Homeless people, especially those older than 50, get sicker more often and are not getting the medical attention they need, according to a study published in the Canadian Medical Association Journal.
The study said people experiencing homelessness develop medical conditions more commonly identified with much older people including cognitive and functional impairment, at younger ages than people who have not been homeless.
"The proportion of people 50 years and older using shelters is increasing, but most shelters in Canada are not adequately designed and resourced to meet the needs of older adults," said the study.
The study was authored by Jillian Alston, Stefan Baral, Aaron Orkin and Sharon Straus; scientists and researchers association with Division of Geriatric Medicine at St. Michael’s Hospital in Toronto; the University of Toronto; the Johns Hopkins School of Public Health, Baltimore, Md.; St. Joseph's Health Centre, Toronto; and the Dalla Lana School of Public Health, University of Toronto.
Other key points in the study said older adults who are homeless and have often had a history of injustice and trauma, require individualized and integrated approaches to meet their needs. The study said these approaches require collaborations between health and long-term care, public health, housing, and other community agencies.
It also reported that while many older adults experience homelessness in Canada, current shelters and temporary housing are not designed or resourced for them.
The study quoted data from Canada’s National Shelter Study that said the proportion of adults aged 50 and older, who frequented homeless shelters, was estimated at 13.5 per cent in 2005 rising to 24.2 per cent in 2014. In 2021, 32 per cent of people using shelters were aged 50 years and older.
People who are homeless before the age of 50 are more likely to have had a history of earlier adverse situations, such as trauma and abuse, lower attainment of typical life milestones such as stable employment, stable relationships and a high school education. Other experiences could include mental health difficulties and substance use.
Other circumstances have included physical health problems, relationship break up (in a cohabitation setting), death of a relative, loss of a job, and loss of income.
Homelessness can also happen because of health changes for older adults -- things such as dementia, frailty and falls, and chronic health conditions — also contribute to the risk of homelessness, said the study.
The authors also wrote that dementia and other causes of cognitive impairment make it harder to navigate health care, social services, and housing systems, especially in the context of breakdowns in personal relationships or social networks.
The authors said mental instability demonstrated by hoarding or missed rental payments can result in eviction. The situation is made worse by the shortage of appropriate housing options, not enough social services for older adults and not enough vacancies in long-term care homes.
In conclusion, the authors said the homeless situation is going to require a multi-role partnership before the issue can be resolved.
"Caring for the growing population of older adults experiencing homelessness in Canada will require intersectoral collaborations between health, LTC, public health, housing, and other community agencies," said the authors.
"Without urgent action, older adults experiencing homelessness will remain marginalized, undergo early aging, and continue to be at risk for deterioration and death in shelters and other temporary accommodations that are neither equipped nor designed to meet their needs," the study concluded.
A full text version of the study can be found online here.
Len Gillis covers health care and mining for Village Media's Sudbury.com.
