Homeless Suffer from Geriatric Conditions Decades Early

Homeless individuals in their 50s suffer from more geriatric health conditions than non-homeless people who are decades older, according to new research at the University of California, San Francisco (UCSF).

The findings highlight the importance of developing new ways to help homeless people, a population that is becoming increasingly older. Half of single homeless adults are now 50 or older, compared to only 11 percent in 1990.

For the study, researchers tracked 350 homeless individuals aged 50 and over in the city of Oakland. Even though the people in the study had a median age of just 58, they experienced more difficulty bathing, dressing, and eating than 80 year olds living in homes.

These younger homeless individuals were more likely to fall down frequently and suffer from depression. They also had a harder time using transportation, taking their medications, managing money, applying for benefits, arranging a job interview, and finding a lawyer. They were more likely to suffer from cognitive and visual impairment and urinary incontinence.

“Usually, we think of geriatric conditions as affecting much older adults in their 70’s, 80’s, and 90’s,” said Rebecca Brown, M.D., M.P.H., assistant professor of medicine in the Division of Geriatrics and first author of the paper.

“We found these conditions were very common in homeless adults with an average age of just 58. We studied a very vulnerable population. Our systems need to be responsive to the challenges that these older adults have.”

About 40 percent of homeless adults reported difficulty with one or more activities of daily living, while a third reported having fallen in the past six months. About a quarter had cognitive impairment, 45 percent had vision impairment and 48 percent had urinary incontinence.

“The traditional way of providing services for homeless people may need to be adapted for the aging population, who may need assistance with activities like using the toilet and are at high risk of falling,” said Margot Kushel, M.D., professor of medicine at UCSF and senior author of the paper.

Kushel believes that a better alternative for chronically homeless older adults would be to develop permanent supportive housing to meet the needs of the aging homeless population. This would involve specific accommodations, such as having personal care attendants, as well as grab bars in the bathroom.

Even short-term solutions, like homeless shelters, will need to adapt for the needs of the aging population.

“We need to figure this out, otherwise many homeless people will be placed in nursing homes, for lack of an alternative, even though they would be better off living in less restrictive, and less expensive, environments,” said Kushel.

Researchers found no difference in geriatric conditions between homeless people who camped on the streets, cycled between shelters and hotels, stayed part time with family and friends, or had recently lost their rental housing.

The findings are published in the journal The Gerontologist.

Source: University of California, San Francisco
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