'We Shouldn't Have To Live Like This'

March 13, 2013

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7 min 47 sec Playlist Download Transcript   Hide caption Linwood Hearne, 64, and his wife, Evelyn, 47, stand near Interstate 83 in Baltimore where they have slept on and off for the past four years. According to the local nonprofit Health Care for the Homeless (HCH), a growing percentage of homeless patients nationally are 50 or older, with complex mental and physical conditions. Previous Next Kainaz Amaria/NPR Hide caption Evelyn displays her bag of prescription medications, which she says are for asthma, chronic obstructive pulmonary disease and depression. HCH offers comprehensive services, including medical care, prescription subsidies, mental health services, housing assistance, and access to education and employment. Previous Next Kainaz Amaria/NPR Hide caption Linwood has long suffered from schizophrenia and admits that he was evicted from public housing after stabbing a neighbor in a fight. Many of the city's chronic homeless have criminal records, which makes it harder to get employment. "I'm getting older, and being out on the streets plays with my mental stability," he says. Previous Next Kainaz Amaria/NPR Hide caption Meredith Johnston, HCH's director of psychiatry, meets with Linwood once a month to review his medications and screen for behavioral symptoms. "Getting into housing will be a huge stabilizing change for Linwood and Evelyn," Johnston says. Previous Next Kainaz Amaria/NPR Hide caption HCH also runs a convalescent floor in a nearby shelter where patients can recover from fractures or recent surgeries. Susan Zator, a community nurse for more than 41 years, bandages 66-year-old William Jones' foot injury. Zator says this service is vital for homeless men and women who cannot recover properly while living on the street. Previous Next Kainaz Amaria/NPR Hide caption Physician assistant Jean Prevas tends to Jones' leg wound. Many aging homeless suffer from ailments not readily visible to outsiders. Medical conditions often go untreated and escalate into more acute health problems. Previous Next Kainaz Amaria/NPR Hide caption Albert Monroe and many others sleep on the porch and under the bright lights of the HCH clinic. Many say it's safer than sleeping under the highway or in city shelters, where theft and violence aren't uncommon. Previous Next Kainaz Amaria/NPR Hide caption Paul Behler, 59, and Tony Simmons, 51, leave a shelter where residents have to be out at 5 a.m. HCH also cultivates potential advocates still struggling to get back on their feet, like Behler and Simmons. Previous Next Kainaz Amaria/NPR Hide caption Behler lost his job as a piano tuner and has been living in shelters for a year and a half. "I'm going to find the way back," he says, "and part of this lobbying effort is making inroads in that respect." The two pass time at a 24-hour Dunkin' Donuts before HCH opens for the day. Previous Next Kainaz Amaria/NPR Hide caption Behler and Simmons take up issues on behalf of the homeless population. Here, they discuss Maryland House Bill 137, which calls for proof of identification at polling places, before going to a hearing in Annapolis. Simmons argues that many homeless have lost their IDs but shouldn't be disenfranchised. Previous Next Kainaz Amaria/NPR Hide caption Simmons irons a dress shirt at his storage unit, which he shares with three other homeless men, in preparation for the hearing. A father of three, he became homeless after a 2011 drug arrest and has been staying in shelters for 14 months. Previous Next Kainaz Amaria/NPR Hide caption Simmons, now clean for more than two years, lost his family and says he's too ashamed to go back home. "I have to find my own way now," he says. "This is my way." Previous Next Kainaz Amaria/NPR Hide caption Simmons hugs Evelyn inside HCH. He has been trying to help the Hearnes and many others get off the streets. Previous Next Kainaz Amaria/NPR

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Tony Lithgow and Andrea Mayer have been living under a highway overpass in downtown Baltimore, Md., since last year. He's 49 and has been homeless on and off for eight years. She's 51 and has been homeless for 10 years.

Living on the streets has clearly taken a toll on the couple, both physically and mentally. While they're standing at a corner waiting for a free city bus to take them to a soup kitchen, Tony shouts at a passenger staring at them from a car stopped at the light.

"We're homeless!" Tony calls out to the man.

Andrea tries to get him to stop, but Tony is on a roll. His anger is palpable.

"You're one paycheck away," he says. "That's all they are. And they don't understand. That's all it was for us."

A growing number of the nation's homeless are reaching what's called "premature old age." They're in their late 40s and 50s, but suffer from ailments more common for those in their 70s. Many will likely die over the next decade. This has posed a challenge for communities trying to care for the homeless, and could mean hundreds of millions of dollars in added costs, especially for health care.

Tony and Andrea say bad circumstances and bad decisions sent them spiraling from their middle-class lives and onto the streets.

"My husband died. I screwed up and I blew all the money," Andrea says. She adds that she was also very sick at the time and couldn't work. She suffered from Lyme disease, high blood pressure, memory loss and osteoarthritis.

Tony took care of his mother until she died of multiple sclerosis, and that cost him all of his savings. He says he worked as a cook and locksmith, but when the economy soured, he couldn't get a job.

Worsening Health Problems

Now they're homeless. Andrea's physical problems have only gotten worse and Tony has a bulging disc. You can see the pain on his face when he hikes a huge, duffel bag onto his back. He carries all their essentials � 75 pounds of clothing, toiletries, important documents and medication. This includes a dozen pill bottles, mostly for Andrea.

She's also in constant pain and needs to have both of her knees replaced. She walks with a cane she received from another homeless person, after hers was stolen.

"I don't feel safe without it," she says. "Because my knees buckle, you know... By the end of the day, I'm in excruciating pain. Right now, I'm living on painkillers."

“ Their priority isn't to get preventive care. It's to make sure there's a roof over their head and food in their stomach.- Yvonne Jauregui, nursing services coordinator It might seem unusual for someone who's 51, like Andrea, to be so infirm. But, it's extremely common if you're homeless. For those living out on the streets, 50 is old. Aging Prematurely "It ages you prematurely," says Nilesh Kalyanaraman, chief medical officer at Health Care for the Homeless, a clinic in Baltimore. Like similar clinics across the country, the Baltimore facility is seeing a growing number of older patients as the baby boom generation ages. Kalyanaraman says people's health problems only snowball the longer they're outside, which makes treatment more difficult and expensive. "If you're on the street, you're about three times more likely to have hypertension, or cardiovascular disease. You're about 50 percent more likely to die from it as well," he says. "Diabetes is more prevalent if you're homeless. It's harder to control." He says it's especially difficult to have a healthy diet when you're homeless. When Andrea and Tony go to the United Church of Christ soup kitchen for dinner, the meal is heavy on the starch � white beans, mashed potatoes with cut-up hot dogs, white hamburger rolls and a pastry. Tony whispers to Andrea that the beans look a little scary. But they have little choice, and know that people here mean well. They finish eating in about 15 minutes, and tell the servers that they'll see them again next week. Finding Work, Finding A Home Tony is frustrated. He says he'd like to get a job, but doesn't want to leave Andrea alone outside. It's too dangerous. Andrea was punched in the face when they were robbed recently at a bus stop. Tony thinks they could afford a small efficiency apartment � using Andrea's Social Security disability payments � but he says they don't have enough money for a security deposit. Source: Analysis of U.S. Census data by Dennis P. Culhane Credit: NPR "I got to get her off the street and I can't do it. Nobody's helping us. I'm tired. I'm tired. I'm exhausted," he says as his voice cracks. "This is not a joke anymore. I hurt." Tony stands up. Andrea watches him walk away with a concerned expression on his face. "I've never seen this, seen him so emotional," she says. The Population On any given night, more than 600,000 people are homeless in the U.S. By some estimates about a third are 47 or older � almost half the single adults. And this group is growing. Enlarge image i

Health Care for the Homeless is a nonprofit that serves many of Baltimore's aging homeless population. Many sleep in front of the clinic, and others hang out inside to stay warm during the winter.

Kainaz Amaria/NPR

Health Care for the Homeless is a nonprofit that serves many of Baltimore's aging homeless population. Many sleep in front of the clinic, and others hang out inside to stay warm during the winter.

Kainaz Amaria/NPR

Researchers say that's partly due to younger baby boomers who are more likely than others to be homeless. They came of age in the late 70s and 80s, when the economy was especially bad, there was a crack cocaine epidemic and some of them never quite got on track.

After dinner, Andrea and Tony take another bus back to a small parking lot downtown under the interstate highway. This is where they sleep, as thousands of cars pass overhead. Their blankets, sleeping bags and everything else they own are hidden away � at least that's what they hope.

"You know, we never know if we're going to be OK until we check the stuff. And it's usually the homeless ripping off the homeless," Andrea says.

Someone stole all their things � including her dentures � last fall, when Andrea had to be rushed to the hospital for emergency gallbladder surgery. She still has no teeth.

Baltimore and other cities are trying to get their homeless residents off the streets and into permanent supportive housing. But money is scarce and they've only scratched the surface.

'Living High Class' Compared To Others

Like other couples, Andrea and Tony prefer to sleep outside rather than in a city shelter, where they'd be separated. And in the parking lot, they've found an electric outlet to charge their phones and plug in a small heater.

"I mean, we're sort of living high class compared to what these people are living," says Andrea, referring to the dozens of others sleeping nearby on city streets. "We're warm at night. These people are freezing to death."

Exhausted, Andrea sits down on a bag and watches Tony proceed with their nightly routine. He takes some rope and attaches solar blankets to a street sign to form a makeshift tent. He then covers the ground with layers of blankets and sleeping bags.

"See, what I do is I put the heater in first. I turn it on and it gets nice and warm in here, while I'm putting it together," he says.

And the tent is pretty cozy inside by the time Tony is finished. Still, he says, this is no way to live. When Andrea was released from the hospital after her surgery, this is where she came to recuperate and where he changed her dressings.

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