Homelessness and Housing Insecurity Among Older Adults
Age-related challenges to housing security include the struggle to afford rent increases on a fixed income, the need for accessible housing and additional services, and increasing vulnerabilities and risk factors, such as physical and cognitive disabilities. Photo credit: iStock.com/FamVeld
In October 2023, the Joint Center for Housing Studies of Harvard University (JCHS) hosted “Older Adults’ Pathways Into — and Out of — Housing Insecurity and Homelessness,” an event to discuss new research on housing stability challenges that older adults in Massachusetts face and some of the programs and services in place to help mitigate those challenges. Samara Scheckler, a research associate at JCHS, presented research findings, and Emily Cooper, chief housing officer for the Massachusetts Executive Office of Elder Affairs and a special advisor on housing at MassHealth, and LaTanya Wright, director of outreach at Hearth, shared their experiences serving older adults in the field.
Research Contextualizes Challenges and Needs
Scheckler framed the conversation by presenting research that she and her JCHS colleagues have conducted on the prevalence of homelessness and housing insecurity among older adults in Massachusetts, the barriers and challenges these older adults must overcome, and the types of services they might need. For this research, Scheckler defined "older adults" as those 50 and older, noting that individuals experiencing homelessness typically exhibit aging conditions such as memory loss, falls, and functional impairment at younger ages than do housed individuals. In addition to those experiencing homelessness, the researchers considered individuals who were housing insecure, meaning that they had difficulty paying rent, paid a large portion of their income toward rent, lived in overcrowded housing, or moved frequently. The researchers differentiated between those who had been chronically homeless and aged into the category of older adults and those who suddenly became homeless at an older age.
The researchers used data from the Massachusetts Homeless Management Information System and conducted interviews with practitioners from organizations in Boston's Continuum of Care. Scheckler reported that the 65 and older age group is the fastest growing among those experiencing homelessness. In 2020, one-third of the chronically homeless population was age 55 or older. Older adults are less likely to have earned income and are more likely than younger adults experiencing homelessness to rely on public benefit programs. Age-related challenges to housing security include the struggle to afford rent increases on a fixed income and the need for accessible housing and additional services, which further narrow the already limited supply range of suitable units. Aging also involves increasing vulnerabilities and risk factors, such as physical and cognitive disabilities, which are further compounded by the lack of long-term care services and healthcare access. In sum, said Scheckler, "Age intersects with other factors that increase the risk of housing insecurity, and older adults may rely more heavily on social policy and public programs to remain stably housed."
Although older adults may have a greater need for public programs, they also face additional barriers to accessing those supports. For example, qualifying for Social Security disability insurance may take too long, and modifying a home for aging in place may be too expensive or prohibited for renters. Shelters typically require people to be able to feed and bathe themselves — areas for which older adults might need help. Some services may be available only after a crisis occurs, limiting the potential for preventative approaches. Age-related factors such as cognitive decline or lack of technological literacy, which housing instability can worsen, may prevent older adults from accessing needed services. Scheckler and her colleagues made several recommendations based on their research. They suggested reducing application and wait times for services, simplified application processes, low-barrier services, building trust, case management, and continuous contact to encourage service providers to be more proactive and intervene before the loss of housing; issuing small amounts of financial assistance to keep people housed; offering assistance for home modifications; and increasing options for affordable housing with services.
Prevention and Mitigation
Cooper reinforced the importance of focusing on prevention — intervening before a loss of housing — and serving those already experiencing homelessness. In terms of keeping people housed, she noted that the state has 110,000 subsidized housing units for older adults. Cooper believes that resident services coordinators, who played a critical role in keeping people safe during the coronavirus pandemic, should be in each building to support resident health and wellness. The state also is investing in eviction prevention, stationing service providers in housing courts to respond to crises that might otherwise lead to eviction. Although MassHealth cannot use its Medicaid funds to construct or rent housing, it can use them for "health-related social needs services," including housing search support and home modifications. Massachusetts Medicaid helps people find and move into housing by assisting with paperwork and helping residents adjust to new housing, often through community service providers who bill Medicaid for their services. One of those providers is Hearth, a nonprofit provider with the mission of eliminating homelessness among the elderly. Wright said that Hearth works to prevent homelessness through landlord mitigation, helping older adults find resources for arrears and utilities, and helping individuals get back into housing through case management. Hearth also has 228 housing units with onsite services. Wright underscored the need for more funding for assisted living, home modifications, and supportive services.
"There's a strong need to have structures in place to address not only the current elderly population but [also] … to prepare for the [next] generation" who will age into these challenges, said Wright. Policymakers and service providers must address current challenges and anticipate needs as people age amidst mounting affordability pressures. Cooper said that one helpful approach would be to build stronger connections between service organizations that target homelessness and elder services organizations such as the Area Agencies on Aging. The populations these organizations serve overlap, and although they are the primary points of intake for older adults with housing insecurity, they lack each other's knowledge and capacities. Ultimately, Cooper emphasized, the underlying problem is the insufficient supply of affordable housing. "[T]he more we can build, the better off we are in preventing some of these people [from] becoming homeless and helping people who are homeless move into housing."