Homelessness among the institutionalized elderly.

Home is the experience of a dynamic relationship between the individual and the environment. It can be viewed as a lived experience that possesses deep existential meaning for the individual. Homelessness is the experience of the negation of home; the relationship between the individual and the environment loses its intimacy and becomes severely damaged. This painful experience brings about deep existential despair. The data supports the strong probability that the institutionalized elderly are homeless and that the elder's attempts to cope with this unendurable pain results in behaviors that are often misinterpreted as indicating acceptance or adjustment to the nursing home setting. Nursing must recognize the possibility that to be institutionalized is to be homeless. This intolerable state must be alleviated either through significant modification of nursing home psychosocial environments or the identification of alternative settings for the care of chronically ill and debilitated elderly persons.