Homeless people are getting older, but age-appropriate help is limited
Jan. 11, 2024 at 6:00 am
By Jadenne Radoc Cabahug
Special to the The Seattle Times
The Seattle Times’ Project Homeless is supported by BECU, Campion Foundation, Raikes Foundation and Seattle Foundation. The Seattle Times maintains editorial control over Project Homeless content.
In the 1990s, the average age of a homeless person in the U.S. was 30. By 2000, it was 40. Now, it’s 50.
A recent report predicts the average age will continue to rise as the baby boomer generation ages, and the number of people in this older population is growing quickly.
Experts say this large cohort of homeless people should be considered senior citizens because of the toll the elements, poor nutrition, lack of hygiene resources and access to regular medical care take on a body. Many live on Social Security or disability payments because of that, both of which are far below the average rent in Seattle.
Yet the homelessness services system is still mostly geared toward serving younger people.
King County has three programs targeted to this aging population, which made up more than 20% of its homeless population when last surveyed in 2020, and one shelter.
“Social security is way too low. No matter what, it’s ridiculous,” said Nemat Saber, 67, who lived in homeless shelters for almost two years starting in 2020.
He has been receiving Social Security payments for about two years — his only income — and moved into a subsidized Northgate apartment but is worried his money will run out again.
Saber said he plans to go back to work despite having to lose benefits like Medicaid or food stamps since he needs to keep up with inflation.
A recent report predicts the average age will continue to rise as the baby boomer generation ages, and the number of people in this older population is growing quickly.
Experts say this large cohort of homeless people should be considered senior citizens because of the toll the elements, poor nutrition, lack of hygiene resources and access to regular medical care take on a body. Many live on Social Security or disability payments because of that, both of which are far below the average rent in Seattle.
Yet the homelessness services system is still mostly geared toward serving younger people.
King County has three programs targeted to this aging population, which made up more than 20% of its homeless population when last surveyed in 2020, and one shelter.
“Social security is way too low. No matter what, it’s ridiculous,” said Nemat Saber, 67, who lived in homeless shelters for almost two years starting in 2020.
He has been receiving Social Security payments for about two years — his only income — and moved into a subsidized Northgate apartment but is worried his money will run out again.
Saber said he plans to go back to work despite having to lose benefits like Medicaid or food stamps since he needs to keep up with inflation.
A growing population
In Seattle, places like Pike Market Senior Center and its food bank have been serving older homeless adults since 1978.
Most people use the center as a “living room” during the day, showing up early in the morning to have breakfast and stick around for lunch, said Mason Lowe, deputy director of the center.
The majority of people who come are homeless and about a third of those are between 55 and 60, until recently when 85% of the guests are 60 and older, Lowe said.
Margot Kushel, director of the University of San Francisco Benioff Homelessness and Housing Initiative predicts this population is on track to triple by 2030.
“I think people have a lot of preconceived notions of who experiences homelessness, and older adults probably aren’t people’s first population,” Kushel said.
Her research shows that by the time a person experiencing homelessness turns 50, their health is equivalent to a housed person in their 70s or 80s.
Their life expectancy is also shorter.
“Unfortunately, many of these seniors will die before they hit 65,” Kushel said.
Homeless older adults experience a range of health conditions, such as cognitive decline and mobility challenges and chronic health conditions like diabetes, hypertension, heart disease and cancer.
Dr. Leslie Enzian, medical director of the University of Washington Harborview’s Medical Respite Program, said homeless older adults also experience other diseases related to hygiene such as advanced tooth decay.
The UW Harborview Medical Respite program, which treats homeless people who are too sick to be out on the streets but do not require hospital care, currently has 18 beds for all of King County while its building is under construction.
It will return back to its full capacity of 34 beds in August 2024.
Most shelters are unable to provide health care for older adults, which creates a juggling act of who will serve them.
“The only way to get health care is if they get hospitalized, and once they’re in the hospital, it’s hard to discharge them because they don’t have a home to go to,” said researcher Dennis Culhane, who wrote the report Emerging Crisis of Aged Homelessness.
That results in longer hospital stays and greater costs to the hospital and insurance companies, Culhane said.
Most people use the center as a “living room” during the day, showing up early in the morning to have breakfast and stick around for lunch, said Mason Lowe, deputy director of the center.
The majority of people who come are homeless and about a third of those are between 55 and 60, until recently when 85% of the guests are 60 and older, Lowe said.
Margot Kushel, director of the University of San Francisco Benioff Homelessness and Housing Initiative predicts this population is on track to triple by 2030.
“I think people have a lot of preconceived notions of who experiences homelessness, and older adults probably aren’t people’s first population,” Kushel said.
Her research shows that by the time a person experiencing homelessness turns 50, their health is equivalent to a housed person in their 70s or 80s.
Their life expectancy is also shorter.
“Unfortunately, many of these seniors will die before they hit 65,” Kushel said.
Homeless older adults experience a range of health conditions, such as cognitive decline and mobility challenges and chronic health conditions like diabetes, hypertension, heart disease and cancer.
Dr. Leslie Enzian, medical director of the University of Washington Harborview’s Medical Respite Program, said homeless older adults also experience other diseases related to hygiene such as advanced tooth decay.
The UW Harborview Medical Respite program, which treats homeless people who are too sick to be out on the streets but do not require hospital care, currently has 18 beds for all of King County while its building is under construction.
It will return back to its full capacity of 34 beds in August 2024.
Most shelters are unable to provide health care for older adults, which creates a juggling act of who will serve them.
“The only way to get health care is if they get hospitalized, and once they’re in the hospital, it’s hard to discharge them because they don’t have a home to go to,” said researcher Dennis Culhane, who wrote the report Emerging Crisis of Aged Homelessness.
That results in longer hospital stays and greater costs to the hospital and insurance companies, Culhane said.
Costs exceed Social Security
Culhane’s study, along with researchers in Boston, Los Angeles and New York, posits that many of today’s homeless older adults have experienced housing instability before or have been tracking toward it throughout their lifetime.
For people born between 1955 and 1965, back-to-back recessions, a competitive labor market, plummeting wages and soaring housing prices set them up to struggle to get ahead financially.
Some face higher obstacles, such as mass incarceration and lower rates of high school education among Black people, who made up 25% of King County’s homeless population in 2022, despite being 7% of the county’s total population, according to federal data.
In Los Angeles County, 4,700 people aged 65 or older were homeless in 2015, according to Culhane’s study. In 2023, there were about 10,000. The report projects that to rise to 13,900 by 2030.
Yet, Social Security payments have stagnated and little has been done on a federal level to invest more resources to help older people find or stay in housing. The maximum federal Supplemental Security Income payment, which is determined based on income and other factors, is $942 a month for a single person and $1,415 for a couple.
The median cost of a one-bedroom in the Seattle area is $1,505 a month.
“Many communities are very concerned because the stories are proliferating across the country that there are all these fragile and frail older people coming into the system, and these shelters are not designed to deal with an aging population,” Culhane said of the “disappointing” federal response.
Experts point to the federal effort to end veterans homelessness as a template for solutions.
Since 2010, providing housing vouchers, wraparound medical care, substance use treatment and mental health care resulted in a 55% decrease in homeless veterans across the U.S. At the same time, the homeless population overall is rising.
Between January 2018 and the end of 2022, King County saw a 37% drop in veteran homelessness, augmented by county-level money added to federal resources.
“So that is what can happen when Congress sort of decides that it’s a priority,” San Francisco researcher Kushel said.
For people born between 1955 and 1965, back-to-back recessions, a competitive labor market, plummeting wages and soaring housing prices set them up to struggle to get ahead financially.
Some face higher obstacles, such as mass incarceration and lower rates of high school education among Black people, who made up 25% of King County’s homeless population in 2022, despite being 7% of the county’s total population, according to federal data.
In Los Angeles County, 4,700 people aged 65 or older were homeless in 2015, according to Culhane’s study. In 2023, there were about 10,000. The report projects that to rise to 13,900 by 2030.
Yet, Social Security payments have stagnated and little has been done on a federal level to invest more resources to help older people find or stay in housing. The maximum federal Supplemental Security Income payment, which is determined based on income and other factors, is $942 a month for a single person and $1,415 for a couple.
The median cost of a one-bedroom in the Seattle area is $1,505 a month.
“Many communities are very concerned because the stories are proliferating across the country that there are all these fragile and frail older people coming into the system, and these shelters are not designed to deal with an aging population,” Culhane said of the “disappointing” federal response.
Experts point to the federal effort to end veterans homelessness as a template for solutions.
Since 2010, providing housing vouchers, wraparound medical care, substance use treatment and mental health care resulted in a 55% decrease in homeless veterans across the U.S. At the same time, the homeless population overall is rising.
Between January 2018 and the end of 2022, King County saw a 37% drop in veteran homelessness, augmented by county-level money added to federal resources.
“So that is what can happen when Congress sort of decides that it’s a priority,” San Francisco researcher Kushel said.
Few beds available
St. Martins de Porres Shelter, with a capacity of 100, is the only homeless shelter in King County focused on people 50 and older.
Dan Wise, director of shelter operator Catholic Community Services, said pandemic precautions halved the number of people they could serve.
They employ skilled nurses who specialize in caring for older homeless adults.
Alton Fields, 66, stayed at St. Martins in 2015. He became homeless for the first time in his life and spent a majority of his time outside before being found by a cook at St. Martins de Porre.
Before the pandemic, residents slept on thin mats on the ground and had little privacy. His health while homeless had deteriorated due to his drinking habits, to the point where he almost lost his eyesight. He suffered from severe blisters on his feet from staying out on the streets.
“Homelessness had taken this toll, and being in that shelter was heavy on my spirit,” Fields said.
His case managers helped him get to rehab in 2016 for his drinking and drug addiction. Fields said since he stopped using his Social Security money to buy drugs, he was able to save immensely.
Now, Fields has been recently elected to the Catholic Community Services board of trustees.
Dan Wise, director of shelter operator Catholic Community Services, said pandemic precautions halved the number of people they could serve.
They employ skilled nurses who specialize in caring for older homeless adults.
Alton Fields, 66, stayed at St. Martins in 2015. He became homeless for the first time in his life and spent a majority of his time outside before being found by a cook at St. Martins de Porre.
Before the pandemic, residents slept on thin mats on the ground and had little privacy. His health while homeless had deteriorated due to his drinking habits, to the point where he almost lost his eyesight. He suffered from severe blisters on his feet from staying out on the streets.
“Homelessness had taken this toll, and being in that shelter was heavy on my spirit,” Fields said.
His case managers helped him get to rehab in 2016 for his drinking and drug addiction. Fields said since he stopped using his Social Security money to buy drugs, he was able to save immensely.
Now, Fields has been recently elected to the Catholic Community Services board of trustees.
Looking for more funds
King County also has one street medic team and two mobile medical vans, one for Seattle and another for South King County, focused on older homeless people.
“We are not even scratching the tip of the iceberg when it comes to the need,” said Semone Andu, Healthcare for the Homeless Network regional health administrator.
Andu said the mobile outreach team must prioritize encampments with high numbers of older people, knowing that means others aren’t getting the support they need.
“There’s a reason why people live outside,” Andu said. “More and more people are living outside because the existing infrastructure was not meeting their need.”
Healthcare for the Homeless Network receives support from the city, county and several federal departments and wants to use these funds to find more spaces where their patients can stay, but with limited resources, people and inflexible funds, they can only do so much, Andu said.
The 2019 report on the aging population points to housing — especially housing with health care, counseling and other support — as a way to alleviate the growing crisis and reduce costs to the homelessness support and health systems.
Creating housing will take time, so Andu suggests also investing in current services to allow more people who are still on the streets, in encampments or in shelters to get the assistance they need.
“By doing that, I think you’re able then not just to meet the need but also understand the challenges in real time,” Andu said.
Lowe at the Pike Place Senior Center said the center receives funding from the city of Seattle and federal Older Americans Act for its meals program and wonders if there is more money to expand services.
“These are people who have lived through really unexamined racism, anti-LGBT bias, wrongful imprisonment, the draft, the Vietnam War,” Lowe said, adding the COVID-19 pandemic, which was especially deadly to older people.
“So, theoretically, there is a pot of money out there that is for older adults. Why wouldn’t you use it to assist the vulnerable older adults?”
“We are not even scratching the tip of the iceberg when it comes to the need,” said Semone Andu, Healthcare for the Homeless Network regional health administrator.
Andu said the mobile outreach team must prioritize encampments with high numbers of older people, knowing that means others aren’t getting the support they need.
“There’s a reason why people live outside,” Andu said. “More and more people are living outside because the existing infrastructure was not meeting their need.”
Healthcare for the Homeless Network receives support from the city, county and several federal departments and wants to use these funds to find more spaces where their patients can stay, but with limited resources, people and inflexible funds, they can only do so much, Andu said.
The 2019 report on the aging population points to housing — especially housing with health care, counseling and other support — as a way to alleviate the growing crisis and reduce costs to the homelessness support and health systems.
Creating housing will take time, so Andu suggests also investing in current services to allow more people who are still on the streets, in encampments or in shelters to get the assistance they need.
“By doing that, I think you’re able then not just to meet the need but also understand the challenges in real time,” Andu said.
Lowe at the Pike Place Senior Center said the center receives funding from the city of Seattle and federal Older Americans Act for its meals program and wonders if there is more money to expand services.
“These are people who have lived through really unexamined racism, anti-LGBT bias, wrongful imprisonment, the draft, the Vietnam War,” Lowe said, adding the COVID-19 pandemic, which was especially deadly to older people.
“So, theoretically, there is a pot of money out there that is for older adults. Why wouldn’t you use it to assist the vulnerable older adults?”
Jadenne Radoc Cabahug: [email protected]; Jadenne Radoc Cabahug is a freelance journalist and former intern with The Seattle Times.