Study Shows Homeless People Develop Geriatric Problems Decades Early

A new research study shows homeless people in their fifties develop the kind of geriatric conditions more likely to be seen in people many decades older.   A team of researchers led by Rebecca Brown of the University of California at San Francisco found that homeless people in their fifties often reported problems with cognitive and visual impairments as well as urinary incontinence.   The homeless people they studied, with an average age of 58, often showed profound difficulties with many of the regular activities of daily living the rest of us take for granted.  This includes applying for benefits, taking medication, managing money, or finding a lawyer.   The study is one of the first to look at a broad cross-section of the homeless population rather than just focusing on shelters.   This meant going to homeless encampments, food lines, emergency shelters, and short-term hotels.

Most of the people in the study were male and 80 percent were African American.  Nearly three-quarters of the homeless people studied had a history of mental and physical health problems and more than half had problems with drug and alcohol use. 

"Usually, we think of geriatric conditions as affecting much older adults in their 70's, 80's and 90's," said Brown, in a media interview. "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."  

The research article, which was recently published in the journal, The Gerontologist, highlights the serious health problems faced by aging homeless people.  A third of homeless adults reported having fallen in the previous six months and a full 48 percent reported urinary incontinence.  Half of all single, homeless adults are now 50 or older.  This is a sharp rise from the 11 percent reported in 1990 and reflects the critical need for geriatric care in homeless shelters as well as developing more long-term solutions.

Margaret Kushel, a professor of medicine at UCSF and one of the authors of the paper, argues that many of these impaired homeless people may end up in substandard care facilities, even if better alternatives exist.  "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," she said.  "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."

There didn't appear to be any difference in geriatric health problems between "hard-core" homeless who lived on the street on a basis and homeless people who stayed with friends or family part of the time. 

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