Out at elbows is a phrase used to describe clothing that has become worn and tattered, or a person who appears shabby or impoverished. Some synonyms for this phrase may include threadbare, shabby, ragged, worn-out, dilapidated, or frayed. These words all convey a sense of something that is in a state of disrepair or decline. Other synonyms might be tattered, bedraggled, dingy, or scruffy. All of these words evoke a feeling of wear and tear or neglect. It's important to note that the phrase out at elbows can also refer to a person who is experiencing financial hardship, so synonyms could also include broke, destitute, or impoverished.