Older Homeless Adults: Can We Do More?

Kushel, Margot

doi:10.1007/s11606-011-1925-0

Cited by 24 publications

(13 citation statements)

References 16 publications

(19 reference statements)

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“…Poor household and neighborhood conditions have been associated with poorer physical functioning in older people (Lan et al, 2009; Samuel et al, 2015). Although such individuals may rely on environmental modifications and external supports to mitigate impairments, homelessness impedes the ability to control one’s environment (Kushel, 2012). …”

Section: Introductionmentioning

confidence: 99%

Residential patterns in older homeless adults: Results of a cluster analysis

Lee

Guzman

Ponath

et al. 2016

Social Science & Medicine

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Adults aged 50 and older make up half of individuals experiencing homelessness and have high rates of morbidity and mortality. They may have different life trajectories and reside in different environments than do younger homeless adults. Although the environmental risks associated with homelessness are substantial, the environments in which older homeless individuals live have not been well characterized. We classified living environments and identified associated factors in a sample of older homeless adults. From July 2013 to June 2014, we recruited a community-based sample of 350 homeless men and women aged fifty and older in Oakland, California. We administered structured interviews including assessments of health, history of homelessness, social support, and life course. Participants used a recall procedure to describe where they stayed in the prior six months. We performed cluster analysis to classify residential venues and used multinomial logistic regression to identify individual factors prior to the onset of homelessness as well as the duration of unstable housing associated with living in them. We generated four residential groups describing those who were unsheltered (n=162), cohabited unstably with friends and family (n=57), resided in multiple institutional settings (shelters, jails, transitional housing) (n=88), or lived primarily in rental housing (recently homeless) (n=43). Compared to those who were unsheltered, having social support when last stably housed was significantly associated with cohabiting and institution use. Cohabiters and renters were significantly more likely to be women and have experienced a shorter duration of homelessness. Cohabiters were significantly more likely than unsheltered participants to have experienced abuse prior to losing stable housing. Pre-homeless social support appears to protect against street homelessness while low levels of social support may increase the risk for becoming homeless immediately after losing rental housing. Our findings may enable targeted interventions for those with different manifestations of homelessness.

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Section: Introductionmentioning

confidence: 99%

Residential patterns in older homeless adults: Results of a cluster analysis

Lee

Guzman

Ponath

et al. 2016

Social Science & Medicine

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“…7,8 In contrast, older adults who live in shelters or on the street may encounter great difficulty in modifying their environment to accommodate functional impairments and other geriatric conditions. 9 Moreover, adaptive equipment used to cope with impairments – such as glasses, hearing aids, or walkers – may be lost or stolen. This mismatch between an older homeless person’s environment and their abilities may magnify the negative effect of geriatric conditions on their quality of life and ability to function independently, leading to the premature need for costly long-term care.…”

Section: Introductionmentioning

confidence: 99%

“…This mismatch between an older homeless person’s environment and their abilities may magnify the negative effect of geriatric conditions on their quality of life and ability to function independently, leading to the premature need for costly long-term care. 9,10 …”

Section: Introductionmentioning

confidence: 99%

“…9 Studies of the adult homeless population support the putative health benefits of housing, having found decreased rates of acute care utilization after housing is received. 11–13 However, little is known about the impact of housing on the unique health concerns of older homeless adults, including the geriatric conditions that play a key role in health and quality of life.…”

Section: Introductionmentioning

confidence: 99%

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Health Outcomes of Obtaining Housing Among Older Homeless Adults

et al. 2015

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Objectives To determine the impact of obtaining housing on geriatric conditions and acute care utilization among older homeless adults. Methods We conducted a 12-month prospective cohort study of 250 older homeless adults recruited from shelters in Boston, Massachusetts between January and June 2010. We determined housing status as reported at the follow-up interview. We examined 4 measures of geriatric conditions at baseline and 12 months: independence in activities of daily living and instrumental activities of daily living, depressive symptoms, and symptoms of urinary incontinence. We determined number of emergency department visits and hospitalizations over 12 months by medical record review. We used multivariate regression models to evaluate the association between obtaining housing and our outcomes of interest. Results At 12 months, 41% of participants had obtained housing. Compared to participants who remained homeless at follow-up, those with housing had fewer depressive symptoms. Other measures of health status at follow-up did not differ by housing status. Participants who obtained housing had a lower rate of acute care utilization over the follow-up period (IRR, 0.5; 95% CI, 0.4–0.6), with an adjusted annualized rate of acute care visits of 2.5 per year (95% CI, 1.7–3.3) among participants who obtained housed and 5.3 per year (95% CI, 3.8–6.7) among participants who remained homeless. Conclusions Older homeless adults who obtained housing experienced improved depressive symptoms and reduced acute care utilization compared to those who remained homeless.

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“…Current research from across North America indicates the homeless population is broadening in its composition to include members of various social groups and age cohorts (Crane and Warnes, 2010;Cronely, 2010;Daly, 1996;DeVerteuil et al, 2009;Lee et al, 2010;Meanwell, 2012). While many studies point to growing numbers of homeless youth (Gaetz et al, 2013a(Gaetz et al, , 2013bKlodawsky et al, 2006;Rachlis et al, 2009), almost an equal share of researchers project increasing numbers of older homeless persons in their senior and elderly years (Cranes andWarnes, 2007, 2010;Kushel, 2011;McDonald et al, 2007McDonald et al, , 2009. Within this literature, experts generally point to two different subgroups, including both older persons who experience housing loss for the first time in their senior years (Crane et al, 2005) and those who have long histories of chronic homelessness Warnes, 2001, 2007;McDonald et al, 2007;Rota-Bartelink and Lipmann, 2007).…”

Section: Introductionmentioning

confidence: 99%

Exploring opportunities for healthy aging among older persons with a history of homelessness in Toronto, Canada

Waldbrook

2015

Social Science & Medicine

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Older Homeless Adults: Can We Do More?

Cited by 24 publications

References 16 publications

Residential patterns in older homeless adults: Results of a cluster analysis

Residential patterns in older homeless adults: Results of a cluster analysis

Health Outcomes of Obtaining Housing Among Older Homeless Adults

Exploring opportunities for healthy aging among older persons with a history of homelessness in Toronto, Canada

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