Introduction: The prevalence of homelessness among older adults in middle- to high-income countries is growing. Concurrently, there is increasing recognition that individuals who are precariously housed often have experiences of trauma, leading to increasing calls for trauma-and-violence-informed care in practice and research. It is unclear, however, to what extent researchers have focused on the lived experience of older adults who are or have previously been unhoused. We conducted this review to consolidate existing literature exploring experiences of trauma among older adults who have experienced homelessness.

Methods: We conducted a systematic review of qualitative evidence and meta-aggregation following the Joanna Briggs Institute methodology, in adherence with PRISMA guidelines.

Results: Our search yielded 22 studies. Through a process of meta-aggregation, we generated five synthesized findings: 1) Being let down by society and systems; 2) The world is not a safe place; 3) Survivor not victim; 4) Living in the long shadow of trauma; and 5) Homelessness as a deeply personal trauma.

Discussion and Conclusion: Our findings underscore the reality that older adults without housing face multiple experiences of trauma, including the trauma of homelessness itself. Considering these findings, research, practice, and policies need to focus on ways to better support older adults, both in preventing trauma and assisting those who have already experienced trauma. Our findings indicate the necessity of: 1) implementing trauma-and-violence-informed care across all sectors who work with older adults; 2) supporting older adults to age in place in safe, affordable, accessible housing; and 3) creating shelter environments more suitable for older adults, and especially those who have experienced trauma.