Author Identifier

Phuntsho Om: https://orcid.org/0000-0001-9011-552X

Date of Award

2026

Keywords

Older adults, homelessness, Bhutan, ageing, poverty, isolation

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Doctor of Philosophy

School

School of Nursing and Midwifery

First Supervisor

Lisa Whitehead

Second Supervisor

Amanda Towell-Barnard

Third Supervisor

Caroline Vafeas

Abstract

A shift in the demographics of homelessness started to occur in the 1900s, with a significant increase in the number of middle-aged or elderly men and women being recognised as a part of the homeless population. The rising urgent global concern of homelessness of older adults necessitates a deeper understanding of the lived experience and holistic well-being of these marginalised adults. This thesis aimed to explore the phenomenon of homelessness of older adults in Bhutan, which is an often neglected topic in both national and international gerontological research.

Employing narrative inquiry within the constructivist approach as articulated by Pino Gravidia and Adu (2022), this study involved nine participants from urban and rural areas of Bhutan and utilised in-depth interviews and storytelling sessions to collect data, ensuring maximum participant autonomy and cultural appropriateness during the process. Qualitative data were collected as stories, which facilitated an in-depth analysis of the interplay of factors such as ageing, health and social marginalisation within the unique socio-cultural framework of Bhutan, where homeless older adults encounter substantial obstacles to obtaining essential resources and services.

The principal aims of this research were threefold: to uncover the factors leading to homelessness, to identify the proximate needs of homeless older adults and to understand the impact of homelessness on their physical, mental and social well-being. The findings point to an intricate relationship between several key factors, specifically revealing (1) intergenerational loss of filial responsibility, (2) cumulative impact of poverty and early-life hardship, and (3) severe social isolation and systemic exclusion as the primary drivers of late life homelessness in the Bhutanese context.

Drawing upon Maslow’s hierarchy of needs and Gross National Happiness frameworks, this study offers a holistic lens to analyse the challenges and hopes of homeless older adults. The narratives shared by participants often reveal a history of early hardship, ongoing poverty, declining filial responsibility and social isolation, which diminished their ability to secure stable housing as they age. It explores how elements such as ageing, declining health, relationship breakdowns and social exclusion intersect within Bhutan’s unique socio-cultural landscape, leading to chronic homelessness.

The findings significantly contribute to the body of knowledge of both nursing and public health fields, by offering a culturally nuanced understanding of older adult homelessness in a low-income country context, informing future policy development and evidence-based person centred interventions for this vulnerable population.

Download

Share

 
COinS
 

Link to publisher version (DOI)

10.25958/qmgb-1f78