Older, Homeless, No Family Caregiver – What Do They Do?

Get ready to see more older homeless men and women on the street. Since most don’t have families or are estranged from them, there’s no family caregiver. Here’s a TED talk that gives perspective on homelessness.

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The U.S. Department of Housing and Urban Development reports there are 1.6 million homeless people a year on any given day. According to an NPR story, more than half of single homeless adults are age 47+. Younger boomers born between 1955-1965 are driving the aging homeless population, says Dennis Culhane, professor of social policy at the University of Pennsylvania. He is the lead author of a new study, “Age Structure of Contemporary Homelessness.” Culhane says it’s the dismal economy from 1979-1984 that first put these now older adults on the streets. He believes this population is almost twice as likely as other age groups to be homeless.

But take note: it’s not that older people are becoming homeless at a rate they hadn’t before. It’s that those who have been homeless and near homeless for the last 35 years are getting older.

For the most part, not really old. The homeless usually die prematurely. (I’ve seen different statistics on life expectancy for the homeless, from ages 42-52, but also some reports that it can be as high as 64 .) Regardless, it’s at least 20 years younger than the non-homeless population. Says Culhane: “Most will die over the next 10 years and will face all sorts of health care hurdles. It’ll be very costly to society if we don’t try to get them into housing.” The shortage of affordable subsidized housing for the poor and a struggling economy isn’t helping, either.

Because they don’t take care of themselves, they have health problems often seen in much older people such as heart disease and diabetes. John Lozier, executive director of the National Health Care for the Homeless Council, says the homeless have three to six times the rates of all illnesses, often with multiple diseases (i.e. mental illness, renal disease and foot problems).

It wasn’t until I attended a health care conference this month that I thought about who takes care of this aging demographic, or really, the homeless of any age. What do they do if they need rehab after surgery? Are undergoing chemotherapy? Are diabetic and need to refrigerate their insulin? What if they’re dying?

The health care conference highlighted an innovative program, the Boston Health Care for the Homeless Program (BHCHP). Part of its program takes place at the Barbara McInnis House, which has a 24/7 medical respite care facility. (In 2012, 51 percent of those who were enrolled in the program were age 45 and over.)

It’s one of 60 or so medical respite programs around the country for the homeless. They’re designed for those who don’t need a high level of nursing care and aren’t well enough to go to a shelter. Usually, someone goes for medical respite and then gets discharged back into the shelter system. But the McInnis House happens to be in the forefront of end-of-life services for the homeless. In fact, it may be the only end-of-life program of its kind.

“We try to help patients reconcile with family members before they die,” says Cheryl Kane, director of nursing at BHCHP’s Barbara McInnis House. “We have a man who is dying who had been estranged from his sister in Mexico for 30 years. We made it possible for him to Skype with her.”

Some families do take back their long-lost siblings, spouses and adult children at the end of their lives, but that’s not typically the case. “It used to be the expectation that you took care of your own but that seems to be less the case in today’s world,” says Lozier.

For more information on homelessness, go to the website for the National Coalition for the Homeless.

Know of any good programs for the older homeless population?

Sally Abrahms covers aging and boomers for national publications and websites with a focus on caregiving, housing, livable communities and work. Follow her on Twitter or visit her website.