Thursday, January 12, 2012

Homeless Older Adults: Geriatric Problems and Hospice Care (Research, Video 5:15)

Living in a large urban city, I see homeless people a lot. At one point, the public school where I was principal had more homeless students than any school in Michigan. Having interacted with homeless people at various age levels, I often wonder about their life stories. Of particular concern are older adults who have been homeless for many years. What brought them to this condition?  What’s really going on with them physically, mentally, and emotionally? What happens to those living in shelters and on the streets when they are actively dying?

The average age of America’s homeless population continues to increase along with the geriatric syndromes many of them have. Research is important to understand and improve the plight of homeless older adults. With this in mind, researchers at Beth Israel Deaconess Medical Center studied two hundred forty-seven homeless adults aged 50-69 who were recruited from eight homeless shelters in Boston, MA. Their goal was to determine the prevalence of common geriatric syndromes of older adult homeless. Among their key findings are these percentages involving research participants:

1. Difficulty in performing at least one activity of daily living was reported in 30%.

2. Cognitive impairment was present in 24.3%.

3. Impaired executive function was present in 28.3%.

4. Criteria for frailty were met by 16%.

5. Major depression was present in 39.8%.

6. Self-reported hearing and visual impairment was present among 29.7% and 30.0% of subjects.

7. Urinary incontinence was reported by 49.8%.

In summary, homeless older adults were more likely to have functional impairment, frailty, depression, visual impairment, and urinary incontinence compared to three population-based cohorts of older persons. Geriatric problems that are potentially treatable are common in older homeless adults and are experienced at higher rates than in the general older population

If homeless people are living ill on the streets, they are also dying on the streets. What can be done to help homeless older adults in need of hospice care? Alpha Project for the Homeless has launched one of the only Hospices for the Homeless programs in the country. Living with Dignity, a program inspired by Kyla Winters, is located in San Diego, California. This video describes how hospice care supports the homeless.

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback at many booksellers and in e-book form at Amazon and Barnes and Noble booksellers.

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