The essay will focus on the old aged (over 50) groups of mentally ill homeless people and their vulnerable status as an increasing population requiring decent health and welfare. The vulnerability principle is analysed and interpreted in conjunction with the reasons why homeless old aged people with mental disorder are among within our own most vulnerable people in the country.

Causes directly linked to vulnerability among old people are highlighted and investigated, explaining the reasons for social, physical, economic and psychosocial factors contributing to vulnerability. Finally, analyse multi-professional and multi-agency interventions used to moderate their effects and how they relate to future learning.

As referred to in the Health Department (DH 2015), the meaning of a vulnerable adult is a person who is 18 years of age or older in need of social services due to mental or other disability or age incapable of dealing with physical harm or mistreatment.

Complicated to defined homelessness dependent on being homeless and being provide accommodation, Local authorities must recognise all submissions not only from millions of people needing housing or aid in securing accommodation in order to comply with the (Housing Act 1996, cited Larkin 2009).

Hard to estimate total numbers of homeless people because of the fluctuating nature of the homeless population. There are different ways by the agencies on counting homelessness due to some being street homeless, some sofa surfing and other ways being assumed (Greenfields et al 2012). Page on facts and figures in relation to homelessness can be find at www.homeless.org.uk/facts. Health care demand of vulnerable group has shifted it age group which has developed to meets ever more difficult health needs for homeless people

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To comprehend vulnerable old homeless groups, the meaning of vulnerability needs to be understood. Yet according to (Rogers 1997, cited in Larkin 2009), it is hard to quantify a vulnerable group, as anyone at different points in their lives can be or feel vulnerable. The phrase vulnerable is generally used in health and social care, although there is no known evidence of a person at risk, now under potential threat and in need of safety (Larkin 2009). The Care Act (2014) makes reference to vulnerable persons as those who are at risk and describes them as someone who has care desires and support and who perspectives, or is at risk of, abuse or neglect and therefore cannot protect himself due to his care needs.

It’s estimated that there is around 400,000 ‘hidden homeless’ adults at any point in time (Firth, 2007b; New policy institute, 2007). Ultimately, on the basis of ethnic, social, economic, health or cultural characteristics, all these societies are vulnerable to injustices in access to healthcare and risk poor health outcomes ( Shivayogi, P. 2013).  (Rogers 1997; cited in Heaslip 2003) The client might well be implicated by psychological and physiological vulnerability. Experiencing vulnerable has a profound impact on psychological well- being and can lead to fear, frustration and lack of motivation.

There are a number of causes for groups of mentally disordered older people (over 50) of homeless background.

The first one is loneliness which is widespread among the homeless. Loneliness among the homeless is common for the old aged population of England. Including the old aged population in England, loneliness as a psychological factor appears which guide to vulnerability has been identified as an immediate public health problem and as a response to any specific general lack of social affairs (Goll et al., 2015; Department of Health 2012).

Rokach (2004) found in her experience of loneliness five composite causes which are emotional distress, growth and discovery, interpersonal isolation, social insufficiency and alienation and self-alienation.

Homeless (male and female) scored higher compared to the loneliness of the rest of the population experience (Rogers and Pilgrim, 2003; Rokach, 2004, 2005).

Homeless people with physical and mental health problems are likely to be more than other members of the population. 19 percent of rough sleepers (Shelter 2007, cited Greenfields 2012) reported having mental health problems. It’s not known whether this exacerbated due to them being homeless or happened before they become homeless meaning they were ill at that point in time. There are plenty of reasons for this, homelessness health Conditions such as mental illness, drinking and drug related medical problems are sometimes triggered (Firth, 2007b, cited M, Larkin 2009). For that reason, over time It’s easy over a period of time for an older group to experience vulnerability over their life time.

Some of these health problems are chronic chest, respiratory, wound and skin problems, Musculo-skeletal and digestive. Also, tuberculosis rates among rough sleepers are also 200 times that of the rest of the population (Larkin, 2009).

Victims of abuse is another factor where Rogers (1997) stated that some people are more likely to be abused because of their age, gender, race and ethnicity, low incomes, poor education and lack of social assistance. Indeed, domestic violence accounts for an average 16 percent of the households accepted as homeless each year (Rogers and Pilgrim, 2003; Hill, 2006). And the social exclusion concept explains that people suffer from a combination of linked problems such as low incomes, poor housing, unemployment and health, family breakdown and poor skills (social exclusion unit 2002; cited in Larkin 2009). Eating problems, post-traumatic stress disorder, anxiety,

drug overdose, sleep disturbance, depression, substance intake is all part of domestic violence (Walby, 2001).

For rough sleepers, average age of death is between 42 and 63 which is high. Also, likely four times to due to natural causes like accidents, assaults and drug or alcohol poisoning and also likely to commit suicide 35 times than rest of the population (National statistics, 2004).Older homeless people are prone to neglect and abuse in the community, which worsens their risk of depression, solitude and significantly reduced quality and quantity of life (Manthrorpe et al., 2007).

These is the interventions, as mentioned by NICE (2014) that offered advises that all Safety should be provided to domestic victims by all health and social care providers. Homeless people are being supported by the voluntary sector within the provision of services. The First multi-Agency is called Crisis, this helps vulnerable single/groups homeless people. There services are education, transform homeless life’s, publishing and commissions research, organised events to promotes awareness cause and nature of homelessness and campaigns for more inclusive society Larkin 2009 cited (Crisis, 2008).

Some responsibilities of a mental health Nurse implements care planning and truly care for older homeless Mental disorders groups, especially in the community and also often expected to work as multi- professional staff and with multi- agency teams in the care of vulnerable persons (Cornwell, 2012). However, policy guidance and legislation, such as No Secrets (Department of health, 2000a), the mental capacity Act, 2005 (Department of Health, 2005b), and the accompanying code of practice, provide a framework, which is meant to clarify and improve decision-making around capacity, particularly in relation to adult protection.

The government put in place some mechanisms to enhance information sharing among some organisation such as Multi-Agency Risk Assessment and control (MARAC) and Multi-Agency Public Protection Arrangements (MAPPA) (Norman and Ryrie 2013).

Lifestyle interventions to improve patient care should be added to mental health care and begin when service users try and contact mental health services (Robson; cited in Norman & Ryrie).

There exist various types of paths which are adopted by the Multi-agencies working team. They share information among themselves, joint decision making and coordinate intervention (Home office 2014). The six key principal which helps the team to reduce the problem in the society are empowerment, proportionality, prevention, protection, partnership and accountability.

Empowerment, this is influence by vulnerable homeless people having a say and making their own decision. Happy with it and thinking about their future health in the

accommodation provided and the surrounding area. Proportion meaning informing the vulnerable that is the older homeless mental disorder groups not to allow any types of discrimination like age, ethnicity in the society. Prevention against any bad event like attacks, beating up in the street, whereby awareness/surrounding is much important before any sign of bad situation. Protection stables their mental states and gives them self-confidence, comfortable and safe which satisfaction. Partnership between the multi-agency and the homeless people in the community is the best especially when they feel isolated and needs assistant. Accountability sustain homeless people in the safeguarding situation.

Psychological interventions are in place for mentally disordered older homeless people to work out ways of dealing with their distress. Psychological strategies such as talking therapies (Gurney; cited in Norman and Ryrie) should therefore be provided for those with depression at significant positive risk of complications.

Then again, many factors benefiting to the vulnerability of older homeless people and their serious health problems demonstrate why multi- agency and multi- professional work is very important in getting the best possible results for older people (NHS England, 2014). The Mental Capacity Act (2007) liaises with vulnerable persons with their consent to safeguarding activities. Under (NHS Choices 2015) which states that the health professional should support everyone with their right Act in making their own decision. Older homeless people should be referred to heart of England NHS services that provide prevention strategies for adults leaving the area who need anxiety and depression treatment and care even though they are homeless..

Under (NMC 2015) people and organisation required Mental health Nurses and other health professional to work together by having duty of care to prevent risks and have experiences of preventing abuse and neglect in the community (DH 2014)

As the lead coordinating organizations, the local authority maintains responsibility, while the NHS safeguard our service users (London Multi- Agency safeguarding for Adult Policy and Procedures).Psychological stress, social isolation depression and reduced quality of life is associated with financial hardship (Tucker-Seeley et al, 2012).

The quality of life is promoted, the outcomes gets improved through financial and assistance relief.

In summary, Groups of mentally disordered older people vulnerability is restricted to access to health, homelessness and accommodation outcomes. Also, older population of mental disordered groups in England represent a high risk of vulnerable homelessness among their groups due to factors such as social isolation, high rates of financial hardship and lack of social participation. This vulnerability increased rates of hospitalisation amongst older group due to health issues such as chronic chest, respiratory, wound and skin problems leading to mortality, reducing functional and cognitive capacity.

Early intervention for the vulnerable is vital with the services of Multi-professional and Multi agency approach. In addition, other health professionals from other disciplines must act in a variety of ways to recognize vulnerable homelessness in particular Mental Health professionals. Under the interventions multi agency working along other Agencies such as local authorise help find homes for the qualified vulnerable older groups.

Lastly finding crucial vulnerability risks ways to overcome increased older groups of homelessness in the society is important.

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