Aging - VA Homeless Programs
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Aging

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Aging

veterans in wheelchairsWhile the population of homeless veterans has been decreasing, the number of older homeless veterans has actually increased.  This is important as research with older homeless individuals has shown that they are characterized by a reduced lifespan and greater prevalence and earlier onset of geriatric conditions such as frailty, falling, urinary incontinence, sensory and cognitive impairment, and inability to execute activities of daily living.  Higher mortality rates among homeless veterans have been found across the adult life cycle compared to veterans without a history of homelessness. Compared to adults in the general population, homeless adults have been found to have a mortality rate that is 4.5 times higher.

Graying of the Homeless

By 2050, there are expected to be
95,000

Elders living without stable housing—which is more than doublethe current homeless population for this age group.

Higher Rates of Mortality

Adults 50 and older who are homeless have mortality rates that are
4x higher
than the general population—and studies show that end-of-life planning is not a priority for this group.

Preventing Suicide Among Older Veterans – Brochure

Preventing Suicide Among Older Veterans – Brochure

Bridging Housing and Healthcare for Older Homeless Veterans Fact Sheet

Bridging Housing and Healthcare for Older Homeless Veterans Fact Sheet

VHA NCP Clinician Fact Sheet on Detection of Cognitive Impairment (2016)

VHA NCP Clinician Fact Sheet on Detection of Cognitive Impairment (2016)

Use of warning signs to prompt cognitive assessment

5-D Assessment Guide (pocket card)

5-D Assessment Guide (pocket card)

Differential Diagnosis of Delirium, Dementia, and Depression.

VHA GEC Brain Health Information Cards

VHA GEC Brain Health Information Cards

Homeless and Evidence Research Synthesis Proceedings: Aging and the Homeless Community December 2015

Homeless and Evidence Research Synthesis Proceedings: Aging and the Homeless Community December 2015

Older Veteran Behavioral Health Resource Inventory

Post-Traumatic Stress Disorder in Older U.S. Military Veterans: Prevalence, Characteristics, and Psychiatric and Functional Burden. Moye J, Kaiser AP, Cook J, Pietrzak RH. Am J Geriatr Psychiatry. 2021 Oct 30:S1064-7481(21)00520-0. doi: 10.1016/j.jagp.2021.10.011. Epub ahead of print. PMID: 34823979.

Behavioral Epidemic of Loneliness in Older U.S. Military Veterans: Results From the 2019-2020 National Health and Resilience in Veterans Study. Straus E, Norman SB, Tripp JC, Tsai J, Sippel LM, Jeste DV, Southwick SM, Pietrzak RH. Am J Geriatr Psychiatry. 2021 Jul 24:S1064-7481(21)00392-4. doi: 10.1016/j.jagp.2021.07.006

A mixed methods study on the manifestations of behavioural symptoms of dementia among Veterans with and without posttraumatic stress disorder. Kang B, Karel MJ, Corazzini KN, McConnell ES. J Adv Nurs. 2021 May 10. doi: 10.1111/jan.14864

Incidence of Homelessness among Veterans Newly Diagnosed with Alzheimer's Disease and Related Dementias. Jutkowitz E, DeVone F, Halladay C, Hooshyar D, Tsai J, Rudolph JL. R I Med J (2013). 2021 May 3;104(4):20-25

Elder Abuse-A Guide to Diagnosis and Management in the Emergency Department. Cimino-Fiallos N, Rosen T. Emerg Med Clin North Am. 2021 May;39(2):405-417. doi: 10.1016/j.emc.2021.01.009

The Efficacy of the Geriatric Model of Care in Emergency Housing Programs for Homeless Veterans. Knapp J, Betancur J, Nabors C, Pascual F. Med Care. 2021 Apr 1;59(Suppl 2):S154-S157. doi: 10.1097/MLR.0000000000001438

Trends in Opioid Use Disorder Among Older Adults: Analyzing Medicare Data, 2013-2018.
Shoff C, Yang TC, Shaw BA. Am J Prev Med. 2021 Mar 4:S0749-3797(21)00092-1. doi: 10.1016/j.amepre.2021.01.010

Characteristics and patterns of older adult homicides in the United States. Shawon RA, Adhia A, DeCou C, Rowhani-Rahbar A. Inj Epidemiol. 2021 Feb 1;8(1):5. doi: 10.1186/s40621-021-00299-w

The National Health and Resilience in Veterans Study: A Narrative Review and Future Directions. Fogle BM, Tsai J, Mota N, Harpaz-Rotem I, Krystal JH, Southwick SM, Pietrzak RH. Front Psychiatry. 2020 Dec 9;11:538218. doi: 10.3389/fpsyt.2020.538218. eCollection 2020

Multicenter Validation of an Emergency Department-Based Screening Tool to Identify Elder Abuse.
Platts-Mills TF, et al. Ann Emerg Med. 2020 Sep;76(3):280-290. doi: 10.1016/j.annemergmed.2020.07.005

Sex, Race, and Risk of Dementia Diagnosis after Traumatic Brain Injury among Older Veterans. Kornblith E, Peltz CB, Xia F, Plassman B, Novakovic-Apopain T, Yaffe K. Neurology. 2020 Sep 4:10.1212/WNL.0000000000010617. doi: 10.1212/WNL.0000000000010617

Changing demography of homeless adult populations. Tsai J, Mehta K, Mongtomery AE, Elbogen E, Hooshyar D. Perspect Public Health. 2020 Jun 1:1757913920919796. doi: 10.1177/1757913920919796

Impact of Wartime Stress Exposures and Mental Health on Later-Life Functioning and Disability in Vietnam-Era Women Veterans: Findings From the Health of Vietnam-Era Women's Study. Smith BN, Spiro A, Frayne SM, Kimerling R, Cypel Y, Reinhard MJ, Kilbourne AM, Magruder KM. Psychosom Med. 2020 Feb/Mar;82(2):147-157. doi: 10.1097/PSY.0000000000000762.

Homeless Veterans in Nursing Homes: Care for Complex Medical, Substance Use, and Social Needs. Jutkowitz E, Halladay C, McGeary J, O'Toole T, Rudolph JL. J Am Geriatr Soc. 2019 Aug;67(8):1707-1712. doi: 10.1111/jgs.15993. Epub 2019 Jun 17.

Trajectories of functional impairment in homeless older adults: Results from the HOPE HOME study. Brown RT, Guzman D, Kaplan LM, Ponath C, Lee CT, Kushel MB. PLoS One. 2019 Aug 13;14(8):e0221020. doi: 10.1371/journal.pone.0221020. eCollection 2019.

A picture of the older homeless female veteran: A qualitative, case study analysis. Kenny DJ, Yoder LH. Arch Psychiatr Nurs. 2019 Aug;33(4):400-406. doi: 10.1016/j.apnu.2019.05.005. Epub 2019 May 22.

Homeless Veterans in Nursing Homes: Care for Complex Medical, Substance Use, and Social Needs. Jutkowitz E, Halladay C, McGeary J, O'Toole T, Rudolph JL. J Am Geriatr Soc. 2019 Aug;67(8):1707-1712. doi: 10.1111/jgs.15993. Epub 2019 Jun 17.

Early Cognitive Decline and Dementia in Homeless Veterans. Schinka, J. (January 2019).

Six-Month Emergency Department Use among Older Adults Following Jail Incarceration. Humphreys J, Ahalt C, Stijacic-Cenzer I, Widera E, Williams B. J Urban Health. 2018 Aug;95(4):523-533. doi: 10.1007/s11524-017-0208-4.

Home Safety Fall and Accident Risk Among Prematurely Aging, Formerly Homeless Adults. Gutman SA, Amarantos K, Berg J, Aponte M, Gordillo D, Rice C, Smith J, Perry A, Wills T, Chen E, Peters R, Schluger Z.Am J Occup Ther. 2018 Jul/Aug;72(4):7204195030p1-7204195030p9. doi: 10.5014/ajot.2018.028050

Advance Care Planning for Older Homeless-Experienced Adults: Results from the Health Outcomes of People Experiencing Homelessness in Older Middle Age Study. Sudore RL, Cuervo IA, Tieu L, Guzman D, Kaplan LM, Kushel M. J Am Geriatr Soc. 2018 Jul;66(6):1068-1074. doi: 10.1111/jgs.15417. Epub 2018 May 9.

Mortality and Cause of Death in Younger Homeless Veterans. Schinka JA, Leventhal KC, Lapcevic WA, Casey R.Public Health Rep. 2018 Mar/Apr;133(2):177-181. doi: 10.1177/0033354918755709. Epub 2018 Feb 8.

Aging and Life Expectancy in Homeless Veterans: Nine Questions. Schinka, J. & Byrne, T. (September 2018).

Predictors of Mortality in Older Homeless Veterans. Schinka JA, Curtiss G, Leventhal K, Bossarte RM, Lapcevic W, Casey R.J Gerontol B Psychol Sci Soc Sci. 2017 Oct 1;72(6):1103-1109. doi: 10.1093/geronb/gbw042.

Factors associated with substance use in older homeless adults: Results from the HOPE HOME study. Spinelli MA, Ponath C, Tieu L, Hurstak EE, Guzman D, Kushel M., Subst Abus. 2017 Jan-Mar;38(1):88-94. doi: 10.1080/08897077.2016.1264534. Epub 2016 Nov 29.

Emerging Populations: Female, OEF/OIF/OND, and Older Veterans. Byrne, T. (August 2016).

Challenges of Providing End-of-Life Care for Homeless Veterans. Hutt E, Whitfield E, Min SJ, Jones J, Weber M, Albright K, Levy C, O'Toole T. Am J Hosp Palliat Care. 2016 May;33(4):381-9. doi: 10.1177/1049909115572992. Epub 2015 Feb 20.

Aging on the Street: Homeless Older Adults in America. Sorrell JM.J Psychosoc Nurs Ment Health Serv. 2016 Sep 1;54(9):25-9. doi: 10.3928/02793695-20160817-04.

Proceedings Document: Aging and the Homeless Community (December, 2015)

Increased Mortality Among Older Veterans Admitted to VA Homelessness Programs. Schinka JA, Bossarte RM, Curtiss G, Lapcevic WA, Casey RJ. Psychiatr Serv. 2016 Apr 1;67(4):465-8. doi: 10.1176/appi.ps.201500095. Epub 2015 Dec 1.

A Literature Review of Homelessness and Aging: Suggestions for a Policy and Practice-Relevant Research Agenda.Grenier A, Barken R, Sussman T, Rothwell D, Bourgeois-Guérin V, Lavoie JP. Can J Aging. 2016 Mar;35(1):28-41. doi: 10.1017/S0714980815000616. Epub 2016 Jan 19. Review.

Predictors of Mortality in Older Homeless Veterans. Schinka JA, Curtiss G, Leventhal K, Bossarte RM, Lapcevic W, Casey R. J Gerontol B Psychol Sci Soc Sci. 2017 Oct 1;72(6):1103-1109. doi: 10.1093/geronb/gbw042.

Characteristics of the old and homeless: identifying distinct service needs. Kimbler KJ, DeWees MA, Harris AN.Aging Ment Health. 2017 Feb;21(2):190-198. doi: 10.1080/13607863.2015.1088512. Epub 2015 Sep 24

The Course of Functional Impairment in Older Homeless Adults: Disabled on the Street. Cimino T, Steinman MA, Mitchell SL, Miao Y, Bharel M, Barnhart CE, Brown RT. JAMA Intern Med. 2015 Jul;175(7):1237-9. doi: 10.1001/jamainternmed.2015.1562. No abstract available

Health risk factors and differences in outcomes between younger and older veterans using VA transitional housing.Brown LM, Barnett SD, Frahm KA, Schinka JA, Schonfeld L, Casey RJ. Psychiatr Serv. 2015 Jan 1;66(1):33-40. doi: 10.1176/appi.ps.201400022. Epub 2014 Oct 31.

Characteristics of the old and homeless: identifying distinct service needs.Kimbler KJ, DeWees MA, Harris AN Aging Ment Health. 2017 Feb;21(2):190-198. doi: 10.1080/13607863.2015.1088512. Epub 2015 Sep 24.

Development of the Primary Care Quality-Homeless (PCQ-H) instrument: a practical survey of homeless patients' experiences in primary care. Kertesz SG, Pollio DE, Jones RN, Steward J, Stringfellow EJ, Gordon AJ, Johnson NK, Kim TA, Daigle SG, Austin EL, Young AS, Chrystal JG, Davis LL, Roth DL, Holt CL. Med Care. 2014 Aug;52(8):734-42. doi: 10.1097/MLR.0000000000000160.

Perceptions of homelessness in older homeless veterans, VA homeless program staff liaisons, and housing intervention providers. Molinari VA, Brown LM, Frahm KA, Schinka JA, Casey R. J Health Care Poor Underserved. 2013 May;24(2):487-98. doi: 10.1353/hpu.2013.0089.

Elderly homeless veterans in Los Angeles: chronicity and precipitants of homelessness. Van den Berk-Clark C, McGuire J. Am J Public Health. 2013 Dec;103 Suppl 2:S232-8. doi: 10.2105/AJPH.2013.301309. Epub 2013 Oct 22.

Homeless aging veterans in transition: a life-span perspective.Thompson CJ, Bridier NL., J Aging Res. 2013;2013:570407. doi: 10.1155/2013/570407. Epub 2013 Oct 27.

Geriatric Scholars Program addresses the shortage of specialized geriatric skills and knowledge in rural VA clinical settings by training VA general clinicians in the treatment of older rural Veterans. (Lead: VRHRC Salt Lake City, Utah)

The Geriatric Scholars Training Program one-page overview

The Geriatric Scholars Training Program implementation issue brief

VHA Geriatric Mental Health Community of Practice: A VA SharePoint site that provides information and archived webinars on subjects impacting geriatric patients.

VACO GEC Internet Website – variety of information about VHA Geriatrics and Extended Care programs: 

Geriatric Scholars Program:  including;

GRECC "Team App" – to get regular announcements about national VHA webinars on geriatric care topics

screen From your Mobile Device.  Go the app store and download "Team App" (team is in the name).  Search and Request membership in "Team GRECC" -OR-
From your Desktop.  Go to www.teamapp.com and create an account.  Search and Request membership in "Team GRECC" 

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