When you think of a homeless person, you likely do not envision a senior citizen. Yet studies have been cropping up in the United States pointing to a growing percentage of homeless older Americans.
For purposes of accuracy, an “older person” is considered to be those between the ages of 50 and 64. Studies have claimed that given the vulnerability of this age group (too young to claim Medicare and usually not well enough to attain stable income) they are falling in between the governmental cracks of support. Taking a deeper look at how service-enriched supportive housing developments alleviate some of these problems may help policy makers frame better recommendations to solve a growing problem.
Higher Mortality Rates with Chronically Homeless and Chronically Ill Older People
The sad truth of the matter is that a large portion of the homeless older person population will not live to see age 65. They simply do not have access to affordable housing or healthcare, including substance abuse and mental health treatment. As a result, their mortality rate is triple and in some cases quadruples that of a younger homeless person.
Those born between the years 1954 and 1964 have the highest rates of being chronically homeless.
Another contributing factor to the higher mortality rate is the concurrence of chronic health conditions associated with a particular age group within the Baby Boomer generation. Those born between the years 1954 and 1964 have the highest rates of being chronically homeless. According to Dr. Dennis Culhane of Penn State Social Policy and Practice about 50% of the chronically homeless fall within this age cohort.
Of those older people, 85% of them reported having at least one chronic health condition requiring treatment of some sort. As one can imagine, being homeless presents many challenges a non-homeless person would not confront. Things such as not having a refrigerator for certain medications, medications being stolen by other homeless people, poor sleeping habits and poor access to healthy foods that may be of utmost importance to those struggling with diabetes are factors. These unfortunate circumstances are what contribute to the average life span of just 64 years old for a chronically homeless older person.
Proposed Solutions Require Social Stimulus
Affordable government housing is not associated with white picket fences and perfectly manicured flower beds. However, when researchers have looked into projected models for permanent supportive housing (PSH) solutions, or service-enriched housing for homeless older persons, they found some encouraging associations. When data was gathered from across the country the following improvements were seen:
- 83% of residents remained in the housing for a minimum of a year
- 87% reduction in emergency drug detox services
- 57% decrease in emergency room visits
- 52% reduction in the rate of incarceration
Permanent supportive housing is housing beyond your typical government subsidized housing developments and a step down from assisted living facilities. These PSH developments are designed with older people in mind and offer a variety of services aimed at upholding aging in place. Services range from structural design for special needs such as wheelchair accessibility to family-based care approaches. Care management programs offer ongoing support with client centered counseling, accountability for substance abuse, and mental health outreach. Meal assistance, personal care assistants, and crisis management teams also aim at improving the quality and longevity of life.
While not the same as assisted living, permanent supportive housing developments would give an older person the opportunity to age in place inside the comfort of four walls, with greater access to accommodations that empower them to be more independent. State and federal policy needs to be reframed to better fund PSH developments for this unique and growing demographic.
It is expensive to care for elderly stricken with health complications…
Despite the worthiness of the cause, though, funds are short to go around. It is expensive to care for elderly stricken with health complications, let alone mental health and substance abuse issues. The most common reasons why older Americans are homeless are because of mental health problems, physical health problems, and family/friends requesting the elder to leave.
However, in the last decade or so, more and more studies are coming to light that illustrate the cost advantage to service-enriched homes. Less money is spent in emergency crisis situations. Medicare costs actually decrease on the whole as older persons become healthier and happier having a roof over their heads and regular caretaking help. Given this promising research, it could be that PSH developments are an answer to older Americans’ homelessness.
CSH (Corporation for Supportive Housing. (December 2011). Ending Homelessness among Older Adults and Elders through Permanent Supportive Housing. Revised Policy Paper Prepared for the National Leadership Initiative to End Elder Homelessness. CHS and Hearth, Inc. Available at http://www.csh.org/wp-content/uploads/2012/01/Report_EndingHomelessnessAmongOlderAdultsandSeniorsThroughSupportiveHousing_112.pdf. Last Visited March 4, 2016.
Culhane, D.P., Metraux, S. & Bainbridge, J. (2010). The age structure of contemporary homelessness: Risk period or cohort effect? Penn School of Social Policy and Practice Working Paper, 1-28. Available at http://works.bepress.com/dennis_culhane/93. Last visited March 8, 2016.
Hearth. (November 19, 2009). Ending Elder Homelessness: The Importance of Service-Enriched Housing Available at http://static1.squarespace.com/static/5345ab11e4b0f69e5c973033/t/5421be75e4b0a990b3440c3e/1411497589705/hearth_research09.pdf. Last Visited March 4, 2016.