January 7, 2013

Baby boomers with no place to call home

Shelters are seeing a surge in older men with age-related illnesses, a trend that could have implications for how we shape public policy.

By Tom Bell tbell@pressherald.com
Staff Writer

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Charles Jones, 55, struggles to sling his bags up onto his shoulder while walking on Alder Street Friday morning. Jones suffers from bulging discs in his back, and says that being homeless – and having to carry his belongings – exacerbates his injury.

Gabe Souza/Staff Photographer

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The combination of substance abuse, loss of family support and economic displacement became defining factors that affected those men the rest of their lives. The impact, Culhane says, has implications both for their own lives and for society.

In an academic paper written this month, Culhane and four of his colleagues contend that the homeless in this age group have been the mainstay of the single adult homeless population since the 1980s and “will soon fade into history but not before medical issues related to aging ensures that they will have one last profound impact on the social welfare system.”

As the men continue to age and suffer poor health, managing their chronic diseases will become increasingly problematic over the next 15 years until the men reach age 64, the average life span of the chronically homeless. While continuing to treat them in homeless shelters is not a realistic solution, there are few other options besides expensive hospital and nursing home care.

No community has yet to figure out a strategy for dealing with this demographic wave, Culhane says.

“Everyone is struggling with this issue,” he says.

The emergency room at Maine Medical Center has seen an increase in the number of homeless patients, and many of them are of the baby boomer generation, says Dr. James Wolak, service chief of psychiatric emergency services at Maine Med.

He says it’s difficult to provide a continuum of services to homeless patients once they leave the emergency room. Their only treatment is often to return to emergency rooms whenever they get sick. It’s an expensive way to treat people.

“They may not be sick enough to require hospitalization but too sick for appropriate care at the shelter,” Wolak says. “There is a lack of something in between.”

In Portland, only two beds are available for homeless people who are recovering from a medical issue and need respite care. The beds are located in a room at the Barron Center, a city-run nursing home.

When the Barron Center program first began in 2000, the men who sought help were typically in their 20s and 30s, says Karen Percival, the center’s administrator. Now she’s seeing men in their late 40s to 60s.

Two beds are not adequate to meet the growing demand, O’Brien says.

He says the Oxford Street Shelter recently housed a man in his 70s who had cancer and had been discharged from a hospital. He had difficulty walking and left behind a pool of blood whenever he was moved from a seat or bed.

The man wasn’t sick enough to qualify for nursing home care, and he also didn’t need to be in a hospital, O’Brien says. If he were in an apartment, he would be able to get some kind of in-home care, such as a visiting nurse. But he wouldn’t qualify for home care under Medicaid while living in a shelter.

Moreover, O’Brien says, a homeless shelter is simply a lousy place to be sick.

“The lack of privacy and comfort is a real struggle,” he says.

The problem is unlikely to find a solution soon. The state is continuing to slash funding for programs that could help the homeless and sick, says Bill Burns, coordinator of Adult Day Shelter Services at the Preble Street Resource Center. He pointed to two cuts in Gov. Paul LePage’s most recent curtailment order: $1.5 million in cuts to a state-funded program that provides mental health services to seniors, and $1.4 million in cuts to the state Office of Aging and Disability Services.

While staff-supported housing would be much cheaper than nursing home care, Burns says, it’s in short supply, and it’s hard to imagine the state creating new housing in the current political climate.

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Additional Photos

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Here is a look at how Charles Jones, 55, spent part of his time last week: Above, he walks to the Preble Street Resource Center on Friday after spending the night at the Oxford Street Shelter. ...

Gabe Souza/Staff Photographer

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... At the Portland Public Library, he fills out applications for housing. ...

Gabe Souza/Staff Photographer

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Gabe Souza/Staff Photographer

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... The Belfast native at the Oxford Street shelter on Wednesday.

John Ewing/Staff Photographer

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Charles Jones visits the Portland Housing Authority Friday morning to fill out forms for assistance. Experts say no community has yet figured out a working strategy for dealing with the demographic wave represented by baby-boomer generation men like Jones.

Gabe Souza/Staff Photographer

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Charles Jones, 55, zips up his bags at the corner of Chestnut Street and Cumberland Avenue Friday morning on his way to the Portland Public Library.

Gabe Souza/Staff Photographer

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The 55-year-old homeless man checks for traffic before crossing a street on his way to the Portland Housing Authority.

Gabe Souza/Staff Photographer

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