Survey Data Collection with Older Adults Experiencing Housing Insecurities: A Reflection

By Aislynn Sharrock (Research Assistant, SFU), Rachelle Patille (Vancouver Regional Coordinator, SFU), and Atiya Mahmood (Co-Investigator, SFU)          

As part of the Aging In The Right Place (AIRP) Project, our research team had the unique opportunity to work on a complementary project in parallel with the already existing AIRP Project due to a supplementary funding source to conduct pre-post surveys with older adults (age 65 and over) residing in affordable supportive housing in Metro Vancouver who are receiving support services through a non-profit organization named Whole Way House (WWH). This experience presented another opportunity for the AIRP Project team to evaluate the housing situation and well-being of older adults living in the community who are experiencing or at risk of experiencing housing insecurity and/or homelessness. The survey was developed in collaboration with Whole Way House (WWH). WWH provides non-medical home support and social engagement opportunities to housing precarious older adults to help reduce social isolation and promote aging in the right place. Recently, WWH received pilot funds to administer their services in four affordable housing sites. Surveys were conducted to collect baseline data at these four pilot intervention sites about the types of supports the residents receive, their quality of life and social well-being. To evaluate the role of services from WWH in the intervention sites, surveys were also conducted at several control sites where WWH services were not provided. The goal of the pre-post surveys was to better understand the experiences of older adults living in supportive housing, their physical health and emotional well-being, as well as their involvement with services provided by WWH. This blog post highlights the experience of survey data collection at baseline (T1) with older adults facing housing insecurity.

During May 2022, our team of research assistants (RAs) set out to complete our baseline Time 1 (T1) intense data collection when WWH had just started administrating their support services. Our intervention sites included four supportive housing sites and our control sites included five control sites - both of which were operated and managed by same group of housing providers. Both sets of surveys had questions that related to quality of life, social isolation, mental health, and overall well-being. The survey questionnaires administered at the intervention sites differed as they included additional questions relating to specific WWH services. During the T1 period of data collection, RAs completed a total of 234 surveys. The follow-up surveys (T2) will be conducted in the next 6 months, with the participants from T1 at both the control and intervention sites. Data from T1 and T2 will be compared and analyzed to determine whether there are statistically significant differences in older adults’ experiences and well-being with the supports provided by WWH.

Given the nature of the housing and the tenants, the experience of conducting these surveys at T1 itself is a noteworthy experience for the AIRP RAs, many of whom had not worked with older adults with limited incomes and lived experiences of housing insecurity before. This two-week intense data collection experience is highlighted in this section. On each scheduled day of data collection, our research team of more than 10 individuals met up bright and early to debrief and arrange the plan for the day. Shortly after that, we were off walking up to each door, where we would politely knock, and ask if residents were willing to participate in our study. Initially, we expected the survey questions to take about 10-15 minutes, where we would hand the participants their honorarium of a $10 gift card for their time and be off to the next door. However, we quickly realized that the survey questions we asked prompted the residents to engage in deep and nuanced conversations. To the RAs surprise, residents volunteered to elaborate and share their own experiences living in below-market rate supportive housing where they were often living on limited fixed income, alone, and without formal or informal supports. They also highlighted how the COVID-19 pandemic exacerbated their vulnerability and social isolation. As JM, one of our RAs, shared: “These 15 minutes almost always turned into 30 minutes to over an hour-long interview about their life experiences, difficulties, and hopes for the future”. It was saddening to hear that many individuals did not have anyone to talk to for several months because of the shelter-in-place directives during the COVID-19 pandemic. After each day of data collection, our team came back together as a group to share our experiences and debrief, given the emotional and heart-wrenching stories shared by the survey participants. Our hearts went out to the residents as they expressed how grateful they felt that people like us were coming around and gathering this information to help spread awareness of how people like them face daily challenges and how social isolation and lack of support and housing affordability factors affect them. They hoped that raising awareness about their situation might lead to some action that could make a meaningful difference in lives of similar older adults.

The majority of our RAs realized that there were a few questions that especially evoked these in-depth and emotional conversations, as these questions were sensitive and directly related to social isolation, food insecurity, and loneliness. One question in particular asked residents if there was anyone in their network who would come to find them within 48-hours if something dangerous or serious happened to them in their home. Many of the residents shook their head indicating no or answered the question by stating that no one would come looking for them in 48 hours and it would most likely be much longer before their situation was discovered. Replies like this were incredibly difficult to hear but also motivated us to keep going as we realized how important this work was. We realized we were actively contributing to raising awareness about social isolation and the need for social support and engagement in these types of housing. In turn, we became extremely hopeful and proud at the thought that our research may play a vital role in making experiences better for these residents.

As our research team was reflecting and sharing how our individual surveys went, we realized that every one of our RAs experienced kindness and generosity from the residents. Many of residents were quick to welcome us into their homes and answer our questions with honesty and sincerity. Some residents offered us refreshments and beverages from their limited supply of food, and even gifts as we departed. Overall, the RAs were touched by the generosity of the older adults we interacted with. In some buildings, the word spread quickly that a team of RAs were in the building to survey older adults. Several residents came down to the common room throughout the day, intrigued by our efforts to collect data to understand their experiences. They were ready to sit down and have a conversation with us to understand what we were doing. Many residents mentioned that they felt lucky to have this affordable rental home in this expensive housing market in Vancouver. Research assistant JM reflects on a specific experience with a resident at one of the control sites, where she explains that “apart from all of the hardships he has experienced throughout his life, he expressed only gratitude for having a place over his head, and food in his home”. Our research team became aware of a variety of positive and negative comments regarding their living situation, but that the predominant sentiment was that residents were thankful to have a place at all.

The older adults who were surveyed included people from a wide variety of ethnic and cultural backgrounds. Three RAs from our team spoke fluent Spanish and were able to complete surveys with Latino residents. In addition, several of the sites had residents from Chinese backgrounds who only spoke either Mandarin or Cantonese. We had help from bilingual staff at WWH and one of our own RAs, EL to conduct these surveys in either Mandarin or Cantonese. The staff member from WWH also translated the survey into Chinese. As EL explains: “it was comforting and heart-warming to see how this specific demographic of older adults could really connect with me through a shared language and cultural background”. Nonetheless, some questions had cultural nuances that did not translate well into Chinese. Thus, our bilingual RAs faced some difficulty at times to elicit responses to these culturally sensitive questions. EL explains that “in the Chinese culture, especially in immigrant and older populations, it is not common and even stigmatized to share one’s personal troubles with others or even to ask for help.” This meant that survey questions that asked about emotional support if in need or asking for help from others did not elicit a strong response. Our work with WWH highlighted to us the importance being sensitive about cultural norms and expectations when reaching out and talking to participants who come from different and intersecting backgrounds and identities. We hope that our survey findings in collaboration with the much needed non-medical and social support that WWH provides to this group of older adults can help to shed light on these cultural nuances and promote provision of services in a culturally relevant and appropriate manner to bridge the gap that exists in service delivery among non-English speaking ethnic populations.

Even though WWH had started offering services at the intervention sites only a short time ago, we observed some differences between our intervention and control sites, which highlights that WWH has already started to make a positive impact on older adults’ lives in these communities. SW, a research assistant, explains that she had observed that the WWH sites had “cleaner buildings and more pride. A sense of building a community of caring…most appreciative of the meals and opportunities to socialize”. Even so, the overall maintenance in both intervention and control sites were an issue for many residents. DP, a research assistant, described the maintenance and upkeep of the buildings as “poor with dirty carpets, lack of ventilation, and heavy cigarette smell”. Walking up and down the hallways of these buildings and reflecting on the stories residents shared with us about their living conditions, showed us all how critical these types of non-medical social support like those provided by WWH are to these residents. We all felt emotional at the end of the two weeks of surveying as the residents had welcomed us into their homes and appreciated our company even it was for a short time. It highlighted how social interaction and friendly visits are important for the well-being of older adults, especially those living on their own. This survey experience was an eye-opener for many of our research team members and provided them with a new perspective of older adults living in supportive housing in our community and how meaningful our conversations and human interaction are for these residents. Our team hopes that the support provided by WWH employees and volunteers paired with the survey results will result in this pilot program receiving more permanent funding and these types of programs and services be provided in other similar affordable supportive housing sites and contribute to bettering older adults’ lives in different parts of Metro Vancouver.

We want to give a big thank you to all the residents at each supportive housing site who opened their doors and homes to us to complete the survey and graciously shared their life stories, which were sometimes sensitive, touching, and personal. We hope our research shines some light on the challenges and barriers faced by this particular group of older adults, as well as showcases their resilience and gratitude to initiate some changes to lighten the system-wide barriers these types of marginalized communities face in Metro Vancouver and other parts of our province.