Homelessness in female veterans: A phenomenological study of perceived precipitating factors.

BACKGROUND

Although researchers have examined health issues among women veterans, the phenomenological study of homeless women veterans is limited.

PURPOSE: A qualitative, phenomenological approach was used to describe the experience and context of homelessness and perceived related factors including military sexual trauma and adverse childhood experiences (ACEs).

METHODOLOGY: Twelve female veterans living in Veterans Administration (VA)-sponsored transitional housing participated in interviews that were analyzed using Colaizzi phenomenological analytic method and N-Vivo.

RESULTS

Nine major themes emerged: family dysfunction (family origin instability, family instability during and after military service), lifespan abuse, history of ACEs, military sexual trauma (MST), absurd MST reporting structure, hidden homelessness, substance misuse, poor chronic illness self-care (including mental illness), and lost expectations. Related subthemes were also derived.

CONCLUSIONS

Findings suggest that older homeless female veterans are a vulnerable group as they can describe a lifetime of maladaptive behaviors and, at points, are "paralyzed" cognitively with critical decision making and lack of self-advocacy. Major precipitating factors for homelessness were military sexual abuse, substance misuse, and acute episodes of neglected chronic illnesses. Homelessness did not occur immediately after military service; it was usually 20-30 years afterward.

IMPLICATIONS: Implications for care include advanced practice nurse practitioner awareness of need to advocate for female veterans, and that multiple interacting vulnerabilities make them a complex population. Wraparound services targeting the female veteran and her family are crucial.