|
 Those conditions include thinking problems, visual impairment,
urinary incontinence and falls, write the researchers in The
Gerontologist.
“I think in a sense this is a problem of severe poverty,” said
senior author Dr. Margot B. Kushel, of the University of
California's San Francisco General Hospital.
Geriatric conditions occur earlier in life for people in poverty and
even earlier in life for those who are homeless, Kushel told Reuters
Health.
However, researchers didn't know how common these conditions were
among homeless people, and if those rates varied by where homeless
people stayed from time to time.
For the new study, researchers interviewed 350 people who are
homeless and aged 50 and over. The participants stayed in
unsheltered locations, shelters, intermittently with family or
friends, or in rental housing. Half of the group was younger than
age 59.
A third of the homeless group said they had suffered a fall over the
past six months, a quarter had cognitive impairment, 45 percent had
vision problems, and almost half screened positive for urinary
incontinence, regardless of their living arrangements.
These issues typically first arise for housed adults age 75 and
older, write the researchers.
The homeless participants had as much or more trouble bathing,
dressing and eating, using transportation, taking medications,
managing money, applying for benefits, arranging a job interview and
finding a lawyer as 80 year olds with housing in the general
population, they found.
“Some of these impairments come out because of a lifetime of poor
access to healthcare, and potentially substance use disorders,”
Kushel said.
The rate of cognitive impairment was “astonishingly high,” she said.
“In my mind that raises the question, did the cognitive impairment
potentially lead to their homelessness,” she said.
But homelessness itself, and the struggles or trauma that precede
it, can have physical health effects and cause old age to express
earlier, said Dr. Josh Bamberger, medical director for housing and
urban health at the San Francisco Department of Public Health.
“One of the ways we handle geriatric conditions is we make changes
to the environment, add grab bars in the bathroom, we light their
path to the bathroom with nightlights to prevent a fall,” Kushel
said. “When people are in unstable environments, we can’t do that.”
[to top of second column] |
More than 40 percent of the homeless group had not been homeless
before age 50.
“That makes me fearful that cognitive impairment or physical
limitation contributed to their homelessness,” Kushel said. “It’s
already hard to fight an eviction notice, but if you’re cognitively
impaired or having difficulty walking, that only makes it harder.”
“What we ask them to go through to leave homelessness, that includes
cognitively and physically hard things,” like taking public
transportation to various offices and filling out paperwork, which
may be too difficult for people suffering the health problems common
to 80 year olds, she said.
Permanent supported housing may help prevent and treat some of these
health problems, she said.
“There doesn’t have to be any new allocation of funding, just
repurposing of funding,” said Bamberger, who was not part of the new
study.
Most adults who become homeless first start utilizing the healthcare
system more and more in emergency rooms, as inpatients or in nursing
homes, he said. Repurposing those healthcare expenditures for
housing has been done successfully in some U.S. cities and states,
he told Reuters Health.
“We define housing as something other than healthcare but that’s
purely a theoretic definition,” Bamberger said. “We can define
things however we wish.”
SOURCE: http://bit.ly/1SfSa1t The Gerontologist, online February 26,
2016
[© 2016 Thomson Reuters. All rights
reserved.] Copyright 2016 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
