It has been determined that approximately 15 to 30% of homeless adults have been classified to fall within the age range of 50 years old and above. This number has been projected to correspondingly increase as society ages hence there is now a higher degree of concern with regards to its causes and risks. More importantly, any information that will be generated from such studies will facilitate in the design of intervention programs for these marginalized individuals.
The risks associated with the condition of homelessness have long been analyzed and these are comprised of trauma, infection, gastric disorders, hypothermia and pulmonary infections. These risks do not include the common diseases that an individual may acquire while living in the comfort of his own home. The situation of being homeless is further complicated when an individual is older because he has to face additional health issues such as vision problems, chronic medical conditions, physical and sexual abuse.
It is actually unfortunate to see elderly homeless individuals because they often experience significantly inferior conditions than their juvenile counterparts and their contemporaries who live stable lives. It has also been determined that older homeless individuals experience a greater degree of mortality due to these homelessness-related circumstances (Barrow et al. , 1999). This proposal aims to determine the perception of these elderly homeless individuals with regards to their health requirements.
Specifically, this research would like to identify specific issues related to an elderly individual’s acquisition of health-related resources, including food, clothing, shelter and medical treatment. One specific question that this proposal would like to address is whether an elderly individual feels that he is situated in a worse condition that a younger counterpart who is also homeless. This question is imperative in designing preventive and supportive care for the ageing homeless individuals, as well as to prevent any further increase in the number of these people living in the fringes of society.
LITERATURE REVIEW THE DEFINITION OF HOMELESSNESS The simplest way to define the term homelessness is to associate this with an individual’s capability to maintain a form of housing (Burt et al. , 2001). On the other hand, specific academic fields have attempted to explain that the main characteristic of a homeless individual is the extreme dissociation and detachment from his surrounding and immediate support groups such as the traditional family, relatives and friends (Bassuk et al. , 1984).
Investigators have experienced difficulty in defining homelessness from the viewpoint of housing because there is no standard mark that can be associated with this condition that may distinguish these individuals from the rest of the society. Hence the description of a homeless individual is typified by one’s lack of a regular residence, especially during the evenings, thus any individual spending the night on the streets without provisional accommodations may be included in this category.
The depiction of living on the streets also includes staying by the riverbank, in a cave or in a car, as well as residing in an unassigned sleeping quarter such as a restaurant, office or theater. A homeless individual may also be someone who settles in a shelter that has been primarily conceived to provide transitory accommodations, including centers for victims of domestic violence and juvenile youth (Stuart and Arboleda-Florez, 2000). There are also homeless individuals, originating from detention centers such as prisons, mental hospitals and group homes, who do not have any capacity to afford housing of any kind.
A chronically homeless individual pertains to a solitary person who carries a disabling feature and has not retained a constant residence for at least one year or has at the minimum of four incidents of being transitory in the last 3 years. A disabling feature refers to a condition or a combination of characteristics that influence a negative impact on the normal functioning of a person, such as substance abuse, mental disorder, developmental abnormality or physical disability. An individual may be determined to be at risk for homelessness if he becomes unemployed due to any kind of personal emergency.
It has been determined that housing expenditures takes up approximately 50% of an individual’s monthly salary and the rest of a person’s salary is spent on food, clothing and medicines. It is thus very difficult to set aside some money from one’s monthly salary for savings that could be used during cases of emergency. An individual may be also at risk for homelessness if he resides in a housing that is of substandard conditions that often are characterized by extremely overcrowded environments.
Homelessness has been an important issue of public concern because this condition has been strongly linked to infections diseases such as pulmonary tuberculosis and AIDS. In addition, this public health condition has also been correlated with health disorders that are of physical and mental in origin. The industrialization of particular cities starting from the 1980’s has been coupled with the dramatic increase of homeless individuals. There is a huge concern on the extent of increase in the number of homeless individuals within the last two decades.
Reports have indicated that the condition of homelessness is generally observed in cities and that the degree of increase in number of homeless individuals is correlated to the size of the city. In the United States alone, it has been estimated that there are approximately 2 to 3 million homeless individuals living on the streets. This number is perceived to be an underestimate because the actual counting was performed based on each actual sighting of a homeless individual hence those that are situated in extremely remote areas were not included in the actual counting.
There are a number of problems that are related to the determination of the actual number of homeless individuals in a city. Finding these homeless individuals is quite tricky because these individuals tend to situate themselves in hidden areas such as box cars, rooftops and campgrounds which are seldom checked or even searched. Another problem with finding homeless people is that these particular individuals avoid interaction or even deny the fact that they are really homeless. Another issue with regards to the establishment of statistics on homeless individuals is that vague criteria in identifying a homeless individual.
There may be particular people who are intermittently homeless hence this poses a disparity when the actual statistical test is performed when that particular individual in temporarily living in a home. There is also a concern in estimating the number of homeless individuals in a particular area and extrapolating this to a rural area in the same state. It is thus not easy to say that the number of homeless people in the rural area is a third of the number of homeless people in the city of that same state. The enumerated problems influenced the reliability of data on the exact number of homeless individuals in a particular city.
Some research groups have employed an approach that would attempt to determine the number of homeless individuals each year for a span of at least 5 years. This repeated counting will facilitate the identification of trends in the increase or decrease of the homeless population in a specific city. INTEGRATING HOMELESSNESS AND AGEING Aside from the ongoing debate with regards to the precise description of homelessness, arguments have also arisen over the issue of the age ranges of homeless individuals that should be included in analytical studies.
One of the first research reports that examined homeless males with ages 50 years and above claimed that their investigation was significant because the general age range of homeless males is between 10 and 20 years old (Cohen et al. , 1988). The subsequent reports involved descriptions of homeless elderly men aged 55 years old and above (Kutza and Keigher, 1991; Crane, 1996). It has been determined that examination of homeless elderly individuals is very challenging because of this group’s heterogeneity, sub-classifications, features and needs.
There is great concern that the number of elderly homeless individuals may be underestimated and this may be partly due to the observed higher death rates among older homeless people. The number of elderly homeless individuals in the United States has been observed to increase in the last 20 years. It has been reported that approximately 15% to 30% of the general homeless population are of 50 years of age and older. A more age-specific estimate is that 3% to 10% of the general homeless population of the largest cities in the United States are of 60 years of age and older.
Another survey has reported that approximately 3% of the general homeless population is 65 years old and above. These estimates have been perceived as underestimates because most elderly homeless people avoid public shelters because they fear that they might be mugged or treated insensibly. Research surveys have described higher frequencies of elderly homeless individuals, even reaching 30% of the general homeless population. The same trend has also been observed in large cities in Europe and Canada.
Elderly homeless individuals have been described to be heterogeneous, depicted by several categories that are employed in describing this particular subgroup of marginalized individuals of the society. One descriptor of an elderly homeless person may be the chronic or traditional homeless individual, while another descriptor is the deinstitutionalized homeless person. Another descriptor is the dishoused or temporarily homeless elderly, while another classification of elderly homeless people may be based on their condition of being homeless for variable durations.
The mechanism behind reaching the condition of homelessness among the elderly has been determined to multi-factorial because it is influences by issues such as deinstitutionalization, financial breakdown and inability to afford any form of housing. Risk factors for homelessness among older people have been identified and these include eviction from their place of residence, the death of his significant partner or relative and the termination of his employment.
The main causes of homelessness is gender-related and it has been determined that a dysfunctional family and the gradual loss of an individual social network increases an elderly woman’s risk to homelessness. Another factor that increases the risk for homelessness is the condition of an individual’s mental health. It is well-understood that any individual may suffer extreme mental disturbances either pathologically, or through breakups or divorces from a partner.
An individual’s mental condition is also affected when one looses his place of residence or employment, as well as when an individual is exposed to extreme conditions of alcohol consumption. In particular cities such as Toronto, Canada, it has been reported that women are more likely to end up homeless if she lives in poor conditions as well as try to hide her being homeless for fear of being abuse and violated. Being an elderly homeless individual is commonly associated with a higher incidence of morbidity and mortality and a lifestyle that prevents achievement of disease-prevention practices.
It also interferes with attempts to receive medical assistance for specific health problems. The homeless elderly individuals experience conditions related to aging and these are further magnified by their poor living situation. One of the most frequently described health issues among elderly homeless people are dental problems, muscle and joint pain, hypertension, heart disorders, pulmonary diseases, gastrointestinal disorders, eye problems, diabetes and hearing loss.
These elderly homeless individuals also experience problems that directly originate from the condition of homelessness, including the consequences of physical injury or criminal assault, pest infestations such as scabies and lice, peripheral vascular disease, infection of the skin and ulceration of the legs, hypothermia and communicable diseases such as pulmonary tuberculosis and HIV. Hence older homeless people are at a higher risk of suffering from medical disorders than their younger homeless counterparts.
Research surveys have shown that more than 50% of elderly homeless individuals admit that they have active medical issues. Approximately 33% of elderly homeless individuals have also been admitted to a hospital for medical disorders. Although there is great variation among the early estimates of the number of mental illness cases among homeless persons in the United States, it is now acknowledged that around 33% of single homeless individuals suffer from a severe mental health disorder. It has also been determined that the incidence of mental health conditions among homeless single women is greater than that among men.
It is unfortunate to know that there is insufficient information of the mental health conditions of elderly homeless individuals and the only reports published describe conditions is the large cities such as Los Angeles, London and New York. There is difficulty in comparing each report because the approaches employed by each study was different hence it is impossible to standardize and even integrate all these reports into one comprehensive description. Yet the common description that has been included in these reports is that there is a significant number of mental health cases among the elderly homeless population.
Some of the reports compared the mental health requirements of elderly homeless individuals with their younger counterparts. It has been estimated that approximately 24% of those aged 65 years and above required immediate psychiatric testing as compared with the estimated 35% in the younger homeless counterparts. Another report described that elderly homeless individuals showed less psychotic signs and indications for drug abuse than their younger homeless counterpart. The observed psychiatric signs or previous hospitalization were however, similar among the elderly and younger homeless groups.
In several studies, a high degree of elderly homeless individuals were described to experience at least one previous psychiatric hospitalization. Earlier psychiatric hospital admissions are generally frequent among elderly homeless women. The most common mental health conditions among the elderly homeless include depression, dementia and psychosis. In addition, there is a greater number of elderly homeless women who have been suffering from poor mental conditions than elderly homeless men. It has been estimated that approximately 65% of elderly homeless men suffer from depression.
It has been determined that high correlation between depression and physical disorder, as well as stress and disappointment. In London, approximately 45% of the elderly homeless men and 15% of the elderly homeless women were determined to experience depression. Moreover, 65% of the elderly homeless women and 17% of the elderly homeless men harbored symptoms of psychosis. Statistics on the proportion of elderly homeless men who abuse alcohol show that the incidence was similar to their younger homeless counterparts.
Gender-related studies show that elderly homeless women are not prone to alcohol abuse. There are resources that attempt to provide support to homeless individuals. This may be in the form of financial or human aid, yet is has also been determined that these resources are insufficient to control and eradicate the public health issue of homelessness. The creation of homeless prevention plans in each state perceives that prevention resources should be well coordinated so that the increase in the number of these marginalized individuals may be controlled and ultimately prevented.