Tag Archive for seniors

With Baby Boomers Aging, Elderly Homelessness Could Skyrocket, Vastly Increasing Emergency Room Usage

Sign: Elderly People

Photo by Ethan Prater on Flickr, thanks for using Creative Commons!

A 2011 study by the Homeless Research Institute of the National Alliance to End Homelessness estimated that the number of homeless senior citizens will increase by 33% in 2020 (from 44,172 in 2010 to 58,772 in 2020) and will more than double from the current number by the year 2050 (to 95,000)—unless something is done to reduce these numbers.

According to Medicare, nearly half of all seniors (48%) live in poverty today, especially in: DC (59%); California (56%); Hawaii (55%); Georgia (54%); Louisiana, New York, Rhode Island and Tennessee (52%); Florida and Mississippi (51%) and Arizona (50%).

Fortunately, chronic homelessness decreased by 3% from 110,911 in 2009 to 107,148 in 2011. And the chronically homeless population has declined by 13% since 2007. The drop is associated with an increase in the number of permanent supportive housing beds from 188,636 in 2007 to 266,968 in 2011. Providing permanent supportive housing ends chronic homelessness.

A study named The State of Homelessness 2012 lays out a roadmap for ending homelessness:

Prevention and rapid re-housing clearly work. This is the lesson of the Homelessness Prevention and Rapid Re-Housing Program, which appears to have forestalled an increase in homelessness, despite the poor economy, high unemployment and lack of affordable housing. With 40% of homeless people unsheltered, the crisis-response system must be improved.

Today, many older individuals with histories of housing stability experience a first-time period of homelessness. Living on limited, fixed incomes—including Social Security and/or Supplemental Security Income—elderly persons experience severe housing cost burdens more frequently than the general population, potentially resulting in housing loss. Twenty-six percent of elderly households were “severely cost-burdened,” versus 20% of all households in 2007. Compounding this, access to affordable senior living can be challenging, with an average wait time lasting about three to five years.

According to one study, common causes of elderly homelessness include: financial problems, mental health problems, relationship breakdown, physical health problems and issues related to work.

Another study identified three non-overlapping reasons for homelessness: “36% said they lost a job and could not find another and/or had problems with drinking; 39% reported discontinued or inadequate public assistance and/or a disagreement with family or friends with whom they were staying; and 25% reported inadequate income and/or illness.

Lack of stable housing has been associated with increased Emergency Department (ED) utilization. Unstably housed adults over age 50 use the ED at rates nearly four times that of the general population. Certain factors among these older patients were associated with making at least four ED visits in the past 12 months: female sex, white race, no usual source of primary care, at least one outpatient visit during the past year, alcohol problem, at least one fall during past year, executive dysfunction and sensory impairment.

Due to prolonged exposure to stress, those living in poverty often experience weathering, causing them to age prematurely by 10 to 20 years beyond their chronological age.

Factors that are significantly correlated with frailty in the older homeless population include: chronological age, being female, increased health care utilization and poorer nutrition scores. Additionally, adverse life events including trauma, drug and alcohol use and incarceration are can place those without stable housing at greater risk for hospitalizations, falls, and premature mortality.

Systems of care must be improved to accommodate the unique needs of older and elderly adults without stable housing. To reduce avoidable ED utilization and improve health status, a study recommends routine screening and counseling on alcohol abuse, addressing common risk factors for falls, increasing access to eyeglasses and hearing aids and connecting patients with housing to decrease acute-care use.

Another study recommends:

Having frontline geriatric nursing triage, shelter-based convalescence or medical-respite facilities, and nurse case management utilizing a chronic-disease self-management program.

Photo: Ethan Prater on Flickr

D.C.Proposed Bill Would Help Pay Rent for Low-income and Very-low-income Seniors

Washington D.C. council member Tommy Wells has introduced legislation to help pay rent for “low-income and very-low income seniors.”  The Housing Assistance Program for Unsubsidized Seniors Act of 2013 would provide assistance to D.C. residents over the age of 65 whose rental payments exceed 35 percent of their income.

Wells said:

Because of the rising costs of living and the rising costs of health care, District seniors are more and more frequently confronted by homelessness. It is unacceptable that they are being forced to choose between paying for medicine and food or paying their rent.

Too many longtime District residents have been forced to move away from the city they’ve helped build or worse fallen into homelessness. It is time for the District to step up and provide the preventative assistance necessary to ensure our seniors do not end up homeless.

Recently, the National Health Care for the Homeless Council (NHCHC) reported that “strong demographic trends, economic insecurity and lack of affordable senior living have contributed to increased housing instability among seniors.
A study by the Kaiser Family Foundation found that 26 percent of the senior citizens who live in the nation’s capital, about 25,000 men and women, live at or below the poverty level.

A 2011 study by the Homeless Research Institute of the National Alliance to End Homelessness estimated that the number of homeless senior citizens will increase by 33 percent in 2020 (44,172 in 2010 to 58,772 in 2020) and will double from the current number by the year 2050, with 95,000 older people expected to be living without stable housing.

According to AARP:

A great contributor to this phenomenon is the fact that the baby boomer generation is now hitting 65. Already, about 45 million Americans are considered senior citizens and according to U.S. Census projections, that number is expected to grow to 60 million, topping off at 90 million by the year 2050. These numbers mean that added services such as housing, health care and nutrition will greatly be needed.

The NHCHC reports that the age composition of the homeless population has shifted significantly over the past two decades, with the median age of single adults increasing from 35 years in 1990 to 50 years in 2010. Still, the majority of unstably housed adults over 50 are between 50 and 64 years old, with only 5 percent age 65 and over.

While a number of safety net programs exist for the elderly, those between ages 50 and 64 often fall through the cracks, despite having similar physical health to those much older, due to daily stress, poor nutrition and poor living conditions.

The D.C. council members who proposed and have expressed support for the rent-assistance measure believe the number of homeless senior citizens can be reduced if they are given assistance through this program and another proposed effort proposed to exempt senior citizens who are long-time residents of the District and earn less than $60,000 from paying property taxes.