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APHA Scientific Session and Event Listing

Jill Roncarati, PA-C, James O'Connell, MD, and Stacy Swain, MPH. Boston Health Care for the Homeless Program, 729 Massachusetts Avenue, Boston, MA 02118, 617-414-7779, jroncarati@bhchp.org

PURPOSE: Homelessness in the waning years is a societal disgrace. To improve understanding of elderly homeless, we prospectively followed 30 elderly individuals living on Boston's streets from 2000-2004.

METHODS: The Boston Health Care for the Homeless Program's (BHCHP) Street Team cares for 800 individuals living on the streets yearly. In 2000, a cohort of 30 persons 60 years or older was identified: 8 (27%) women, 22 (73%) men. Ages ranged from 60-82 years. 28 (93%) were homeless for a decade or more. The two others were episodically homeless for five years. All suffered from medical illness, 22 (73%) had a DSM-IV diagnosis: (23%) schizophrenia, (20%) bipolar, (3%) OCD, (27%) anxiety or depression, (57%) substance abuse. Contact data is recorded weekly at meetings and gathered from the BHCHP EMR, hospital records and team database.

RESULTS: Ten (33%) individuals died during five years: nine men, one woman. Six were still living on the streets at time of death. Four died of complications of medical problems. Four deaths occurred in nursing homes. After five years, 8 people are in nursing homes. Only five (17%) successfully found stable housing. Of the remaining 8 persons, 7 (23%) are on the streets and one is lost to follow up.

CONCLUSIONS: The morbidity and mortality amoung this cohort elderly rough sleepers poses challenges. Housing and health care services for this sub-group and goals to improve continuous primary care, despite difficulties in reaching out to this elusive population is imperative.

Learning Objectives:

• Learn seriousness of elderly homeless living on streets
• Understand health outcomes and desparities of elderly street dwellers
• Understand that continous primary physical and mental health care vital to this vulnerable group

Keywords: Elderly, Homelessness

Presenting author's disclosure statement:

Any relevant financial relationships? No