Homelessness Is Increasing Among Elderly Adults

There is some troubling evidence that homelessness is beginning to increase among elderly adults. In addition, there are demographic factors—such as the anticipated growth of the elderly population as baby boomers turn 65 years of age and recent reports of increases in the number of homeless adults ages 50 to 64—that suggest a dramatic increase in the elderly homeless population between 2010 and 2020. While the country's changing demographics may make this finding unsurprising, it has serious implications for providers of homeless services and should be deeply troubling to the policy makers that aim to prevent poverty and homelessness among the elderly through local and federal social welfare programs....

Homelessness among elderly persons will increase substantially over the next decade. There are two primary demographic factors that contribute to the projected increase in homelessness among the elderly. One is the overall growth in the elderly population, which is expected to more than double in size between now [April 2010] and 2050. The other factor is the relative stability in the proportion of the elderly population facing economic vulnerability. Together, these factors signal an increase in elder economic vulnerability and homelessness.


Because of anticipated increases in the elderly homeless population as the general population ages, a projection of the elderly homeless population [has been made] based on the following assumptions:

• The elderly population will increase as projected by the U.S. Census Bureau through 2050.
• The rate of deep poverty in the elderly population will remain constant at 2 percent through 2050, as it has remained since 1975.
• The 2008 ratio of 1 sheltered elderly homeless person to every 22 elderly persons in deep poverty remains constant through 2050.

Elderly chronically homeless people often require intensive service coordination. This helps them transition into permanent housing smoothly and ensures they remain there. Case management is often critical in coordinating care—primary health care, housing assistance, food, and other services can get lost without some assistance and supervision. Elderly homeless people often face barriers to accessing resources and benefits such as Social Security, Medicare, and Supplemental Security Income (SSI). They may not know that they are eligible for such benefits, they may not know where to start, and/or they may have a hard time following up with service providers, meeting appointments, or completing the necessary paperwork due to health limitations (mental or physical). A coordination of services, coupled with housing assistance, can help homeless or formerly homeless seniors age in their own housing with dignity....


The existence of homelessness among the elderly indicates that our safety nets are failing our most vulnerable citizens. However, with thoughtful and strategic planning, we can greatly reduce elderly homelessness and prevent the population at risk from experiencing homelessness. Addressing the unmet housing and service needs of our at-risk and homeless elderly, as well as understanding the characteristics and needs of the elderly population at risk of homelessness can help us end elder homelessness. As a nation, we are judged by how we care for our most vulnerable citizens. It is a failing of public policy that any of our elderly are homeless. To fail to act would be, in short, irresponsible.

Physician-Assisted Suicide Should Not Be Legalized

Nearly 95 percent of those who kill themselves have a psychiatric illness diagnosable in the months before suicide. The most common mental illness in these suicides is depression, which can be treated. This is particularly true of those over fifty, who are more prone than younger victims to take their lives during the type of acute depressive episode that responds most effectively to treatment.

Like other suicidal individuals, patients who desire an early death during a serious or terminal medical illness usually suffer from a treatable depressive condition. Although pain and other factors such as lack of family support contribute to their wish for death, depression is the most significant factor, and researchers have found it is the only factor that predicts the desire for death.

Both patients who attempt suicide and those who request assisted suicide often test the affection and care of others, confiding feelings like "I don't want to be a burden to my family" or "My family would be better off without me."

Such expressions usually reflect depressed feelings of worthlessness or guilt, and may be a plea for reassurance. They are also classic indicators of suicidal depression in patients who are in good physical health. Whether physically healthy or terminally ill, these patients need assurance that they are still wanted; they also need treatment for depression.

Most of the indignity of which patients justifiably complain is associated with futile medical treatments. Doctors are learning to forego such treatment although patients are only beginning to learn that they can refuse them. On the other hand patients are also afraid of being abandoned by their doctors while they are dying. There is basis for these fears since only in the past decade have we begun to educate physicians that caring for patients they can not cure is an integral part of medicine.

There are patients who find it hard to be dependent on others. Yet serious illness usually requires this. Dependency is hardest for patients when their families do not want that responsibility. A change in family attitudes, however, can modify the outcome in cases where patients wish to die. A 1989 Swedish study showed that when chronically ill patients attempted suicide, their overburdened families often did not want them resuscitated. But when social services stepped in and relieved the family's burden by sending in home care helpers, most patients wanted to live and their families wanted them to live, too.

Awareness of the dangers of physician-assisted suicide must be coupled with comparable awareness of the dangers of the unbridled use of life-prolonging medical technologies. It is now accepted practice—supported by the American Medical Association, the courts, and most churches—that patients need not be kept alive by invasive, artificial means, such as by feeding tubes.

Public Opinion on Physician-Assisted Suicide

Many people have seen others suffer terribly while dying. When asked, "Are you in favor of euthanasia?" most people reply "yes," meaning that they would prefer painless death over suffering. But when asked, "If terminally ill, would you rather treatment make you comfortable, or have your life ended by a physician?" their responses might be different.

People confuse their support for the right to refuse medical treatment—a right supported by law and by civil and religious leaders—with support for the right to die by assisted suicide or euthanasia. The more people know about the care of people who are terminally ill and the pros and cons of legalizing euthanasia, the less they support legalization. Yet the public is still grossly misinformed. A recent poll indicates that only 61 percent of people are aware that under current law, patients may refuse any and all unwanted treatments. Ten percent of the population believe that the law requires a patient to accept whatever treatment a doctor wants to provide....

A More Humane Option

Patients who request assisted suicide or euthanasia are usually asking in the strongest way they know for mental and physical relief from suffering. When that request is made to a caring, sensitive, and knowledgeable physician who can address their fear, relieve their suffering, and assure them that he or she will remain with them to the end, most patients no longer want to die and are grateful for the time remaining to them.
Euthanasia advocates have come to see suicide as a cure for disease and a way of appropriating death's power over the human capacity for control. In the process, they have derailed constructive efforts to better manage the final phase of life. Our social policy must be based on a larger and more positive concern for people who are terminally ill. It must reflect an expanded determination to relieve their physical pain, to discover the nature of their fears, and to diminish suffering by giving affirmation to the life that has been lived and still goes on.

Juveniles Should Not Be Placed in Adult Prisons

Incarcerating juvenile criminals with adults is both ineffective and harmful, maintains J. Steven Smith. According to Smith, youth in adult prisons are likely to be assaulted and are also likely to commit more crimes when released. The desire to incarcerate juveniles with adults is based on the public's fear that juvenile crime is increasing; however, crimes committed by youth are actually decreasing. He advocates treatment rather than incarceration for young criminals.

Several years ago, one of the news feature shows on television had an interviewer talking with a freckle-faced, redheaded 12-year-old boy. The interview was taking place in a maximum-security prison yard.

When asked what he had done to warrant being in the prison, he told them how he had been spotted by local police as he drove a stolen car. After a high-speed chase, he crashed into an interstate highway roadblock. Several state and local law enforcement agencies and dozens of police cars were involved.

The interviewer asked if the child was sorry for what he had done because it had resulted in a sentence to an adult maximum-security prison. The boy responded that he would do it again because it was the "greatest day" of his life!

"It was just like 'Smokey and the Bandit'!". Clearly, he continued after a period of months to be caught up in the childish excitement of his criminal act. A mature sorrow for his actions and the resulting punishment were absent.

While most of us would expect that youths in adult prisons were the most-violent and dangerous juvenile offenders, the Department of Justice reported that 39% of the juveniles in adult prisons were sentenced for a nonviolent offense. The most-serious charge for almost 40% of these young Americans was most likely a drug or nonviolent property offense. It is reasonable to propose that seriously violent youths should be held in adult facilities only if they are incapable of being effectively managed in a juvenile facility.

They indicated that juveniles locked up in adult male prisons are four times more likely than adults to report being assaulted, and 21 times more likely to be assaulted than teens held in one of Florida's secure juvenile facilities. They also pointed out the likelihood that one-half of these improperly placed juveniles will be assaulted while incarcerated.

In 1980, Congress passed amendments to the Juvenile Justice and Delinquency Prevention Act of 1974. Among these amendments was a requirement to separate juveniles from adults in the nation's jails. This required local jails absolutely to prevent juveniles from seeing or hearing adult offenders. This provision was strictly enforced and required the restructuring of supervision for more than 6,000 juveniles in Indiana alone. This amendment is still on the books in spite of the ever-increasing use of adult prisons and jails for juvenile offenders.

With regard to juvenile crime, communities need to develop and support early childhood intervention programs to promote healthy families. In most communities, schools are the focal point for youths and their families. Schools need to be the focus for prevention programs. Elementary schools need to focus on providing counselors and social service personnel, rather than metal detectors and armed police officers, to stop the violence.