Introduction to Elder Homelessness
At age 82, Roberta Rabinovitz realized she had no place to go. A widow, she had lost both her daughters to cancer, after living with one and then the other, nursing them until their deaths. Then she moved in with her brother in Florida, until he also died. And so last fall, while recovering from lung cancer, Rabinovitz ended up at her grandson’s home in Burrillville, Rhode Island, where she slept on the couch and struggled to navigate the steep staircase to the shower. That wasn’t sustainable, and with apartment rents out of reach, Rabinovitz joined the growing population of older Americans unsure of where to lay their heads at night.
The Growing Challenge of Elder Homelessness
But Rabinovitz was fortunate. She found a place to live, through what might seem an unlikely source — a health care nonprofit, the PACE Organization of Rhode Island. Around the country, arranging for housing is a relatively new and growing challenge for such PACE groups, which are funded through Medicaid and Medicare. PACE stands for a Program of All-Inclusive Care for the Elderly, and the organizations aim to keep frail, older people in their homes. But a patient can’t stay at home if they don’t have one. As housing costs rise, organizations responsible for people’s medical care are realizing that to ensure their clients have a place to live, they must venture outside their lanes. Even hospitals — in Denver, New Orleans, New York City, and elsewhere — have started investing in housing, recognizing that health isn’t possible without it.
The Statistics of Elder Homelessness
In the U.S., 1 in 5 people who were homeless in 2024 were 55 or older, with the total older homeless population up 6% from the previous year. Dennis Culhane, a University of Pennsylvania professor who specializes in homelessness and housing policy, calculated that the number of men older than 60 living in shelters roughly tripled from 2000 to 2020. “It’s a national scandal, really, that the richest country in the world would have destitute elderly and disabled people,” Culhane said. Over decades of research, Culhane has documented the plight of people born between 1955 and 1965 who came of age during recessions and never got an economic foothold. Many in this group endured intermittent homelessness throughout their lives, and now their troubles are compounded by aging.
The Causes of Elder Homelessness
But other homeless older adults are new to the experience. Many teeter on the edge of poverty, said Sandy Markwood, CEO of USAging, a national association representing what are known as area agencies on aging. A single incident can tip them into homelessness — the death of a spouse, job loss, a rent increase, an injury or illness. If cognitive decline starts, an older person may forget to pay their mortgage. Even those with paid-off houses often can’t afford rising property taxes and upkeep. “No one imagines anybody living on the street at 75 or 80,” Markwood said. “But they are.”
The Role of PACE Organizations in Addressing Elder Homelessness
PACE officials worry that, as federal funding for Medicaid programs shrinks, states will curtail support. But the PACE concept has always had bipartisan support, said Robert Greenwood, a senior vice president at the National PACE Association, because its services are significantly less expensive than nursing home care. The financing structure gives PACE the flexibility to do what it takes to keep participants living on their own, even if it means buying an air conditioner or taking a patient’s dog to the vet. Taking on the housing crisis is another step toward the same goal. In the Detroit area, PACE Southeast Michigan, which serves 2,200 participants, partners with the owners of senior housing. The landlords agree to keep the rent affordable, and PACE provides services to their tenants who are members. Housing providers “like to be full, they like their seniors cared for, and we do all of that,” said Mary Naber, president and CEO of PACE Southeast Michigan.
Examples of PACE Organizations Addressing Elder Homelessness
For participants who become too infirm to live on their own, the Michigan organization has leased a wing in an independent living center, where it provides round-the-clock supportive care. The organization also is partnering with a nonprofit developer to create a cluster of 21 shipping containers converted into little houses in Eastpointe, just outside Detroit. Still in the planning stages, Naber said, the refurbished containers will probably rent for about $1,000 to $1,100 a month. In San Diego, the PACE program at St. Paul’s Senior Services cares for chronically homeless people as they move into housing, offering not just health services but the backup needed to keep tenants in their homes, such as guidance on paying bills on time and keeping their apartments clean. St. Paul’s also helps those already in housing but clinging to precarious living arrangements, said Carol Castillon, vice president of its PACE operations, by connecting them with community resources, helping fill out forms for housing assistance, and providing meals and household items to lower expenses.
Conclusion
The issue of elder homelessness is a growing concern in the United States, with many older adults struggling to find affordable housing and facing homelessness as a result. PACE organizations, which provide comprehensive care to frail older adults, are playing an increasingly important role in addressing this issue by providing housing support and partnering with housing providers to keep participants in their homes. However, the challenge of elder homelessness requires a comprehensive approach that involves not only healthcare organizations but also policymakers, housing providers, and community organizations. By working together, we can ensure that older adults have access to safe, affordable, and supportive housing that meets their needs and allows them to live with dignity.
FAQs
Q: What is the main cause of elder homelessness in the United States?
A: The main cause of elder homelessness is a combination of factors, including poverty, lack of affordable housing, and health problems.
Q: How many older adults are homeless in the United States?
A: According to recent statistics, 1 in 5 people who were homeless in 2024 were 55 or older, with the total older homeless population up 6% from the previous year.
Q: What is the role of PACE organizations in addressing elder homelessness?
A: PACE organizations provide comprehensive care to frail older adults and are playing an increasingly important role in addressing elder homelessness by providing housing support and partnering with housing providers to keep participants in their homes.
Q: What can be done to address the issue of elder homelessness?
A: Addressing the issue of elder homelessness requires a comprehensive approach that involves not only healthcare organizations but also policymakers, housing providers, and community organizations. This includes increasing funding for affordable housing, providing support services for older adults, and raising awareness about the issue of elder homelessness.
Q: How can I get involved in addressing elder homelessness in my community?
A: You can get involved in addressing elder homelessness in your community by volunteering with local organizations that provide housing and support services to older adults, advocating for policies that address affordable housing and homelessness, and raising awareness about the issue of elder homelessness.
