Our Aging Homeless Population: A Growing Crisis
Our Aging Homeless Population: A Growing Crisis
Addressing the unique challenges faced by elderly individuals experiencing homelessness
11 July 2023 | By Jericho Kilpatrick
IN BRIEF: Homelessness is a pressing issue in America, affecting individuals from all walks of life. However, a concerning trend has emerged in recent years: the increase of elderly people within homeless communities. This blog entry explores: 1) the reasons behind this trend, 2) the physical and psychological challenges faced by America's aging homeless population, 3) mortality rates of our aging homeless population, and 4) how the Weingart Center addresses the needs of this diverse, yet distinct, population.
Source: California Homeless Data Integration System
Introduction
Data and history show us that a variety of factors contribute to homelessness. These factors can include economic conditions, lack of affordable housing, mental health issues, substance abuse, domestic violence, natural disasters, and others. And while there are numerous services and programs that are designed to address many of the needs that someone experiencing homelessness may have, there is no “one-size-fits-all” solution that works for everyone.
Situated in the infamous Skid Row district of downtown Los Angeles, the Weingart Center has been operating as a nonprofit organization since its establishment in 1983. As a 501(c)(3) homeless service provider, it has a deep understanding of the difficulties faced by individuals enduring homelessness. The organization’s primary focus is to offer comprehensive services and innovative housing solutions to thousands of people in the greater Los Angeles area, including the elderly population.
Source: U.S. Department of Housing and Urban Development
Image source: Weingart Center Association
Homelessness and Age
Homelessness affects people of all ages, including adults, youth, and seniors. The average age of individuals experiencing homelessness in the United States varies depending on the specific demographic group being considered.
According to the Annual Homeless Assessment Report (AHAR) published by the U.S. Department of Housing and Urban Development (HUD) in 2020, with additional data from homeless shelters and other facilities:
The average age of adults experiencing homelessness is 45 years
The average age of unaccompanied homeless youth (aged 24 and below) is 18 years.
The average age of older adults (aged 50 and above) experiencing homelessness is 66 years.
An Increase in Elderly Homelessness -- A Concerning Trend
According to the California Homeless Data Integration System, California is home to approximately one-third of the nation's unhoused population, and within this group, senior citizens are experiencing the most significant growth. This trend is evident in the data on individuals seeking homelessness services in the state. Between 2017 and 2021, while California's senior population as a whole grew by 7%, the number of individuals aged 50 and over accessing homelessness services skyrocketed by 84%. This increase surpassed that of any other age group. In comparison, the overall number of people seeking homelessness services across all age groups rose by 43% during the same period.
Several factors contribute to the rise in elderly individuals experiencing homelessness. One reason is the lack of affordable housing options, as rental costs continue to rise faster than incomes. Many seniors live on fixed incomes, such as social security, which often do not keep pace with rising housing expenses. Additionally, the lack of affordable healthcare and the high cost of prescription medications can lead to financial instability, pushing elderly individuals into homelessness.
Physical and Psychological Ailments
Image source: United States Interagency Council on Homelessness
Elderly individuals experiencing homelessness face numerous physical and psychological ailments due to prolonged exposure to harsh living conditions. Some common issues include:
Musculoskeletal Factors
Lack of proper bedding, exposure to cold temperatures, and sleeping on hard surfaces contribute to musculoskeletal problems like arthritis and chronic pain.
Neural Sensorial Factors
Sensory deprivation, noise pollution, and exposure to environmental hazards can lead to sensory impairments, such as hearing loss and vision problems.
Movement and Functionality Factors
Poor nutrition, limited physical activity, and a lack of hygiene facilities can result in reduced mobility, muscle weakness, and difficulty performing everyday tasks.
Digestive and Dietary Factors
Unhoused individuals often struggle with inadequate access to nutritious food, which can lead to malnutrition, gastrointestinal issues, and weakened immune systems.
Memory, Cognition, and Behavioral Factors
The stress and trauma associated with homelessness can contribute to cognitive decline, memory problems, and mental health issues like depression, anxiety, and post-traumatic stress disorder (PTSD).
Mortality Rates
It is well-documented that unhoused individuals, regardless of age, face significantly higher mortality rates compared to the general population. As mentioned previously, homelessness itself exposes people to various health risks and contributes to poorer overall health outcomes and higher mortality rates.
When it comes to elderly individuals experiencing homelessness, their mortality rates tend to be even higher compared to their younger counterparts. Several reasons contribute to this disparity:
Decline in Physical Health
Aging individuals experiencing homelessness often have more health problems compared to their housed counterparts. Aging is associated with a natural decline in physical health and increased susceptibility to various diseases and chronic conditions. Homelessness exacerbates these vulnerabilities, as older individuals often lack access to regular medical care and are exposed to harsh living conditions. As a result, they are more prone to developing serious health problems, including cardiovascular diseases, respiratory illnesses, and complications from diabetes.
Lack of Access to Healthcare
Aging individuals typically require more frequent and specialized medical care, including regular check-ups, screenings, and management of chronic conditions. However, homeless older adults often struggle to access healthcare services due to financial constraints, lack of health insurance, and limited availability of healthcare facilities specifically catering to their needs.
Increased Co-Morbidities
Aging individuals experiencing homelessness often have a higher prevalence of co-morbidities, meaning they suffer from multiple health conditions simultaneously. These may include physical ailments such as hypertension, arthritis, and respiratory issues, as well as mental health disorders like depression and anxiety. The presence of co-morbidities can complicate healthcare management and increase the risk of mortality.
Social Isolation
Older unhoused individuals may face increased social isolation, as they may be estranged from their families or have limited support networks. Social isolation has been linked to negative health outcomes, including higher mortality rates. The lack of emotional support and social connections further contributes to the overall vulnerability and poorer health outcomes experienced by elderly homeless individuals.
Limited Resources
Elderly individuals often have limited financial resources, relying primarily on fixed incomes such as social security or pensions. However, these incomes may not be sufficient to secure stable housing or cover necessary healthcare expenses. The financial strain, coupled with the high cost of healthcare and medication, leaves many aging homeless individuals unable to address their health needs adequately.
Unique Needs
When considering the unique needs of older people experiencing homelessness, it's important to address various aspects of their well-being. Here are some types of needs that an elderly person experiencing homelessness might have:
Limited Income and Financial Insecurity
Many elderly unhoused individuals have limited or no income, relying on inadequate pensions, social security benefits, or government assistance. This financial insecurity makes it difficult for them to meet basic needs, access healthcare, or secure stable housing.
Financial Assistance
Many older individuals experiencing homelessness may lack a stable income and face financial difficulties. Providing access to financial resources, benefits, and assistance programs can help meet their immediate needs and support them in finding long-term stability.
Lack of Safety and Security
Older individuals are generally more susceptible to physical and emotional harm on the streets. They face higher risks of being victims of violence, exploitation, abuse, or neglect. The physical demands of homelessness can also lead to faster deterioration of health.
Lack of Suitable Housing
Finding safe and affordable housing that meets the unique needs of older adults can be extremely challenging. Elderly individuals may require accessible housing, proximity to medical services, and accommodations for mobility aids, which may be scarce or unaffordable.
Barriers to Services
Elderly homeless individuals often face difficulties in accessing necessary support services. Challenges may include limited transportation options, lack of knowledge about available resources, complex bureaucracy, and age-related barriers that prevent them from accessing benefits or assistance programs.
Ageism and Stigma
Negative stereotypes and ageism can further marginalize elderly homeless individuals, leading to social exclusion and decreased opportunities for support. The perception that homelessness only affects younger populations can result in inadequate attention to the specific needs of older adults experiencing homelessness.
Transportation
Access to affordable and reliable transportation is crucial for older homeless individuals to attend medical appointments, access social services, and seek employment opportunities. Public transportation options or partnerships with transportation services can make a significant difference.
Advocacy and Legal Support
Older individuals experiencing homelessness may require assistance in navigating bureaucratic systems, accessing entitlements, and advocating for their rights. Legal aid and support services can help them address issues related to housing, benefits, and other legal matters.
Geriatric Care Management
Older unhoused individuals often have complex health needs that require coordinated care. Geriatric care management services can help ensure comprehensive and holistic healthcare, including assistance with scheduling appointments, coordinating treatments, and managing health-related paperwork.
Empathy and Respect
Treating older homeless individuals with dignity, empathy, and respect is fundamental. Recognizing their unique life experiences and valuing their contributions can help foster a sense of self-worth and restore their confidence.
Ways the Weingart Center Helps
As highlighted above, elderly clients of the Weingart Center often have unique needs. Many of our comprehensive programs and services address these needs, allowing our clients to return to a more productive, enjoyable life. This is achieved through trauma-informed organizational and clinical best practices, which are proven to improve health outcomes.
Below are just a few examples of programs and services that benefit our elderly clients:
On-site Medical Clinic & Medical Referrals
The Weingart Center partners with JWCH, directly referring clients for comprehensive medical services, which can include: primary and specialty care, HIV/AIDS care, vision care, dental care, mental health care, and medication-assisted treatment. JWCH even has an on-site clinic and an on-site pharmacy located inside our main DTLA location.
Recuperative Care
After release from the hospital, many individuals still need time to recover. Homelessness can hamper that recovery. Inadequate meals, lack of clean facilities, and an inability to maintain a schedule are all factors that can turn manageable conditions into life-threatening emergencies. Unhoused patients, after release back to the streets, often return to emergency rooms and must be re-admitted to hospitals. In an attempt to prevent these returns, many hospitals delay the release of unhoused patients for several days beyond what the standard of care typically requires. Weingart Center’s Recuperative Care program, in partnership with JWCH, offers patients nursing care, assistance with medications, dressing changes, and other aftercare tasks, and assistance establishing eligibility for public benefits.
Transportation Assistance
Traveling to and from medical appointments is crucial for the well-being of our elderly clients. Equally, having the ability to visit local Veterans Affairs, Social Security, and other benefits offices is important. And while many of our on-site services provide direct assistance, the Weingart Center also partners with FAME Corporations to provide transportation assistance to off-site locations when needed. This program offers access to regional ride trip tickets, taxi coupons, and taxi variable vouchers.
Dental Services
Oral health issues can significantly impact a person's ability to eat and digest food properly. Elderly individuals, especially those experiencing homelessness, often face barriers in accessing dental care, leading to untreated dental problems such as oral pain, tooth decay, gum disease, oral infections, and missing teeth. These conditions can cause pain, difficulty chewing, and discomfort while eating, which may result in a limited diet or avoidance of certain foods. For example, not being able to eat fresh fruits, vegetables, and some proteins can result in a diet consisting of soft, sugary, and high-carb diets. As a consequence, malnutrition can arise, affecting overall health and well-being. The Weingart Center understands that all clients, whether elderly or not, deserve proper dental care. That is why we partner with the USC Dental Clinic to deliver high-quality dental services, which include cleanings, fillings, extractions, root canals, and complete/partial dentures.
If you are experiencing homelessness and would like to know more about these and other programs and services offered at the Weingart Center, visit our Access Center to begin your journey to housing and wellness.
In Conclusion
It is essential to address the unique challenges faced by aging homeless individuals to improve their health outcomes and reduce mortality rates. This includes implementing targeted healthcare interventions, increasing access to affordable housing options specifically designed for older adults, and providing comprehensive support services to address both physical and mental health needs. Collaboration between communities, policymakers, government agencies, organizations, and healthcare providers is crucial in addressing the complex issues faced by this vulnerable population and working towards ensuring the well-being and dignity of our elderly unhoused population.
