Experiences of poverty amongst low-income older adults living in a high-income country: A qualitative study

Abstract

Aim: To understand the experience of low-income older adults living in poverty in a high-income country.

Design: A qualitative study based on Gadamer's hermeneutic phenomenology.

Methods: A convenience sample of twenty-seven low-income older adults were interviewed in-depth between September 2021 and January 2022. Fleming's method for conducting phenomenological qualitative studies was followed and ATLAS.ti software was used for data analysis.

Results: Three main themes were extracted from the analysis: (i) 'living in the shadow of poverty', (ii) 'unprotected by the 'social shield' of the welfare state' (iii) 'the struggle to attain good health'.

Conclusion: Living in poverty affects all spheres of life. Older adults living in poverty feel excluded from social support policies and laws. This has a negative impact on the older adults' mental health and can lead to social isolation.

Implications for the profession and/or patient care: Nursing interventions to promote health amongst older adults living in poverty should include an assessment of the patient's social determinants and a focus on increasing social participation. Older people living in poverty experience difficulties accessing formal social support so nurses should implement patient navigation interventions that aim to help them overcome the complexities of the system. Nursing interventions to improve mental health amongst older adults living in poverty are much needed.

Impact: Living in poverty increases older adults' vulnerability. Older adults living in poverty suffer from mental health issues as they live under constant pressure to meet their basic needs and lack formal social support. These findings are important for nurses, who play a pivotal role in the design, implementation and evaluation of policies and interventions that promote health equity.

Reporting method: The study has been conducted following the COREQ guidelines.

Patient or public contribution: There has been no public or patient involvement in the design or development of the study.

Keywords: experiences; health services accessibility; low-income; mental health; older adults; poverty; social isolation.