Wednesday, March 13, 2013

A "Silver Tsunami" Among The Homeless

We all know that there are millions of homeless Americans of all ages. According to some recent studies, approximately 21 out of every 10,000 citizens is homeless. So, as the population ages across the board, how do we address the fact that a great number of homeless Americans are reaching the time when they should be retiring and enjoying the remainder of their lives rather than struggling on the streets?

On my way to work this morning, I heard a story on National Public Radio (NPR) about the aging homeless population in our country. Although it should come as no surprise, we all need reminders of these harsh realities.

A great number of the American homeless are children or elderly, and these significantly vulnerable populations are falling through the proverbial cracks, perhaps more so as the economy continues to reel and sputter. And while we see corporate profits continuing to climb (along with CEO compensation), ordinary Americans generally face stagnant wages (we nurses can certainly relate to this!), rising prices, and sluggish financial news despite historical highs for the Dow Industrial and other markers.

Aside from economics, the healthcare disparities underscored by the plight of the elderly homeless are legion. Mortality for the homeless is significantly lower as compared to the rest of the population, and there are countless barriers to accessing preventive healthcare. Not surprisingly, the homeless seek acute care in emergency rooms, and oftentimes the conditions that are treated in the ER could have been prevented if access to regular medical care was more seamless.

For homeless individuals with diabetes, the NPR report underscores the reality that the refrigeration of insulin is virtually impossible, and most shelters ban the use of syringes, thus the elderly diabetic struggling with homelessness is often logistically prevented from treating his or her chronic illness.

As nurses, some would argue that we carry an assumed professional (and moral) responsibility to assess, evaluate and intervene when we see disparities that can be alleviated. However, the issue of the elderly homeless is a multifaceted one that will take more than the metaphoric bandaids that could be applied by nurses working for homeless advocacy organizations and treatment centers (although these initiatives are worthwhile and important in the larger scheme of things).

Housing, health insurance, healthcare access, and economic support are just some of the pressing issues that contribute to the suffering of the elderly homeless--and their burgeoning numbers. And as so-called "entitlements" are considered for cuts in this age of sequestration, we also need to consider those members of our society who are unwittingly "sequestered" on a daily basis, relegated to the cultural, economic and healthcare sidelines.

Perhaps nurses have some of the answers to this issue, but I would readily opine that it will take a seismic shift in our societal priorities to fully understand and reverse this very disturbing trend of an aging homeless population.

Homelessness is, of course, just one of the many challenges facing our nation. However, when you consider the ethical, medical, economic and human costs of a growing population of elderly citizens living on the streets, we realize that these disparities readily undermine our strongly held national collective notion of moral superiority.

The "Silver Tsunami" is breaking upon the shores of this country, and we are apparently slow to consider how that tsunami will also impact the homeless who live on our streets, in our shelters, under our bridges, and in the shadows of our collective lives.
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