.

“After the death of my parents I stayed in rented house where I worked but, due to loss of job, I cant pay the rent for house. I have managed few days with my savings. After that I didn’t get any job due to my health conditions and no money for buying food. So at that situation I have started begging and I’m doing this for more than 5 years.”

Effects of Homelessness

From the findings it was clear that the effects of homelessness can vary depending on individual circumstances and the duration of homelessness. Efforts to address homelessness should aim not only to provide immediate shelter and support but also to address the underlying eff and work toward long-term solutions. Some of the effects of homelessness were mentioned below:

Figure 4.

Effects of homelessness.

Figure 5.

Life of the homeless elderly beggars before rehabilitation.

Techniques Used During the Rehabilitation Process

Figure 6.

Techniques used during the rehabilitation process.

Observation Based on the Interview

Table 1.

Life of Elderly Homeless Beggars Before and After Rehabilitation.

Life before rehabilitation	Life after rehabilitation
Earned approximately Rs.50 per day	Learned new skills such as paper plate making, agarpathi making, and soap making they were earning more than Rs. 200 per day as a result, which enhanced their standard of living.
No connection with the Society - Lack of Social Support. No one is willing to speak or support them.	Opportunity to mingle with peer groups and interact with people with the self identity.
Lack of accessibility and affordability to appropriate health care.	Can access to the health care system with their daily income as well as social assistance.
Lack of access to health care has a negative impact on both physical and mental wellbeing.	Physical and mental well-being improved due to rehabilitations technique and good health care.
Lack of love from their family due to conflicts with their partner or childrens.	The trust has taken action to reunite the elderly with their families and children.
No job so started begging in search of food.	Learned a new skill to lead their life with self respect.

Figure 7.

Life of the homeless elderly beggars after rehabilitation.

Discussion

Homeless elders represent a vulnerable and often overlooked segment within the homeless population. They have distinct issues that necessitate specialized attention and customized solutions.

Vulnerability: Homeless elderly individuals are particularly vulnerable due to a combination of age-related health issues, limited resources, and social isolation. They often lack access to affordable housing, healthcare, and support networks, making it difficult for them to escape the cycle of homelessness (Jyothi, 2022).

Health challenges: Studies have shown that homeless elderly individuals experience a higher prevalence of chronic physical and mental health conditions. Lack of adequate healthcare, poor nutrition, and exposure to harsh weather conditions worsen their health problems, leading to increased morbidity and mortality rates (Brown et al., 2013).

Social isolation: Homeless elderly individuals often face social isolation and disconnection from their families and communities. This isolation can be attributed to factors such as strained relationships, loss of social networks, and the stigma associated with homelessness. Social isolation further contributes to their vulnerability and negatively impacts their mental well-being (Omerov et al., 2020).

Economic factors: Many homeless elderly individuals resort to begging as a means of survival due to limited income options. Factors such as insufficient retirement savings, low wages during their working years, and lack of affordable housing options and also due to some tragedies like natural disaster contribute to their economic instability. Studies have shown that the majority of elderly individuals who beg do so out of necessity rather than choice (Afroz, 2017).

Emotional support: Homeless elderly individuals often experience feelings of loneliness, hopelessness, and despair. Providing emotional support through counseling, peer support programs, and outreach initiatives can help address their psychological well-being and improve their overall quality of life (Reilly et al., 2022).

In summary, homelessness among the elderly is a pressing issue that requires attention and action. By understanding the challenges faced by homeless elderly individuals and implementing comprehensive policies, society can work toward providing them with the support and resources necessary to improve their lives.

Recommendation

The following recommendations should be given by the Government:

Affordable and Accessible Housing: Provide affordable and accessible housing options specifically tailored to the needs of homeless elderly individuals. This includes safe and secure accommodation that considers their mobility limitations and provides necessary amenities.

Healthcare and Support Services: Ensure easy access to healthcare services, including regular check-ups, preventive care, and treatment for chronic conditions. Establish mobile healthcare units or dedicated healthcare facilities that cater to the unique needs of homeless elderly individuals.

Comprehensive Social Support: Develop comprehensive social support systems that address the physical, emotional, and social well-being of homeless elderly beggars. This can include counseling services, social activities, and peer support groups that combat social isolation and provide a sense of belonging.

Income Support and Employment Opportunities: Facilitate access to income support programs and employment opportunities that consider the limitations and abilities of homeless elderly individuals. This can involve vocational training programs, job placement services, Capacity building programs and initiatives that encourage entrepreneurship. Encouraging elderly individuals to participate in micro, small, and medium-sized businesses for both their income and employment.

Empowerment and Dignity: Ensure that interventions prioritize the empowerment and dignity of homeless elderly beggars. Involve them in decision-making processes, respect their autonomy, and provide opportunities for self-expression and personal growth.

The following recommendations should be given by the Non-Governmental Organization:

Outreach and Awareness: Increase public awareness and understanding of the challenges faced by homeless elderly beggars. Educate the public, policymakers, and service providers about the unique needs of this population to combat stereotypes and stigma.

Collaboration and Coordination: Foster collaboration between government agencies, non-governmental organizations, community stakeholders, and homeless elderly individuals themselves. Establish coordination mechanisms to streamline services and resources, ensuring a holistic and integrated approach to support.

The following recommendations should be given through Policy and Research:

Advocacy and Policy Reform: Advocate for policy reforms that address the systemic factors contributing to homelessness among the elderly population. Push for legislation that promotes affordable housing, healthcare access, income support, and age-friendly policies.

Research and Data Collection: Encourage further research and data collection on homeless elderly beggars to better understand their experiences, needs, and the effectiveness of interventions. This will contribute to evidence-based decision-making and continuous improvement of services.

By incorporating these suggestions and recommendations into intervention and policy development, we can work toward creating a supportive and inclusive environment for homeless elderly beggars.

Conclusion

Addressing the issue of homeless elderly beggars requires a multifaceted approach that encompasses social, economic, and healthcare interventions. The problem of homeless elderly individuals resorting to begging is a complex one that requires a comprehensive understanding of the underlying causes and a holistic response to effectively address the issue. Firstly, it is crucial to recognize that homelessness among the elderly is often a result of various factors, including poverty, lack of affordable housing, limited social support networks, and inadequate access to healthcare services. These factors contribute to their vulnerability and increase the likelihood of resorting to begging as a means of survival. To tackle this issue, governments and communities must prioritize the development and implementation of social welfare programs and policies aimed at alleviating poverty and ensuring access to affordable housing for the elderly population. This could include measures such as increasing social security benefits, expanding subsidized housing options, and providing targeted financial assistance to low-income elderly individuals.

Additionally, efforts should be made to enhance support systems and social services specifically customized to the needs of homeless elderly individuals. These services may include outreach programs that connect them with shelters, healthcare facilities, and community resources, as well as mental health services and substance abuse treatment if needed. Collaborations between government agencies, non-profit organizations, and community stakeholders are essential for the effective delivery of these services. Furthermore, raising public awareness about the challenges faced by homeless elderly individuals can help combat stereotypes and stigma associated with begging. This can be achieved through educational campaigns and community initiatives aimed at fostering empathy, understanding, and compassion toward the elderly population.