Modifying Services to Protect Older Adults Experiencing Homelessness

Researchers have warned that the number of older adults (age 55 and above) will increase in the unsheltered and sheltered homeless population over the next decade unless policymakers take significant action to prevent it. The “graying” of the homeless population is already underway in many localities, often outpacing providers’ ability to modify program services and practices to accommodate their unique needs.

Providers and system leaders would benefit from analyzing programmatic and systemic responses that center older adults, particularly older adults of color and those with complex health issues. When their needs are put at the forefront in assessing performance and service delivery, it may quickly become evident that some required adjustments in practices are needed.

Among the many adjustments will be the retention and development of strategies to keep people safe from COVID-19. The virus remains a threat to people experiencing homelessness, particularly for older adults. What should providers and system leaders do to protect them?

Carefully Consider Risk to Older Adults Before Dismantling COVID-19 Safety Measures

Across the country, public officials and businesses are dismantling the requirements they put in place to keep people safe from COVID-19. Masks are no longer being worn in crowded spaces, and vaccination pushes are waning. New reported COVID-19 cases and deaths steadily and sharply declined in recent weeks, although new upticks are being reported in both.

In general, homeless service programs should be very cautious about dismantling the protections they instituted to keep people safe during the COVID-19 pandemic, including requiring masks, vaccinated staff, and expanded shelter space to provide necessary safe distancing. These safety measures are particularly important for older adults, especially older adults of color, who are at heightened risk of hospitalization and death from COVID-19. Older adults and others with complex medical needs should continue to be prioritized for non-congregate shelter that can protect their health and safety, as well as for interventions that will end their homelessness.

Promote Full Vaccinations – Including Second Booster Shot for Older Adults

While data is limited, there is evidence that vaccination rates among people experiencing homelessness may have lagged beyond the general population. Relying on data from six urban centers, the Centers for Disease Control and Prevention (CDC) found that full vaccination coverage in a convenience sample of individuals experiencing homelessness ranged from 19% to 45% in the jurisdictions they examined. The rate for the general population ranged from 44% to 60% in those same jurisdictions.

In general, homeless service programs should undertake steps to promote full COVID-19 vaccination among all people experiencing homelessness and the people they closely interact with. Communities may find it helpful to include people who have experienced homelessness in strategic planning to improve uptake of vaccinations.

For older adults, CDC recommends a second booster shot. CDC’s recently adjusted recommendations “acknowledge the increased risk of severe disease in certain populations including those who are elderly or over the age of 50 with multiple underlying conditions, along with the currently available data on vaccine and booster effectiveness.”

Target Housing Resources to Help Older Adults Escape Homelessness

Over the last two years, the federal government has provided states and localities significant new federal tools and resources to help protect people from COVID-19 and its ramifications. This included new tools to expand safe non-congregate shelter options for people experiencing homelessness, as well as resources that can be used to help people escape homelessness. Some of these tools include Emergency Housing Vouchers, Emergency Rental Assistance, and HOME funds.

While the Emergency Housing Vouchers and Emergency Rental Assistance can be used to move people quickly out of homelessness and into available rental housing, the HOME funds can be used for the acquisition and/or renovation of buildings to provide permanent housing for people experiencing homelessness. This can include the acquisition of motels for permanent affordable or permanent supportive housing suitable to the needs of single older adults and individuals with disabilities.

It is certainly easier said than done for homeless leaders to access these resources and/or ensure they are used to maximum effect in ending homelessness, particularly for those who already may require significant support both to access and retain housing due to age or disability. That said, it seems unconscionable to pass by the availability of these resources and their potential to assist some of the most vulnerable adults in our nation. Ensuring resources reach and effectively help older adults and others with significant challenges to permanently escape homelessness must remain a key priority and rallying cry for providers and advocates.

Foster New Service Connections

Older adults living outdoors, in shelter, or transitioning into new permanent housing may require supportive services that homeless service providers have yet to cultivate. New relationships with health care providers, gerontologists, Area Agencies on Aging, Adult Protective Service providers, and other specialists can help ensure that older adults are receiving the array of tailored supports they require to stay safe and stabilized in housing. For example, programs that are targeted to meet the needs of older adults, especially those with cognitive impairments or who need assistance with daily personal care, have successfully intertwined accessible housing with health care and tenancy supportive services.

Moving Forward

The National Alliance to End Homelessness, in close coordination with national and local partners working to end homelessness, will work to deepen its understanding of homelessness among older adults and strategies to end it. As always, we will learn from the innovations of local partners who generously share their experiences and insights with us and other colleagues.

It is our hope that more localities will examine their homelessness data with an intersectional lens. This will help communities to understand the different experiences of homelessness and outcomes of older adults (ages 55-64, and those 65 and above who may be eligible for other resources) across race, gender, and other characteristics. This will help us better understand needs, challenges and assess when we are making progress (and for whom). The Alliance urges localities analyzing their 2022 Point-in-Time Count data to examine (and share with us!) the prevalence of older adults experiencing sheltered and unsheltered homelessness. This data will provide an important step forward in the advancement of policy solutions.