Elderly homelessness: is this the future of growing old?

 

(Part 2 in a 2 part series)

Statistics in U.S. have shown a distinct increasing trend in the number of “older” persons (ages 50-64) within the homeless population.  Due to a variety of circumstances, this is a group which frequently falls through holes in governmental safety nets.

As the “tsunami” of older adults burgeons, so will elderly homelessness.  In anticipation of this, it is becoming increasing clear that U.S. needs to take stock of existing programs and filter out the ones that are creating positive outcomes so that those can be expanded and improved.  The U.S. tends to often act reactively to such social situations, rather than proactively and we pay dearly for this lack of foresight.

Proffered solutions, while seemingly complicated, nonetheless begin to shed light on what are already intertwined issues that will demand equally multifaceted solutions.  To create lasting workable results, it will take government, public and private partnerships to act together, as there is no single way of attacking the causes that feed into elderly homelessness.

Some existing programs have created encouraging results.  But there are also concomitant barriers that are thwarting and even halting movement toward success.

– It should be recognized that the Affordable Care Act (ACA) has given those with low incomes increased access to much needed Medicaid services. (It remains to be seen if the new administration in the U.S. will be able to preserve a health care plan that will retain these positive outcomes.) Once identified by Medicaid, the next step should be creating a simple approach to identifying those with significant housing needs and working towards placing them into shelter they can afford.

“As the economy has grown, so have property values and rental
rates, putting permanent housing out of reach and actually
throwing more people into homelessness.  Linking more affordable housing to supportive services creates an immediate win-win
situation to help the homeless stay off the streets.”

The fact that there is a nation-wide crisis in reasonably priced housing continues to be the biggest barrier to this issue.  Government funding will continue to dry up, so public/private funding needs to explored to put a dent in this continuing conundrum. Creating tax credits for specific housing modifications would help close some of this loophole.

There is abundance of existing housing stock that can be converted to satisfy permanent housing requirements.  This is especially true for seniors.  Alterations to existing housing to accommodate changes in mobility, hearing, vision and physical limitations are cost-effective and would still provide a reasonable return on investment as this housing becomes “universal design.”

– Expansion of Medicare and Medicaid benefits, which would reduce the burden of out-of-pocket spending that those on fixed incomes can ill afford.  The Qualified Medicare Beneficiary program (which pays the Medicare premium and coinsurance for low-income older adults) could be simplified and even broadened, providing greater access to health care which would help reduce the risk of homelessness. The current Medicaid income and asset eligibility limits for seniors are too stringent and must be more flexible to reduce this additional unnecessary barrier.

– Enlarging Medicare coverage to include vision, hearing and dental benefits would reduce the gap that directly affects quality of life, especially for those living on the street. Enhance and refine the existing programs already in place. The eligibility rules as they are now, again, continue to reduce the discretionary income for seniors.  Admittedly, with the strain that already exists on these programs, increasing funding to cover these benefits would be a hard sell.  We can already see the burden this demographic is placing on our social service system so it is no surprise that difficult decisions are going to have to be made.

– The saying, “When you have your health, you have everything,” could not be truer than for the homeless.  Programs that address seniors who are too ill to live on the street, but do not require hospitalization should also be enriched, which could significantly reduce overuse of the emergency room in these cases.  This includes increased funding to train safety net providers in the unique needs of this population.  Short term programs, such as those provided to homeless individuals who are recovering from hospitalization and longer term supports, such as links to specialized case workers who can help older adults navigate their specific needs, like chronic conditions, all need to be factored into this immense puzzle.

– Increased access to low-cost legal services and advocacy.  While there are a number of “free” legal help providers, across the nation this is not the case.  The homeless need guidance and representation to navigate foreclosure, eviction. adult abuse and financial exploitation.  In June of this year the Department of Justice and the Corporation for National and Community Service (CNCS) announced a new partnership called the Elder Justice AmeriCorps.  This consists of $2 million in grants to provide legal assistance and support services to victims of elder abuse, neglect and exploitation – the majority of whom are women.

Homelessness, in general, is a worldwide issue with every country creating solutions that they hope will bring an end to this. While some do not address the elderly population specifically, nonetheless, there is hope on the horizon.

In Australia:

In 2015 a new National Partnership Agreement on Homelessness (NPAH) began. The government is providing $230 million over two years, matched by states and territories, to fund frontline homelessness services. In total, funding of nearly $250 million per year is being directed to around 800 homelessness services around Australia.

In Canada:

A 2010 OECD report stated that senior women are more likely to have worked part-time, low-wage and/or temporary jobs – which can lead to poverty and homelessness. This especially affects senior women who are separated or divorced. Another issue cited by this report is that seniors in Canada depend more heavily on private capital (assets, private pensions, etc.) to live than most other OECD countries. This leaves all low-income seniors vulnerable, as they are less likely to have such resources. (The Organization for Economic Cooperation and Development (OECD) is an intergovernmental economic organization with 35 member countries, founded in 1960 to stimulate economic progress and world trade.)

The Homelessness Partnering Strategy (HPS) uses the “Housing First” model which “is intended to channel funding to long-term housing rather   than the crisis response services provided through shelters and emergency health care. It aims specifically to reduce the number of people who are chronically and episodically homeless and to relieve pressures on emergency systems.”

In China:

China has the fastest-ageing population in human history, but the state provides very little support for elderly people. Ageing parents have traditionally been looked after by their children – but in today’s China that is not always the case. Some are too poor to go elsewhere; others have no children to care for them. But most have simply been abandoned by their families. However in many of China’s cities, the government is rushing to address the needs of its booming elderly population. New senior centers are opening, putting free basic medical care and community services under one roof. “Only relying on the government for elderly care isn’t enough. That’s why we’re trying out a new model that combines government, community and family support to try to build a new system that fits Chinese society.”

There are a myriad of workable, affordable and incredibly valuable solutions to the tangle of issues that bring about homelessness.  There is no “one size fits all” answer and there never will be.  But every one of us who ignores that homeless person means we are refusing to acknowledge that this sector of our society needs our help, especially when it comes to elder homelessness. There has to be a clear “path out of homelessness” created with documented and deliberate steps and viable, workable alternatives that will serve as the safety net against a life on the streets that no one wants and no one deserves.

Seeing homelessness first hand is a first step. Why not volunteer at your local homeless shelter so that you can experience this for yourself, even if is just an hour or two? I volunteer at my local homeless shelter and while I feel that my contribution to the seriousness of homelessness is extremely miniscule, nonetheless it gives me an incredible appreciation for what it is like to struggle every day.  We all need to remember that we can be just one paycheck, one major health crisis, one job loss or one family death away from having no place to turn. Don’t look away, but look towards supporting local and national efforts to keep America’s elderly population safe.

References:

Goldberg, Jennifer, et al (April 2016). How to Prevent and End Homelessness Among Old Adults. Justice in Aging: Special Report.
Retrieved from http://www.justiceinaging.org/homelessness/

Nagourney, Adam. “Old And On The Street: The Graying of America’s Homeless.”  2017.
https://projecthome.org/about/facts-homelessness

Hecht, Laura B.C. “Elderly Homeless: A Comparison of Older and Younger Adult Emergency Shelter Seekers in Bakersfield, California,” abstract, Sage Journals: American Behavioral Scientist, (September, 2001) Web. Republished January 2017.
abs.sagepub.com/content/45/1/66.full.pdf

 Banerjee, Sudipto.  “More Americans Are Entering Poverty as They Age.” Twin Cities Public Television. Nextavenue.org. June 18, 2012 18 June 2012.  Web.  17 December 2016.
http://www.nextavenue.org/more-americans-are-entering-poverty-they-age/

Woolley, Emma. “What are the pathways to homeless in old age?  Canadian Observatory on Homelessness/Homeless Hub: York University. Homelesshub.ca/blog. 24 July 2015.  Web.  15 January 2017.
http://homelesshub.ca/blog/what-are-pathways-homelessness-old-age

Australian Government, Department of Social Services. Housing Support: National Partnership Agreement on Homelessness.  15 March 2016.  Web.  2 January 2017.
https://www.dss.gov.au/housing-support/programmes-services/national-partnership-agreement-on-homelessness

Hatton, Celia. “Who will take care of China’s elderly people?” BBC News, Fujian province, China.  Bbc.com. 21 December 2015. Web.  1 January 2017.
http://www.bbc.com/news/magazine-35155548

Barken, Rachel et al. (April 2015) “Aging and homelessness in Canada: A review of frameworks and strategies.” Social Sciences and Research Council.
Retrieved from http://aginghomelessness.com/wp-content/uploads/2012/10/PolicyReview-FINAL-REPORT-

Image: Dreamstime.com

See Parts 1 and 2 at silverspacesblog.com.  Become a subscriber today!

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