Too Many Cancer Patients Leave the Hospital for Homelessness

It's a tragic tale: a story of a little old mentally handicapped lady with cancer leaving a hospital to convalesce in a homeless shelter.
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Lulu looked thin. She looked healthy but very thin. You could really only tell that Lulu had lost a lot of weight by looking at her face. Her trunk and legs still looked chunky because of her decades old habit of packing her clothes - regardless of outside temperature - with plastic shopping bags. If living on the street had taught the old lady one thing, it was that she didn't like to be cold.

Homeless seniors are relatively rare. A lot of factors - like social security - keep the percentage of low income adults becoming newly homeless artificially low when compared with other demographics. Couple age onset safety nets with high morbidity rates for the chronically homeless and there just aren't as many old folks in shelters or on the street as there are other age groups. Plus one family going homeless may have a single elderly person, where a homeless family may have four or five kids.

Because social security helps most seniors who've worked all their lives and developmentally delayed folks generally have someone to care for them into middle age, Lulu was the kind of homeless older person that many homeless older people are: the intellectually handicapped kind.

Of course in her home state of Pennsylvania folks like Lulu are still referred to as mentally retarded.

Funny, my Microsoft Word program spell check just flagged the word "retarded" as a non-word, but that doesn't stop governments all across the country from using the term. And, like the term or not, it's still a good enough reason to wind up homeless in the U.S. Lulu got by as a young person but then she got older, her safety network died off, and then her really bad luck struck.

In late 2011, Lulu was diagnosed with esophageal cancer. Over 65 with medicare, Lulu had access to a hospital room even if she didn't have a kitchen or living room. Because her intellectual capacity is about the same as a fifth grader, one wonders how well she understood the surgery she needed to save her life or how difficult it would be to care for herself. Lulu spent about a week in the hospital. After her surgery she was sent home. For Lulu, home is a room on the second floor of a homeless shelter.

When I saw Lulu this week, I asked how she was doing. She said she was doing much better. The doctors had removed the tube that had been inserted into her throat and her gut was healing up, "finally," she explained with a sad smile.

It's a tragic tale: this story of a little old mentally handicapped lady with cancer leaving a hospital to convalesce in a homeless shelter. And while I try to write these real life stories, I generally like to insert facts and statistics to explain the size and scope of the problem. This time, not so much. See this time the Lulu's anecdotal tale has to speak in large part for itself. It seems our society doesn't keep too many statistics on how many homeless individuals are struggling with life threatening diseases. Unless we just want to acknowledge the elevated morbidity rates for the homeless and consider homelessness a life threatening disease all by itself.

Frustratingly, the only statistics I could find on homeless individuals getting ill were pretty ancient history. Most dated from the 1990's. Then - and all advocates for the homeless would agree things have only gotten much worse - the Boston Healthcare for the Homeless Program determined that 31 to 46 % of homeless persons experience chronic health problems. And mental illness numbers are often twice that depending on the source and demographic discussed.

As for how many were hospitalized? The very few statistics I could find were provided by the Veterans Administration and therefore apply to homeless vets. The VA says that our about 30% of homeless vets are ill enough to require hospitalization.

And what about the kids that get ill or injured while living on the streets? Oh, I've got plenty of stories, but I've got no numbers. I can only guess at the reason that we don't know how many kids are critically ill - but it would be an educated guess based on years of working with the poor - is because we just don't care. We don't know how many kids are sick and homeless because neither the U.S. Congress nor the Executive Branch have required hospitals or healthcare providers to keep track of whether a kid is released to a home or to homelessness. But certainly even one is too many.

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