Addressing Frailty in the Homeless Population

Frailty is a fancy term for when someone’s health isn’t doing so great. It’s like your body is running out of batteries and can’t keep up with life’s demands. This situation makes people more likely to have health problems. Now, it turns out that frailty often hangs out with folks who have lower incomes and face tough times. People without homes are in this group too, and many of them deal with serious issues like Homelessness, substance use, and poor health.

Recent reports show that in 2023, over 653,000 Americans were homeless. That’s a staggering number. Those living on the streets or in shelters face a lot of risks, including substance misuse. It’s not just about sleeping rough; they often deal with a mix of health problems: mental issues, physical health concerns, and substance misuse. Drug addiction is a big problem worldwide and one of the main reasons people die young.

Many people experiencing homelessness struggle to get medical help, as most healthcare services are set up in a very structured way. What’s needed are more relaxed, trauma-informed approaches that actually help meet their needs. Exercise can be a part of the solution. Some studies suggest that moving more may help those dealing with substance use issues. But there’s not much evidence on how exercise can help people experiencing homelessness and their frailty.

Nutrition also plays a big role in frailty. It turns out that not eating well can make frailty worse. Adding Protein to meals, especially when combined with strength training, can help improve or slow down frailty. Recently, one trial looked into how helpful exercise and protein could be for people experiencing homelessness. They found that while people could join in for exercise once a week, it would be better to offer more sessions.

#Project Goals

The goal of this study was to see if a new exercise program could help people experiencing homelessness who also face addiction issues. The focus was on easy access to exercise through several sessions every week, combined with protein supplements.

#Study Design

The study involved a 12-week exercise program accompanied by protein supplements. It took place in Dublin, Ireland, at a day center aimed at individuals with ongoing addiction problems, a lot of whom were also homeless. The local college’s ethics committee approved everything, ensuring it was safe and ethical.

Before starting the program, the researchers held a meeting with potential participants to ask their opinions and gain insights on what would work best. They worked closely with people who understood the struggles of homelessness and addiction. Information about the program was shared through a person in charge at the center. Consent was gathered before anyone could join, and doctors were informed about those who participated.

People between 18 and 65 who used the center’s services and agreed to join were included in the study. Those who had serious behavior issues, major physical difficulties, or were pregnant couldn’t participate.

The main goal was to see how feasible the program was by measuring how many people signed up, how many stayed, and whether they liked the program.

#Outcomes Measured

In addition to the feasibility, the researchers looked at various health aspects before and after the program. These included physical function, pain, nutritional status, and self-reported health. Specific tests were used to measure strength, muscle mass, and balance.

The exercise program was designed to be very approachable. Classes took place in a way that fit the participants’ needs and were led by two trained physiotherapists. There were group and individual Exercises, as well as special classes for women, to make sure everyone felt comfortable. The sessions included music, which was a fun addition.

Safety was a priority, so heart rates and blood pressure were monitored during exercises to make sure everyone was okay. The exercise intensity was low to moderate, allowing participants to feel good without overdoing it. Those who joined the program were also given protein supplements after their workouts and received basic advice on nutrition.

To encourage attendance, participants received phone calls as gentle reminders to join the exercises and to tackle any challenges they faced.

#Data Analysis

Data was collected to summarize participant information. Before and after program participation, results were compared to see if any changes occurred. Basic statistics were used to analyze the data, with a focus on how many people responded to a follow-up survey.

In total, 47 people were recruited at the start. After some dropped out, 30 took part in the sessions, with 20 completing the program.

The average age of participants was about 46 years, with a little more than half being women. Most were single and unemployed. Many faced issues with substance use, and half were homeless. All participants reported having some form of mental health condition, and a range of physical health issues was common as well.

The main reasons given for not attending sessions included personal struggles related to addiction, injury, and the challenges of managing time. Surprisingly, nobody reported any negative events during the program, which is encouraging.

#What Participants Thought

An exit survey was filled out by around half of the participants. Several themes emerged regarding their experiences.

#Barriers to Retention

Many participants mentioned that personal challenges affected their ability to keep coming back. For some, the struggle with addiction made it hard for them to feel positive about joining the sessions.

#Psychological Benefits

Most participants enjoyed the exercise classes, calling them fun and social. The music made a big difference and helped create a positive atmosphere. They described feeling full of life after sessions and found comfort in socializing with others.

Some also mentioned that taking part in the program helped them use fewer substances. For several participants, it became a distraction from their cravings, helping them delay substance use.

#Initial Measurements

At the start of the study, many participants showed signs of frailty. Results indicated that a significant number had low measurements for muscle strength and other health indicators. This matched the idea that those experiencing homelessness and addiction often have poorer health.

#The Impact of the Program

After the program, improvements were noted in various areas among those who completed the program. Participants showed better performance on tests that measured strength and balance. Additionally, nutrition levels improved as well.

A closer look at those who attended regularly revealed even greater benefits. Regular participants had less pain and showed improvements in both strength and nutritional status.

#Key Takeaways

The study highlighted important points regarding the challenges faced by this group, including how complex factors impact their health. While some participants faced difficulties returning to the program, others benefitted from the social and health aspects of the exercise classes.

The findings showed that older participants and women were more likely to attend regularly, suggesting that these groups might need extra attention in future programs.

The inclusion of the walking sessions, known as the “Park Walk,” was a hit, offering a more casual way for participants to stay active.

The study showed that low-threshold, flexible programs could provide valuable health benefits for people facing homelessness and addiction. They opened doors to better health, delayed frailty, and even encouraged some positive lifestyle changes.

#What’s Next?

This research points to the need for more studies focusing on how exercise and nutrition can improve health among those dealing with homelessness and addiction. It’s essential to consider their unique situation and create programs that meet their needs while boosting their opportunities for better health.

Fun fact: keeping people moving not only helps with their physical health but could also lead to happier, more engaged lives. It’s time for our society to take notice and act on these findings. Perhaps one day, when someone mentions frailty, we can simply laugh and say, “Not on my watch!”