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A Step Forward For Elder Homelessness

The next time you see an elder homeless man, ask yourself, “How did they get there?” You can take the question to mean “how did they end up homeless” but we are thinking in simpler terms. How did they literally get to that place on the street, in the park, at the store, etc.? The answer is they most likely walked.

Research suggests elder homeless men walk an average of 15 kilometres a day including to meet with a social worker, visit the doctor and connect with friends. They also have to walk to and from the shelter, walk to get meals, and to get their mail. No home means no home delivery.

In most cases, transit is not an option as the cost of the fare exceeds their budget or the funds can be better used elsewhere. When faced with the choice, walking is easier than not eating but it comes at a price, like the toll it takes on their foot health and their overall wellbeing.

Days spent walking in all kinds of weather, especially rain and snow, mean footwear has a short life span. A pair of shoes that should last a few years often lasts mere months. That might help explain why 40 percent of people who are homeless wear shoes that are the wrong size – you take what you can get or can find. In theory, something is better than nothing.

While the effects of the pandemic have meant an increase in the number of people who are living on the streets, there are also increased cases of foot health concerns. A Toronto street nurse recently shared that she treated more cases of frostbite in just one week last winter than she did in the last four years combined.

Corns and calluses, blisters and bunions, and infections and ingrown toenails are common problems for elder homeless men whose chronic foot issues can be made significantly worse by diabetes.

A three-year study of 6900+ homeless patients with diabetes uncovered a prevalence of Charcot foot, diabetic foot ulcers, and lower extremity amputation. After 10 years of follow-up, 29 percent of participants had died. The majority of the deceased were older and male.

Why do people ignore their feet? They are right there, we tower over them, and yet we also overlook them.

Studies have shown that nearly eight out of 10 adults in the general population have, or have had, some type of foot pain in their lives. Despite the pain, close to half of these individuals also report that they have done nothing about it.

In a similar study of homeless people, 92 percent believe healthy feet are important. However, elder homeless men face barriers to proper foot care including foot hygiene, improper fitting shoes and lack of access to medical health care.

One downtown Toronto drop-in centre is taking steps to change that by making foot care more accessible.

Haven Toronto, the only drop-in centre in Canada dedicated to elder homeless men, has been reducing barriers to health care, housing and food security since 1933. With support care workers, counsellors and a full-time nurse onsite, clients come to Haven Toronto for a healthy meal and while they are there they can visit with the nurse and counsellors – no appointment necessary.

For several years, Haven Toronto has been planning to launch a clinic focused on foot care, but the initiative has always been sidelined by other immediate and often unexpected priorities, like COVID-19.

In the first half of 2020, early in the pandemic, the drop-in centre saw a rise in the number of clients and the number of meals served. In 2021, those numbers spiked. Haven Toronto served over 108,000 meals last year, up 260 percent compared to pre-pandemic numbers. Food costs also rose 518 percent over the same time period. Drop-in centre staff also saw mental health and addiction supports increase by 380 and 345 percent, respectively.

If a Foot Clinic was ever going to get up and running, it would require a dedicated source of support. During a pandemic, finding such a partner would be quite the feat, but not impossible.

Haven Toronto is excited to share that they have taken a step forward in the care of elder homeless men with the official launch of a Foot Clinic made possible with funding from George C. Hunt Family Foundation.

George C. Hunt Family Foundation prides itself on supporting programs that without funding would otherwise not happen.

The drop-in centre’s new clinic offers foot assessments, treatment for toenails (including fungal nails), and callous reduction and removal. Foot Clinic staff also provide important testing to assess foot health, including nerve function.

The clinic is available for free to clients of Haven Toronto, the only drop-in centre in Canada dedicated to serving the unique needs of elder homeless men.




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