Socioeconomic Pressures on the Elderly and Newly Homeless in Toronto

Socioeconomic Pressures on the Elderlyand Newly Homeless in Toronto

The upcoming 2012 City of Toronto budget seeks to drop spending levels ten percent across the board (Dale, 2011), regardless of the need for services, increasing demand or consideration on the effects to the most marginalised within our city. One such cut will see the closure of homeless shelters gears to the elderly poor – a group that is considered one of the most at risk for abuse, neglect and health issues on the street or at other generalised shelters. This decision comes on the heels of the largest ever cohort of people entering old-age – the baby boom generation (MacDonald, Dergal & Cleghorn, 2007), – and on the cusp of the financial downturn that eradicated a large part of peoples’ retirement savings. Even those with proper housing are facing dramatic increases in property value and, in turn, property taxes based on new assessments that may be well outside any structured retirement plan they have in place (Gillespie, 2007). Persistently high unemployment along with near stagnant economic growth, leaves the elderly, along with the young, as the first groups to be rejected as potential candidates for hiring due to their age and perceived long-term value to a company which denies them the ability to supplement their retirement income (Cohen, 1999). This perfect storm of socioeconomic conditions sets the stage for what might be the largest influx of elderly homeless on our streets at a time when we callously rollback services.

 

The pathway to homelessness in the elderly is not unlike that of street youth in that it consists of multidimensional factors including the lack of affordable housing, employment or institutional services (Stegiopoulos & Herrmann, 2003) – but the risk factors are different, including the of loss of stable income, death of a spouse or significant other, lack of a proper caregiver or eviction (Crane, 1999). Others that have been institutionalised for a long period for physical or mental health issues and have lost their housing within that time (Hecht & Coyle, 2003) and are often released to shelters as a last resort. Further still, some have become homeless in their middle-age as they were living with elderly parents – due to economic or health concerns – who since passed away leaving their offspring little-to-no social safety net (Crane & Warnes, 2000). All of these factors are pressured by past economic ability – with many surviving in poor or near-poor conditions most of their lives – and never having the benefits that full- and long-time employment provides, such as personal saving or pensions (Cohen, 1999). While the relative population of this subgroup is falling when compared to all homeless people, in absolute numbers it is in fact increasing and expected to climb in North America by an estimated half million people (Cohen, 1999) in the next fifteen years as our general population ages.

 

Many studies argue that the defining age for elderly homeless be decrease by 10 to 20 years than in the average population since the physical and mental health effects of living on the street causes the appearance and behaviour of being older (Crane & Warnes, 2000). It is expected that a homeless man over the age of 45 were twice as likely to die prematurely than the average male and that “the cost of being homeless in North America is losing about 20 years of your life expectancy” (Wright, Rubin & Devine, 1998, 167). Unlike the rest of the homeless population, women outnumber men –  possibly due to life expectancy (Cohen 1999) but also because men spend 50% more time on the street in comparison (Crane & Warnes, 2000) and women tend to enter street life in their later years (Crane, 1999). The lack of adequate and safe hospice for the elderly in shelters tends to bring the on-set of street sickness – a combination of a number of issues including respiratory problems, skin afflictions and malnutrition from exposure to the elements and poor hygiene (Higgitt, et al, 2003) – that further accelerates physical and mental health issues already progressing in the elderly population. This can lead to an increase of degenerative diseases and chronic conditions such as hypertension, anaemia, cardio- and cerebro-vascular diseases (MacDonald, Dergal & Cleghorn, 2007). Unlike other homeless groups whose mortality is more often caused by AIDS, suicide or homicide, the elderly tend to die early from cancer and heart diseases and mostly alone in a hospital or residential setting (Hwang, 2000).

 

Mental health issues are often sited as a driving factor to homelessness in the elderly population, such as the on-set of early dementia or Parkinson’s disease (Stegiopoulos & Herrmann, 2003), but often the conditions from living on the street and isolation from family and friends are the catalyst for these issues. One third of older homeless men were found to be clinically depressed (Cohen, 1999) which stresses am already weakened immune systems and physical health. Elderly women tend to be even further debilitated depending on age: with 57-75% reporting depression over the age of fifty in comparison to only 10 % under the age of twenty (Crane & Warnes, 2000). The lost of a long-time partner, isolation from a community or the inability to adapt to a life of poverty leads to an entrenched feeling of isolation and loss of pride that leads to depression, hostility, poor self-esteem and psychosomatic illnesses (Rokach, 2003). Males are four times more likely than women to engage in long-term alcohol abuse which follows them to the street and increases with age (Cohen, 1999) and is often neglected upon medical review, being incorrectly attributed to physiological changes due to aging or dementia (MacDonald, Dergal & Cleghorn, 2007).

 

The lack of services and support is sited as the causation and continuance of both mental and physical health issues and reliance on the street. Often, without encouragement, physical ailments go undiagnosed because of the lack of a family physician, inability to recognise the severity of the issue or fear, either of being shunned by or directly suspicious of, the medical community and potential institutionalisation (Crane & Warnes, 2000). Others were barred from seeking medical help because of the lack of a health card or insurance and from the reluctance of health providers to register homeless people because of their multiple inflictions and transient nature (Hwang, 2000). The Daily Bread Food bank also notes that 40% of their older recipients of their service often had difficulty paying for their prescription medications every month with as many as 27% declining outright to purchase them simply because of affordability (2001). The newly elderly homeless also tend also to stay with services familiar and close to them, such as onsite clinics where they take shelter, but are seemingly oblivious to community outreach programs and drop-in centres (MacDonald, Dergal & Cleghorn, 2007). They are also subject to more victimization within these shelters from other residents due to their frail condition, including physical assault, thief and rape (Cohen, 1999).

 

Traditional services to aid the homeless rely on as methodology of crisis intervention and attempt to focus on building independence and self-sufficiency (MacDonald, Dergal & Cleghorn, 2007) a program better geared to youth and young adults. Elderly homeless require greater access to mobility and care during the day, often unavailable in shelter as they only operate during the evening hours (Stegiopoulos & Herrmann, 2003). Mental health issues – including depression, requires constant and static care to stymie isolation – and chronic and multiple physical health conditions need support and aid for medication (Cohen, 1999). While income among older homeless people is reportedly two times higher than their younger counterparts due to social assistance, old age security and past pensions (Cohen, 1999; Crane & Warnes, 2000) their ability to find alternative sources of income from temporary employment or street services is limited by their physical abilities and public perception (Crane, 1999). The MacDonald, Dergal & Cleghorn study in Toronto also showed that 50% of the recently elderly homeless also are immigrants to Canada and have suffered from family breakdowns and little communications with ex-spouses and community. Those who are moved immediately out of standard social programs to dedicated, specialised shelters where they can obtain services and a proper network suffer less from chronic health issues and are more likely to survive longer and find permanent homes (2007). Regardless of who, where, when and how they arrive, the elderly homeless population struggle with differing needs that require much more substantive and long-term care and need for these programs, particularly when socioeconomic conditions are pushing more into old age and near poverty, has never been more prevalent. The audacity to close services rather than opening more seems ludicrous, untimely and wholly unpalatable.

 

 


References

Cohen, C. I. (1999) Aging and homelessness. The Gerontologist, 39(1). 5-14.

Crane, M. (1999) Understanding Older Homeless People. Housing Studies, 15(2). 325-327.

Crane, M & Warnes, A. M. (2000) Lessons from Lancefield Street: Tackling the needs of older homeless people. National Homeless Alliance. London.

Daily Bread Food Bank (2001) Aging with Dignity? How governments create insecurity for low-income seniors. Toronto.

Dale, D. (2011, Dec. 7) Environmentalists, child-care advocates speak out: Follow it Live. The Toronto Star. Retrieved from:  http://www.thestar.com/news/cityhallpolitics/article/1098229–environmentalists-child-care-advocates-speak-out-follow-it-live

Gillespie, K. (2007, Sept. 27) Who can rescue seniors from property tax trap? The Toronto Star. Retrieved from: http://www.thestar.com/article/261080

Hecht, L. & Coyle, B. (2001). Elderly Homeless: A Comparison of Older and Younger Adult Emergency Shelter Seekers in Bakersfield, California. American Behavioral Scientist, 45(1). 66-79.

Hwang, S. (2000) Homelessness and Health. Canadian Medical Journal, 164(2). 229-233.

MacDonald, L., Dergal, J. & Cleghorn, L. (2007) Living on the Margins. Jornal of Gerontological Social Work, 49(1-2). 19-46.

Rokach, A. (2003) The Lonely and Homeless: Causes and Consequences. The Institute for the Study and Treatment of Psychosocial Stress, Toronto.

Stergiopoulos, V. & Herrmann, N. (2003, July) Old and Homeless: A Review and Survey of Older Adults Who Use Shelters in an Urban Setting. The Canadian Journal of Psychiatry, 48. Canadian Psychiatric Association. 374-380.

Wright, J. D., Rubin, B. A. & Devine J. A. (1998). Beside the golden door: Policy, politics and the homeless. Aldine de Gruyter, New York.

Homelessness in Canada

Homelessness in Canada

Describe and discuss the challenges and policy implications of defining homelessness

The common stereotype of the homeless is based on those in direct visibility – often unwashed, crazed individuals that roam aimlessly through the streets seeking whatever pittance afforded to them by the passing public. This is a reflection of absolute homelessness – those who live on the street or in emergency shelters – but it is argued that this only represents the “tip of the iceberg” (Echenberg & Jensen, 2008) not to mention begin facetious and misinformed. Two further categories that should be considered or those that are concealed and in relative homelessness – living in places not of their own or are in conditions that are unfit or intermediate (Girard, 2006) – and can be given temporal qualities such as the chronic, cyclical or temporary (Being, et al., 1999). While this may expose more of the issue and help delineate between particular groups in order to define policy approaches, it remains broad and too exclusive definition whereas members can easily move between or out of groups over time depending on a number of factors (Springer, 2011).

 

The definition of homelessness also hinges on the bias of those whose responsibility it is to develop policy and approach the issue – often influenced by the perception of the public who prefer to pass blame to the homeless rather than adopt social and fiscal responsibility (Layton, 2008, 42-44). This creates a schism between those in the position to provide aid and those who are in need of it – with governments creating a minimalist construct of the issue as to limit negative public response (Chapham, 1990). Neo-conservatives Mulroney, Harris and Lastman took views to appease the public sentiment (Layton, 2008, 39-45) and curtailed social assistance, distancing themselves under the premise that homelessness is a “choice” and it is up to the individual to mete out their own fate (Fallis & Murray, 1990) or by out-right dismissing the argument – insisting it doesn’t exist or that unfettered market forces will ultimately solve the issue by removing the impediment to competitiveness made by public welfare spending (Harvey, 1989, 7-16).

The inability and will to develop a holistic definition of homelessness – coerced by public and political leanings bent toward neo-liberalist ideals – leads to a statistic that is immeasurable and thus impossible to develop an overarching policy (Hulchanski, 2000). Houselessness helps define a broader view of the issues that are staging grounds for more transparent definitions including those who are inadequately housed. These are families or individuals that are without long-term legal tenure to ensure security; removed from required social and natural resources that affect health, safety and community; lack affordable housing – not only at the offset but over time – where less than 50% of their income is required for proper shelter; or bee made available a space which provides adequate privacy, sound living conditions and accessibility for those with special needs. A home should encompass not only the bare minimum standards of outlined by the United Nation Declaration of Human Rights (1948) but be resilient against social, environmental and economic shifts that – with globalization and an ever-changing environment – occur at a more frequent scale (Springer, 2000).

 

Annually, 22,000 make use of the 3,800 shelter beds available in Toronto, 68,000 remain in line for affordable housing, 150,000 pay more than 50% of their income towards rent (StatsCan, 2006) and 260,000 pay more than 30% – an amount that encompasses approximately 20% of all households (QuickFacts, 2011). The issue of homelessness under the auspices of houselessness attempts to capture a much greater group than the official count of 5,000 under the absolute definition (QuickFacts, 2011) and shows how close many are to being At Risk (Hulchanski, 2000). But even this number leaves out the number of hidden homeless – those who have lost their homes only to be taken in by friends or family, commonly referred to as “couch-surfers” – and should be considered too for inclusion in the At Risk category (Hwang, 2000). It is estimated that mitigating the needs of the homeless through programs and shelters on a interim basis costs taxpayers an estimated ten times that it would cost to house them properly in the long-term facilities (Blueprint, 2007) – not including the effects of stress that physical and mental health will have on our social and health infrastructure budgets (Hwang, 2000) – a amount that, if acted upon pre-emptively, can atone neo-conservative ideals of shrinking government expenditures if the initial capital outlay is made to mitigate the At Risk population.

 

Public policy is driven by clear and balance declaration and said definition may be based on bias – particularly when discussing an emotionally-charged issue such as homelessness (Cassavant, 1999). Major educational and economic players – including Finance Ministers, Bank Governors and Professors – have recently contributed their concern over continuing global economic turmoil (Whittington, 2011) a city becoming increasing divided by income disparity (Hulchanski, 2007) and activism reflecting the public disdain for inaction (Torobin, 2011). With continued policies that hinder our cities ability to solve the issue – such as the recent decision to sell TCHC units (Vincent, 2011) – we are shown the direct result of not having a clear, cohesive definition to provide concrete quantitative measures needed to define policy that can lead public discourse toward a viable, fiscally and socially responsible solution (Cassavant, 1999).

 

 “No one chooses to be hungry, dirty, sleepless and afraid” (Hector, homeless youth, 1999). Discuss this statement critically with specific reference to the health, morbidity, social stigma and legal issues facing street youth.

Out of all the sub-groups in the homeless population, adolescents experience the most extreme of conditions – with increased health concerns and higher morbidity and morality rates than all other groups.  It is also the group with the highest rate of increase (Report Card, 2003) and faces greater social and economical resistance while being exposed to more instances of physical and sexual assaults on the street, alcohol and drug abuse and disproportionate amount of conflicts with the law (CMHC, 2001). No one chooses this life to be “hungry, dirty, sleepless and afraid” (Hector, 1999) but often the opportunities they have to avoid or escape are limited and they have either fled worse conditions at home or have never known a home in the first place (Rokach, 2003).

 

Many homeless youth identify a problematic childhood as a driving force (Kidd, 2003) with physical, mental and sexual abuse being the catalyst to them leaving home (CHMC, 2001). Stability at home or within the child welfare system also plays a major factor where neglect, family continuity or domestic violence (Kidd, 2003) pushes adolescents to the street – while pull factors, such as a desire for independence, resistance to rules or authority and desire for experimentation also play a deciding factor (Miller, et al., 2004). Differing sexual orientation is disproportionately higher in street youth then their counterparts and has been on the rise in recent years – specifically from those who traveled from smaller communities –  (McCreary, 2007) and can be attributed to lack of acceptance by family members or social problems at school (Higgitt, et al. 2003).

 

Half of street youth start to become involved between the ages of 11-14 years old (McCreary, 2007) with many having left school prior to completing a basic level of education due to alienation, poor achievement (Higgitt, et al. 2003) or have been expelled for reasons spawning from their troubled lives (McCreary, 2007). As a result, they have trouble obtaining employment or suffer from low wages which along with the lack of affordable housing have driven them to the street (CMHC, 2001). Welfare assistance programs in many provinces are not available to those between the ages of 16 and 19 where they are outside the catchments of child welfare policy and below the cut-off for social assistance (Kelly & Caputo, 2007) driving many to seek less mainstream employment and become relegated to more marginal sources of income such as panhandling, “squeegeeing”, selling drug and prostitution (Baron, 2001). This requires adolescents to form bonds with other disenfranchised youth – often described as their street family – and further perpetuates their reliance on street lifestyle (Higgitt, et al. 2003).

 

Youth are at higher risk of being exposed to violent crime (Kufeldt & Burrows, 1994) which makes them adverse to shelters leading to more time being spent on the street where a condition that Higgitt et al. describe as ‘street sickness’ occurs (2003). Poor hygiene, exposure to the elements and a substandard diet exacerbates existing conditions, specifically those who encounter a laissez-faire attitude to sexual encounters (Dachner & Tarasuk, 2002) – either by choice, lack of means or requested or forced in-trade (AHS, 2003). Drug abuse is common as a part of sexual encounters (McCreary, 2007) or to combat or subdue mental health issues (Kidd, 2003) which can lead to increased violence and injury (Kelly & Caputo, 2007). This high-risk lifestyle coupled with poor living conditions (Dachner & Tarasuk, 2002) and lack of funds for medication (Caputo, 1996) or ability to store or regulate those provided for free (Kelly & Caputo, 2007) leads to a higher morbidity rate than other homeless people for similar and preventable ailments.

 

Unchecked mental health (Kidd, 2003) driven by the malaise of poor health (Higgitt, et al, 2003) coupled with feelings of inadequacy, loneliness through ostracism and anxiety over the future (Rokach, 2003) can lead to a higher rate of drug and alcohol abuse – compounding the problem – as well as increased violence and suicide rates among street youth. Increased violence not only leads to a higher rate for murder (Roy, et al., 2004) but more theft and drug arrests and convictions among adolescents on the street (McCreary, 2007). This causes a social backlash against street youth and forces governments to enforce laws that limit the remaining “legal” sources of income that are less prone to health or safety issues – such as panhandling or “squeegeeing” (Layton, 2008).

 

While it is the combination of physical and mental health issues that contribute to the lessened life expectancy of adolescents on the street, many of the factors that drive these conditions are often unavoidable and seen as a better alternative to that which they escaped. Without recourse to elevate from their current position and the “comfort” that is provided by the street community, many are stuck in a vicious cycle of depression and abuse that makes them easy prey for exploitation. Street youth are, by far, the most marginalised of the homeless population – but by no means is it a construct of choice. It is the negative and misinformed perception from society that has directed policy against this group that has limited the means for survival and caused many to live in conditions fraught with repetitive, life-threatening choices.

 

References

[AHS] Adolescent Health Survey (2003) McCreary Centre Society, Vancouver.

Baron, S. (2001) Street Youth labour market experience and crime. Canadian Review of Sociology and Anthropology, 38. 189-215.

[Blueprint] Framework for the Blueprint to End Homelessness in Toronto (2006) Wellesley Institute, Toronto. Retrieved from http://www.wellesleyinstitute.com/files/blueprint/Blueprint_TheFramework%28final%29.pdf

Cassavant, L. (1999, Jan.) Definition of Homelessness (PRB 99-1E). Political and Social Affairs Division of the Parliamentary Research Branch, Government of Canada.

Chapman, D (1990) “Conclusions” Homelessness: Public Policies and Private Troubles. Cassell, New York. 232.

CHMC (2001, July) Environmental Scan of Youth Homelessness. Research Highlights: Socio-economic Series, 86;

Dachner, N. & Tarasuk, V. (2002) Homeless ‘squeegee kids’: Food insecurity and daily survival. Social Science & Medicine, 54. 1039-1049.

Echenberg, H. & Jensen, H. (2008) Defining and Enumerating Homelessness in Canada. Library of Parliament, Ottawa.

Farris, G. & Murray A. eds. (1990) Housing the Homeless and Poor: New Partnerships among the Private, Public and Third Sectors. University of Toronto Press, Toronto. 3.

Girard, M. (2006) Determining the Extend of the Problem: The Values and Challenges of Enumeration. Canadian Review of Social Policy (58). 104.

Harvey, D. (1989) From managerialism to entrepreneurialism: The Transformation in Urban Governance in Late Capitalism. Geografiska Annaler 71B(1). Wiley-Blackwell, Sockholm. 3-17.

Higgitt, N., Wingert, S. & Ristock, J (2003) Voices from the margins: Experiences of street-involved youth in Winnipeg. University of Winnipeg.

Hulchanski, D. (2000, Dec.) Categorizing Houselessness for Research and Policy Purposes: Absolute, Concealed and At Risk. University of Toronto Press, Toronto.

Hulchanski, D. (2007) The Three Cities within Toronto. Cities Centre Press, Toronto.

Hwang, S. (2000) Homelessness and Health. Canadian Medical Journal, 164(2). 229-233.

Kelly, K. & Caputo, T. (2007) Health and Street/Homeless Youth. Journal of Health Psychology, 12(5). 726-736.

Kidd, S. A. (2003) Street Youth: Coping and Interventions. Child and Adolescent Social Work Journal, 20. 235-261.

Layton, J. (2008) Homelessness: How to End the National Crisis. Penguin Books, Toronto.

McCreary Centre Society (2007) Against the Odds: A profile of marginalized and street-involved youth in BC. Vancouver.

Miller, P., Donahue, P. Este, D. & Hofer, M. (2004) Experiences of being Homeless or At Risk of being Homeless among Canadian Youth. Adolescence, 39. 736-755.

QuickFacts (2011, May) Toronto Shelter, Support & Housing Administration. City of Toronto. Retrieved from http://www.toronto.ca/housing/pdf/quickfacts.pdf

[Report Card] Toronto Report Card on Housing and Homelessness (2003) City of Toronto.

Rokach, A. (2003) The Lonely and Homeless: Causes and Consequences. The Institute for the Study and Treatment of Psychosocial Stress, Toronto.

Roy, E., Haley, N. Leclerc, P., Sochanski, B., Boudreau, J. & Boivin, J. (2004) Mortality in a cohort of street youth in Montreal. Journal of the American Medical Association, 292(5). 569-574.

Springer, J. (2011) Defining Homelessness: PLE845 [In-Class Lecture].  RyersonUniversity, Toronto. September 21st, 2011.

Springer, S. (2000) Homelessness: A Proposal for a Global Definition and Classification. Habitat International, 24. 475-484.

Torobin, J. (2011, Oct. 14) Bank of Canada head calls Occupy protests ‘entirely constructive’. The Globe and Mail. http://www.theglobeandmail.com/news/politics/bank-of-canada-head-calls-occupy-protests-entirely-constructive/article2202064/

United Nations (1948) The Universal Declaration of Human Rights, Article 25.1.

Vincent, D. (2011, Oct. 21) Toronto Community Housing approves sale of 706 houses. The Toronto Star. Retrieved from http://www.thestar.com/news/article/1074258–toronto-community-housing-approves-sale-of-706-houses

Whittington, L. (2011, Oct. 21) European debt crisis has Flaherty worried. The Toronto Star. Retrieved from http://www.thestar.com/news/article/1073809

 

Defining and Mediating the Cause of the Newly and Elderly Homeless in Toronto

Defining and Mediating the Cause of the Newly and Elderly Homeless in Toronto

While there are many studies on the cause and effect of homelessness within our cities that provide analysis and policy remedies – even for subsections of this problem, such as families and youth groups – little research has been committed to a growing trend in our culture: The newly-elderly homeless. In the past, this stratum of poverty has been extrapolated from more generalised statistics and merely speculated on the berth and condition of its members (Cohen, 1999) offering little insight in how to combat the problem or even provide a solid definition of the core issue. A recent study by MacDonald, Dergal & Cleghorn sought to identify issues revolving around the recently homeless who are elderly, identifying the causation and current policy and regiment gaps that allow these members to silently suffer more so than their counterparts (2007) and shed light on this growing cohort. Shifting demographics with an aging population coupled with economic turmoil and subsequent austerity measures have placed elderly people who live at the margin in peril of losing adequate shelter and services – breeding a new housing condition which is complex to anticipate and demands further research and planning intervention.

 

Determining the pathway to homelessness in the elderly is cumbersome and not unlike that of street youth in that it consists of multidimensional factors including the lack of affordable housing, employment or institutional services (Stegiopoulos & Herrmann, 2003). But the risks are different, harder to measure and often more abrupt:  the sudden loss of stable income, death of a spouse or significant other, lack of a proper caregiver and even eviction (Crane, 1999). Others that have been institutionalised for a long period due to physical or mental health may have lost their ability to maintain housing within that time (Hecht & Coyle, 2003) and are often released to shelters as a last resort. Further still, some have become homeless in their middle-age as they were living with elderly parents – due to economic or health concerns – who’ve since passed away leaving their offspring little-to-no social safety net (Crane & Warnes, 2000). While generally better educated, these factors are pressured by past economic ability – with many surviving in poor or near-poor conditions most of their lives – never having the benefits that full- and long-time employment provides, such as personal saving or pensions (Cohen, 1999). Alternatively, they may have had their pensions rescinded through bankruptcy or corporate raiding or their retirement savings dwindled by sudden economic decline (MacDonald, Dergal & Cleghorn, 2007; Gillespie, 2007).

 

Capturing the scope and severity of the issue through traditional services who aid the homeless – which rely on a methodology of crisis intervention in an attempt to focus on building independence and self-sufficiency (MacDonald, Dergal & Cleghorn, 2007) – is often untenable as they are programs more attractive to youth and young adults. Elderly homeless require greater access to mobility and care during the day, often unavailable in shelters as they only operate during the evening hours or are inaccessible for those with disabilities (Stegiopoulos & Herrmann, 2003). Mental health issues – including depression – requires constant and consistent care to stymie isolation and chronic and multiple physical health conditions need support and aid for medication (Cohen, 1999). The current lack of services and support are cited as the causation and continuance of both mental and physical health issues and further isolation and reliance on the street. Often, without third-party encouragement, physical ailments go undiagnosed because of the lack of a family physician, inability to recognise the severity of the issue or fear, either of being shunned by or directly suspicious of, the medical community and potential institutionalisation (Crane & Warnes, 2000). Others were barred from seeking medical help because of the lack of a health card or insurance and from the reluctance of health providers to register homeless people because of their multiple inflictions and transient nature (Hwang, 2000). The newly-elderly homeless tend to stay with services familiar and close to them, such as family doctors or neighbourhood clinics where they make shelter, but are seemingly oblivious to community outreach programs and drop-in centres (MacDonald, Dergal & Cleghorn, 2007) where research can be completed more comprehensively. Agencies, such as The Daily Bread Food bank have conducted their own surveys that show 40% of older recipients of their service often had difficulty paying for their prescription medications every month with as many as 27% declining outright to purchase them simply because of affordability (2001). The MacDonald, Dergal & Cleghorn study in Toronto also showed that 50% of the recently elderly homeless are also recent immigrants to Canada and have suffered from family breakdowns and have little communication between ex-spouses or the community and suffer from a language or cultural disadvantage. The elderly are also subject to more victimization within these shelters from other residents due to their frail condition, including physical assault, thief and rape (Cohen, 1999) but rarely are these events reported out of neglect, indifference or shame.

 

Those who are moved immediately out of standard programs to dedicated, specialised shelters where they can obtain services and a more appropriate social network suffer less from chronic health issues and are more likely to survive longer and find permanent homes (MacDonald, Dergal & Cleghorn , 2007). Similar studies in the United States and Britain confirms the stark difference in needs and services between the elderly homeless and existing policy structures. While programs are available to provide economic support in both nations – including old age security and medical care – often these are only enough to mitigate the current problem and not enough to permit a further decline in physical or mental health (Hecht & Coyle, 2003). As well, the qualification cut-off rate to obtain these services often disallow the ability to earn other income, however little or temporary, rendering those who claim this aid constantly reliant and remain at the upper-edge of poverty (Crane & Warnes, 2000) where they become an invisible statistic. Defining the issues that cause elderly homelessness and capturing the potential size of this problem will require resources from multiple agencies and personal interviews to create effective and preventative policy and support services that will not only take undue strain off of existing social assistance – but better and lengthen the lives of those who spent theirs building the community we have today.

 

 

References

Cohen, C. I. (1999) Aging and homelessness. The Gerontologist, 39(1). 5-14.

Crane, M. (1999) Understanding Older Homeless People. Housing Studies, 15(2). 325-327.

Crane, M & Warnes, A. M. (2000) Lessons from Lancefield Street: Tackling the needs of older homeless people. National Homeless Alliance. London.

Daily Bread Food Bank (2001) Aging with Dignity? How governments create insecurity for low-income seniors. Toronto.

Gillespie, K. (2007, Sept. 27) Who can rescue seniors from property tax trap? The Toronto Star. Retrieved from: http://www.thestar.com/article/261080

Hecht, L. & Coyle, B. (2001). Elderly Homeless: A Comparison of Older and Younger Adult Emergency Shelter Seekers in Bakersfield, California. American Behavioral Scientist, 45(1). 66-79.

Hwang, S. (2000) Homelessness and Health. Canadian Medical Journal, 164(2). 229-233.

MacDonald, L., Dergal, J. & Cleghorn, L. (2007) Living on the Margins. Jornal of Gerontological Social Work, 49(1-2). 19-46.

Rokach, A. (2003) The Lonely and Homeless: Causes and Consequences. The Institute for the Study and Treatment of Psychosocial Stress, Toronto.

Stergiopoulos, V. & Herrmann, N. (2003, July) Old and Homeless: A Review and Survey of Older Adults Who Use Shelters in an Urban Setting. The Canadian Journal of Psychiatry, 48. Canadian Psychiatric Association. 374-380.