Physical and mental health needs of homebound seniors 85 years and older

Low-income homebound seniors 85 years and older face poverty, have limited social support, rarely leave their homes, and are at a disproportionate risk for physical and mental health issues. The purpose of this qualitative study was to explore the physical and mental health needs of this population. A convenience sample of 9 homebound seniors 85+ living in a low-income neighborhood in San Francisco, and 12 providers that care for this population were recruited for this study and addressed physical and mental health needs, health services utilized, gaps in health services, and how to address these gaps in services. Findings revealed the priority mental health problem is depression and more social engagement is needed to combat isolation. Among this population there is a stigma associated with utilizing mental health services. Seniors wanted more vigor and variety in exercise programs. Obstacles to accessing the variety of services available are physical frailty, lack of access to adequate transportation, and senior's desire to maintain a sense of autonomy and independence. Finally, providers mentioned the cuts in funding to programs like adult day health. Based on these interviews we recommend senior centers implement inter-generational programs to increase social engagement, use technology to diversify exercise programs, provide trainings about the mental and physical effects of aging to increase relevant treatment and reduce stigma, increase advocacy efforts to stop budget cuts, provide in-home mental health and fall prevention screening, and increase transit services. Future studies are warranted to determine the feasibility and efficacy of such community-based programs.